Resultados de Búsqueda

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ®: Things we do for no reason

Lactate above 2 mmol/L is associated with increased sepsis severity and mortality, however, lactate elevation may not be indicative of the current perfusion state. Evidence suggests that during states of increased metabolic demand, which can otherwise be thought of as physiologic stress in the critically ill, hyperlactatemia develops. Lactate should be used as an adjunctive screening of patients who may have sepsis to aide in risk stratification of those patients who may need more monitoring. ...

NICE

NICE

A high quality health technology assessment in the UK provided new evidence on external beam radiotherapy after stenting in people with dysphagia whose condition needed palliation, and the committee agreed that it did not support the routine use of external beam radiotherapy. However, the committee noted that there was some evidence of improved outcomes for gastrointestinal tract-related bleeding. Although this was of low certainty, they agreed that, in their experience, external beam ...

Choosing Wisely Canada

Canadian Society of Clinical Chemists

Screening for monoclonal gammopathies should only be performed in patients with unexplained “CRAB” symptoms (hyperCalcemia, Renal insufficiency, Anemia, or lytic Bone lesions) or diseases associated with monoclonal gammopathies. For such patients, serum protein electrophoresis (SPE) should be the initial screening test with follow-up immunofixation electrophoresis (IFE) if indicated.

Choosing Wisely Canada

Canadian Society of Clinical Chemists

The lifespan of a red blood cell is approximately 90-120 days, thus the effects of a patient’s change in behaviour, diet, or newly adjusted medications will not be reflected in the HbA1c measurement until most of the previous RBCs in circulation are replaced (~90 days). Therefore, testing at time intervals earlier than 3 months does not allow enough time to pass to reach the treatment target or new steady-state. Overtesting may lead to unnecessary regimen changes, adverse effects, and higher ...

NICE

NICE

This guideline covers the care of women who go into labor at term (37+0 to 41+6 weeks). The care a woman receives during childbirth has the potential to affect her (both physically and emotionally, in the short and long term) and the health of her baby. Good communication, support and compassion from staff, and respect for her wishes can help her feel in control of what is happening and help make birth a positive experience for the woman and her companions. . An example of caring for women at ...