Resultados de Búsqueda
Do not assume that bilateral redness and swelling of both lower legs is due to infection unless there is clinical evidence of sepsis such as malaise, fever and neutrophilia, plus an expanding area of ...
Choosing Wisely Australia
The Australasian College of Dermatologists
Bilateral lower leg cellulitis is very rare. Most commonly the redness is due to an underlying inflammatory skin disorder such as venous eczema or a more deeply extending inflammation involving the subcutaneous fat known as lipodermatosclerosis. This condition, which occurs more frequently in patients with venous disease, who are overweight and immobile, may initially present as bilateral redness and swelling, and then progresses over time to produce scarring and hardening of the underlying ...
ver más ... 2016Don’t routinely use extensive loco regional therapy in most cancer situations where there is metastatic disease and minimal symptoms attributable to the primary tumor.
Choosing Wisely Australia
Royal Australian and New Zealand College of Radiologists
In the past, extensive local regional therapies (e.g., surgery) were often provided in patients with metastatic disease, regardless of the symptomatology of the primary tumour. However, recent evidence has suggested that in many cases these therapies do not improve outcome and, at times, delay the more important treatment of metastatic disease (e.g., chemotherapy). In general, patients with metastatic disease from solid organ malignancies and a relatively asymptomatic primary tumour should be ...
ver más ... 2016Don’t routinely add adjuvant whole-brain radiation therapy to stereotactic radio surgery for limited brain metastases.
Choosing Wisely Australia
Royal Australian and New Zealand College of Radiologists
Randomised studies have demonstrated no overall survival benefit from the addition of adjuvant whole brain radiation therapy (WBRT) to stereotactic radiosurgery (SRS) in the management of selected patients with good performance status and brain metastases from solid tumors. The addition of WBRT to SRS is associated with diminished cognitive function and worse patient-reported fatigue and quality of life. These results are consistent with the worsened self-reported cognitive function and ...
ver más ... 2016Don’t routinely use extended fractionation schemes (>10 fractions) for palliation of bone metastases.
Choosing Wisely Australia
Royal Australian and New Zealand College of Radiologists
Studies suggest equivalent pain relief following 30 Gy in 10 fractions, 20 Gy in 5 fractions, or a single 8 Gy fraction. A single treatment is more convenient but may be associated with a slightly higher rate of retreatment to the same site. Strong consideration should be given to a single 8 Gy fraction for patients with a limited prognosis or with transportation difficulties.
ver más ... 2016Don’t initiate management of low risk prostate cancer without discussing active surveillance.
Choosing Wisely Australia
Royal Australian and New Zealand College of Radiologists
Patients with prostate cancer have a number of reasonable management options. These include surgery and radiation, as well as conservative monitoring without therapy in appropriate patients. Shared decision making between the patient and the physician can lead to better alignment of patient goals with treatment and more efficient care delivery. ASTRO has published patient-directed written decision aids concerning prostate cancer and numerous other types of cancer. These types of instruments can ...
ver más ... 2016