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61. Discharge planning for people with diabetes

facilities and reducing risk of readmission (Dunning, 2003). Assessment provides the opportunity for information gathering, and anticipation of potential problems which allows for early resolution of potential barriers to discharge. Clear, sensitive communication with the patient and family is essential especially for the patients who experience a considerable new loss of function (Katicreddi & Cloud, 2009). Initial Discharge Assessment by the Ward Nurse The initial discharge assessment (...) and consideration of age Diabetes equipment required – pens, needles, insulin pump, monitoring equipment, specialist adaptations to support independence Educational potential – sight, hearing, manual dexterity, cognitive ability Presence of any symptoms Diabetes complications – kidney function, liver disease, retinopathy, neuropathy Social support – carers and family circumstances, social services, community support Presence of co-morbidities Ability to continue/start insulin self-administration Dependence

2017 Association of British Clinical Diabetologists

62. Herpes Zoster - Diagnosis

rash. 54 Ramsey Hunt syndrome is de?ned as involvement of the facial or auditory nerves, with ipsilateral facial palsy, HZ lesions of the external ear, tympanic membrane and/or the anterior two- thirds of the tongue. 55–57 Complications are vertigo, tinnitus, otalgia, dysgeusia, osteonecrosis and deafness. 58 No speci?c recommendation for enhanced diagnostic means is proposed in the case of HZ oticus, but due to the risk of severe compli- cations, 58 it is recommended to seek advice of an otorhino (...) - laryngologist, especially in the case of involvement of the facial or auditory nerves (Table 5), in order to determine the treat- ment strategy and necessity for otorhinolaryngologist reassess- ment. Herpes zoster sine herpete is de?ned as the presence of uni- lateral dermatomal pain without cutaneous lesions in patients with virologic and/or serologic evidence of VZV infection. The most accurate method to con?rm the diagnosis is to demon- strate an increase in the blood of anti-VZV IgG and IgM. The identi

2017 European Dermatology Forum

63. Familial Dilated Cardiomyopathy

. It is one of the most common forms of heart muscle disease with an estimated prevalence of 1:2500 [1]. DCM can be caused by diverse conditions that promote cardiomyocyte injury or loss, including viral myocarditis, alcohol excess, and chemotherapeutic drugs. In approximately 50% cases, an underlying cause is unable to be identified and the condition is referred to as “idiopathic” DCM [2]. It is now recognised that approximately 1 in 4 patients with “idiopathic” DCM have a positive family history, which (...) may be associated with additional cardiac manifestations eg. conduction-system disorders, valvular abnormalities, congenital heart defects, left ventricular non-compaction, or with extra-cardiac manifestations eg. skeletal myopathy, partial lipodystrophy, sensorineural deafness. 1.3 Clinical diagnosis A diagnosis of familial DCM generally requires the presence of DCM in two or more affected individuals in a single family in the absence of another heritable cardiac or systemic cause of left

2016 Cardiac Society of Australia and New Zealand

64. Familial Long QT Syndrome

Torsade de pointes* 2 D T wave alternans 1 E Notched T wave in 3 leads 1 F Low heart rate for age@ 0.5 Clinical History A Syncope* With stress 2 Without stress 1 B Congenital deafness 0.5 Family History A Family members with de?nite LQTS$ 1 B Unexplained sudden cardiac death age 30 among immediate family members$ 0.5 # In the absence of medications or disorders known to affect these electro- cardiographic features; ^QTc calculated by Bazett’s formula where QTc=QT/HRR; *Mutually exclusive; @Resting (...) , Evans CA, et al. Prospective,population-basedlongQTmolecularautopsystudyofpost- mortem negative sudden death in 1 to 40 year olds. Heart Rhythm 2011;8:412–9. [37] Nazeri A, Massumi A, Wilson JM, Frank CM, Bensler M, Cheng J, et al. Arrhythmogenicity of weight-loss supplements marketed on the Inter- net. Heart Rhythm 2009;6:658–62. [38] SakaguchiT, ShimizuW,ItohH, NodaT,MiyamotoY,NagaokaI,etal. Age-andgenotype-speci?ctriggersforlife-threateningarrhythmiainthe genotyped long QT syndrome. J Cardiovasc

2016 Cardiac Society of Australia and New Zealand

65. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sport-Related Concussion/mTBI

(post-traumatic amnesia) less than 24 hours Any alteration in mental state at the time of the injury (e.g., confusion, disorientation, slowed thinking, alteration of consciousness/mental state) Physical symptoms (e.g., vestibular, headache, weakness, loss of balance, change in vision, auditory sensitivity, dizziness) Note: No evidence of intracranial lesion on standard imaging (if present, it is suggestive of more severe brain injury) Refer to Table for a comprehensive list of signs for possible (...) to as a concussion. In this Guideline, the term concussion/mTBI will be used to maintain consistency within this document. A sport-related concussion/mTBI is a traumatic brain injury that may be caused by either a direct blow to the head, face, neck or elsewhere on the body as an indirect force being transmitted to the head during sports activity. A sport-related concussion/mTBI can result in a range of clinical signs and symptoms that may or may not involve a loss of consciousness. While the injury may result

2018 Ontario Neurotrauma Foundation

67. Monitoring Progress of Neurological and Functional Outcomes in the Paediatric HIV Cohort in the UK

risk factors on cognitive development among young children. Pediatrics, 117(3), 851-862. Smith, R., & Wilkins, M. (2015). Perinatally acquired HIV Infection: Long-term neuropsychological consequences and challenges ahead. Child Neuropsychology, 21 (2), 234-268 Torre 3rd, P., Zeldow, B., Hoffman, H. J., Buchanan, A., Siberry, G. K., Rice, M., Sirois, P.A. & Williams, P. L. (2012). Hearing loss in perinatally HIV-infected and HIV-exposed but uninfected children and adolescents. The Pediatric (...) such as executive functioning (Llorente et al, 2014), hearing and language (Torre et al, 2012) memory (Keller et al 2004), attention (Koekkoek et al, 2008), visual-spatial processing (Martin et al, 2006), achievement (Franklin et al, 2005) and adaptive functioning (Smith et al, 2012). Furthermore, Pearlstein et al (2014) found that older youth with PHIV had lower daily skill mastery, and this can be important when considering how much independence a young person would be expected to have in relation

2019 The Children's HIV Association

68. Syphilis

such as unilateral sensori-neural deafness, ocular nerve palsies, uveitis and meningitis. • If untreated symptoms slowly resolve over a period of weeks. Note: Skin lesions may be extremely infectious so always use gloves during examination of any rash or genital lesion. Syphilis MANAGEMENT GUIDELINESSyphilis Management Guidelines page 3 of 4 Latent syphilis • This means syphilis with no clinical symptoms or signs. Early latent is defined as less than 2 years duration, and late latent beyond 2 years. • Some

2017 New Zealand Sexual Health Society

70. ACR–ASNR–SPR Practice Parameter for the Performance of Computed Tomography (CT) of the Extracranial Head and Neck

9. Radiation therapy treatment planning 10. Foreign body 11. Diplopia 12. Loss of vision 13. Complications of sinusitis and sinus surgeries PRACTICE PARAMETER CT_Extracranial Head and Neck / 3 14. Preoperative and intraoperative planning and/or guidance 15. Vascular malformations D. Indications for CT of the temporal bone include, but are not limited to [35,57,58]: 1. Conductive or sensorineural hearing loss 2. Benign and malignant neoplasms 3. Trauma 4. Acute or chronic otomastoid inflammatory (...) disease 5. Preoperative evaluation prior to mastoidectomy 6. Preoperative or postoperative evaluation for auditory devices 7. Suspected inner ear disease 8. Radiation therapy treatment planning 9. Follow-up after surgery, chemotherapy, or radiation therapy 10. Congenital anomalies 11. Preoperative and intraoperative planning and/or guidance For the pregnant or potentially pregnant patient, see the ACR–SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant Adolescents and Women

2019 American Society of Neuroradiology

71. ACR–ASNR–SPR Practice Parameter for the Performance of Magnetic Resonance Imaging (MRI) of the Head and Neck

in this area. Thin section, 3-D T2-weighted techniques are useful in temporal bone imaging to evaluate the relationship of a vestibular schwannoma or other pathology to the surrounding nerves [88], the patency of labyrinthine structures, the size of the endolymphatic sac, and the extent of cochlear dysplasia in cases of congenital or developmental hearing loss. In children, reformatted oblique sagittal images perpendicular to the long axis of the internal auditory canal are particularly helpful (...) is the primary imaging modality for evaluating the nonosseous components of the temporal bone region [43], including evaluation of suspected retrocochlear pathology [28] and cranial nerve dysfunction, most commonly sensorineural hearing loss [10,83,84]. MRI is useful to determine if temporal bone pathology, such as infection or neoplasm, involves the intracranial compartment. CT is favored if a labyrinthine or cochlear lesion is suspected [85,86], although lesions such as cochlear schwannomas or labyrinthine

2019 American Society of Neuroradiology

72. Iron Deficiency – Diagnosis and Management

receive guidance to prevent excessive cow’s milk intake. Prescribe oral iron supplements as first line therapy for iron deficiency. One preparation is not preferred over another; patient tolerance should be the guide. Anemia should correct in 2-4 months. Continue oral iron for 4-6 months after anemia corrects to replenish iron stores. Consider prescribing IV iron when there is inadequate response to oral iron, intolerance to oral iron therapy, or ongoing blood loss. Definitions Iron deficiency (...) : insufficient total body iron stores, caused by increased requirements, decreased intake, increased loss, and/or decreased absorption (see Table 1). Anemia: low hemoglobin level, most frequently defined as a hemoglobin value over two standard deviations below the gender- and age-adjusted mean. A hemoglobin value below the local, lab-specific lower reference interval indicates anemia. Iron deficiency anemia (IDA) : anemia due to insufficient body iron stores. The following laboratory findings are typical

2019 Clinical Practice Guidelines and Protocols in British Columbia

73. ACR–ASNR Practice Parameter for the Performance of Computed Tomography (CT) of the Brain

and MR imaging of the inner ear and brain in children with congenital sensorineural hearing loss. Radiographics. 2012;32(3):683-698. 12 / CT Brain PRACTICE PARAMETER 73. Gelfand JM, Wintermark M, Josephson SA. Cerebral perfusion-CT patterns following seizure. Eur J Neurol. 2010;17(4):594-601. 74. Hess CP, Barkovich AJ. Seizures: emergency neuroimaging. Neuroimaging Clin N Am. 2010;20(4):619- 637. 75. Hsieh DT, Chang T, Tsuchida TN, et al. New-onset afebrile seizures in infants: role of neuroimaging (...) . 2012;22(3):519-524. 70. Miyasaka M, Nosaka S, Morimoto N, Taiji H, Masaki H. CT and MR imaging for pediatric cochlear implantation: emphasis on the relationship between the cochlear nerve canal and the cochlear nerve. Pediatr Radiol. 2010;40(9):1509-1516. 71. Yan F, Li J, Xian J, Wang Z, Mo L. The cochlear nerve canal and internal auditory canal in children with normal cochlea but cochlear nerve deficiency. Acta Radiol. 2013;54(3):292-298. 72. Joshi VM, Navlekar SK, Kishore GR, Reddy KJ, Kumar EC. CT

2019 American Society of Neuroradiology

74. Newborn Screening and the Role of the Obstetrician-Gynecologist

is used to detect the lower oxygen saturation levels in the blood that are associated with some forms of critical congenital heart defects (5, 6). Screening for hearing loss in the newborn is performed by either otoacoustic emissions or automated auditory brainstem response (7). StateGuidelines All states and the District of Columbia have newborn screening programs with varying screening panels, policies, statutes, and regulations. Most programs have adopted the guidelines suggested (...) States (2). The goal of this public health program is to decrease morbidity and mortality by screening for disor- ders in which early intervention will improve neonatal and long-term health outcomes. This screening is done throughbloodtestinginthenewborn withinthefirst24– 48 hours of life in addition to other noninvasive means to screen specifically for hearing loss and critical congen- ital heart disease. Most of the disorders screened for have no clinical

2019 American College of Obstetricians and Gynecologists

75. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

recommendations are proffered with the awareness that, regardless of the intended level of sedation or route of drug administration, the sedation of a pediatric patient represents a continuum and may result in respiratory depression, laryngospasm, impaired airway patency, apnea, loss of the patient’s protective airway reflexes, and cardiovascular instability. Procedural sedation of pediatric patients has serious associated risks. These adverse responses during and after sedation for a diagnostic (...) terminology, “conscious sedation” or “sedation/analgesia”) is a drug-induced depression of consciousness during which patients respond purposefully to verbal commands or after light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained. The caveat that loss of consciousness should be unlikely is a particularly important aspect of the definition of moderate sedation; drugs and techniques used

2019 American Academy of Pediatrics

76. Iron Deficiency and Anaemia in Adults

with respect to any loss or damage caused or alleged to be caused directly or indirectly by what is contained in or left out of this website information and guidance. The sponsors have not had any editorial input into the content, other than a review for factual inaccuracies. Published by the Royal College of Nursing, 20 Cavendish Square, London, W1G 0RN © 2019 Royal College of Nursing. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any (...) Reproduced with kind permission from Vifor Pharma UK Systemic in?ammation Malabsorption Blood loss Connective tissue disorders Rheumatoid arthritis COPD CKD GI cancer Gastritis In?ammatory bowel disease CHF Coeliac disease GI infection GI bleeding Peri-operative Haemodialysis Gastrectomy Medications Gut oedema Dietary insu ciencyROYAL COLLEGE OF NURSING 7 Measuring iron status If Hb is reduced, further blood iron studies identify if the anaemia is caused by iron deficiency. Iron tests can also help

2018 Royal College of Nursing

77. Older people in care homes: Sex, Sexuality and Intimate Relationships

the RCN provides accurate and expert information and guidance, it is impossible to predict all the circumstances in which it may be used. Accordingly, the RCN shall not be liable to any person or entity with respect to any loss or damage caused or alleged to be caused directly or indirectly by what is contained in or left out of this website information and guidance. Published by the Royal College of Nursing, 20 Cavendish Square, London, W1G 0RN © 2018 Royal College of Nursing. All rights reserved (...) identity, self-image, self-concept and self-worth. It also affects mental health, physical health, social relationships and quality of life. Sense of self and identity are also maintained through relationships with others and can become increasingly important in later life. Relationships, particularly those which are long-term and close, can provide comfort and support to sustain individuals through multiple life changes and loss. Relationships can help individuals to feel valued, wanted, desired

2018 Royal College of Nursing

78. Treatment of Diabetes in Older Adults (Full text)

loss. (2|⊕⊕OO) 4.6 In patients aged 65 years and older with diabetes who cannot achieve glycemic targets with lifestyle modification, we suggest avoiding the use of restrictive diets and instead limiting consumption of simple sugars if patients are at risk for malnutrition. (2|⊕OOO) Technical remark: Patients’ glycemic responses to changes in diet should be monitored closely. This recommendation applies to both older adults living in the community and those in nursing homes. Drug therapy (...) the next 3 decades; as the population ages, the numbers of higher-risk minority groups increase, and people with diabetes live longer because of decreasing rates of cardiovascular deaths ( ). Moreover, older adults are susceptible to all of the usual complications of diabetes [reviewed in Refs. ( ) and ( )]. The prevalence rates of end-stage renal disease, loss of vision, myocardial infarction, stroke, peripheral vascular disease, and peripheral neuropathy are increased by the presence of diabetes

2019 The Endocrine Society PubMed abstract

79. Suspected neurological conditions: recognition and referral

on consent and mental capacity), and safeguarding. 1.1 Blackouts in adults 1.1.1 Refer urgently adults with new-onset blackouts (transient loss of consciousness), accompanied by features that are strongly suggestive of epileptic seizures, for neurological assessment in line with the recommendation for people with suspected epilepsy in the NICE guideline on transient loss of consciousness ('blackouts') in over 16s. 1.1.2 Do not routinely refer adults with blackouts if there are clear features of vasovagal (...) syncope, even if associated with brief jerking of the limbs. See recommendation on uncomplicated faint in the NICE guideline on transient loss of consciousness ('blackouts') in over 16s. T o find out why the committee made the recommendations on blackouts in adults, see rationale. 1.2 Dizziness and vertigo in adults Sudden-onset dizziness with a focal neurological deficit Sudden-onset dizziness with a focal neurological deficit 1.2.1 For adults with sudden-onset dizziness and a focal

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

80. Meningitis (bacterial) and menigococcal septicaemia in under 16s: recognition, diagnosis and management

implants as soon as they are fit to undergo testing (further guidance on the use of cochlear implants for severe to profound deafness can be found in the NICE technology appraisal guidance on cochlear implants for children and adults with severe to profound deafness). Children and young people should be reviewed by a paediatrician with the results of their hearing test 4–6 weeks after discharge from hospital to discuss morbidities associated with their condition and offered referral to the appropriate (...) services. The following morbidities should be specifically considered: hearing loss (with the child or young person having undergone an urgent assessment for cochlear implants as soon as they are fit) orthopaedic complications (damage to bones and joints) skin complications (including scarring from necrosis) psychosocial problems neurological and developmental problems renal failure. [1] Ethylenediaminetetraacetic acid. [2] See National Patient Safety Agency (2007) Patient safety alert 22: Reducing

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines


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