Practice Guidelines

Καλώς ήρθατε στην διαδικτυακή μας κοινότητα.
Εδώ μπορείτε να συζητήσετε και να ενημερωθείτε για θέματα που αφορούν την Πρωτοβάθμια Φροντίδα Υγείας.
Για να συμμετέχετε και να μπορείτε να κατεβάσετε αρχεία και εικόνες που βρίσκονται στα μηνύματα πρέπει να εγγραφείτε.
Η εγγραφή είναι δωρεάν και θα σας αποσταλεί άμεσα ένα e-mail για την ενεργοποίηση της εγγραφής σας.
Εάν δεν το λάβετε σε λίγα λεπτά ελέγξετε το φάκελο ομαδικής αλληλογραφίας ή το φάκελο SPAM ή το φάκελο ανεπιθύμητης αλληλογραφίας καθώς μπορεί να βρεθεί εκεί από λάθος του λογισμικού ηλεκτρονικού ταχυδρομείου.

[Μαρία Χόρτη]

Το American College of Obstetricians and Gynecologists (ACOG) συστηνει πλέον μαστογραφία σε ετήσια βάση για όλες τις γυναίκες άνω των 40 ετων

http://www.acog.org/from_home/publications/press_releases/nr07-20-11-2.cfm

ενω το U.S. Preventive Services Task Force (USPSTF) πιστεύει πως γυναίκες <50 ετών δε θα έπρεπε να κάνουν μαστογραφία ως ρουτίνα, αλλά η απόφαση για μαστογραφία θα πρέπει να εξατομικευθεί ανάλογα με την ασθενή.

http://womens-health.jwatch.org/cgi/content/full/2009/1116/1?q=pfw

[kdiwavvou]

Posttraumatic stress disorder

Διαταραχή μετατραυματικού στρες


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some notes of mine

https://docs.google.com/document/pub?id=1zxVt11OAy02wR56Keh-Hn8DXcWHB1TKbpdoNeD_7aZw


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Guidelines for Treatment of PTSD

Edna B. Foa, Terence M. Keane and Matthew J. Friedman


http://www.springerlink.com/content/g34738676507ml01/


έχει να προσφέρει κάτι επιλέον μια `συνδρομητική` αναφορά οδηγιών συγκριτικά με δωρεάν αναφορές λοιπών εκδοτών ;

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ΝΙCE

http://www.google.gr/url?sa=t&source=web&cd=3&ved=0CDQQFjAC&url=http%3A%2F%2Fwww.nice.org.uk%2Fnicemedia%2Fpdf%2FCG026publicinfo.pdf&ei=gBJBTsLbMcHt-gb-99irCQ&usg=AFQjCNGVbzLts2_SzoRQHrAP_k5NGGN4Gg&sig2=scnT153kvkqVaEc6xPhEuQ


my link

http://kdiwavvou.comuv.com/_____aRxeia/     967 Posttraumatic stress disorder guidance.pdf

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CREST

http://www.google.gr/url?sa=t&source=web&cd=4&ved=0CD4QFjAD&url=http%3A%2F%2Fwww.gain-ni.org%2FLibrary%2FGuidelines%2Fpost_traumatic_stress_disorder.pdf&ei=gBJBTsLbMcHt-gb-99irCQ&usg=AFQjCNHyVVRW91q7PT0_mww6kJmcOespLw&sig2=_izVKfse_L2iYxaGW3zDJg


my link  

http://kdiwavvou.comuv.com/_____aRxeia/      967 post_traumatic_stress_disorder.pdf


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επαρκούν τα συγκεκριμένα guidances ;

Τι προτείνει η εμπειρία των Ειδικών ;


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paroxetine [ = SSRI ]  Or mirtazapine [ TeCA ]  ή  οποιονδήποτε  SSRI ;

έχουν ρόλο οι SNRI ;

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[ τα ερωτήματα που τίθενται δεν είναι ρητορικά , δεν βρήκα απαντήσεις στο διαδίκτυο [ που είναι η εκπαίδευση στην ΓΙ ; ]


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jUst fOr fUn

[Denominator]

Kατευθυντήριες οδηγίες του Αmerican College of Physicians για τη ΧΑΠ - Από το τελευταίο τεύχος του Annals of Internal Medicine [2011;155(3):179-191].

[carlita]

Draft Guidelines Recommend Against PSA Screening: USPSTF Review

The USPSTF already recommends against routine PSA screening in men older than 75 years. In the new draft recommendation, it extends this to all men. It now recommends against routine screening in men younger than 75 years, giving this a "D" rating, which means "there is moderate or high certainty that the service has no benefit or that the harms outweigh the benefits."

............

PSA Test is Not Specific
"It cannot distinguish cancer that will never make a difference in a man's lifetime from cancers that will make a difference," so might prompt men to undergo aggressive treatment unnecessarily, Virginia Moyer, MD, MPH, chair of the USPTSF panel that made the recommendation, stated in an interview yesterday with Bloomberg News. "So you go from being a guy who feels fine and who is potentially one of the majority who would never have known they had this disease, to being a guy who wears adult diapers," she said. Dr. Moyer is a professor of pediatrics at Baylor College of Medicine in Houston, Texas.
.........


http://www.medscape.org/viewarticle/751461?src=cmemp

[anasm]

Draft Guidelines Recommend Against PSA Screening: USPSTF Review

The USPSTF already recommends against routine PSA screening in men older than 75 years. In the new draft recommendation, it extends this to all men. It now recommends against routine screening in men younger than 75 years, giving this a "D" rating, which means "there is moderate or high certainty that the service has no benefit or that the harms outweigh the benefits."
............

PSA Test is Not Specific
"It cannot distinguish cancer that will never make a difference in a man's lifetime from cancers that will make a difference," so might prompt men to undergo aggressive treatment unnecessarily, Virginia Moyer, MD, MPH, chair of the USPTSF panel that made the recommendation, stated in an interview yesterday with Bloomberg News. "So you go from being a guy who feels fine and who is potentially one of the majority who would never have known they had this disease, to being a guy who wears adult diapers," she said. Dr. Moyer is a professor of pediatrics at Baylor College of Medicine in Houston, Texas.
.........

http://www.medscape.org/viewarticle/751461?src=cmemp

Γεια χαρά..!

Καταρχάς, έχει ενδιαφέρον, νομίζω, η ενδεχόμενη Διαδικασία που ακολουθείται, προκειμένου μια Έρευνα,
από επίπεδο Draft Guidelines να μεταβεί σε επίπεδο Official Guidelines...

Δεν νομίζω οτι, απλά και μόνο, ένα σχετικά υψηλό PSA, από μόνο του, να αποτελεί την καθοριστική ένδειξη για προστατεκτομή...
Επίσης,
ένας άνδρας, που έχει υποβληθεί σε προστατεκτομή, δεν νομίζω οτι φτάνει σε τέτοιο βαθμό αναπηρίας, ώστε να ζεί πια μόνιμα με μια πάνα ηλικιωμένων (adult diaper..).
Παρεμπιπτόντως,
μια βασική, και σίγουρα βαθιά "ακρωτηριαστική", σωματικά αλλά κυρίως ψυχολογικά, επιπλοκή της προστατεκτομής,
ήταν η ανικανότητα στύσης, λόγω "αναπόφευκτης" εκτομής των αντίστοιχων νεύρων...
Τώρα πια, νομίζω, με σύγχρονες τεχνικές, η επιπλοκή αυτή έχει περιοριστεί σε πολύ χαμηλά ποσοστά...

Επίσης, μου κάνει εντύπωση που, βασικός εκπρόσωπος της αντίστοιχης Έρευνας, είναι μια Καθηγήτρια Παιδιατρικής...
Νομίζω, θα είχε τεράστια σημασία η τοποθέτηση των Ουρολόγων,
και αντίστοιχα του American Association/ College of Urologists...

[schumifer]

Όταν οι Αμερικάνικες ιδιωτικές εταιρείες είδαν πόσα θα γλίτωναν προφανώς και πίεσαν. Αυτό είναι όλο

[Argirios Argiriou]

Draft Guidelines Recommend Against PSA Screening: USPSTF Review

The USPSTF already recommends against routine PSA screening in men older than 75 years. In the new draft recommendation, it extends this to all men. It now recommends against routine screening in men younger than 75 years, giving this a "D" rating, which means "there is moderate or high certainty that the service has no benefit or that the harms outweigh the benefits."
............

PSA Test is Not Specific
"It cannot distinguish cancer that will never make a difference in a man's lifetime from cancers that will make a difference," so might prompt men to undergo aggressive treatment unnecessarily, Virginia Moyer, MD, MPH, chair of the USPTSF panel that made the recommendation, stated in an interview yesterday with Bloomberg News. "So you go from being a guy who feels fine and who is potentially one of the majority who would never have known they had this disease, to being a guy who wears adult diapers," she said. Dr. Moyer is a professor of pediatrics at Baylor College of Medicine in Houston, Texas.
.........

http://www.medscape.org/viewarticle/751461?src=cmemp

Γεια χαρά..!

Καταρχάς, έχει ενδιαφέρον, νομίζω, η ενδεχόμενη Διαδικασία που ακολουθείται, προκειμένου μια Έρευνα,
από επίπεδο Draft Guidelines να μεταβεί σε επίπεδο Official Guidelines...

Δεν νομίζω οτι, απλά και μόνο, ένα σχετικά υψηλό PSA, από μόνο του, να αποτελεί την καθοριστική ένδειξη για προστατεκτομή...
Επίσης,
ένας άνδρας, που έχει υποβληθεί σε προστατεκτομή, δεν νομίζω οτι φτάνει σε τέτοιο βαθμό αναπηρίας, ώστε να ζεί πια μόνιμα με μια πάνα ηλικιωμένων (adult diaper..).
Παρεμπιπτόντως,
μια βασική, και σίγουρα βαθιά "ακρωτηριαστική", σωματικά αλλά κυρίως ψυχολογικά, επιπλοκή της προστατεκτομής,
ήταν η ανικανότητα στύσης, λόγω "αναπόφευκτης" εκτομής των αντίστοιχων νεύρων...
Τώρα πια, νομίζω, με σύγχρονες τεχνικές, η επιπλοκή αυτή έχει περιοριστεί σε πολύ χαμηλά ποσοστά...

Επίσης, μου κάνει εντύπωση που, βασικός εκπρόσωπος της αντίστοιχης Έρευνας, είναι μια Καθηγήτρια Παιδιατρικής...
Νομίζω, θα είχε τεράστια σημασία η τοποθέτηση των Ουρολόγων,
και αντίστοιχα του American Association/ College of Urologists...

Ίσως μια καθηγήτρια Παιδιατρικής (η οποία δεν έχει οικονομικά συμφέροντα απο το να χειρουργεί τους ασθενείς) να είναι πιο αντικειμενική στην συγκεκριμένη περίπτωση.

.............
............................
Τώρα πια, νομίζω, με σύγχρονες τεχνικές, η επιπλοκή αυτή έχει περιοριστεί σε πολύ χαμηλά ποσοστά...

;

[noname]

Και για πρωτη φορα ελληνικα πρωτοκολλα ιατρικών πράξεων και φαρμάκων .

http://www.eof.gr/web/guest/protocols

[Μαρία Χόρτη]

Αν και εφαρμόζοντας τα πρωτόκολλα του ΕΟΦ θα σταματήσουμε να κοιτάμε απο δω και απο εκεί για κατευθυντήριες οδηγίες,
ποστάρω οδηγίες για την αντιμετώπιση της οξείας παραρρινοκολπίτιδας απο το IDSA

http://cid.oxfordjournals.org/content/early/2012/03/20/cid.cir1043.full


Guideline Issued for Managing Acute Bacterial Rhinosinusitis

The Infectious Diseases Society of America has released a clinical practice guideline on the management of acute bacterial rhinosinusitis in children and adults.
The guideline, published in Clinical Infectious Diseases, first points out that a bacterial cause accounts for 2%–10% of acute rhinosinusitis cases. Among the recommendations:
    Bacterial rather than viral rhinosinusitis should be diagnosed when any of the following occurs:
        persistent symptoms lasting at least 10 days, without improvement;
        severe symptoms or high fever and purulent nasal discharge or facial pain for 3–4 days at illness onset;
        worsening symptoms after an initial respiratory infection, lasting 5–6 days, has started to improve.
    Empirical therapy should be started as soon as acute bacterial rhinosinusitis is diagnosed clinically; amoxicillin-clavulanate, instead of amoxicillin alone, is recommended for both children and adults.
    Macrolides and trimethoprim-sulfamethoxazole are not recommended as empirical therapy, because of high rates of antimicrobial resistance.

The guideline includes an algorithm for sinusitis management, with recommendations for treating patients who do not respond to initial empirical therapy.

[carlita]

New Screening Guidelines for Cervical Cancer

The American Cancer Society today released new screening recommendations for the prevention and early detection of cervical cancer. Screenings are tests for women who have no symptoms of cervical cancer. Among the changes: the American Cancer Society no longer recommends that women get a Pap test every year.

During the past few decades, screening has reduced deaths from cervical cancer, as doctors have been able to find cancer early and treat it, or prevent it from ever developing. Researchers continue to find out more about what causes cervical cancer, and the best ways to screen for it.

There are 2 types of tests used for cervical cancer screening.

    The Pap test can find early cell changes and treat them before they become cancer. The Pap test can also find cervical cancer early, when it’s easier to treat.
     
    The HPV (human papilloma virus) test finds certain infections that can lead to cell changes and cancer. HPV infections are very common, and most go away by themselves and don’t cause these problems. The HPV test may be used along with a Pap test, or to help doctors decide how to treat women who have an abnormal Pap test.

The American Cancer Society regularly reviews the science and updates screening recommendations when new evidence suggests that a change may be needed. The latest recommendations are:

    All women should begin cervical cancer screening at age 21.
     
    Women between the ages of 21 and 29 should have a Pap test every 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.
     
    Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
     
    Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical pre-cancer should continue to be screened.
     
    Women who have had their uterus and cervix removed in a hysterectomy and have no history of cervical cancer or pre-cancer should not be screened.
     
    Women who have had the HPV vaccine should still follow the screening recommendations for their age group.
     
    Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES. They should talk with their doctor or nurse.

In short, the American Cancer Society no longer recommends that women get a Pap test every year, because it generally takes much longer than that, 10 to 20 years, for cervical cancer to develop and overly frequent screening could lead to procedures that are not needed.

http://www.cancer.org/Cancer/news/new-screening-guidelines-for-cervical-cancer

[Λέξεις κλειδιά:]