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Updated Pulmonary Embolism Guidelines
The European Society of Cardiology updated its guidelines for pulmonary embolism in 2019. Jonathan Paul, MD, from the University of Chicago discusses what is new in the management of pulmonary embolism based on his August 11, 2020, JAMA Guidelines Synopsis article.
Source : JAMA
Obesity In Adults : A Clinical Practice Guideline
Effect of Spinal Manipulative & Mobilization Therapies in Young Adults With Mild to Moderate Chronic LBA
Acute Colonic Diverticulitis Clinical Practice Guidelines (WSES, 2020)
Updated recommendations on the management of acute left-sided colonic diverticulitis (ALCD) were released in May 2020 by the World Society of Emergency Surgery (WSES). In addition to including recent changes in the management of ALCD, there is a section about advances in acute right-sided colonic diverticulitis (ARCD), a condition that is more common than ALCD in certain regions of the world.
ALCD Classification
There is no single classification system for ALCD that has been conclusively proven to be superior in predicting patient outcomes. Thus, the WSES does not provide a specific recommendation on which of the many existing classifications should be used in patients with ALCD.
Clinical Practice Guidelines For The Management of Malignant Pleural Mesothelioma (ERS/ESTS/EACTS/ESTRO, 2020)
Clinical practice guidelines for the management of malignant pleural mesothelioma were released in May 2020 by the European Respiratory Society, European Society of Thoracic Surgeons, European Association for Cardio-Thoracic Surgery, and European Society for Radiotherapy and Oncology.
Epidemiology Research Priorities
The task force recommends large international epidemiological studies to determine the relationship between pleural plaques and malignant pleural mesothelioma.
Additionally, well-designed clinical trials are needed to determine the effectiveness of CT screening in populations exposed to asbestos.
Further research is needed, and highly encouraged, on biomarkers for malignant pleural mesothelioma, as the ones proposed previously have not proven useful for diagnosis, prognosis, or clinical follow-up for disease monitoring.
Sevoflurane Shows Promise as Topical Analgesic for Intractable Pain
The widely used inhalational anesthetic sevoflurane was effective as a topical analgesic in treating otherwise refractory pain in an elderly patient with a severe leg ulcer, in a case report newly published by Spanish physicians.
In addition, there are indications that the medication accelerated healing of the year-old ulcer, Dr. Manuel Geronimo-Pardo of Complejo Hospitalario Universítario, in Albacete, and colleagues report in the BMJ Supportive and Palliative Care.
“Sevoflurane produces a rapid, intense, and long-lasting analgesic effect when it is irrigated on painful wounds, regardless of the etiology of the ulcer and the nature of the pain,” Dr. Geronimo-Pardo told Reuters Health by email. “Mild and transient itching at the wound edges is the most frequent adverse effect, so the risk-benefit profile is favorable.”
An 87-year-old woman was under palliative treatment for advanced endometrial cancer, but also had numerous comorbidities, including type 2 diabetes, hypertension, acute coronary syndrome with a stent, chronic kidney failure, and peripheral arterial occlusive disease. Her living will barred hospital admission or any invasive procedures.