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Optimal Indications (optimal + indication)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Procedural sedation in children in the emergency department: A PREDICT study

EMERGENCY MEDICINE AUSTRALASIA, Issue 1 2009
Meredith Borland
Abstract Objective: To investigate current procedural sedation practice and compare clinical practice guidelines (CPG) for procedural sedation at Paediatric Research in Emergency Departments International Collaborative (PREDICT) sites. This will determine areas for improvement and provide baseline data for future multicentre studies. Methods: A questionnaire of specialist emergency physicians regarding demographics, general procedural sedation practice and specific sedation agents given to children. CPG for general sedation and sedation agents were obtained for each site. Results: Seventy-five (71%) useable surveys returned from 105 potential respondents. Most commonly used agents were nitrous oxide (N2O) (75, 100%), ketamine (total 72, 96%; i.v. 59, 83% and i.m. 22, 31%) and midazolam (total 68, 91%; i.v. 52, 81%, oral 47, 73%, intranasal 26, 41% and i.m. 6, 9%). Sedation was used for therapeutic and diagnostic procedures. Forty-three (57%) used formal sedation records and sedation checklists and thirty-one (41%) respondents reported auditing sedations. Four sites ran staff education and competency programmes. Nine sites had general sedation CPG, eight for ketamine, nine for N2O, eight for midazolam (four parenteral, five oral and six intranasal) and three for fentanyl. No site had a guideline for propofol administration. Conclusion: Procedural sedation in this research network commonly uses N2O, ketamine and midazolam for a wide range of procedures. Areas of improvement are the lack of guidelines for certain agents, documentation, staff competency training and auditing processes. Multicentre research could close gaps in terms of age cut-offs, fasting times and optimal indications for various agents. [source]

Molecular diagnosis in dermatopathology: What makes sense, and what doesn't

EXPERIMENTAL DERMATOLOGY, Issue 1 2009
Markus Braun-Falco
Abstract:, Molecular techniques have provided us with a wealth of information about biological events in healthy individual, and improved tremendously our understanding about the pathogenesis of a huge variety of cutaneous diseases. Those methods have originally been invented to support basic scientific investigations on a molecular level and are translated increasingly into sophisticated diagnostic tools changing the classic paradigm of diagnostic pathology; among them are immunohistochemistry (IHC), polymerase chain reaction (PCR), G-banding, loss of heterozygosity, fluorescence in situ hybridization (FISH), chromogen in situ hybridization (CISH), comparative genomic hybridization on chromosomes and microarray technology. Some of them such as IHC and PCR have already been standardized to a level that allows its utility in daily routine diagnostics for several dermatological diseases. For others like array-based technologies, their optimal indications await to be fully determined. These ancillary methods have the great potential to contribute important new information to challenging cases, and will help to improve diagnostic accuracy particularly in cases in which conventional histopathology is ambiguous. Thus, they will broaden our armamentarium for diagnostic pathology. Herein, some key techniques will be reviewed and their applicability towards the diagnosis of dermatological diseases critically discussed. [source]

Beneficial effects of omega-3 fatty acids in cardiovascular disease

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 9 2010
Lisa M. Freeman
There is a large body of evidence supporting beneficial effects of omega-3 fatty acids for both primary and secondary prevention of cardiac disease in people. However, evidence is increasing for the use of omega-3 fatty acids in dogs with cardiac disease as well. Omega-3 fatty acids' anti-inflammatory and anti-arrhythmic effects may be beneficial in managing the loss of lean body mass and arrhythmias that are common in heart failure. However, omega-3 fatty acids also may have positive effects on myocardial energy metabolism, endothelial function, heart rate and blood pressure, and immune function. Additional research is needed to determine optimal indications, doses and formulations for dogs and cats with cardiac disease. [source]

Primary vitrectomy in retinal detachment: is scleral buckling still indicated?

ACTA OPHTHALMOLOGICA, Issue 2009
CJ POURNARAS
Purpose The surgical management of rhegmatogenous retinal detachment has evolved due to introduction of primary pars plana vitrectomy (PPV). The choice of primary vitrectomy has grown over recent years even for managment of simple retinal detachment. Methods Review of reports on primary vitrectomy treatment for rhegmatogenous uncomplicated retinal detachment. Evaluation of optimal indications of vitreectomy for specific types of retinal detachments. Results Comparaison of primary vitrectomy with scleral buckling had failed to demonstrate advantage of this method regarding anatomical and functional results. Vitrectomy avoids some of the complications associated with scleral buckling, such as diplopia, choroidal detachment, perforation of the sclera, abnormalities in the eyelid, but it carries higher risks of several other complications,including cataract formation in phakic eyes, glaucoma and other problems with tamponade, and new retinal breaks. Data from case series and randomized studies suggest that primary detachments in phakic eyes may be treated successfully with scleral buckling or vitrectomy, whereas vitrectomy appears to be preferable for corresponding detachments in pseudophakic eyes. Conclusion The choice of primary PPV in new uncomplicated retinal detachment remains to the surgeon's discretion and skills due to lack of controlled randomized trials covering the large spectrum of the retinal detachment pathology. [source]