Abstract The Scottish Intercollegiate Guidelines Network (SIGN) have recently published their guideline SIGN168 on ‘Assessment, Diagnosis, Care, and Support for People with Dementia and their ...Carers’. The guideline makes evidence-based recommendations for best practice in the assessment, care and support of adults living with dementia. Topics featured in this guideline are limited to those prioritised by stakeholders, especially people with lived and living experience, and those not well covered under pre-existing guidance. We summarise the guideline recommendations related to identification and diagnosis of dementia, investigative procedures, postdiagnostic support living with dementia, including non-pharmacological approaches for distressed behaviours, using technology to support people with dementia, grief and dementia and changing needs of people with dementia. The guideline content is summarised as officially published, with additional commentary in the final section.
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, significantly impacting patients' quality of life and increasing the risk of death, stroke, heart failure, and dementia. Over ...the past two decades, there have been significant breakthroughs in AF risk prediction and screening, stroke prevention, rhythm control, catheter ablation, and integrated management. During this period, the scale, quality, and experience of AF management in China have greatly improved, providing a solid foundation for the development of guidelines for the diagnosis and management of AF. To further promote standardized AF management, and apply new technologies and concepts to clinical practice in a timely and comprehensive manner, the Chinese Society of Cardiology of the Chinese Medical Association and the Heart Rhythm Committee of the Chinese Society of Biomedical Engineering have jointly developed the
. The guidelines have comprehensively elaborated on various aspects of AF management and proposed the CHA
DS
-VASc-60 stroke risk score based on the characteristics of AF in the Asian population. The guidelines have also reevaluated the clinical application of AF screening, emphasized the significance of early rhythm control, and highlighted the central role of catheter ablation in rhythm control.
In 2016, the British Society of Gastroenterology (BSG) published comprehensive guidelines
for obtaining consent for endoscopic procedures. In November 2020, the General Medical
Council (GMC) ...introduced updated guidelines on shared decision making and consent. These
guidelines followed the Montgomery ruling in 2015, which changed the legal doctrine
determining what information should be given to a patient before a medical intervention.
The GMC guidance and Montgomery ruling expand on the role of shared decision making
between the clinician and patient, explicitly highlighting the importance of understanding
the values of the patient. In November 2021, the BSG President’s Bulletin
highlighted the 2020 GMC guidance and the need to incorporate patient -related factors
into decision making.
Here, we make formal recommendations in support of this communication, and update the
2016 BSG endoscopy consent guidelines. The BSG guideline refers to the Montgomery
legislation, but this document expands on the findings and gives proposals for how to
incorporate it into the consent process. The document is to accompany, not replace the
recent GMC and BSG guidelines.
The recommendations are made in the understanding that there is not a single solution to
the consent process, but that medical practitioners and services must work together to
ensure that the principles and recommendations laid out below are deliverable at a local
level. The 2020 GMC and 2016 BSG guidance had patient representatives involved throughout
the process. Further patient involvement was not sought here as this update is to give
practical advice on how to incorporate these guidelines into clinical practice and the
consent process. This document should be read by endoscopists and referrers from primary
and secondary care.
Background. Pneumonia remains a major cause of morbidity and mortality amongst South African children. More comprehensive immunisation regimens, strengthening of HIV programmes, improvement in ...socioeconomic conditions and new preventive strategies have impacted on the epidemiology of pneumonia. Furthermore, sensitive diagnostic tests and better sampling methods in young children improve aetiological diagnosis. Objective. To produce revised guidelines for pneumonia in South African children under 5 years of age. Methods. The Paediatric Assembly of the South African oThracic Society and the National Institute for Communicable Diseases established seven expert subgroups to revise existing South African guidelines focusing on: (i) epidemiology; (ii) aetiology; (iii) diagnosis; (iv) antibiotic management and supportive therapy; (v) management in intensive care; (vi) prevention; and (vii) considerations in HIV-infected or HIVexposed, uninfected (HEU) children. Each subgroup reviewed the published evidence in their area; in the absence of evidence, expert opinion was accepted. Evidence was graded using the British Thoracic Society (BTS) grading system. Sections were synthesized into an overall guideline which underwent peer review and revision. Recommendations. Recommendations include a diagnostic approach, investigations, management and preventive strategies. Specific recommendations for HIV infected and HEU children are provided. Validation. The guideline is based on available published evidence supplemented by the consensus opinion of SA paediatric experts. Recommendations are consistent with those in published international guidelines.
A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on ...Clostridium difficile infection (CDI) in adults. The update, which has incorporated recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment), includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis. Clostridium difficile remains the most important cause of healthcare-associated diarrhea and has become the most commonly identified cause of healthcare-associated infection in adults in the United States. Moreover, C. difficile has established itself as an important community pathogen. Although the prevalence of the epidemic and virulent ribotype 027 strain has declined markedly along with overall CDI rates in parts of Europe, it remains one of the most commonly identified strains in the United States where it causes a sizable minority of CDIs, especially healthcare-associated CDIs. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, infection prevention, and environmental management.
Despite apparent method similarities between laboratories there appear to be confounding factors inhibiting uniform reporting and standardisation of vitamin assays. The Australasian Association of ...Clinical Biochemists (AACB) Vitamins Working Party, in conjunction with The Royal College of Pathologists of Australasia Quality Assurance Programs, has formulated a guideline to improve performance, reproducibility and accuracy of fat-soluble vitamin results. The aim of the guideline is to identify critical pre-analytical, analytical and post-analytical components of the analysis of vitamins A, E and carotenoids in blood to promote best practice and harmonisation. This best practice guideline has been developed with reference to the Centers for Disease Control and Prevention (CDC) "Laboratory Medicine Best Practices: Developing an Evidence-Based Review and Evaluation Process". The CDC document cites an evaluation framework for generating best practice recommendations that are specific to laboratory medicine. These 50 recommendations proposed herein, were generated from a comprehensive literature search and the extensive combined experience of the AACB Vitamins Working Party members. They were formulated based on comparison between an impact assessment rating and strength of evidence and were classified as either: (1) strongly recommend, (2) recommend, (3) no recommendation for or against, or (4) recommend against. These best practice recommendations represent the consensus views, in association with peer reviewed evidence of the AACB Vitamins Working Party, towards best practice for the collection, analysis and interpretation of vitamins A, E and carotenoids in blood.
Summary • Asthmatics do not appear to have increased susceptibility to COVID-19. • Uncontrolled severe asthma may be associated with worsened COVID-19 outcomes, especially in asthmatics managed with ...oral corticosteroids. • Risk mitigation measures such as hand hygiene, social distancing and wearing of face masks must be observed at all times. • Asthma should be managed as outlined in local and international guidelines. • Ensure an adequate supply of medication, and inhaled corticosteroids should not be withdrawn. • Chronic obstructive pulmonary disease (COPD) is associated with severe COVID-19 disease and poor outcomes. • Maintenance of background medication is important to avoid exacerbations of COPD. • Vaccination against inuflenza is strongly advised for all patients with asthma and COPD. • Vaccination against pneumococcal infection is advisable for patients with COPD. • Patients with obstructive airway disease on oral corticosteroids and/or with impaired lung function should take stringent safety precautions hTis statement will be updated when more data become available. Asthma and COPD occur commonly in South Africa. SARS-CoV-2 is a novel coronavirus, which can result in COVID-19-associated severe respiratory infection with respiratory failure and the need for mechanical ventilation. The South African oThracic Society has prepared a guidance statement to assist clinicians and patients with asthma and COPD during the current epidemic.
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