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How low can you go: Restrictive transfusion strategies in major surgery and physiological triggers.
Best Pract Res Clin Anaesthesiol
December 2023
Department of Anesthesia, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Anemia and red blood cell transfusion are associated with adverse outcomes. Large randomized trials have demonstrated that restrictive transfusion strategies can safely reduce patient exposure to transfusion, forming a foundational pillar of patient blood management. The restrictive transfusion thresholds in these trials ranged from 7 to 8 g/dL for different populations and this variability is reflected in recent guideline recommendations for transfusion triggers.
View Article and Find Full Text PDFExecutive Summary: Clinical Practice Guidelines on the Management of Resistant Tuberculosis of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC).
Arch Bronconeumol
December 2024
Pulmonology Service, Cruces University Hospital (OSI EEC), Barakaldo, Spain; BioBizkaia Health Research Institute, Spain.
The Spanish Society of Pneumology and Thoracic Surgery (SEPAR) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) have developed together Clinical Practice Guidelines (GPC) on the management of people affected by tuberculosis (TB) resistant to drugs with activity against Mycobacterium tuberculosis. These clinical practice guidelines include the latest updates of the SEPAR regulations for the diagnosis and treatment of drug-resistant TB from 2017 and 2020 as the starting point. The methodology included asking relevant clinical questions based on PICO methodology, a literature search focusing on each question, and a systematic and comprehensive evaluation of the evidence, with a summary of this evidence for each question.
View Article and Find Full Text PDFMethodological description of knowledge translation: Implementation of clinical practice guidelines into clinical practice.
PM R
January 2025
Board Certified Clinical Specialist in Oncological Physical Therapy, Board Certified Clinical Specialist in Women's Health Physical Therapy, LANA Certified Lymphedema Therapist, Select Medical, ReVital Cancer Rehabilitation, Mechanicsburg, Pennsylvania, USA.
This methodological paper explores the intricacies of implementing evidence-based medicine in the health care sector specifically focusing on the clinical practice guideline (CPG) published by the American Physical Therapy Association's Academy of Oncologic Physical Therapy for diagnosing upper quadrant lymphedema secondary to cancer (diagnosis CPG). Although CPGs are widely available, their implementation into clinical practice remains inconsistent, slow, and complex. To address this challenge, this paper employs the Knowledge-to-Action framework, offering a detailed description of the seven stages through the lens of an in-progress case study on the implementation of the diagnosis CPG.
View Article and Find Full Text PDFDelays in getting injured patients to hospital in a timely manner can increase avoidable death and disability. Like many low- or middle-income countries (LMICs), Rwanda experiences delays related to lack of efficient prehospital communication and formal guidelines to triage patients for hospital care. This paper describes the protocol to develop, roll out, and evaluate the effectiveness of a Destination Decision Support Algorithm (DDSA) integrated in an electronic communication platform, '912Rwanda'.
View Article and Find Full Text PDFStudy Question: Do recent changes in European Society of Human Reproduction and Embryology (ESHRE) clinical guidelines result in more comprehensive diagnosis of women with endometriosis?
Summary Answer: The latest shift in clinical guidelines results in diagnosis of more women with endometriosis but current ESHRE diagnostic criteria do not capture a sizable percentage of women with the disease.
What Is Known Already: Historically, laparoscopy was the gold standard for diagnosing endometriosis, a complex gynecological condition marked by a heterogeneous set of symptoms that vary widely among women. More recently, changes in clinical guidelines have shifted to incorporate imaging-based approaches such as transvaginal sonography and magnetic resonance imaging.
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