Cochrane Russia for the first time in history publishes in PLOS ONE the results of the quality assessment of Russian clinical practice guidelines using the AGREE tool
Recently PLOS ONE published a paper from Cochrane Russia, a Research and Education Centre for Evidence-Based Medicine, housed at the Kazan Federal University, which presents the first experience of scientific assessment of the quality of Russian clinical practice guidelines on the international criteria of the AGREE instrument.The authors from Kazan, Kaliningrad (Russian Federation) and Phoenix (Arizona, USA) for the first time applied the AGREE II instrument to clinical practice guidelines for surgical treatment of diseases of the hepatopancreatobiliary system and showed their generally poor quality, highlighting as the best CPG that for chronic pancreatitis.The AGREE Tool (Appraisal of Guidelines for Research&Evaluation) has become the international gold standard for the evaluation and development of clinical practice guidelines (CPGs). However, it has never been used in Russia to develop the health system and improve health policy, while the appreciation of the value of CPGs is high in the academic and leadership health community, and the need for quality CPGs is screaming today.The AGREE tool is a method of consolidating expert appraisals, it allows assessment of the methodological rigour and transparency of the process of guideline development, ideally should be used in the process of developing CPGs.Clinical practice guidelines represent the essential tool of health policy based on evidence. Their quality and reliability determine the quality of care and allow to ac...
In 2015, the scientist ’s husband was almost killed by an antibiotic-resistant superbug, until she found a cure that is now saving othersInfectious disease epidemiologist Steffanie Strathdee ’s husband survived a deadly antibiotic-resistant bacterial infection thanks to her suggestion of using an unconventional cure popular in the former Soviet Union: fighting the bug with a virus. Now the global health expert at the University of California, San Diego, she has, along with her husband , Tom Patterson, who is also a scientist at the institution, written an account of their nine month ordeal –The Perfect Pr...
CONCLUSIONS: In patients diagnosed with acute gallstone pancreatitis, it is reasonable to proceed directly to surgery using intraoperative cholangiography on the same admission as the definitive assessment of the common bile duct. This negates the need for magnetic resonance cholangiopancreatography and can translate into cost savings and reduced length of stay. PMID: 31155897 [PubMed - as supplied by publisher]
Gallstone disease is a common clinical problem that leads to pancreatitis and cholangitis if left undiagnosed. Guidelines from the American Society for Gastrointestinal Endoscopy (ASGE) categorize patients with suspected choledocholithiasis (CDL) into 3 risk categories (low, intermediate, high) based on prognostic indicators. When compared to endoscopic ultrasound (EUS), these guidelines may result in unnecessary endoscopic retrograde cholangiopancreatographies (ERCPs) and associated complications.
Population aging and comorbidity are leading to an increase in patients unfit for cholecystectomy.
PANCREATIC cancer does not have any major symptoms to look out for at the start. Many of the symptoms described could be caused by other conditions. The symptoms could also be a sing of other illnesses such as pancreatitis, gastritis or gallstones. It is important to distinguish the difference and know when to speak with your doctor.
CONCLUSION: Acute biliary pancreatitis related to pregnancy is not limited to pregnant women, and the incidence of these cases was greater than expected. Acute biliary pancreatitis related to pregnancy can be successfully managed with conservative treatment because it usually has a mild to moderate clinical course. However, the surgeon should keep an early cholecystectomy in mind for patients other than those in the first trimester. PMID: 31135938 [PubMed - in process]
This article reviews the definition, aetiology, pathophysiology, therapeutic strategies and outcomes in light of recent evidence and guidelines.
Conclusions: In South Korea, type 2 AIP is not as rare as previously thought. Overall, the clinical profile of type 2 AIP was similar to that of Western countries. Type 2 AIP should be considered in young UC patients with acute pancreatitis of uncertain etiology. PMID: 30970429 [PubMed - as supplied by publisher]
Conclusions: : The findings of current study emphasize that clinicians should be awareof the possibility of RFS in malnourished AP patients with electrolyte imbalances. PMID: 30970437 [PubMed - as supplied by publisher]
Each year choledocholithiasis results in biliary obstruction, cholangitis, and pancreatitis in a significant number of patients. The primary treatment, ERCP, is minimally invasive but associated with adverse events in 6% to 15%. This American Society for Gastrointestinal Endoscopy (ASGE) Standard of Practice (SOP) Guideline provides evidence-based recommendations for the endoscopic evaluation and treatment of choledocholithiasis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to rigorously review and synthesize the contemporary literature regarding the following topics: EUS...