steve's blog

Stroke scales

These are useful tools for stroke patients

* Barthel Index o www.strokecenter.org/trials/scales/barthel.pdf

* Glasgow Outcome Scale o www.strokecenter.org/trials/scales/glasgow_outcome.html

* Hunt and Hess Classification of Subarachnoid Hemorrhage o www.strokecenter.org/trials/scales/hunt_hess.html

* Modified Rankin Scale o www.strokecenter.org/trials/scales/modified_rankin.pdf

* NIH Stroke Scale o PDF File o Prehospital Stroke Scales

Osteoporosis guidelines

This website [url=http://www.osteoporosis.ca/english/News/GuidelinesNewsRelease/]ostroporosis.ca [/url]said :The Osteoporosis Society of Canada (OSC) has launched the first evidence-based clinical practice guidelines for osteoporosis in the world. it also mentions [quote]Prevention and Treatment Higher intakes of calcium and vitamin D are recommended, particularly in adults over 50 (calcium 1500 mg/day and vitamin D 800 IU/day). Children, particularly those entering and passing through puberty, should participate in impact exercise or sports (mainly field and court sports). Men and women throughout life should participate in exercise, particularly weight-bearing exercises such as brisk walking, running or dancing. Bisphosphonates (Didrocal, Fosamax and Actonel) and raloxifene (Evista) are first choice therapies for individuals without menopausal (vasomotor) symptoms. Hormone Replacement Therapy (HRT) is no longer the "gold standard" for treatment of osteoporosis.

Fall intervention

Fall is one of the major causes of mobidity and mortality in the elderly. The most effective intervention was a multifactorial falls risk assessment and management programme. It is a research trial in 2004 [url=http://www.bmj.com/cgi/content/abridged/328/7441/680?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=fall&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT]go to BMJ[/url]

Reducing the risk of venous thromboembolism

Venous thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in inpatients undergoing surgery New NICE guide line : April 2007 [url=http://www.nice.org.uk/CG46]Click here[/url]

Aspirin, dipyridamole and secondary prevention of stroke

My consultant neurologist normally prescribes the patients with stroke: Aspirin, Ramipril,Statin.This ESPS-2 shows there is a benefit of adding dipyridamole. It was done in 1988. so there should be more research data somewhere. [b]European Stroke Prevention Study 2 (ESPS-2):[/b] After doing randomised, double-blind, placebo-controlled trial of 6602 patients, it was discovered that the 24-month stroke rate was 12.9% in the aspirin-alone group, 13.2% in the dipyridamole-alone group, 9.9% in the combination group and 15.8% in the placebo group. Stroke risk was significantly reduced by 18.1% in the aspirin-alone group, by 16.3% in the dipyridamole-alone group, and by 37.0% in the combination group compared to the placebo group. The results regarding the endpoint of stroke or death were similar but there was no significant difference among the groups for the endpoint of death . [url=http://www.ncbi.nlm.nih.gov]source[/url]

Early management of suspected meningitis

This is the guide lines for Early Management of Suspected Bacterial Meningitis and Meningococcal Septicaemia in Immunocompetent Adults [url=http://www.britishinfectionsociety.org/Adult_men_early_poster%202004.pdf]Click here[/url]

Pandemic Influenza management guidelines 2007

Clinical management of patients with an influenza-like illness during an influenza pandemic Provisional guidelines from the British Infection Society British Thoracic Society Health Protection Agency in collaboration with the Department of Health Version 11, updated on 2 October 2006 [url=http://www.britishinfectionsociety.org/Pandemic%20guidelines%202007.pdf]Guidelines[/url]

Switching patients from atorvastatin to simvastatin and losartan to candesartan

This is not exciting but interesting topic. I think. You may check [url=http://www.onmedica.net/content.asp?t=2&c=4462&pid=84cdcccdcccec6c9bbd2c8bccfcfd2cbbbbdced2c6bbc6bcd2becfcebecdbac8beccb9c6c882]here[/url]

TIMI RISK SCORE for UA/NSTEMI

Age ≥ 65 years? 1
> 3 Risk Factors for CAD? 1
Known CAD (stenosis ≥ 50%)? 1
ASA Use in Past 7d? 1
Severe angina (≥ 2 episodes w/in 24 hrs)? 1
ST changes ≥ 0.5mm? 1
+ Cardiac Marker? 1

Risk Factors:

Adjuvant Chemotherapy With Gemcitabine vs Observation in Patients Undergoing Curative-Intent Resection of Pancreatic Cancer

Postoperative gemcitabine significantly delayed the development of recurrent disease after complete resection of pancreatic cancer compared with observation alone. These results support the use of gemcitabine as adjuvant chemotherapy in resectable carcinoma of the pancreas. [url=http://jama.ama-assn.org/cgi/content/abstract/297/3/267]Full article on JAMA[/url]
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