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It is recommended to evaluate the exacerbation of inflammatory bowel disease in patients with rectal bleeding, evaluate predisposing risk factors during hospital admission and, in their absence, ...
Choosing Wisely ® : Things we do for no reason
Choosing Wisely ®: Things we do for no reason
It is recommended to evaluate the exacerbation of inflammatory bowel disease in patients with a known history when presenting to the hospital for rectal bleeding or hematochezia. It is also recommended to evaluate risk factors that predispose the patient to an excessive risk of major bleeding during hospitalization. In the absence of risk factors for major bleeding, it is recommended that prophylactic medications be prescribed for all hospitalized patients with flares of inflammatory bowel ...
ver más ... 2023It is recommended to significantly reduce or eliminate the use of patient safety indicators, in addition to evaluating the relevance of existing ones, in order to avoid the stigmatization of patients ...
Choosing Wisely ® : Things we do for no reason
Choosing Wisely ®: Things we do for no reason
Given the low effectiveness of safety indicators in preventing violence and the growing evidence of harm, we recommend significantly reducing their use. For existing ones, we recommend that institutions assess their current relevance (what circumstances surround previous behavioral incidents) and remove obsolete ones. Institutions should evaluate their stigma potential (word choice, tone, criminalizing language) and application (certain patient populations have more indicators than others) as ...
ver más ... 2023It is not recommended to routinely order a Nil per os diet for patients with acute pancreatitis.
Choosing Wisely ® : Things we do for no reason
Choosing Wisely ®: Things we do for no reason
Current data suggests that patients admitted with acute pancreatitis benefit from hospitalists initiating early oral nutrition. Initial studies investigating the benefit of feeding in pancreatitis revealed an association between bowel rest therapy, usually with parenteral nutrition, and an increased likelihood of the development of disruptions of the gut–mucosal barrier, persistence of the systemic inflammatory response, and admission to the intensive care unit. Indeed, data from human ...
ver más ... 2023Velmanase alfa is recommended as an option to treat non-neurological signs and symptoms of mild to moderate alfamannosidosis, only if treatment is initiated in people under 18 years of age.
NICE
NICE
Clinical trial evidence suggests that velmanase alfa may lead to improvements in functions such as walking, stair climbing and lung capacity, and quality of life, for people with alpha‑mannosidosis. But the size and nature of these benefits are highly uncertain because of the ultra-rare nature of the condition, which makes evidence generation difficult. The most likely cost-effectiveness estimate for velmanase alfa is around what is considered value for money in the context of a highly ...
ver más ... 2023Se recomienda realizar una angiografía coronaria por tomografía computarizada, si va a cambiar el manejo, para la evaluación de dolor torácico agudo en un paciente de riesgo intermedio después ...
Choosing Wisely ® : Things we do for no reason
Choosing Wisely ®: Things we do for no reason
Functional stress tests have served as the standard of care for the evaluation of cardiac ischemia for decades. Before 2021, guidelines recommended a functional stress test as the diagnostic imaging modality of choice for patients with low or intermediate‐risk chest pain. As a result, clinicians most commonly ordered stress tests for the diagnosis of coronary artery disease. Evidence of moderate to severe reversible ischemia on imaging‐based functional stress tests and severe ischemia on ...
ver más ... 2023