Our objective was to develop a guide based on the best available evidence that allow family physicians to establish criteria for screening, diagnosis, prevention, treatment of disease, early detection and management of complications; to standardize the organizing processes of the diabetic patient's care in the primary care level; and to achieve lifestyle modification for patients and promote self-care. Clinical questions were stated according to the diagram and structured patient-intervention-comparison-outcome. We used a mixed methodology-adoption adjustment, and include 32 guides. For recommendations not included in these, the search process was conducted in PubMed and Cochrane Library Plus with these terms: diabetes mellitus type 2, epidemiology, detection and diagnosis, classification, drug therapy, effects, prevention, control and complication. The clinical practice guideline emphasizes the fundamental change in lifestyle (diet and exercise), self-care and proactive participation of the patient, in addition to the dynamic prescription of medications that would achieve metabolic control in order to reduce late complications.
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Alzheimers Dement
December 2024
Northwestern Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Chicago, Illinois, USA.
The Alzheimer's Association convened a Diagnostic Evaluation, Testing, Counseling and Disclosure Clinical Practice Guideline workgroup to help combat the major global health challenges surrounding the timely detection, accurate diagnosis, and appropriate disclosure of mild cognitive impairment (MCI) or dementia due to Alzheimer's disease (AD) or other diseases that cause these types of cognitive-behavioral disorders. The newly published clinical practice guidelines are proposed as a structured approach to evaluation. The purpose of the present article is to provide a clinical perspective on the use of neuropsychology within the new framework and practice guidelines outlined under the Diagnostic Evaluation, Testing, Counseling and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD) recommendations for primary care and specialty care.
View Article and Find Full Text PDFChronic kidney disease (CKD) is a common clinical condition with significant health risks for patients and is widely recognised as a major public health concern. Laboratory medicine plays a crucial role in both diagnosing and managing CKD, as diagnosis and staging rely on estimated glomerular filtration rate (GFR) and evaluating albuminuria (or proteinuria). It was evident that the laboratory assessment of CKD in Malaysia is not standardised.
View Article and Find Full Text PDFPediatr Transplant
February 2025
Division of Critical Care, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.
Background: Pediatric solid organ transplantation is challenging due to the limited availability of suitable organs resulting in an increasing waitlist. Many pediatric transplant recipients receive organs from deceased donors, often after neurologic determination of death. Organ donation from patients on extracorporeal membrane oxygenation (ECMO) at the time of death has been described in adults, offering the potential for donation after circulatory determination of death (DCDD) with minimal ischemia time.
View Article and Find Full Text PDFJAMA Netw Open
December 2024
Department of Surgery, University of Vermont, Burlington.
Importance: The 2009 US Preventive Services Task Force breast cancer screening guideline changes led to decreases in screening mammography, raising concern about potential increases in late-stage disease and more invasive surgical treatments.
Objective: To investigate the incidence of breast cancer by stage at diagnosis and surgical treatment before and after the 2009 guideline changes.
Design, Setting, And Participants: This population-based, epidemiologic cohort study of women aged 40 years or older used 2004 to 2019 data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program.
Curr Oncol
December 2024
Princess Margaret Hospital, 610 University Ave, Toronto, ON M5G2M9, Canada.
(1) Background: To make recommendations on the most effective therapy options for Ductal Carcinoma of the Breast (DCIS) patients; (2) Methods: MEDLINE, EMBASE, Cochrane Library, PROSPERO databases, and main relevant guideline websites were searched. Draft versions of the guideline went through formal internal and external reviews, with a final approval by the Program in Evidence Based Care and the DCIS Expert Panel. The Grading of Recommendations, Assessment, Development, and Evaluation approach was followed; (3) Results: Based on the current evidence from the systematic review and this guideline authors' clinical opinions, initial draft recommendations were developed to improve the management of patients with DCIS.
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