WHO Guidelines (who + guideline)

Distribution by Scientific Domains

Selected Abstracts

Cancer Pain: Progress Since the WHO Guidelines

PAIN PRACTICE, Issue 3 2001
Allen W. Burton MD
Abstract: In has been 15 years since the WHO Guidelines for the management of cancer pain were developed. This article reviews the guideline development and its effectiveness. Current trends in cancer care utilizing aggressive chemotherapeutic and surgical protocols lead to many patients living longer with advanced cancer and an attendant increase in pain. Future trends in cancer pain care are outlined. [source]

Defining targets in myeloproliferative disorders: reflecting on what is important,

Martin Griesshammer
Abstract The current lack of curative options for essential thrombocythaemia (ET) leads to the goal of reducing the risk of potentially life-threatening thrombohaemorrhagic complications with long-term treatment. The setting of relevant treatment targets is an important consideration in this process, allowing the monitoring of disease control. Recent revisions to the World Health Organization (WHO) diagnostic criteria for the chronic MPDs 1 have implications not only for the diagnosis of patients, but also for the management of their disease and the continuing assessment of their progress. The purpose of this article is to discuss recent revisions to the WHO guidelines, and their influence on the setting of treatment targets in patients with ET. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Comparison between computerized slow-stage and static liquid nitrogen vapour freezing methods with respect to the deleterious effect on chromatin and morphology of spermatozoa from fertile and subfertile men

M. E. Hammadeh
The purpose of this study was to determine the negative effects (cryodamage) on human spermatozoa after freeze-thawing and to determine whether freeze-thawing of spermatozoa with a programmed slow freezer is better than freezing with liquid nitrogen vapour (rapid freezing) with regard to alterations in sperm chromatin and morphology in semen from fertile (donor) and subfertile, IVF/ICSI, patients. Ninety-five semen samples were obtained either from patients attending our IVF unit for treatment (n=34) or from donors (n=25) with proven fertility and normal sperm quality according to WHO guidelines. Each semen sample was divided into two parts after liquefaction and addition of the cryoprotectant. The first part was frozen using a programmed biological freezer and the second part was frozen by means of liquid nitrogen vapour. Smears were made before the freezing and after the thawing procedure to assess morphology (strict criteria) and chromatin condensation (Acridine Orange test). The mean percentage of chromatin condensed spermatozoa in the samples from donors (control group) was 92.4 ± 8.4% before freezing and this decreased significantly (p < 0.0001) to 88.7 ± 11.2% after freeze-thawing with the computerized slow-stage freezer and to 87.2 ± 12.3% after using static liquid nitrogen vapour (p < 0.001). The corresponding values for semen obtained from patients was 78.9 ± 10.3% before freezing which decreased to 70.7 ± 10.8 and 68.5 ± 14.8%, respectively (p < 0.001). On the other hand, the mean percentage of normal sperm morphology in the control group decreased from 26.3 ± 7.5% before freezing to 22.1 ± 6.4% (p < 0.0001) after thawing with the computerized slow-stage freezer and to 22.2 ± 6.6% (p < 0.0001) after the use of static liquid nitrogen vapour. In the patient group, the mean percentage of normal morphology decreased from 11.7 ± 6.1% after freezing with the biological freezer to 9.3 ± 5.6% and to 8.0 ± 4.9% after freezing with static liquid nitrogen vapour. This study demonstrates that chromatin packaging and morphology of human spermatozoa decrease significantly after the freeze-thawing procedure, not only after the use of static liquid nitrogen vapour but also after the use of a computerized slow-stage freezer. However, the chromatin of semen samples with normal semen parameters (donor sperm) withstand the freeze-thaw injury better than those with low quality semen samples. Therefore, the computerized slow stage freezer could be recommended for freezing of human spermatozoa, especially for subnormal semen samples, for example, ICSI and ICSI/TESE candidates and from patients with testicular tumours or Hodgkin's disease, in order to avoid further damage to the sperm chromatin structure. [source]

Treatment of mild to moderate dehydration in children with oral rehydration therapy

Kristene C Diggins RN
Abstract Purpose: To review current literature on the effectiveness of oral rehydration therapy (ORT) in the treatment of mild to moderate dehydration in children. Data sources: Recommendations from American Academy of Pediatrics (AAP), World Health Organization (WHO), selected research articles (2000,2006), and Internet sources. Conclusions: Dehydration is a common diagnosis in pediatric primary care. The literature indicates that dehydration is more often treated with intravenous (IV) therapy when ORT would be equally effective. ORT is an effective treatment for children with mild to moderate dehydration. ORT could be used more frequently rather than IV rehydration therapy. The use of ORT versus traditional methods of IV hydration matches the nursing philosophy of holistic care by enhancing client comfort and autonomy. Implications for practice: Current practice in the treatment of mild to moderate dehydration in children does not match both AAP and WHO guidelines, which are based on evidence supporting ORT effectiveness. Treatment with ORT allows children more flexibility to be treated at home and thus decreases hospital stay. Evidence shows that the time required to initiate ORT is actually quicker than IV therapy and allows for a less stressful therapy that can be performed in the home. [source]

Optimization of treatment parameters for Foscan®-PDT of basal cell carcinomas

Christian S. Betz MD
Abstract Background and Objective Basal cell carcinomas (BCCs) are the most common form of skin cancers with high and increasing incidence rates. Photodynamic therapy (PDT) with mTHPC (Foscan®) has shown to be a promising treatment alternative with good cosmetic results. The current study was aimed to determine optimal treatment parameters for this indication. Study Design/Materials and Methods mTHPC-PDT was performed in 117 patients with a total of 460 BCCs with diagnosis confirmed by scratch cytology. Treatment parameters were altered as follows: Foscan® dose 0.03,0.15 mg/kg, drug-light interval (DLI) 1,96 hours, total energy density 20,120 J/cm2. Outcomes were assessed 8 weeks post-PDT following WHO guidelines. Results The overall rate of complete remissions (CR) was 96.7% and the cosmetic outcome was very good. In the largest subgroup (n,=,80) where low-dose Foscan® was applied (0.05 mg/kg mTHPC; 48 hours DLI; 50 J/cm2 total energy density), a CR rate of 100% with a high and narrow 95% Confidence Interval of 0.955,1.000 was achieved. Smaller variations of the treatment parameters (i.e., reducing the photosensitizer dose to 0.04 mg/kg or shortening the DLI to 24 hours) yielded similarly good results. Side effects were encountered in 52 out of 133 PDT sessions. They were more common in patients who had received high drug doses (0.06,0.15 mg/kg) and comprised mostly pain and phototoxic reactions. Three patients developed severe sunburns with subsequent scarring at the injection site following bright sunlight exposure 15,19 days after photosensitizer administration. Conclusions The presented data suggest that mTHPC-PDT with the treatment parameters mentioned above seems to be an effective treatment option for BCCs. If sensibly applied, it is well tolerated and provides mostly excellent cosmetic results. Long-term results are yet to be evaluated. Lesers Surg. Med. 40:300,311, 2008. © 2008 Wiley-Liss, Inc. [source]

From expert opinion to evidence-based: changes in the gold standard of primary brain tumour diagnosis,

JM Kros
Abstract Since 1997, significant progress has been made in the WHO guidelines for the diagnosis of primary tumours of the central nervous system. A large group of international experts was involved in editing the content; consensus on definitions and classifications was sought; and updated findings of genomic investigations were included. Nevertheless, significant inter-observer variability still exists in the histopathological diagnosis of several tumour types. The challenge for the near future is to identify histological and genotypic characteristics with prognostic or predictive value. With that aim, testing histological or molecular parameters in prospective clinical studies is indicated. Copyright © 2007 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source]

Arsenic pollution of groundwater in Bangladesh,

Kimiko Tanabe
Abstract Arsenic concentrations in groundwater around the village of Samta, Jessore District, Bangladesh were measured. Distribution patterns of arsenic in groundwater were determined. Arsenic concentrations in drinking water tubewells mostly exceeded WHO guidelines. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Water fluoridation in the Blue Mountains reduces risk of tooth decay

RW Evans
Abstract Background:, In April 1992, the fluoride concentration in the Blue Mountains water supply was adjusted to 1 mg/L. Baseline dmft/DMFT has been determined in children attending schools in the region and in the adjacent reference region of Hawkesbury, fluoridated since 1968. The aim of this study was to evaluate the effect of the water fluoridation programme in the Blue Mountains. Methods:, In 2003, children attending the same schools were sampled. Residential history data were obtained by questionnaire and caries experience was assessed according to WHO guidelines. The analysis was restricted to lifelong resident children aged 5,11 years. Results:, The baseline and follow-up dmft scores for Blue Mountains children aged 5,8 years were 2.36 and 0.67, respectively. The age-adjusted decrease in odds of experiencing one or more dmft due to fluoridation was 0.26 (CI95 0.19, 0.37). The corresponding DMFT scores for Blue Mountains children aged 8,11 were 0.76 and 0.21 and the corresponding decrease in odds of experiencing one or more DMFT due to fluoridation was 0.25 (CI95 0.16, 0.40). Conclusions:, Tooth decay reduction observed in the Blue Mountains corresponds to high rates reported elsewhere and demonstrates the substantial benefits of water fluoridation. [source]