National Guideline Clearinghouse Research Articles

Summary of Best Evidence for Perioperative Management Practices in Hair Transplantation Patients : Facial Skeleton.

To integrate and summarize the best evidence on perioperative management practices for hair transplantation patients, providing an evidence-based reference for clinical. An exhaustive literature search was conducted to identify the best evidence for managing patients undergoing hair transplantation during the perioperative period. The databases searched included Up To Date, BMJ Best Practice, UK National Institute for Health and Care Excellence, National Guideline Clearing House, Scottish Intercollegiate Guidelines Network, Guidelines International Network, Cochrane Library, JBI Database of Systematic Reviews and Implementation Reports, PubMed, Web of Science, European Dermatology Forum, China National Knowledge Infrastructure, Wanfang Data, Medlive Guideline Network, and Sinomed. The search spanned publications from February 2013 to February 2024, focusing on clinical decisions, evidence summaries, guidelines, and expert consensus. We finally identified 22 articles with high-quality results (consisting of 9 clinical decisions, 6 guidelines, 7 expert consensuses), providing 41 pieces of evidence across seven categories: assessment of transplantation conditions, transplant planning and preoperative preparation, anesthetic preparations, surgical methods and operation skills, postoperative wound management, medication-related guidance, optimization of nursing and treatment strategies. Special emphasis has been placed on the sections covering anesthesia preparation, surgical methods, and operational techniques, with detailed explanations provided. The summarized best evidence on perioperative management practices for hair transplantation patients can serve as evidence-based guidelines for clinical. It is recommended that clinical staff adopt evidence-based recommendations to improve and optimize patient outcomes and promote postoperative recovery. As these evidences came from different countries, factors such as the clinical environment should be evaluated before application. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Clinical practice guidelines and expert consensus statements on rehabilitation for patients with COVID-19: a systematic review

ObjectivesTo appraise the quality of clinical practice guidelines (CPGs) and expert consensus statements on rehabilitation for patients with COVID-19, summarise recommendations of rehabilitation assessments and interventions and evaluate the heterogeneity...

Best evidence summary for aspiration prevention and management in critically ill patients with nasogastric feeding.

To evaluate and summarize the available evidence on the prevention and management of nasogastric aspiration in critically ill patients to inform the development of evidence-based clinical practice. This study was an evidence summary according to the evidence summary reporting standard of the Fudan University Center for Evidence-Based Nursing. According to the '6S' model of evidence resources, evidence on the prevention and management of aspiration in critically ill patients on nasogastric feeding was retrieved, including clinical decision-making, best practices, guidelines, evidence summaries, expert consensus and systematic evaluations. UpToDate, BMJ Best Practice, JBI, National Guideline Clearing-house, Guidelines International Network, Scottish Intercollegiate Guidelines Network, National Institute for Health and Care Excellence, Registered Nurses Association of Ontario, Yi Mai tong Guidelines Network, the Cochrane Library, PubMed, Web of Science, Embase, OVID, Sinomed, CNKI, Wan Fang database. The search period was from January 2013 to June 2023. We included a total of 30 high-quality articles and summarized 36 pieces of evidence from them. These pieces of evidence covered 11 dimensions of multidisciplinary management, aspiration risk assessment, tube location, nutritional infusion management, position management, airway management, and oral hygiene. The level of evidence in the study was predominantly level 1 and level 5, with 27 pieces of evidence recommended as 'strong' and 9 pieces of evidence recommended as 'weak'. This study summarizes 36 pieces of evidence on preventing and managing aspiration in critically ill patients with nasogastric feeding. But the characteristics of hospitals should be considered in the application of future evidence. Aspiration is the most serious complication during nasogastric feeding, which seriously affects the prognosis of patients. Preventing and managing aspiration in nasogastric patients has proven to be a challenging clinical problem. This study summarized 36 pieces of best evidence in 11 dimensions, including multidisciplinary team, assessment and identification, line position, feeding management, and so on. The implementation of these evidences is conducive to standardizing the operation behaviour of nasogastric feeding in clinical medical staff and reducing the occurrence of aspiration. This research followed the evidence summary reporting specifications of the Fudan University Center for Evidence-based Nursing. The registration number is 'ES20221368'.

Guideline for the diagnosis and treatment of incomplete Kawasaki disease in children in China

BackgroundKawasaki disease (KD) is a pyretic ailment predominantly observed in children aged below 5 years. There is currently a dearth of precise markers for timely identification of incomplete Kawasaki disease (IKD). It is imperative to develop updated, comprehensive, and evidence-based guidelines to effectively direct clinical practice.MethodsThe guideline development group comprised individuals with diverse expertise in both content and methodology and carried out an extensive exploration of the following digital repositories: CNKI, VIP, Wanfang Data, UpToDate, BMJ, Clinical Evidence, National Guideline Clearinghouse, Joanna Briggs Institute Library, Cochrane Library, and PubMed. The entire period from the establishment of these databases until January 1, 2024 was covered. To evaluate IKD, systematic reviews and randomised controlled trials were assessed using the risk of prejudice instrument specified in the Cochrane Handbook, along with the evidence robustness framework established by the GRADE group. The recommendations were formulated based on the findings, considering the evidence strength. After several iterations of expert consensus, the relevant professional committees in China endorsed the ultimate guideline.ResultsThese guidelines address clinical questions regarding the classification and definition of KD, diagnosis of IKD, treatment during the acute phase of IKD, and follow-up of IKD.ConclusionsTo provide healthcare professionals with guidance and decision-making bases for the diagnosis and treatment of IKD in China, 13 recommendations were formulated based on expert consensus and evidence of best practices.

Summary of the best evidence for early exercise rehabilitation in patients with mechanically ventilated ICU-acquired weakness

To integrate the best evidence for early rehabilitation of mechanically ventilated ICU-acquired weakness (ICU-AW) patients using evidence-based methods, providing evidence-based basis for standardized evaluation and intervention of early exercise therapy for mechanically ventilated ICU-AW patients. A systematic search was conducted on the American Thoracic Society (ATS) Clinical Practice Guidelines, Registered Nurses' Association of Ontario (RNAO), Guidelines International Network (GIN), Canadian Medical Association Clinical Practice Guideline Library (CMACPGL), BMJ Clinical Evidence, UpToDate, Scottish Intercollegiate Guidelines Network (SIGN), PubMed, Cochrane Library, National Guideline Clearinghouse (NGC), Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), UM-library, Physiotherapy Evidence Database (PEDro), National Institute for Health and Care Excellence (NICE), New Zealand Guidelines Group (NZGG), Chinese Medical Pulse Guidelines Website, CNKI and Wanfang data and other Chinese and English databases, professional team websites, and guideline websites for expert consensus, guidelines, randomized collected trial (RCT), systematic reviews and other evidence on early exercise rehabilitation for mechanically ventilated ICU-AW patients. The search time limit was from the establishment of the database to December 31, 2023. Literature search, screening, evaluation, information extraction was independently conducted by two evaluators with cross checking, and quality evaluation of the included literature was conducted. A total of 21 literatures were enrolled, including 5 guidelines, 5 systematic reviews, 4 expert consensuses, and 7 RCT, all of which with high evidence level and all were enrolled. They were summarized into seven aspects with assessment screening, exercise safety standards, precautions, setting of exercise time, exercise intensity, exercise sequence, and recommended exercise content as the core, and 32 best evidences. The evidence summarized can provide evidence-based basis for standardized assessment and intervention of early exercise rehabilitation in mechanically ventilated ICU-AW patients. ICU medical practitioners need to combine the actual clinical environment, individual differences and rehabilitation goals of patients, to provide targeted health guidance and intervention for the prevention of ICU-AW in mechanically ventilated patients.

Best evidence summary of sleep protection in premature infants in the neonatal intensive care unit: a narrative review.

Sleep influences the interaction between infants and their environment, as well as the achievement of crucial milestones in motor and language development. This is particularly significant for preterm infants in vulnerable positions. However, prematurely born infants in the neonatal intensive care unit (NICU) are exposed to various stimuli such as noise and light, which disrupt their normal sleep patterns. This study assesses and consolidates the existing evidence on non-pharmacological strategies for protecting and promoting sleep in preterm infants. By providing an evidence-based data repository, it offers a valuable reference for clinical interventions. We conducted computer-based searches using various databases and resources, including UpToDate, BMJ Best Practice, Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Registered Nurses Association of Ontario (RNAO), Joanna Briggs Institute (JBI), World Health Organization (WHO), Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang Data, and China Biology Medicine disc (CBM). The search period spanned from January 2014 to May 2024. We have included a total of 22 articles in our review, comprising two guidelines, 11 systematic reviews, 1 evidence summary, 1 technical report, 2 practice recommendations, and 5 randomized controlled trials. The evidence was synthesized from eight domains: sleep team construction, risk factor assessment, sleep assessment tools, positional management, noise control, light management, sensory stimulation, and hospital-home transition sleep management, resulting in 27 pieces of evidence. This study summarizes the optimal evidence for the management of sleep in premature infants, providing empirical support for standardizing the management of sleep in premature infants. It is recommended that healthcare professionals judiciously apply the best evidence while considering the clinical context, thus promoting safe sleep for premature infants.

The quality of guidelines on the pancreatic perioperative enhanced recovery after surgery: a systematic quality appraisal using AGREE II instrument.

To evaluate the quality of guidelines on the pancreatic perioperative enhanced recovery after surgery both domestically and internationally, providing reference and reference for clinical practice. Systemically retrieved in the guideline websites, professional association websites and databases, such as up to date, BMJ Best Practice, PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang Data, China Science and Technology Journal Database(VIP), China Biology Medicine disc (CBMdisc), Medlive, Guidelines International Network(GIN), National Guideline Clearinghouse(NGC), National Institute for Health and Care Excellence(NICE), Registered Nurses Association of Ontario(RNAO), Scottish Intercollegiate Guidelines Network(SIGN), Joanna Briggs Institute Library(JBI), including guidelines and expert consensus on enhanced postsurgical recovery in pancreatic surgery published as of December 20, 2023. The Appraisal of Guidelines for Research and Evaluation II(AGREE II) tool was applied to evaluate the quality of the guidelines by four assessors. This study included seven guidelines, all of which were rated as Grade B in terms of quality, with ICC coefficients ranging from 0.752 to 0.884, indicating a high level of consistency. When formulating guidelines in the future, it is recommended to use AGREE II as a reference, emphasizing the standardization of the guideline development process and methods, fully considering patients' values and preferences, focusing on the applicability of the guidelines, and striving to create high-quality evidence-based recommendations.

Consensus Committee of experts on Kawasaki Disease and Chinese Journal of Contemporary Pediatrics – the expert consensuses on intravenous immunoglobulin, aspirin, and glucocorticoid

Introduction and aim. Kawasaki disease (KD) is an acute vasculitis with unknown etiology, usually occurring in chil dren under 5 years old. This article will summarize the three consensuses formulated in China about KD. Material and methods. English databases for consensus search include UpToDate, BMJ Clinical Evidence, National Guideline Clearinghouse, Joanna Briggs Institute Library, Cochrane Library, and PubMed, etc.; Chinese databases in clude China Biomedical Literature Service, China Knowledge Network, Wanfang database, etc. All literature searches ended on February 28, 2022. Analysis of the literature. KD is a common acquired heart disease in children and can lead to severe complications such as coronary injury. However, intravenous immunoglobulin (IVIG) combined with oral aspirin (Asp) is currently recognized as the most effective treatment in KD acute stage and the first-line treatment to prevent cardiovascular complications. Glucocorticoid (GC) is mainly used for KD patients with a high risk of coronary artery aneurysm (CAA), no immunoglobulin response, and confirmed CAA. There are already consensus guidelines on diagnosing and treat ing KD in different countries. This article summarizes the relevant expert consensus on aspirin, glucocorticoids and IVIG for the treatment of Kawasaki disease in China. Conclusion. Still, there are inconsistent opinions in the literature on the mechanism, optimal timing, and dosage of medication for KD.

Current Approaches for the Diagnosis and Conservative Treatment of Stress Urinary Incontinence - A Guideline of Guidelines

Urologists utilize evidence-based guidelines organized by urological organizations in the management of stress urinary incontinence (SUI). The objective of this study is to provide guidance in the clinical management of stress urinary incontinence (SUI) by reviewing key guidelines. We conducted a medical literature analysis in the following databases: PubMed, Medline, Embase, National Guideline Clearinghouse, the National Institute for Health and Care Excellence, and Cochrane Library. We also manually searched the websites of the following international and national societies to identify relevant guidelines for inclusion in this review: the International Consultation on Incontinence, American College of Obstetrics and Gynecology, American Urogynecologic Society, American Urological Association/Society of Urodynamic, Female Pelvic Medicine and Urogenital Reconstruction, National Institute for Health and Care Excellence, European Association of Urology, and Canadian Urological Association. The recommendations in the guidelines are summarized in different areas, including the diagnostic standards of SUI, examination and evaluation methods, and conservative treatment methods. This ‘guideline of guidelines’ presents the similarities and differences between prominent authorities in the management of SUI.

Global Guidelines in Dermatology Mapping Project (GUIDEMAP)-A systematic review of the methodological quality of contact dermatitis clinical practice guidelines.

The Global Guidelines in Dermatology Mapping Project (GUIDEMAP) assesses the methodological quality of clinical practice guidelines (CPGs) for high-burden skin diseases. This review focuses on contact dermatitis. We searched MEDLINE, Embase, PubMed, Web of Science, Cochrane Library, Emcare, Epistemonikos, PsycINFO and Academic Search Premier for CPGs published between 1 November 2018 and 1 November 2023. Prespecified guideline resources were hand searched. Two authors independently undertook screening, data extraction and quality assessments. Instruments used were the Appraisal of Guidelines for Research and Evaluation (AGREE) II Reporting Checklist, the U.S. Institute of Medicine's (IOM) criteria of trustworthiness, The Agency for Healthcare Research and Quality's National Guideline Clearinghouse Extent Adherence to Trustworthy Standards (NEATS) Instrument and Lenzer's Red Flags. Twenty five CPGs were included, exhibiting heterogeneity in both the topics they addressed and their methodological quality. Whereas the CPGs on management of hand eczema from Denmark, Europe and the Netherlands scored best, most CPGs fell short of being clear, unbiased, trustworthy and evidence-based. Disclosure of conflicts of interest scored well, and areas needing improvement include 'strength and wording of recommendations', 'applicability', 'updating' and 'external review'. Adhering to AGREE II and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) enhances methodological quality.

Summary of best evidence for self-management in postoperative osteoporotic fracture patients

Osteoporotic fracture as a serious complication of osteoporosis which is usually treated surgically, and its recovery is closely related to one's own behavior and lifestyle, and is a long-term, complex management process that often requires the individual to self-manage many health-related factors. ObjectiveTo gather and synthesize the most robust evidence regarding self-management in patients with postoperative osteoporotic fractures, in order to provide scientific, evidence-based guidance for clinical healthcare professionals to assist postoperative patients in self-management efforts, and to assist patients in optimizing their self-management practices and behavioral norms. MethodsBased on the “6 S” pyramid model of evidence resources (System, Summaries, Synopses of synthesis, Syntheses, Synopses of studies, Studies), we searched the Up To Date, BMJ Best Practice, The Cochrane Library, Australian Joanna Briggs Institute JBI Evidence-Based Medicine Center Healthcare Database, National Institute for Health and Clinical Excellence (NICE), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC) and Scottish Intercollegiate Guide lines Network (SIGN), MedPulse, Embase, PubMed, CINAHL, Web of Science, SinoMed, Chinese Medical Journal Full Text Database, CNKI, Wanfang Data Knowledge Service Platform, and VIP database, etc, The search period for clinical decision-making, systematic evaluation, clinical guidelines, evidence summaries and expert consensus on self-management of postoperative osteoporotic fracture patients, and it was from the establishment of the database to 18 February 2023. To ensure the quality of the literature, three researchers strictly screened the literature according to the literature inclusion and exclusion criteria, and two or more researchers independently evaluated the quality of the included literature, and extracted and integrated the relevant evidence. ResultsThirteen documents were finally included, including 4 clinical practice guidelines, 5 expert consensus, 2 recommended practices, 1 systematic evaluation, and 1 clinical decision report. The research team summarized the evidence in 6 dimensions: multidisciplinary teamwork, management of daily living, management of treatment adherence, management of exercise, management of fall prevention and subsequent fracture, and management of emotions, and 33 pieces of evidence were extracted. ConclusionThe study summarized 33 best evidence of self-management in postoperative osteoporotic fracture patients, which provides a scientific and reasonable self-management program for postoperative patients, and also provides important reference and information for clinical healthcare professionals to provide more comprehensive and scientific self-management health education to patients.

Do the Directorate of Health’s guidelines adhere to international standards for trustworthy clinical practice?

The Norwegian Directorate of Health produces national clinical guidelines for the health service, and the development of guidelines must follow international standards for trustworthy clinical practice. We investigated whether the standards are being adhered to. We used the National Guideline Clearinghouse Extent Adherence to Trustworthy Standards Instrument (NEATS) as the scoring tool and assessed a randomly selected chapter from national clinical guidelines that were published or updated during the period 2013 to January 2022. NEATS has 15 domain items; three are assessed with the response alternatives Yes/No/Not known, and twelve are assessed on a Likert scale from 1 to 5, where 1 corresponds to very low trustworthiness and 5 to very high trustworthiness. The assessments were made individually by two authors. Inter-rater reliability was assessed with exact or close reliability, and Cohen's kappa coefficient. We included 60 relevant guidelines. For nine of the twelve NEATS domain items assessed using the Likert scale, there was very low or low adherence to standards for trustworthy clinical guidelines (median score 1 or 2). The domain items with the lowest score (median score 1) were 'The study selection', 'Description of the studies and the results', 'Rating the strength of recommendations' and 'External review'. The domain item with the highest score was 'Specific and unambiguous articulation of recommendations' (median score 4). The majority of the national clinical guidelines had low adherence to the standards for trustworthy clinical guidelines assessed using the NEATS scoring tool.

Supplementation With Bifidobacterium and Symptomatic Control in Irritable Bowel Syndrome: An Evidence-Based Review.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder, with a global prevalence of around 11%. Family doctors should be aware of the diagnosis and treatment of this pathology. The benefit of using probiotics is questionable. The purpose of this review is to establish the evidence of the association between Bifidobacterium supplementation and symptomatic control in patients with IBS. The research was conducted using the National Guideline Clearinghouse, National Electronic Library for Health of the British NHS, Canadian Medical Association Practice Guidelines InfoBase, Cochrane Library, Database of Abstracts of Reviews of Effectiveness, Bandolier, Evidence-Based Medicine Online, and PubMed. Articles published between March 2017 and March 2022in humans and written in Portuguese, Spanish, and Englishusing the terms IBS and Bifidobacterium were included. To stratify the level of evidence (LOE), the Strength of Recommendation Taxonomy (SORT), from the American Academy of Family Physicians, was used. Thirty-seven articles were found corresponding to the search terms, and a total of seven articles were selected. Three clinical trials and a simple review have demonstrated improvement in symptoms, although further studies are needed. The guideline and the systematic review did not demonstrate superiority in symptomatic relief when compared to other species of probiotics. The meta-analysis did not show the efficacy of the isolated use of Bifidobacterium.The evidence of an association between supplementation with Bifidobacterium and symptomatic control in patients with IBS is not clear. Some studies seem to demonstrate benefits in improving symptoms (SORT C).

DENTAL IMPLANT TREATMENT IN DIABETES MELLITUS (DM) PATIENTS: REVIEW

With the development of progressive views on dental restoration and replacement, the clinical approach to seemingly hopeless clinical situations has changed radically, and those patients who would previously be considered extremely difficult are effectively provided with dental care. Diabetes mellitus (DM) is a global problem worldwide. The negative impact of the disease on bone metabolism raises some concerns about the long-term survival of dental implants in diabetic patients. Diabetes mellitus is one of the most significant somatic diseases that determine the protocol for managing dental patients and the long-term functioning of dental implantation. Protocols for the management of patients with diabetes mellitus have been developed. This article reviews the data of dental implantation in patients with diabetes mellitus. The following databases were included in a systematic search of the relevant literature: PubMed, Embase, AWMF Online, National Guidelines Clearinghouse, International Guidelines Network, and The Cochrane Library. The following search terms were used: dental implants and diabetes, diabetes and implant survival, whether diabetes is a risk factor for dental implants, peri-implantitis and diabetes. A total of 58 articles that met the inclusion criteria for this systematic review were included. The results of a systematic review showed that diabetes mellitus has an impact on implant survival rates compared with patients without diabetes.

Summary of the best evidence for the use of mechanical insufflation-exsufflation technique in invasive mechanical ventilation patients

To search and evaluate the literatures on the application of mechanical insufflation-exsufflation technique (MI-E) in patients with invasive mechanical ventilation in China and abroad, and to summarize the best evidence to provide evidence-based basis for clinical practice. The literatures related to the use of MI-E technique in invasive mechanical ventilation patients were searched from the establishment of the database to April 1, 2022 in BMJ Best Practice, UpToDate Clinical Advisor, Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), National Guideline Clearinghouse (NGC), Registered Nurses' Association of Ontario (RNAO), medlive, Cochrane Library, Joana Briggs Instiute, Web of Science, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database, and Website of American Association for Respiratory Care, including guideline, expert consensus, clinical decision, evidence summary, systematic review and randomized controlled trial. The JBI Center for Evidence-Based Health Care Expert Consensus Evaluation Criteria (2016) was used to evaluate the quality of the included systematic reviews; the JBI Center for Evidence-Based Health Care Evaluation Criteria for Randomized Controlled Trials was used to evaluate the quality of the included randomized controlled trial. Two researchers independently evaluated the quality of literature, and extracted and summarized the evidence based on professional judgment. A total of 7 literatures were enrolled, including 3 systematic reviews and 4 randomized controlled trials. After quality evaluation, 7 articles were all enrolled. Thirteen best evidences were formed from four aspects of indications, contraindications, parameter settings, and attention. The study summarizes the best evidence for the application of MI-E technique in invasive mechanical ventilation patients. It is recommended that medical staff undergo professional training, combined with their professional judgment as well as the patient's clinical specific conditions and willingness, and accurately apply MI-E technology to invasive mechanical ventilation patients.

Alergia ao Látex em Contexto Ocupacional

Introduction/framework/objectives Latex allergy is recognized as a widespread health problem that assumed serious proportions in the 1990s. Although preventive measures have markedly decreased its incidence, recent studies have shown that it remains an important health problem in certain population groups, particularly in developing countries. This work aims to provide a comprehensive review of the current status of occupational latex allergies. We summarize various aspects of this condition, such as prevalence, risk groups, latex allergens, the diagnostic approach, prevention, and treatment. Methodology A bibliographic review was carried out in January 2023 in the following databases: PubMed/Medline, Cochrane Library, Evidence-based Medicine, Canadian Medical Association, Practice Guidelines and National Guideline Clearinghouse. Content Repeated exposure to latex in an occupational context can lead to worker sensitivity, with a significant clinical and socio-economic impact. We summarize various aspects of this condition, such as prevalence, risk groups, latex allergens, the diagnostic approach, prevention and treatment. Discussion and Conclusions The history of latex allergies has demonstrated that potent allergens such as Natural Rubber Latex proteins can cause rapid immunoglobulin-E-mediated sensitization and clinical allergies, reaching serious proportions in highly exposed individuals. Occupational exposure has a decisive influence on the allergen sensitivity profile, with important clinical and therapeutic consequences. The effectiveness of secondary prevention measures is limited. Thus, it is essential to implement early primary prevention measures in individuals belonging to risk groups, to avoid or minimize exposure to latex allergens. KEYWORDS: Healthcare Professionals, Latex allergy, Latex gloves, Latex hypersensitivity, Natural rubber latex, Occupational diseases, Occupational health, Occupational Medicine.

Review of the Screening Guidelines for Gestational Diabetes Mellitus: How to Choose Wisely.

Currently, there is no international unanimity regarding the timings, the optimal cut-off points, and standardized methods of screening or diagnosis of gestational diabetes mellitus (GDM). The screening guidelines and recommendations for GDM evolved over time; concise information has been presented here in the review. We searched electronic databases for various guidelines for screening of GDM in PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, Cochrane, Google Scholar, Scopus, Guidelines International Network (GIN library), National Guidelines Clearinghouse (NGC); Web sites of relevant organizations; and trial registries. The mesh headings derived after reviewing the articles and were used to further search the articles are: ("Screening Guidelines GDM" or "Screening Criteria for GDM") and ("Glucose Intolerance in Pregnancy" or "Gestational Diabetes Mellitus"). The articles published from 1960 till December 2022 were included. Key outcomes included the prevalence of GDM is 14.6% according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and 13.4% according to Diabetes in Pregnancy Study Group India (DIPSI) criteria, making the DIPSI criterion a cost-effective method for low-resource settings. The IADPSG) criterion diagnoses and treats GDM earlier, thus reducing the complications associated with GDM in the mother and newborn. The IADPSG criteria at a cut-off of ≥140 mg/dL have a sensitivity of 81% and specificity of 93%, whereas the World Health Organization (2013) criteria at the same cut-off has a lower sensitivity of 59% and specificity of 81%. The risk factors of having GDM are family history, history during past pregnancy, medical history, multiple current pregnancies, and raised hemoglobin A1c. The screening guidelines have been developed by different organizations and institutions over the years. The guidelines with the threshold values for screening and their standardization for detecting GDM in Indian mothers are yet to be established.

Barriers and enablers to implementing clinical practice guidelines in primary care: an overview of systematic reviews

ObjectivesTo identify the barriers and enablers to implementing clinical practice guidelines (CPGs) recommendations in primary care and to provide recommendations that could facilitate the uptake of CPGs recommendations.DesignAn overview of...

The efficacy of tolvaptan for heart failure in chronic kidney disease: A protocol for systematic review and meta-analysis

Approximately half of people with heart failure have chronic kidney disease (CKD). Tolvaptan is reported to be effective in treating heart failure. However, the safety and efficacy of its use in patients with CKD is uncertain. In this study, we conducted a protocol for systematic review and meta-analysis to investigate the efficacy and safety of tolvaptan on patients with heart failure and CKD. This study protocol has been registered in the PROSPERO and the registration number is CRD42022368148. The consent of this protocol report is based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement guidelines. We will include randomized controlled trials related to tolvaptan in patients with heart failure and CKD. Two research members will electronically and independently search 4 English databases (EMBASE, PubMed, National Guideline Clearinghouse, and Cochrane Central Register of Controlled Trials) and 4 Chinese databases (Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Wanfang Database, and VIP Database) from their inception to November 2022. The risk of bias in each included study will be assessed utilizing the Cochrane Collaboration's risk of bias tool. All statistical analyses will be conducted using the software program Review Manager version 5.3. The results of this systematic review will be published in a peer-reviewed journal. This review can provide convincing evidence to help clinicians make decisions when dealing with heart failure and CKD.

The efficacy and safety of Rhodiola formulation for the treatment of ischemic heart disease: A protocol for systematic review and meta-analysis.

Ischemic heart disease is the main cause of heart failure, which seriously endangers the health of people and puts a huge burden on health care resources all over the world. We propose the current protocol to evaluate the effectiveness and safety of Rhodiola on ischemic heart disease, providing a reference for clinical use. Two research members will electronically and independently search 4 English databases (EMBASE, PubMed, National Guideline Clearinghouse, and Cochrane Central Register of Controlled Trials) and 4 Chinese databases (Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Wanfang Database, and VIP Database) from their inception to October 2020. Quality assessment of the included randomized controlled trial was assessed using the Cochrane Collaboration's tool. All calculations were carried out with Stata 11.0 (The Cochrane Collaboration, Oxford, United Kingdom). A synthesis of current evidence of Rhodiola formulation for ischemic heart disease will be provided in this protocol. This study will provide a theoretical basis for the clinical use of Rhodiola formulation for treating ischemic heart disease.