The use of computed tomography enterography (CTE) imaging to investigate patients with suspected or established Crohn’s disease would result in changes being made to around half of management plans.

  • Edward Loftus and colleagues say that the management plan changes observed during the study, namely the exclusion of active CD and medication alterations, arose from an increased level of diagnostic confidence (LOC) among physicians using CTE.
  • These findings demonstrate that CTE, a contrast-based small intestine imaging technique, “allows clinicians to make accurate assessments of small bowel disease activity and complications based on objective data, leading to more appropriate management plans.”
  • Loftus and team reported in the journal Inflammatory Bowel Diseases that they asked the treating physicians of 273 patients with established (n=145) or suspected (n=128) CD to complete a pre- and post-CTE questionnaire indicating their proposed clinical management plan and LOC (on a 5-point scale) when diagnosing active disease and complications, such as fistulas or abscesses.

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The new clinical practice guideline (CPG) is intended to complement and extend existing guidelines available in the literature, including previous CPGs from AACE.

  • The new document advocates a comprehensive approach to routine diabetes management, based on evidence that, although glycemia control variables such as HbA1c and glucose excursions have an impact on cardiovascular disease risk, other factors – including obesity, blood pressure, dyslipidemia, and hypercoagulation – also play important roles.
  • The goals for these guidelines are to provide the health care professional with tools to develop a comprehensive care plan for the prevention and management of diabetes and its complications, addressing not just hyperglycemia, but all associated cardiovascular risk factors.
  • The document advocates an individualized approach to treatment, with personalized goals based on duration of diabetes, comorbidities, longevity, and the ability to provide treatment safely. Read the rest of this entry »

BMI is a highly insensitive measure of obesity prone to under-diagnosis, while direct fat measurements are superior because they show distribution of body fat.

  • In a single-center study, 66% of patients classified as obese on the basis of DEXA scanning had BMI values in the non-obese range, according to Eric Braverman, MD, of New York Presbyterian Hospital/Weill Cornell Medical Center.
  • Among more than 1,000 patients, 56% were obese according to the DEXA results, versus 20% using the standard BMI-based definitions.
  • Scoffing at BMI as the “baloney mass index,” Braverman said it’s “very likely that obesity is a much bigger epidemic than the 300 million people acknowledged by the World Health Organization.” Read the rest of this entry »

Nutricia Middle East Medical Nutrition Conference

Posted by: admin on: July 18, 2011

The First Nutricia Middle East Medical Nutrition Conference presents the latest in the management of disease and the improvement of clinical outcomes for patients with the support of Medical Nutrition.

 

  • Aim
    • To present and discuss scientific evidence and clinical experience with Medical Nutrition as an integral part of treatment in several key disease areas.
  • What exactly is Medical Nutrition?
    • Medical Nutrition may be classified as:
      1. General Medical Nutrition: Complete nutrition for patients who need special support for recovery, for quality of life, or for better management of their condition. Examples of such patients include those who are recovering from a serious operation or a stroke as well as a supplement for patients who cannot get enough food intakes from normal meals.
      2. Disease Targeted Nutrition: Adapted nutrition to alleviate specific disease symptoms in patients, to address specialized dietary needs, or to delay the progression of disease. Examples of these conditions include diabetes, cancer, would healing, phenylketonuria and chronic obstructive pulmonary disease.
        Read the rest of this entry »

Are medical students and new doctors overly reliant on tests and technology to make diagnoses?

  • Radiology tests have become a crutch: Doctors in training are no longer taught how to distinguish patients who need testing from those who don’t.
  • A decade ago, a surgeon would spend time interviewing and carefully examining a patient to help decide if he or she needed a CT.
  • Now, many surgeons, especially the younger ones, won’t see a patient until the CT is complete. Read the rest of this entry »
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