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At least 235 records · Page 13Linked to original sources
PubMed2001

[Erysipelas. Clinicopathological classification and terminology].

Erysipelas and necrotizing fasciitis are the words used to qualify 2 well-defined aspects of acute microbial dermohypodermal infection. According to the literature a third word, "cellulitis" is used to describe a large variety of inflammatory conditions of soft tissues, either infectious or not. The authors who advocate using this word consider either that an infectious cellulitis is a clinical variant differing from erysipelas or fasciitis, or that it describes the whole spectrum of acute microbial infections of soft tissues, including these 2 entities. This term, whatever its meaning, has no anatomical or histopathological validation. It should be definitively deleted and replaced by "dermohypodermal infection".

Erysipelas↗
PubMed2003

The diagnosis and treatment of peripheral lymphedema. Consensus document of the International Society of Lymphology.

This International Society of Lymphology (ISL) Consensus Document is the current revision of the 1995 Document for the evaluation and management of peripheral lymphedema. It is based upon modifications suggested and published following the 1997 XVI International Congress of Lymphology (ICL) in Madrid, Spain, discussed at the 1999 XVII ICL in Chennai, India, considered at the 2000 (ISL) Executive Committee meeting in Hinterzarten, Germany, and derived from integration of discussions and written comments obtained during and following the 2001 XVIII ICL in Genoa, Italy as modified at the 2003 ISL Executive Committee meeting in Cordoba, Argentina. The document attempts to amalgamate the broad spectrum of protocols advocated worldwide for the diagnosis and treatment of peripheral lymphedema into a coordinated proclamation representing a "Consensus" of the international community. The document is not meant to override individual clinical considerations for problematic patients nor to stifle progress. It is also not meant to be a legal formulation from which variations define medical malpractice. The Society understands that in some clinics the method of treatment derives from national standards while in others access to medical equipment and supplies is limited and therefore the suggested treatments are impractical. We continue to struggle to keep the document concise while balancing the need for depth and details. With these considerations in mind, we believe that this version of the Consensus represents the best judgment of the ISL membership on how to approach patients with peripheral lymphedema as of 2003. We anticipate that the document will and should be challenged, debated in the pages of Lymphology (e.g., as Letters to the Editor), and ideally become a continued focal point for robust discussion at local, national and international conferences in lymphology and related disciplines. We further anticipate as experience evolves and new ideas and technologies emerge that this "living document" will undergo periodic revision and refinement.

Biopsy↗
PubMedDate not supplied

[Medico-surgical consensus for management of children with gastroesophageal reflux Acapulco, Mexico 2002].

UNLABELLED: Gastroesophageal reflux (GER) is a common disease in children less one year old. It is present around 10% of unselected infant population. 40-50% have abnormal 24 h pH monitoring. An early diagnosis and treatment should be done in order to avoid complications. AIM: To establish the consensus for the diagnosis and treatment of children with GER, to rule out similar diseases avoid the use of unnecessary drugs and the secondary side effects as well as unnecessary surgery. METHOD: The consensus was done with the participation of general pediatricians, pediatrics gastroenterologist, pediatric surgeons, radiologist and endoscopist. An initial paper was done by pediatric surgeon and pediatric gastroenterologist who submitted to the rest of participants. Second stage: the paper was review through E-mail for all participants who send their suggestions and modifications. A new paper was done and discussed by medical and surgery area. During the Congress of Pediatric Surgery, in an open session was discuss again with the participation of the main authors and all the audience present. Finally, a paper was done and review for the main authors.

Child↗
PubMed2004

Treatment of behavior disorders in mental retardation: report on transitioning to atypical antipsychotics, with an emphasis on risperidone.

BACKGROUND: Mental illnesses are more common in people with mental retardation and developmental disabilities than in the general population. Due to the difficulty of making specific psychiatric diagnoses in these patients, the target of medication is often a behavioral symptom. For many symptoms, antipsychotic medications are effective, but the serious side effect profile of conventional antipsychotics renders their use problematic. Recent findings concerning the safety and efficacy of atypical antipsychotics for control of certain disruptive behaviors in adults and children led a Special Topic Advisory Panel to draw up guidelines for transitioning patients with specific symptoms from classical antipsychotics to risperidone and, by extrapolation, to other atypical agents. PARTICIPANTS: Participants were chosen by Janssen Pharmaceutica, based on individual achievements and lifetime experience. The Special Topic Advisory Panel on Transitioning to Risperidone Therapy in Patients With Mental Retardation and Developmental Disabilities comprised academic clinicians with at least 10 years' experience in the field of mental retardation and developmental disabilities. It included a clinical pharmacist, consultant pharmacists, a certified developmental disabilities nurse, psychiatrists, a family physician, and a psychologist. EVIDENCE: The Panel considered recent studies of the efficacy and tolerability of risperidone and other atypical antipsychotics in adults and children with mental retardation and developmental disabilities. MEDLINE searches were conducted using the name of each atypical antipsychotic and the following terms: mental retardation, developmental disabilities, and behavior disorders. Searches were conducted starting in July 2002 and done periodically through April 2004 to capture new additions to the literature. Searches were confined to English. GUIDELINES PROCESS: The Panel reviewed the available evidence, identified optimal doses and titration schedules, considered instruments and rating scales for assessing symptoms, and developed guidelines. CONCLUSIONS: The guidelines set forth initial and target doses and titration schedules of risperidone therapy for some behavioral symptoms and provide recommendations concerning withdrawal of previous medications and for procedures and rating scales for assessing symptoms. In patients with severe retardation, the goal is often to identify specific target behaviors rather than to pursue an exact diagnosis, which may be unattainable.

Adult↗
PubMed2005

Etiology and initial investigation.

The initial evaluation of a patient with atrial fibrillation should include a comprehensive review of historical factors, a physical examination and initial investigations. This evaluation has many important purposes, including the development of a therapeutic strategy for symptom relief, the assessment and management of thromboembolic risks, and the identification of underlying etiology. This evaluation should also review management of risk factors for overall cardiovascular morbidity and the treatment of atrial fibrillation. Baseline history, appropriate laboratory tests, and 12-lead electrocardiogram and echocardiography results should be obtained in all patients to identify the potential etiology and other comorbidities, and to stratify for risk of stroke.

Atrial Fibrillation↗
PubMed2005

Rate control versus rhythm control--decision making.

The present review examines the data and presents recommendations concerning the selection of rate-control or rhythm-control strategies, as opposed to the selection of specific therapies for rate control or rhythm control. There are several trials completed and others in progress that address issues surrounding the comparison of the two strategies, primarily using pharmacological therapies. The main results and some subanalyses of these trials are briefly reviewed. Gaps in the available data are identified. On the basis of the data, there is no clear advantage of one strategy over the other, although each seems to have potential advantages in different subsets of patients. Accordingly, the main recommendations are that either approach is acceptable, and that selection of a rhythm-management strategy should be individualized. This recommendation is based on a primarily pharmacological approach because that is currently the most common form of therapy used for rhythm management and because the evidence base is composed of comparisons of drug therapies. A number of clinical factors are identified to help individualize therapy and, included in these, is patient preference. It is also recommended that treating physicians be prepared to cross over from one strategy to another or change to nonpharmacological therapies when treatment goals are not achieved or adverse effects prevail.

Atrial Fibrillation↗
PubMed2005

Drug therapy for termination of atrial fibrillation and maintenance of sinus rhythm.

Antiarrhythmic drug therapy to maintain sinus rhythm has not been demonstrated in randomized clinical trials to improve prognosis or prevent thromboembolic complications in patients with atrial fibrillation (AF). Therefore, drug therapy to restore and maintain sinus rhythm should be limited to those patients who have a greater symptomatic burden of AF. Patients with AF may be completely unaware of their arrhythmia or may present with palpitations, poor exercise tolerance or symptoms of congestive heart failure. In general, younger patients with paroxysmal arrhythmia and patients with decreased left ventricular compliance tend to be more symptomatic. The present article outlines the mechanisms of action of antiarrhythmic drugs in AF. Drugs that are recommended and frequently used to convert AF and maintain sinus rhythm are reviewed, and the toxicity of antiarrhythmic drug toxicity is discussed.

Anti-Arrhythmia Agents↗
PubMed2005

Pharmacological and nonpharmacological methods for rate control.

In many patients with atrial fibrillation, the most appropriate strategy is 'rate control', designed to slow down the rapid ventricular rates often seen with atrial fibrillation. Based on the hypothesis that symptoms, especially palpitations and exercise intolerance, are due to rapid ventricular rates with activity, optimum rate control usually requires reducing ventricular rates at rest and during activity. Beta-blockers and nondihydropyridine calcium channel blockers are likely more effective than digoxin alone, and the adequacy of rate control is best assessed with heart rate measurement during activity or with ambulatory electrocardiographic monitoring. Taking a patient's symptoms into account, reasonable target ventricular rates are less than 80 beats/min at rest and less than 100 beats/min, on average, over 24 h.

Atrial Fibrillation↗
PubMed2005

Catheter ablation therapy for atrial fibrillation.

Catheter ablation therapy for the treatment of atrial fibrillation (AF) has evolved considerably in the past decade. Although the therapy was initially limited to ablation of the atrioventricular node to ensure adequate rate control for patients with rapid AF, the possibility of catheter-based rhythm control has now been demonstrated in several studies. Atrial extrasystoles originating from the pulmonary veins are now known to be triggers for the initiation of AF. Consequently, attempts at ablation have focused on the ablation of these triggers or on electrical isolation of these veins using radiofrequency ablation. More recently, three-dimensional electroanatomical imaging techniques have allowed for the development of left atrial ablation techniques, whereby long, linear lesions are created around the pulmonary venous ostia. Both of these techniques have shown interesting success rates in the treatment of symptomatic paroxysmal AF. The present article reviews the evolution of these techniques and lists the recommendations for the use of catheter ablation for both rate and rhythm control of AF.

Atrial Fibrillation↗