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At least 91 records · Page 5Linked to original sources
PubMed2004

An update from the latest workshop on asymptomatic primary hyperparathyroidism.

Considerable data have accumulated since 1990 concerning the natural history of asymptomatic primary hyperparathyroidism,the extent of target organ involvement, techniques for preoperative localization of parathyroid glands, and new surgical approaches for parathyroidectomy. Therefore a Workshop on Asymptomatic Primary Hyperparathyroidism: a Perspective for the Twenty-first Century was held in April 2002 with a goal of reevaluating the conclusions from the 1990 National Institutes of Health (NIH)Consensus Development Conference. This article presents the recommendations of the workshop panel and discusses the evidence leading to the changes in the recommendations of the 1990 NIH conference.

Bone Density↗
PubMed2001

Lights! Camera! Action!

Explore the source record for details and available documents.

Consensus Development Conferences, NIH as Topic↗
PubMed1997

Antenatal corticosteroids in pregnancies complicated by preterm premature rupture of membranes.

In 1994, the National Institutes of Health Consensus Development Conference on Antenatal Steroids recommended corticosteroids between 24 and 30-32 weeks' gestation in pregnancies complicated by preterm premature rupture of membranes (PROM). Since the Consensus Conference, the use of antenatal corticosteroids has increased to approximately 60% of potential treatment candidates. Some of the remaining 40% of pregnant candidates may go untreated because of concern that corticosteroids could increase the risk of neonatal infection. Using decision-analysis techniques, we compared the potential benefit of antenatal corticosteroids in reducing the incidence of severe intraventricular hemorrhage with the potential risk of increasing the rate of neonatal sepsis. Our analysis indicates that the benefit of a small decrease in severe intraventricular hemorrhage outweighs the potential harm of a large increase in the rate of neonatal sepsis. Therefore, we support the Consensus Conference panel's recommendation that antenatal corticosteroids be used in pregnancies complicated by preterm PROM.

Adrenal Cortex Hormones↗
PubMed1999

Cystic fibrosis and the National Institutes of Health consensus statement: are obstetrician-gynecologists ready to comply?

OBJECTIVE: To determine if obstetrician-gynecologists are ready to comply with the April 1997 National Institutes of Health (NIH) consensus statement regarding carrier screening for cystic fibrosis. METHODS: A multiple-choice questionnaire was mailed to all active North Carolina nonfederal physicians with a primary specialty of obstetrics and gynecology. Ten questions surveyed the participants' knowledge about cystic fibrosis. RESULTS: Two hundred eighty-six surveys were returned for a response rate of 30.4%. The respondents differed in their knowledge base depending on their specialty, age, and number of years of experience as a physician. The youngest physicians and the least experienced yielded the highest percentage correct. The questions most frequently answered correctly dealt primarily with clinical information about cystic fibrosis, whereas the questions most often answered incorrectly dealt with carrier frequency and testing information. CONCLUSION: The obstetrics-gynecology community is not yet prepared to comply with the NIH Consensus Statement to offer cystic fibrosis carrier screening to couples preconceptionally or prenatally. Further education is necessary before obstetrician-gynecologists can counsel patients adequately.

Adult↗
PubMed2003

Antenatal corticosteroids for fetal maturation in women at risk for preterm delivery.

The available data unambiguously support the beneficial, short-term fetal effects of antenatal corticosteroids in women at risk for preterm delivery. There are still several incompletely addressed questions, including the use of corticosteroids in women with preterm premature rupture of membranes, the optimal corticosteroid preparation to be used, and the impact of repeated dosing. These issues are discussed in this review from the perspective of recent scientific evidence on the mechanisms responsible for positive short-term effects on survival and possible harmful long-term effects.

Adrenal Cortex Hormones↗
PubMed1992

The case for intensive dissemination: adoption of practice guidelines in the coronary care unit.

Medical practice guidelines are being embraced enthusiastically by subspecialty and government organizations, but although hundreds have been developed at great public and private expense, there are few examples of how they have improved the quality of care or reduced health care costs. This article reports documented experience in changing physician behavior after implementing medical practice guidelines in the coronary care unit without altering physician incentives or imposing the threat of sanctions. Guideline adoption did require significant attention to the implementation process, including endorsement of guidelines by local "opinion leaders," validation by local data, and an intensive and concurrent implementation strategy.

Chest Pain↗
PubMed1999

Management of hepatitis C: current and future perspectives.

Chronic hepatitis C is now a major cause of chronic liver disease, cirrhosis and hepatocellular carcinoma. In March 1997, the National Institutes of Health sponsored a Consensus Development Conference entitled "Management of Hepatitis C". The final statement from the Consensus Panel set forth clear, evidence-based guidelines and recommendations regarding the diagnosis, evaluation, prevention and therapy of hepatitis C. The conclusions of the Consensus Panel have been widely accepted and have brought some degree of uniformity to the management of hepatitis C. An important issue is how to keep such recommendations current in such a rapidly evolving area of medicine. In the 2 years since the Consensus Conference there have been important advances in the management of chronic hepatitis C. Two recommendations of the Consensus Panel deserve modification: first, on the clinical usefulness of genotyping of hepatitis C virus and second, on the optimal therapeutic regimen. Two large multicenter, prospective controlled trials have shown that the combination of alpha interferon with ribavirin provides higher sustained virologic responses than interferon alone and that optimal therapy is a 24-week course for patients with genotypes 2 and 3 and a 48-week course for patients with genotype 1. Furthermore, therapy can be stopped at 24 weeks if HCV RNA is still present. Many clinical challenges remain. Major current needs are for accurate means of assessing the grade and stage of disease, for the likelihood of disease progression and of response to therapy as well as for viral eradication by treatment. Also important are new therapies for hepatitis C that might be used alone or in combination with interferon and ribavirin; therapies that could be applied to a wide variety of patients, with different stages of disease and with other comorbitities.

Consensus Development Conferences, NIH as Topic↗
PubMed1996

Universal newborn screening for hearing loss: ideal vs. reality and the role of otolaryngologists.

In 1993 the National Institutes of Health Consensus Statement, Early Identification of Hearing Impairment in Infants and Young Children, recommended "universal screening for hearing impairment prior to three months of age." However, the decision to invoke screening programs that include all newborns remains highly controversial, even though such programs now exist in at least 60 hospitals in 18 states. Unfortunately, otolaryngologists in the United States have not been actively involved in this ongoing debate, despite the role of those in our specialty as "gatekeepers" of hearing loss in patients of all ages. In relation to identification of hearing loss in the neonatal period, we have abrogated our responsibility to other health care professionals. Otolaryngologists, this is your "wake up call."

Attitude of Health Personnel↗
PubMed1992

Asymptomatic impacted teeth in edentulous jaws undergoing preprosthetic surgery. A long-term evaluation.

A long-term evaluation is made of 15 patients with asymptomatic impacted teeth in edentulous jaws. Seventeen impacted teeth in 15 patients were recorded and analysed. They were located in denture-bearing areas and in areas undergoing preprosthetic surgery. All patients, except one lost after 1-year period, were followed clinically and radiographically for 1 to 10 years with an average of 4 years. The asymptomatic impacted teeth in edentulous jaws embedded in bone or covered with mucosa did not cause any problem to the patients. The findings of this study support the view that removal of asymptomatic impacted teeth in denture-bearing areas, or in areas undergoing preprosthetic surgery, is unnecessary as long as the integrity of the covering tissues is preserved. A policy or radiological surveillance is recommended.

Adult↗
PubMed1995

The NIH consensus development program.

The NIH CDCs are a highly visible, public forum to evaluate controversial medical technologies by synthesizing current medical science data. The consensus statements, although not intended as medical practice guidelines, may form part of the database preceding guideline formulation. It is difficult to assess the effect of the conferences on physician practice, in part reflecting the interference of the many other influences, medical and nonmedical, on physician behavior. Yet the program has had some success in influencing reimbursement policy for some technologies here and abroad and in influencing specialty organization policy, thereby indirectly affecting physician behavior. On the other hand, OMAR's dissemination activities have apparently been so successful that demand for CDC statements has more than doubled over the past five years, prompting OMAR to establish an information service (including fax and the Internet). And finally, the program has spawned consensus conferences throughout the world, including Canada, Western Europe, and Israel (Goodman & Baratz 1990).

Consensus Development Conferences, NIH as Topic↗