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Diabetes Mellitus HELP
Based on 99,953 articles published since 2010
|||| 29 

These are the 99953 published articles about Diabetes Mellitus that originated from Worldwide during 2010-2020.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Clinical Recommendations From the European Society for Sexual Medicine Exploring Partner Expectations, Satisfaction in Male and Phalloplasty Cohorts, the Impact of Penile Length, Girth and Implant Type, Reservoir Placement, and the Influence of Comorbidities and Social Circumstances. 2020

Osmonov, Daniar / Christopher, Andrew Nim / Blecher, Gideon A / Falcone, Marco / Soave, Armin / Dahlem, Roland / Czeloth, Karen / Bannowsky, Andreas / Matanes, Emad / Ward, Sam / Martínez-Salamanca, Juan Ignacio / Bettocchi, Carlo / Garaffa, Giulio / Reisman, Yacov / Corona, Giovanni. ·Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany. Electronic address: Daniar.osmonov@uksh.de. · Department of Urology, University College London Hospitals & St Peters Andrology Centre, London, UK. · Department of Urology, The Alfred Hospital, Melbourne, Australia; Monash Health, Melbourne, Australia. · Department of Urology, University of Turin - Cittàdella Salute e della Scienza, Turin, Italy. · Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Vitus Prostata Center Offenbach, Prof. Stehling Institut für bildgebende Diagnostik, Germany. · Department of Urology, ImlandKlinik GmbH, Rendsburg, Germany. · Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel and Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. · Department of Urology, Clinique Saint Jean, Brussels; Medicis Medical Center, Woluwe, Belgium. · Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda Lyx Institute of Urology, Universidad Autónoma de Madrid, Spain. · Department of Urology, University of Bari, Bari, Apulia, Italy. · The Institute of Urology, University College London Hospitals, London, UK. · Department of Urology, Amstelland Hospital, Amstelveen, The Netherlands. · Endocrinology Unit, Medical Department, AziendaUsl Bologna Maggiore-Bellaria Hospital, Bologna, Italy. ·J Sex Med · Pubmed #31812683.

ABSTRACT: INTRODUCTION: To date, several aspects of inflatable penile prosthesis (IPP) surgical procedure have been poorly studied. AIM: The aim of this study was to review the evidence associated with IPP implantation and provide clinical recommendations on behalf of the European Society for Sexual Medicine (ESSM). Overall, 130 peer-reviewed studies and systematic reviews, which were published from 2007-2018 in the English language, were included. METHODS: MEDLINE and EMBASE were searched for randomized clinical trials, meta-analyses, and open-label prospective and retrospective studies. MAIN OUTCOME MEASURE: The panel provided statements exploring patients and partner expectations, satisfaction in male and phalloplasty cohorts, the impact of penile length, girth and implant type, reservoir placement, the influence of comorbidities, and social circumstances. Levels of evidence were provided according to the Oxford 2011 criteria and graded as for the Oxford Centre for Evidence-Based Medicine recommendations. RESULTS: In the preoperative setting, it is fundamental to identify and interact with difficult patients with the intention of enhancing the surgeon's ability to establish the surgeon-patient relationship, reduce physical and legal risk, as well as enhancing patient satisfaction. To address this need, the mnemonic Compulsive, Unrealistic, Revision, Surgeon Shopping, Entitled, Denial, and Psychiatric ("CURSED") has been suggested to identify patients who are at high risk of dissatisfaction. The current recommendations suggest improving glycemic control in patients with diabetes. Available evidence suggests evaluating transplant recipients with the criteria of Barry, consisting of stable graft function for >6 months, avoidance of intra-abdominal reservoir placement, and low-dose immunosuppression. HIV status does not represent a contraindication for surgery. Smoking, peripheral vascular disease, and hypertension may be associated with an increased risk of revision surgery. Patients with spinal cord injury may receive IPP. Patients aged ≥70 years, as well as obese patients, can be offered IPP. The IPP implantation can be performed in patients with stable Peyronie's disease. Ectopic high submuscular reservoir placement can be considered as an alternative method. CLINICAL IMPLICATIONS: There is a relevant lack of high-level data and definite conclusions in certain areas remain difficult to draw. STRENGTH & LIMITATIONS: All studies have been evaluated by a panel of experts providing recommendations for clinical practice. Because of lack of sufficient prospective data, some of the included studies are retrospective and this could be stated as a limitation. CONCLUSION: This ESSM position statement provides recommendations on optimization of patient outcome by patient selection, and individualized peri- and intra-operative management. ESSM encourages centers to collaborate and to create prospective, multicenter registries in order to address this topic of increasing importance. Osmonov D, Christopher AN, Blecher GA, et al. Clinical Recommendations from the European Society for Sexual Medicine Exploring Partner Expectations, Satisfaction in Male and Phalloplasty Cohorts, the Impact of Penile Length, Girth and Implant Type, Reservoir Placement, and the Influence of Comorbidities and Social Circumstances. J Sex Med 2020;17:210-237.

2 Guideline Wilderness Medical Society Clinical Practice Guidelines for Diabetes Management. 2019

VanBaak, Karin D / Nally, Laura M / Finigan, Ryan T / Jurkiewicz, Carrie L / Burnier, Andre M / Conrad, Barry P / Khodaee, Morteza / Lipman, Grant S. ·Department of Family Medicine and Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO. Electronic address: karin.vanbaak@cuanschutz.edu. · Department of Pediatric Endocrinology, Yale University School of Medicine, New Haven, CT. · Travis Family Medicine Residency, Fairfield, CA. · Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA. · Stanford-Kaiser Emergency Medicine Residency, Stanford, CA. · Division of Endocrinology, Stanford Children's Hospital, Stanford, CA. · Department of Family Medicine and Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO. ·Wilderness Environ Med · Pubmed #31753543.

ABSTRACT: The Wilderness Medical Society convened an expert panel in 2018 to develop a set of evidence-based guidelines for the treatment of type 1 and 2 diabetes, as well as the recognition, prevention, and treatment of complications of diabetes in wilderness athletes. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures, as well as best practice recommendations for both routine and urgent therapeutic management of diabetes and glycemic complications. These recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks or burdens for each recommendation.


Mechanick, Jeffrey I / Apovian, Caroline / Brethauer, Stacy / Garvey, W Timothy / Joffe, Aaron M / Kim, Julie / Kushner, Robert F / Lindquist, Richard / Pessah-Pollack, Rachel / Seger, Jennifer / Urman, Richard D / Adams, Stephanie / Cleek, John B / Correa, Riccardo / Figaro, M Kathleen / Flanders, Karen / Grams, Jayleen / Hurley, Daniel L / Kothari, Shanu / Seger, Michael V / Still, Christopher D. · ·Endocr Pract · Pubmed #31682518.


4 Guideline Diabetic kidney disease: New clinical and therapeutic issues. Joint position statement of the Italian Diabetes Society and the Italian Society of Nephrology on "The natural history of diabetic kidney disease and treatment of hyperglycemia in patients with type 2 diabetes and impaired renal function". 2019

Pugliese, Giuseppe / Penno, Giuseppe / Natali, Andrea / Barutta, Federica / Di Paolo, Salvatore / Reboldi, Gianpaolo / Gesualdo, Loreto / De Nicola, Luca / Anonymous3211088. ·Department of Clinical and Molecular Medicine, "La Sapienza" University, Endocrine and Metabolic Unit, Sant'Andrea University Hospital, Rome, Italy. Electronic address: giuseppe.pugliese@uniroma1.it. · Department of Clinical and Experimental Medicine, University of Pisa, Diabetes Unit, University Hospital, Pisa, Italy. · Department of Clinical and Experimental Medicine, University of Pisa, Unit of Internal Medicine, University Hospital, Pisa, Italy. · Department of Medical Sciences, University of Turin, Turin, Italy. · Nephrology Unit, "Mons. Dimiccoli" Hospital, Barletta, Italy. · Department of Medicine, University of Perugia, Perugia, Italy. · Department of Emergency and Organ Transplantation, "Aldo Moro" University, Nephrology, Dialysis and Transplantation Unit, "Policlinico" University Hospital, Bari, Italy. · Nephrology and Dialysis Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. ·Nutr Metab Cardiovasc Dis · Pubmed #31586514.

ABSTRACT: AIMS: This joint document of the Italian Diabetes Society and the Italian Society of Nephrology reviews the natural history of diabetic kidney disease (DKD) in the light of the recent epidemiological literature and provides updated recommendations on anti-hyperglycemic treatment with non-insulin agents. DATA SYNTHESIS: Recent epidemiological studies have disclosed a wide heterogeneity of DKD. In addition to the classical albuminuric phenotype, two new albuminuria-independent phenotypes have emerged, i.e., "nonalbuminuric renal impairment" and "progressive renal decline", suggesting that DKD progression toward end-stage kidney disease (ESKD) may occur through two distinct pathways, albuminuric and nonalbuminuric. Several biomarkers have been associated with decline of estimated glomerular filtration rate (eGFR) independent of albuminuria and other clinical variables, thus possibly improving ESKD prediction. However, the pathogenesis and anatomical correlates of these phenotypes are still unclear. Also the management of hyperglycemia in patients with type 2 diabetes and impaired renal function has profoundly changed during the last two decades. New anti-hyperglycemic drugs, which do not cause hypoglycemia and weight gain and, in some cases, seem to provide cardiorenal protection, have become available for treatment of these individuals. In addition, the lowest eGFR safety thresholds for some of the old agents, particularly metformin and insulin secretagogues, have been reconsidered. CONCLUSIONS: The heterogeneity in the clinical presentation and course of DKD has important implications for the diagnosis, prognosis, and possibly treatment of this complication. The therapeutic options for patients with type 2 diabetes and impaired renal function have substantially increased, thus allowing a better management of these individuals.

5 Guideline [How I manage a patient with type 2 diabetes not well controlled with a metformin plus gliptin combination]. 2019

Scheen, A J. ·Service de Diabétologie, Nutrition et Maladies métaboliques et Unité de Pharmacologie clinique, CHU Liège, Belgique. ·Rev Med Liege · Pubmed #31486312.

ABSTRACT: Type 2 diabetes (T2D) is an evolving disease that requires therapeutic adjustments to maintain adequate glucose control in the long run. An increasing number of patients with T2D are treated with a metformin plus gliptin (DPP-4 Inhibitor) combination, especially those for whom a sulfonylurea is avoided because of a risk of hypoglycaemia. When this dual metformin-gliptin therapy becomes insufficient to reach or maintain adequate glucose control, three solutions may be considered : the addition of a gliflozin (SGLT2 inhibitor), the replacement of the gliptin by a glucagon-like peptide-1 receptor agonist or the addition of a basal insulin whose posology should be progressively up-titrated according to fasting glycaemia. This article describes the pro and contra arguments of these three therapeutic regimens. According to the recent data of the literature, the triple oral therapy combining metformin, a gliptin and a gliflozin appears to offer a favourable alternative in terms of efficacy, tolerance, ease of use, patient adherence and cost.

6 Guideline Management of immune-related adverse events in endocrine organs induced by immune checkpoint inhibitors: clinical guidelines of the Japan Endocrine Society. 2019

Arima, Hiroshi / Iwama, Shintaro / Inaba, Hidefumi / Ariyasu, Hiroyuki / Makita, Noriko / Otsuki, Michio / Kageyama, Kazunori / Imagawa, Akihisa / Akamizu, Takashi. ·Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan. · Department of Endocrinology and Diabetes, Nagoya University Hospital, Nagoya 466-8560, Japan. · The First Department of Medicine, Wakayama Medical University, Wakayama 641-8509, Japan. · Division of Nephrology and Endocrinology, University of Tokyo Graduate School of Medicine, Tokyo 113-8655, Japan. · Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan. · Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki 036-8562, Japan. · Department of Internal Medicine (I), Osaka Medical College, Takatsuki 569-8686, Japan. ·Endocr J · Pubmed #31243183.

ABSTRACT: Immune checkpoint inhibitors (ICIs) have become a promising treatment for advanced malignancies. However, these drugs can induce immune-related adverse events (irAEs) in several organs, including skin, gastrointestinal tract, liver, muscle, nerve, and endocrine organs. Endocrine irAEs comprise hypopituitarism, primary adrenal insufficiency, thyroid dysfunction, hypoparathyroidism, and type 1 diabetes mellitus. These conditions have the potential to lead to life-threatening consequences, such as adrenal crisis, thyroid storm, severe hypocalcemia, and diabetic ketoacidosis. It is therefore important that both endocrinologists and oncologists understand the clinical features of each endocrine irAE to manage them appropriately. This opinion paper provides the guidelines of the Japan Endocrine Society and in part the Japan Diabetes Society for the management of endocrine irAEs induced by ICIs.

7 Guideline 2018 Cholesterol Clinical Practice Guidelines: Synopsis of the 2018 American Heart Association/American College of Cardiology/Multisociety Cholesterol Guideline. 2019

Grundy, Scott M / Stone, Neil J / Anonymous2231083. ·University of Texas Southwestern Medical Center, Dallas, Texas (S.M.G.). · Northwestern University Feinberg School of Medicine, Chicago, Illinois (N.J.S.). ·Ann Intern Med · Pubmed #31132793.

ABSTRACT: Description: In November 2018, the American Heart Association and American College of Cardiology (AHA/ACC) released a new clinical practice guideline on cholesterol management. It was accompanied by a risk assessment report on primary prevention of atherosclerotic cardiovascular disease (ASCVD). Methods: A panel of experts free of recent and relevant industry-related conflicts was chosen to carry out systematic reviews and meta-analyses of randomized controlled trials (RCTs) that examined cardiovascular outcomes. High-quality observational studies were used for estimation of ASCVD risk. An independent panel systematically reviewed RCT evidence about the benefits and risks of adding nonstatin medications to statin therapy compared with receiving statin therapy alone in persons who have or are at high risk for ASCVD. Recommendation: The guideline endorses a heart-healthy lifestyle beginning in childhood to reduce lifetime risk for ASCVD. It contains several new features compared with the 2013 guideline. For secondary prevention, patients at very high risk may be candidates for adding nonstatin medications (ezetimibe or proprotein convertase subtilisin/kexin type 9 [PCSK9] inhibitors) to statin therapy. In primary prevention, a clinician-patient risk discussion is still strongly recommended before a decision is made about statin treatment. The AHA/ACC risk calculator first triages patients into 4 risk categories. Those at intermediate risk deserve a focused clinician-patient discussion before initiation of statin therapy. Among intermediate-risk patients, identification of risk-enhancing factors and coronary artery calcium testing can assist in the decision to use a statin. Compared with the 2013 guideline, the new guideline gives more attention to percentage reduction in low-density lipoprotein cholesterol as a treatment goal and to long-term monitoring of therapeutic efficacy. To simplify monitoring, nonfasting lipid measurements are allowed.

8 Guideline S2k guidelines for skin and soft tissue infections Excerpts from the S2k guidelines for "calculated initial parenteral treatment of bacterial infections in adults - update 2018". 2019

Sunderkötter, Cord / Becker, Karsten / Eckmann, Christian / Graninger, Wolfgang / Kujath, Peter / Schöfer, Helmut. ·Department of Translational Dermatoinfectiology, Medical Faculty of the University of Münster, and Department of Dermatology and Venereology, University Medical Center, Martin Luther University of Halle-Wittenberg, Halle, Germany. · Institute of Medical Microbiology, Münster University Medical Center, Münster, Germany. · Department of General, Visceral and Thoracic Surgery, Peine Medical Center, Peine, Germany. · Medical University of Vienna, Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine, Vienna General Hospital, Vienna, Austria. · Department of Visceral, Vascular and Thoracic Surgery, Heide Medical Center, Heide, Germany. · Department of Dermatology, Venereology, and Allergology, University hospital Frankfurt, Goethe-university, Frankfurt am Main, Germany. ·J Dtsch Dermatol Ges · Pubmed #30920735.

ABSTRACT: These first German S2k guidelines for bacterial skin and soft tissue infections were developed as one chapter of the recommendations for "calculated initial parenteral treatment of bacterial infections" issued under the auspices of the Paul-Ehrlich Society, of which the main part is presented here. Well-calculated antibiotic therapies require precise diagnostic criteria. Erysipelas is defined as non-purulent infection considered to be caused by beta-hemolytic strepto-cocci. It is diagnosed clinically by its bright-red erythema and early fever or chills at disease onset. Penicillin is the treatment of choice. Limited soft tissue infection (cellulitis) is usually caused by Staphylococcus (S.) aureus, frequently originates from chronic wounds and presents with a more violaceous-red hue and only rarely with initial fever or chills. Treatment consists of first- or second--generation cephalosporins or flucloxacillin (IV). Severe cellulitis is a purulent, partially necrotic infection which extends through tissue boundaries to fascias and requires surgical management in addition to antibiotics. Moreover, it frequently fulfills the criteria for "complicated soft tissue infections", as previously defined by the Food and Drug Administration for use in clinical trials (they include comorbidities such as uncontrolled diabetes, peripheral artery disease, neutropenia). It requires antibiotics which besides S. aureus target anaerobic and/or gramnegative bacteria. The rare so-called necrotizing skin and soft tissue infections represent a distinct entity. They are characterized by rapid, life-threatening progression due to special bacterial toxins that cause ischemic necrosis and shock and need rapid and thorough debridement in addition to appropriate antibiotics. For cutaneous abscesses the first-line treatment is adequate drainage. Additional antibiotic therapy is required only under certain circumstances (e.g., involvement of the face, hands, or anogenital region, or if drainage is somehow complicated). The present guidelines also contain consensus-based recommendations for higher doses of antibiotics than those approved or usually given in clinical trials. The goal is to deliver rational antibiotic treatment that is both effective and well-tolerated and that exerts no unnecessary selection pressure in terms of multidrug resistance.

9 Guideline Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline. 2019

LeRoith, Derek / Biessels, Geert Jan / Braithwaite, Susan S / Casanueva, Felipe F / Draznin, Boris / Halter, Jeffrey B / Hirsch, Irl B / McDonnell, Marie E / Molitch, Mark E / Murad, M Hassan / Sinclair, Alan J. ·Icahn School of Medicine at Mount Sinai, New York, New York. · University Medical Center Utrecht, Utrecht, Netherlands. · Presence Saint Francis Hospital, Evanston, Illinois. · Presence Saint Joseph Hospital, Chicago, Illinois. · Complejo Hospitalario Universitario de Santiago, CIBER de Fisiopatologia Obesidad y Nutricion, Instituto Salud Carlos III, Santiago de Compostela, Spain. · University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado. · University of Michigan, Ann Arbor, Michigan. · National University of Singapore, Singapore, Singapore. · University of Washington Medical Center-Roosevelt, Seattle, Washington. · Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. · Northwestern University Feinberg School of Medicine, Chicago, Illinois. · Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota. · King's College, London, United Kingdom. ·J Clin Endocrinol Metab · Pubmed #30903688.

ABSTRACT: OBJECTIVE: The objective is to formulate clinical practice guidelines for the treatment of diabetes in older adults. CONCLUSIONS: Diabetes, particularly type 2, is becoming more prevalent in the general population, especially in individuals over the age of 65 years. The underlying pathophysiology of the disease in these patients is exacerbated by the direct effects of aging on metabolic regulation. Similarly, aging effects interact with diabetes to accelerate the progression of many common diabetes complications. Each section in this guideline covers all aspects of the etiology and available evidence, primarily from controlled trials, on therapeutic options and outcomes in this population. The goal is to give guidance to practicing health care providers that will benefit patients with diabetes (both type 1 and type 2), paying particular attention to avoiding unnecessary and/or harmful adverse effects.

10 Guideline Managing diabetes and liver disease association: Practice guidelines from the Egyptian Association for the Study of Liver and Gastrointestinal Disease (EASLGD). 2019

Hamed, Abd Elkhalek / Elsahar, Medhat / Elwan, Nadia M / El-Nakeep, Sarah / Naguib, Mervat / Soliman, Hanan Hamed / Aboubakr, Ashraf Ahmed / AbdelMaqsod, Amany / Sedrak, Heba / Assaad, Samir N / Elwakil, Reda / Esmat, Gamal / Salh, Samira / Mostafa, Taymour / Mogawer, Sherif / Sadek, Sameh Emil / Saber, Maha M / Ezelarab, Hanan / Mahmoud, Asem Ashraf / Sultan, Souad / El Kassas, Mohamed / Kamal, Ehab / ElSayed, Naglaa M / Moussa, Shorouk / Anonymous4790982. ·The Egyptian Association for the Study of Liver and Gastrointestinal Disease (EASLGD), Egypt; Department of Internal Medicine, Hepatology, and Diabetes, Egyptian Military Medical Academy, Egypt. Electronic address: akhalek_hamed@hotmail.com. · The Egyptian Association for the Study of Liver and Gastrointestinal Disease (EASLGD), Egypt; Police Medical Academy, Egypt. · Tanta University, Egypt. · Ain Shams University, Egypt. · Kasr Al Aini, Egypt. · Department of Internal Medicine, Hepatology, and Diabetes, Egyptian Military Medical Academy, Egypt. · Alexandria University, Egypt. · The Egyptian Association for the Study of Liver and Gastrointestinal Disease (EASLGD), Egypt; Ain Shams University, Egypt. · The Egyptian Association for the Study of Liver and Gastrointestinal Disease (EASLGD), Egypt; Kasr Al Aini, Egypt. · Department of Pharmacy, Cairo University, Egypt. · Department of Clinical Nutrition National Research Centre, Egypt. · Helwan University, Egypt. · Medical Department, National Research Centre, Egypt. ·Arab J Gastroenterol · Pubmed #30852101.

ABSTRACT: -- No abstract --

11 Guideline A Type 1 diabetes technology pathway: consensus statement for the use of technology in Type 1 diabetes. 2019

Choudhary, P / Campbell, F / Joule, N / Kar, P / Anonymous1421074. ·Diabetes Research Group, London, UK. · St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK. · Diabetes, UK. · Diabetes, NHS England, London, UK. ·Diabet Med · Pubmed #30773681.

ABSTRACT: In both adults and children with diabetes, technologies such as continuous subcutaneous insulin infusion using insulin pumps and continuous glucose monitoring can help improve diabetes control, reduce hypoglycaemia and improve quality of life. Access to these technologies in the UK is very variable. Some technologies are recommended by the National Institute for Health and Care Excellence, while others have not been appraised, and new technologies are emerging all the time. Additionally, different guidelines for adults and children further complicate access to diabetes technology in the transition from paediatric to adult care. Against this background, Diabetes UK and NHS England have brought together a multidisciplinary group of experts, including clinicians and people with diabetes, to develop this consensus guideline, combining the different technologies into a common pathway to aid clinical and policy decision-making. We created a pathway that supports the incremental addition of technology as monotherapy and then dual therapy in the same way that we incrementally add in therapeutic agents to support people with Type 2 diabetes to achieve their personalized glycaemic targets. The pathway emphasizes the importance of structured education, specialist support and appropriate access to psychological therapies, as essential pillars for optimized use of diabetes-related technology, and recommends the re-evaluation of its use when the individual is unable either to use the technology appropriately or to achieve the intended outcomes. This pathway is endorsed by UK-wide clinical and patient associations and we recommend that providers and commissioners use it to ensure the right individual with diabetes has access to the right technology in a timely way to help achieve better outcomes.

12 Guideline Dying well with diabetes. 2019

James, June. ·Leicester Diabetes Centre, Leicester General Hospital, Leicester, LE5 4PW, UK. june.james@uhl-tr.nhs.uk. ·Ann Palliat Med · Pubmed #30691282.

ABSTRACT: Death is an inevitable part of living. There are undoubtedly clinical and psychological challenges when any individual is passing from life to death. For a person with a long-term condition such as diabetes, these challenges can be compounded and impact on the care and experience of both the individual and their families and carers. It is estimated that about 500,000 people die each year in the United Kingdom; of these approximately 75,000 will have diabetes. The vast majority of people with diabetes who die do not do so as a result of a metabolic diabetes emergency such as diabetic ketoacidosis or hyperosmolar hyperglycaemic state. Whilst diabetes is listed as one of the top 10 causes of death in developed countries, death occurs more commonly as a result of cardiovascular disease, dementia, respiratory disease, or cancer. Life-long care of people with diabetes centres on glycaemic management and other modifiable clinical elements such as blood pressure, renal function, and cholesterol. These factors may become less important to healthcare professionals caring for the individual who is approaching the end of their life and for safety and holistic reasons clinical targets may be made more liberal. For the person dying and their families and carers this may be a difficult concept to accept. This article is based on the Diabetes UK (2018) Diabetes and End of Life: Clinical Care Recommendations. Offering a comprehensive guide to the management of diabetes through all the stages of dying it provides information on hypoglycaemia and hyperglycaemia prevention and treatment, and the care of people taking glucocorticoid therapy with a previously known and not known diagnosis of diabetes. Controversial areas of care are discussed where there has been no clear consensus.

13 Guideline Diabetes Canada 2018 clinical practice guidelines: Key messages for family physicians caring for patients living with type 2 diabetes. 2019

Ivers, Noah M / Jiang, Maggie / Alloo, Javed / Singer, Alexander / Ngui, Daniel / Casey, Carolyn Gall / Yu, Catherine H. ·Scientist at Women's College Research Institute in Toronto, Ont, a family physician at Women's College Hospital, Adjunct Scientist in ICES, Assistant Professor in the Department of Family and Community Medicine at the University of Toronto, and Innovation Fellow at the Women's College Hospital Institute for Health System Solutions and Virtual Care. noah.ivers@utoronto.ca. · Medical student at Queen's University in Kingston, Ont. · Family physician at Nymark Medical Centre in Toronto. · Associate Professor in the Department of Family Medicine at the University of Manitoba in Winnipeg and a family physician at the Family Medical Centre at the University of Manitoba. · Family physician at Fraser Street Medical in Vancouver, BC, and Clinical Associate Professor in the Department of Family Medicine at the University of British Columbia. · Director of Education and Customer Insight at the Canadian Diabetes Association in Toronto. · Staff endocrinologist in the Department of Medicine at St Michael's Hospital in Toronto, Chair of the Clinical Practice Guidelines Dissemination and Implementation Committee at the Canadian Diabetes Association, Associate Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St Michael's Hospital, and Assistant Professor in the Department of Medicine at the University of Toronto. ·Can Fam Physician · Pubmed #30674509.

ABSTRACT: OBJECTIVE: To summarize the 2018 Diabetes Canada clinical practice guidelines, focusing on high-priority recommendations for FPs managing people who live with type 2 diabetes. QUALITY OF EVIDENCE: A prioritization process was conducted to focus the efforts of Diabetes Canada's guideline dissemination and implementation efforts. The resulting identified key messages for FPs to consider when managing patients with type 2 diabetes are described. Evidence supporting the guideline recommendations ranges from levels I to IV and grades A to D. MAIN MESSAGE: Three key messages were identified from the 2018 guidelines as priorities for FPs: discussing opportunities to reduce the risk of diabetes complications, discussing opportunities to ensure safety and prevent hypoglycemia, and discussing progress on self-management goals and addressing barriers. A theme cutting across these key messages was the need to tailor discussions to the needs and preferences of each person. These important guideline recommendations are highlighted, along with information about relevant tools for implementing the recommendations in real-world practice. CONCLUSION: High-quality diabetes care involves a series of periodic conversations about self-management and about pharmacologic and nonpharmacologic treatments that fit with each patient's goals (ie, shared decision making). Incorporating these conversations into regular practice provides FPs with opportunities to maximize likely benefits of treatments and decrease the risk of harms, to support patients in initiating and sustaining desired lifestyle changes, and to help patients cope with the burdens of diabetes and comorbid conditions.

14 Guideline Special Article: 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. 2019

Singh, Jasvinder A / Guyatt, Gordon / Ogdie, Alexis / Gladman, Dafna D / Deal, Chad / Deodhar, Atul / Dubreuil, Maureen / Dunham, Jonathan / Husni, M Elaine / Kenny, Sarah / Kwan-Morley, Jennifer / Lin, Janice / Marchetta, Paula / Mease, Philip J / Merola, Joseph F / Miner, Julie / Ritchlin, Christopher T / Siaton, Bernadette / Smith, Benjamin J / Van Voorhees, Abby S / Jonsson, Anna Helena / Shah, Amit Aakash / Sullivan, Nancy / Turgunbaev, Marat / Coates, Laura C / Gottlieb, Alice / Magrey, Marina / Nowell, W Benjamin / Orbai, Ana-Maria / Reddy, Soumya M / Scher, Jose U / Siegel, Evan / Siegel, Michael / Walsh, Jessica A / Turner, Amy S / Reston, James. ·University of Alabama at Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, Alabama. · McMaster University, Hamilton, Ontario, Canada. · University of Pennsylvania, Philadelphia. · University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada. · Cleveland Clinic, Cleveland, Ohio. · Oregon Health & Science University, Portland. · Boston Medical Center, Boston, Massachusetts. · New York, New York. · Premier Orthopaedics, Malvern, Pennsylvania. · Stanford University, Stanford, California. · Concorde Medical Group, New York, New York. · Swedish-Providence Health Systems and University of Washington, Seattle, Washington. · Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. · Comprehensive Therapy Consultants and Therapy Steps, Roswell, Georgia. · University of Rochester Medical Center, Rochester, New York. · University of Maryland School of Medicine, Baltimore. · Florida State University College of Medicine School of Physician Assistant Practice, Tallahassee. · Eastern Virginia Medical School, Norfolk. · American College of Rheumatology, Atlanta, Georgia. · ECRI Institute, Plymouth Meeting, Pennsylvania. · University of Oxford, Oxford, UK. · New York Medical College at Metropolitan Hospital, New York, New York. · Case Western/MetroHealth, Cleveland, Ohio. · Global Healthy Living Foundation, Nyack, New York. · Johns Hopkins University, Baltimore, Maryland. · New York University School of Medicine, New York, New York. · Arthritis & Rheumatism Associates, Rockville, Maryland. · National Psoriasis Foundation, Portland, Oregon. · University of Utah and George E. Wahlen VeteranS Affairs Medical Center, Salt Lake City, Utah. ·Arthritis Rheumatol · Pubmed #30499246.

ABSTRACT: OBJECTIVE: To develop an evidence-based guideline for the pharmacologic and nonpharmacologic treatment of psoriatic arthritis (PsA), as a collaboration between the American College of Rheumatology (ACR) and the National Psoriasis Foundation (NPF). METHODS: We identified critical outcomes in PsA and clinically relevant PICO (population/intervention/comparator/outcomes) questions. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available pharmacologic and nonpharmacologic therapies for PsA. GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to rate the quality of the evidence. A voting panel, including rheumatologists, dermatologists, other health professionals, and patients, achieved consensus on the direction and the strength of the recommendations. RESULTS: The guideline covers the management of active PsA in patients who are treatment-naive and those who continue to have active PsA despite treatment, and addresses the use of oral small molecules, tumor necrosis factor inhibitors, interleukin-12/23 inhibitors (IL-12/23i), IL-17 inhibitors, CTLA4-Ig (abatacept), and a JAK inhibitor (tofacitinib). We also developed recommendations for psoriatic spondylitis, predominant enthesitis, and treatment in the presence of concomitant inflammatory bowel disease, diabetes, or serious infections. We formulated recommendations for a treat-to-target strategy, vaccinations, and nonpharmacologic therapies. Six percent of the recommendations were strong and 94% conditional, indicating the importance of active discussion between the health care provider and the patient to choose the optimal treatment. CONCLUSION: The 2018 ACR/NPF PsA guideline serves as a tool for health care providers and patients in the selection of appropriate therapy in common clinical scenarios. Best treatment decisions consider each individual patient situation. The guideline is not meant to be proscriptive and should not be used to limit treatment options for patients with PsA.

15 Guideline Indications for islet or pancreatic transplantation: Statement of the TREPID working group on behalf of the Société francophone du diabète (SFD), Société francaise d'endocrinologie (SFE), Société francophone de transplantation (SFT) and Société française de néphrologie - dialyse - transplantation (SFNDT). 2019

Wojtusciszyn, A / Branchereau, J / Esposito, L / Badet, L / Buron, F / Chetboun, M / Kessler, L / Morelon, E / Berney, T / Pattou, F / Benhamou, P-Y / Vantyghem, M-C / Anonymous251056. ·Department of endocrinology, diabetes and nutrition, university hospital of Montpellier, Lapeyronie hospital, laboratory of cell therapy for diabetes (LTCD), institute of regenerative medicine and biotherapy, (IRMB), university hospital of Montpellier, Saint-Éloi, hospital, IGF, CNRS UMR5203, Inserm U1191, Montpellier university, 34094 Montpellier, France. · Urology department, CHU de Nantes, centre de recherche en transplantation et immunologie, UMR 1064, Inserm, université de Nantes, institut de transplantation urologie néphrologie (ITUN), Nantes, France. · Department of nephrology, 38000 Toulouse, France. · Hospices civils de Lyon, service d'urologie et de chirurgie de la transplantation, pôle Chirurgie, 69000 Lyon, France. · Hospices civils de Lyon, service d'urologie et de chirurgie de la transplantation, pôle Chirurgie, 69000 Lyon, France; Inserm, U1055, 38000 Grenoble, France. · University of Lille, Inserm, CHU de Lille, UMR 1190, translational research in diabetes, endocrine surgery, 59000 Lille, France; CHU Lille, endocrine surgery, 59000 Lille, France. · Department of Endocrinology and Diabetology, University Hospital of Strasbourg, 67000 Strasbourg, France; INSERM UMR 1260, Regenerative Nanomedecine, Federation of Translational Medicine, University of Strasbourg, 67000 Strasbourg, France. · Division of Transplantation, Department of Surgery, University of Geneva Hospitals, Geneva, Switzerland. · Department of Endocrinology, Pôle DigiDune, Grenoble University Hospital, Grenoble Alpes University, 38000 Grenoble, France; Grenoble Alpes University, LBFA, 38000, Grenoble, France. · University of Lille, Inserm, CHU de Lille, UMR 1190, translational research in diabetes, endocrine surgery, 59000 Lille, France; CHU Lille, Endocrinology, diabetology and metabolism, 59000 Lille, France. Electronic address: mc-vantyghem@chru-lille.fr. ·Diabetes Metab · Pubmed #30223084.

ABSTRACT: While either pancreas or pancreatic islet transplantation can restore endogenous insulin secretion in patients with diabetes, no beta-cell replacement strategies are recommended in the literature. For this reason, the aim of this national expert panel statement is to provide information on the different kinds of beta-cell replacement, their benefit-risk ratios and indications for each type of transplantation, according to type of diabetes, its control and association with end-stage renal disease. Allotransplantation requires immunosuppression, a risk that should be weighed against the risks of poor glycaemic control, diabetic lability and severe hypoglycaemia, especially in cases of unawareness. Pancreas transplantation is associated with improvement in diabetic micro- and macro-angiopathy, but has the associated morbidity of major surgery. Islet transplantation is a minimally invasive radiological or mini-surgical procedure involving infusion of purified islets via the hepatic portal vein, but needs to be repeated two or three times to achieve insulin independence and long-term functionality. Simultaneous pancreas-kidney and pancreas after kidney transplantations should be proposed for kidney recipients with type 1 diabetes with no surgical, especially cardiovascular, contraindications. In cases of high surgical risk, islet after or simultaneously with kidney transplantation may be proposed. Pancreas, or more often islet, transplantation alone is appropriate for non-uraemic patients with labile diabetes. Various factors influencing the therapeutic strategy are also detailed in this report.

16 Guideline [Consensus statement of the Chilean endocrinological society on the role of bariatric surgery in type 2 diabetes]. 2018

Sapunar, Jorge / Escalona, Alex / Araya, A Verónica / Aylwin, Carmen Gloria / Bastías, María Juliana / Boza, Camilo / Cárcamo, Carlos / Csendes A, Attila / Davidof F, Patricio / Funke, Ricardo / Gómez, Patricia / González, María Isabel / Lahsen, Rodolfo / Lanzarini, Enrique / Maíz, Alberto / Mujica, Verónica / Muñoz, Rodrigo / Pérez, Gustavo / Raimann, Félix / Salman, Patricio / Sepúlveda, Matías / Soto, Néstor / Villagrán, Rodrigo. ·Departamento de Medicina Interna y Centro EPICYN, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile. · Clínica Universidad de los Andes, Facultad de Medicina, Universidad de los Andes, Santiago, Chile. · Hospital Clínico, Universidad de Chile, Santiago, Chile. · Sección Endocrinología, Diabetes y Nutrición, Departamento de Medicina Interna, Hospital Naval Almirante Nef, Viña del Mar, Chile. · Clínica Las Condes, Santiago, Chile. · Instituto de Cirugía, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile. · Hospital FACH, Santiago, Chile. · Clínica Sanatorio Alemán, Concepción, Chile. · Departamento. Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. · Facultad de Medicina, Universidad Católica del Maule, Talca, Chile. · Departamento de Cirugía Digestiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. · Centro Integral de Obesidad y Diabetes, Servicio de Cirugía y Endoscopía, Clínica Puerto Varas, Puerto Varas, Chile. · Unidad de Endocrinología, Departamento de Medicina Interna, Facultad de Medicina. universidad de Concepción. Concepción, Chile. · Hospital de la Dirección de Previsión de Carabineros de Chile (DIPRECA). Santiago, Chile. · Unidad de Endocrinología y Diabetes, Servicio de Medicina Interna, Hospital San Borja Arriarán. Santiago, Chile. · Departamento de Cirugía Bariátrica Metabólica, Clínica Bupa Antofagasta. Antofagasta, Chile. ·Rev Med Chil · Pubmed #30724982.

ABSTRACT: Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.

17 Guideline Canadian Cardiovascular Society Position Statement on Familial Hypercholesterolemia: Update 2018. 2018

Brunham, Liam R / Ruel, Isabelle / Aljenedil, Sumayah / Rivière, Jean-Baptiste / Baass, Alexis / Tu, Jack V / Mancini, G B John / Raggi, Paolo / Gupta, Milan / Couture, Patrick / Pearson, Glen J / Bergeron, Jean / Francis, Gordon A / McCrindle, Brian W / Morrison, Katherine / St-Pierre, Julie / Henderson, Mélanie / Hegele, Robert A / Genest, Jacques / Goguen, Jeannette / Gaudet, Daniel / Paré, Guillaume / Romney, Jacques / Ransom, Thomas / Bernard, Sophie / Katz, Pamela / Joy, Tisha R / Bewick, David / Brophy, James. ·Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: Liam.brunham@ubc.ca. · Research Institute of the McGill University Health Centre, Royal Victoria Hospital, Montréal, Quebec, Canada. · Department of Medicine, McGill University, Montréal, Quebec, Canada; Nutrition, Metabolism and Atherosclerosis Clinic, Institut de recherches cliniques de Montréal, Montréal, Quebec, Canada. · Faculty of Medicine, University of Toronto, Institute for Clinical Evaluative Sciences, Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. · Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. · Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada. · Department of Medicine, McMaster University, Hamilton, and Canadian Collaborative Research Network, Brampton, Ontario, Canada. · Departments of Medicine and Laboratory Medicine, CHU de Québec-Université Laval, Québec City, Quebec, Canada. · Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada. · Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. · Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada. · Department of Pediatrics, McGill University, Clinique 180, Montréal, Quebec, Canada. · Department of Pediatrics, Université de Montréal, CHU Sainte-Justine, Montréal, Quebec, Canada. · Departments of Medicine and Biochemistry, Schulich School of Medicine and Robarts Research Institute, Western University, London, Ontario, Canada. · Research Institute of the McGill University Health Centre, Royal Victoria Hospital, Montréal, Quebec, Canada; Department of Medicine, McGill University, Montréal, Quebec, Canada. · Department of Medicine, University of Toronto and Division of Endocrinology, St Michael's Hospital, Toronto Ontario, Canada. · Lipidology Unit, Community Genomic Medicine Centre and ECOGENE-21, Department of Medicine, Université de Montréal, Saguenay, Quebec, Canada. · Department of Pathology and Molecular Medicine, Department of Clinical Epidemiology and Biostatistics, Population Health Research Institute and Thrombosis and Atherosclerosis Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada. · Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. · Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada. · Nutrition, Metabolism and Atherosclerosis Clinic, Institut de recherches cliniques de Montréal, Montréal, Quebec, Canada; Department of Medicine, Division of Endocrinology, Université de Montreal, Montréal, Quebec, Canada. · Department of Medicine, Section of Endocrinology and Metabolism, University of Manitoba, St Boniface Hospital, Winnipeg, Manitoba, Canada. · Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. · Division of Cardiology, Department of Medicine, Dalhousie University, St John, New Brunswick, Canada. ·Can J Cardiol · Pubmed #30527143.

ABSTRACT: Familial hypercholesterolemia (FH) is the most common monogenic disorder causing premature atherosclerotic cardiovascular disease. It affects 1 in 250 individuals worldwide, and of the approximately 145,000 Canadians estimated to have FH, most are undiagnosed. Herein, we provide an update of the 2014 Canadian Cardiovascular Society position statement on FH addressing the need for case identification, prompt recognition, and treatment with statins and ezetimibe, and cascade family screening. We provide a new Canadian definition for FH and tools for clinicians to make a diagnosis. The risk of atherosclerotic cardiovascular disease in patients with "definite" FH is 10- to 20-fold that of a normolipidemic individual and initiating treatment in youth or young adulthood can normalize life expectancy. Target levels for low-density lipoprotein cholesterol are proposed and are aligned with the Canadian Cardiovascular Society guidelines on dyslipidemia. Recommendation for the use of inhibitors of proprotein convertase kexin/subtilisin type 9 are made in patients who cannot achieve therapeutic low-density lipoprotein cholesterol targets on maximally tolerated statins and ezetimibe. The writing committee used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology in the preparation of the present document, which offers guidance for practical evaluation and management of patients with FH. This position statement also aims to raise awareness of FH nationally, and to mobilize patient support, promote knowledge translation, and availability of treatment and health care resources for this under-recognized, but important medical condition.

18 Guideline Recommendations of the Polish Society of Gynecologists and Obstetricians regarding caesarean sections. 2018

Wielgos, Miroslaw / Bomba-Opoń, Dorota / Breborowicz, Grzegorz H / Czajkowski, Krzysztof / Debski, Romuald / Leszczynska-Gorzelak, Bozena / Oszukowski, Przemyslaw / Radowicki, Stanislaw / Zimmer, Mariusz. ·1st Chair and Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland. dbomba@wum.edu.pl. ·Ginekol Pol · Pubmed #30508218.

ABSTRACT: -- No abstract --

19 Guideline 2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. 2018

Das, Sandeep R / Everett, Brendan M / Birtcher, Kim K / Brown, Jenifer M / Cefalu, William T / Januzzi, James L / Kalyani, Rita Rastogi / Kosiborod, Mikhail / Magwire, Melissa L / Morris, Pamela B / Sperling, Laurence S. · ·J Am Coll Cardiol · Pubmed #30497881.

ABSTRACT: -- No abstract --

20 Guideline ACOG Practice Bulletin No. 201: Pregestational Diabetes Mellitus. 2018

Anonymous26500969. · ·Obstet Gynecol · Pubmed #30461693.

ABSTRACT: Pregestational diabetes mellitus represents one of the most challenging medical complications of pregnancy because of the need for frequent monitoring and adjustment of medications as well as the potential for maternal and fetal complications. This document provides an overview of the current understanding of pregestational diabetes mellitus and suggests management guidelines during pregnancy. Because few well-designed studies have been performed, many of the guidelines are based on expert and consensus opinion. This document has been updated to reflect current data on pregestational diabetes. This Practice Bulletin is updated with summary information to counsel and manage women with pregestational diabetes before and during pregnancy, more recent literature reflecting experience with continuous subcutaneous insulin infusion during pregnancy, an expanded section on the role of oral hypoglycemic agents in pregnancy, and the option of long-acting reversible contraception during the postpartum period.

21 Guideline Clinical and Investigative Endocrinology and Diabetes. 2018

Anonymous6330968. · ·Endocr Pract · Pubmed #30430841.

ABSTRACT: -- No abstract --

22 Guideline [Definition, epidemiology and risk factors of obstetric anal sphincter injuries: CNGOF Perineal Prevention and Protection in Obstetrics Guidelines]. 2018

Thubert, T / Cardaillac, C / Fritel, X / Winer, N / Dochez, V. ·Service de gynécologie-obstétrique, hôpitaux de Nantes, CHU Hôtel-Dieu, 38, boulevard Jean-Monnet, 44000 Nantes, France; Université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France; GMC-UPMC 01, GREEN (Groupe de recherche clinique en neurourologie), 4, rue de la Chine, 75020 Paris, France. Electronic address: thibault.thubert@chu-nantes.fr. · Service de gynécologie-obstétrique, hôpitaux de Nantes, CHU Hôtel-Dieu, 38, boulevard Jean-Monnet, 44000 Nantes, France; Université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France. · Service de gynécologie-obstétrique, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France. ·Gynecol Obstet Fertil Senol · Pubmed #30385355.

ABSTRACT: OBJECTIVES: The aim of this review was to agree on a definition of the obstetric anal sphincter injuries (OASIS), to determine the prevalence and risk factors. METHODS: A comprehensive review of the literature on the obstetric anal sphincter injuries (OASIS), establishment of levels of evidence (NP), and grades of recommendation according to the methodology of the recommendations for clinical practice. RESULTS: To classify obstetric anal sphincter injuries (OASIS), we have used the WHO-RCOG classification, which lists 4 degrees of severity. To designate obstetric anal sphincter injuries, we have used the acronym OASIS, rather than the standard French terms of "complete perineum" and "complicated complete perineum". OASIS with only isolated involvement of the EAS (3a and 3b) appears to have a better functional prognosis than OASIS affecting the IAS or the anorectal mucosa (3c and 4) (LE3). The prevalence of women with ano-rectal symptoms increases with the severity of the OASIS (LE3). In the long term, 35-60% of women who had an OASIS have anal or fecal incontinence (LE3). The prevalence of an OASI in the general population is between 0.25 to 6%. The prevalence of OASIS in primiparous women is between 1.4 and 16% and thus, should be considered more important than among the multiparous women (0.4 to 2.7%). In women with a history of previous OASIS, the risk of occurrence is higher and varies between 5.1 and 10.7% following childbirth. The priority in this context remains the training of childbirth professionals (midwives and obstetricians) to detect these injuries in the delivery room, immediately after the birth. The training and awareness of these practitioners of OASIS diagnosis improves its detection in the delivery room (LE2). Professional experience is associated with better detection of OASIS (LE3) (4). Continuing professional education of obstetrics professionals in the diagnosis and repair of OASIS must be encouraged (Grade C). In the case of second-degree perineal tear, the use of ultrasound in the delivery room improves the diagnosis of OASIS (LE2). Ultrasound decreases the prevalence of symptoms of severe anal incontinence at 1 year (LE2). The diagnosis of OASIS is improved by the use of endo-anal ultrasonography in post-partum (72h-6weeks) (LE2). The principal factors associated with OASIS are nulliparity and instrumental (vaginal operative) delivery; the others are advanced maternal age, history of OASIS, macrosomia, midline episiotomy, posterior cephalic positions, and long labour (LE2). The presence of a perianal lesion (perianal fissure, or anorectal or rectovaginal fistula) is associated with an increased risk of 4th degree lacerations (LE3). Crohn's disease without perianal involvement is not associated with an excess risk of OASIS (LE3). For women with type III genital mutilation, deinfibulation before delivery is associated with a reduction in the risk of OASIS (LE3); in this situation, deinfibulation is recommended before delivery (grade C). CONCLUSION: It is necessary to use a consensus definition of the OASIS to be able to better detect and treat them.

23 Guideline Spanish Diabetes Society (SED) recommendations for the pharmacologic treatment of hyperglycemia in type 2 diabetes: 2018 Update. 2018

Gomez-Peralta, Fernando / Escalada San Martín, Francisco Javier / Menéndez Torre, Edelmiro / Mata Cases, Manel / Ferrer García, Juan Carlos / Ezkurra Loiola, Patxi / Ávila Lachica, Luis / Fornos Pérez, Jose Antonio / Artola Menéndez, Sara / Álvarez-Guisasola, Fernando / Rica Echevarría, Itxaso / Girbés Borrás, Juan / Anonymous6090966. ·Unidad de Endocrinología y Nutrición, Hospital General de Segovia, Segovia, España. Electronic address: fgomezperalta@gmail.com. · Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Pamplona, España; Diabetes y Enfermedades Metabólicas, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, España; Departamento de Endocrinología y Nutrición, Clínica Universidad de Navarra, Pamplona, España. · Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, España. · CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), España; Centro de Atención Primaria La Mina, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Sant Adrià de Besòs, Barcelona, España. · Sección de Endocrinología y Nutrición, Hospital General Universitario de Valencia, Valencia, España. · Centro de Salud de Zumaia, Zumaia, Gipuzkoa, España. · Centro de Salud Axarquía Oeste, Consultorio Almáchar, Almáchar, Málaga, España. · Grupo Berbés de Investigación y Docencia, Cangas, Pontevedra, España. · Centro de Salud José Marvá, Madrid, España. · Centro de Salud Ribera del Órbigo, Benavides de Órbigo, León, España. · Sección de Endocrinología Pediátrica, Hospital Universitario de Cruces, Baracaldo, Vizcaya, España. · Servicio de Endocrinología y Nutrición, Hospital Arnau de Vilanova, Valencia, España. ·Endocrinol Diabetes Nutr · Pubmed #30366843.

ABSTRACT: Type 2 diabetes mellitus (DM2) has become a problem of global dimensions by their high and growing prevalence worldwide and the personal and economic costs associated with it. Correct treatment can reduce mortality and associated complications. New concepts have recently been included in routine clinical practice and have changed the algorithm of DM2 pharmacological therapy. Therefore, the Spanish Society of Diabetes (SED) entrusted to the Working Group of Consensus and Clinical Guidelines an update of the 2010 document Recommendations for Pharmacological Treatment of Hyperglycemia in Diabetes type2. Novel aspects include nine characteristics to describe each drug group: efficiency, the risk of hypoglycemia, effects on body weight, the demonstrated effect in cardiovascular risk, nephroprotection, limitation of use in renal insufficiency, the rate of secondary effects, complexity and costs. Additionally, the document details combination options, and develop the start and adjustment of available injectable therapies.

24 Guideline 2019 Canadian guideline for physical activity throughout pregnancy. 2018

Mottola, Michelle F / Davenport, Margie H / Ruchat, Stephanie-May / Davies, Gregory A / Poitras, Veronica J / Gray, Casey E / Jaramillo Garcia, Alejandra / Barrowman, Nick / Adamo, Kristi B / Duggan, Mary / Barakat, Ruben / Chilibeck, Phil / Fleming, Karen / Forte, Milena / Korolnek, Jillian / Nagpal, Taniya / Slater, Linda G / Stirling, Deanna / Zehr, Lori. ·R Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada. · Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada. · Department of Human Kinetics, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada. · Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada. · Independent Researcher, Ottawa, Ontario, Canada. · Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. · Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada. · School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. · Canadian Society for Exercise Physiology, Ottawa, Ontario, Canada. · Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain. · College of Kinesiology, University of Saskatchewan, Saskatoon, Canada. · Department of Family and Community Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. · Department of Family and Community Medicine, University of Toronto, Granovsky Gluskin Family Medicine Centre, Sinai Health System, Sinai Health System, Toronto, Ontario, Canada. · Canadian Association of Midwives, Toronto, Canada. · John W Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada. · Middlesex-London Health Unit, London, Ontario, Canada. · School of Health and Human Services, Camosun College, Victoria, Canada. ·Br J Sports Med · Pubmed #30337460.

ABSTRACT: The objective is to provide guidance for pregnant women and obstetric care and exercise professionals on prenatal physical activity. The outcomes evaluated were maternal, fetal or neonatal morbidity, or fetal mortality during and following pregnancy. Literature was retrieved through searches of MEDLINE, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus and Web of Science Core Collection, CINAHL Plus with Full Text, Child Development & Adolescent Studies, Education Resources Information Center, SPORTDiscus, ClinicalTrials.gov and the Trip Database from inception up to 6 January 2017. Primary studies of any design were eligible, except case studies. Results were limited to English-language, Spanish-language or French-language materials. Articles related to maternal physical activity during pregnancy reporting on maternal, fetal or neonatal morbidity, or fetal mortality were eligible for inclusion. The quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation methodology. The Guidelines Consensus Panel solicited feedback from end users (obstetric care providers, exercise professionals, researchers, policy organisations, and pregnant and postpartum women). The development of these guidelines followed the Appraisal of Guidelines for Research and Evaluation II instrument. The benefits of prenatal physical activity are moderate and no harms were identified; therefore, the difference between desirable and undesirable consequences (net benefit) is expected to be moderate. The majority of stakeholders and end users indicated that following these recommendations would be feasible, acceptable and equitable. Following these recommendations is likely to require minimal resources from both individual and health systems perspectives.

25 Guideline Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: US Preventive Services Task Force Recommendation Statement. 2018

Anonymous3960965 / Curry, Susan J / Krist, Alex H / Owens, Douglas K / Barry, Michael J / Caughey, Aaron B / Davidson, Karina W / Doubeni, Chyke A / Epling, John W / Grossman, David C / Kemper, Alex R / Kubik, Martha / Landefeld, C Seth / Mangione, Carol M / Phipps, Maureen G / Silverstein, Michael / Simon, Melissa A / Tseng, Chien-Wen / Wong, John B. ·University of Iowa, Iowa City. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Harvard Medical School, Boston, Massachusetts. · Oregon Health & Science University, Portland. · Columbia University, New York, New York. · University of Pennsylvania, Philadelphia. · Virginia Tech Carilion School of Medicine, Roanoke. · Kaiser Permanente Washington Health Research Institute, Seattle. · Nationwide Children's Hospital, Columbus, Ohio. · Temple University, Philadelphia, Pennsylvania. · University of Alabama at Birmingham. · University of California, Los Angeles. · Brown University, Providence, Rhode Island. · Boston University, Boston, Massachusetts. · Northwestern University, Evanston, Illinois. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University, Medford, Massachusetts. ·JAMA · Pubmed #30326502.

ABSTRACT: Importance: More than 35% of men and 40% of women in the United States are obese. Obesity is associated with health problems such as increased risk for coronary heart disease, type 2 diabetes, various types of cancer, gallstones, and disability. Obesity is also associated with an increased risk for death, particularly among adults younger than 65 years. Objective: To update the US Preventive Services Task Force (USPSTF) 2012 recommendation on screening for obesity in adults. Evidence Review: The USPSTF reviewed the evidence on interventions (behavioral and pharmacotherapy) for weight loss or weight loss maintenance that can be provided in or referred from a primary care setting. Surgical weight loss interventions and nonsurgical weight loss devices (eg, gastric balloons) are considered to be outside the scope of the primary care setting. Findings: The USPSTF found adequate evidence that intensive, multicomponent behavioral interventions in adults with obesity can lead to clinically significant improvements in weight status and reduce the incidence of type 2 diabetes among adults with obesity and elevated plasma glucose levels; these interventions are of moderate benefit. The USPSTF found adequate evidence that behavior-based weight loss maintenance interventions are of moderate benefit. The USPSTF found adequate evidence that the harms of intensive, multicomponent behavioral interventions (including weight loss maintenance interventions) in adults with obesity are small to none. Therefore, the USPSTF concludes with moderate certainty that offering or referring adults with obesity to intensive behavioral interventions or behavior-based weight loss maintenance interventions has a moderate net benefit. Conclusions and Recommendation: The USPSTF recommends that clinicians offer or refer adults with a body mass index of 30 or higher to intensive, multicomponent behavioral interventions. (B recommendation).