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Each year, there are approximately 10 million cases of venous thromboembolism (VTE) worldwide. Non-vitamin K antagonist oral anticoagulants (NOACs) are suggested over warfarin for initial and long-term treatment of VTE in patients without cancer. Routine use of compression stockings is out to prevent postthrombotic syndrome in acute DVT. To date, the updated guideline has been endorsed by American Association for Clinical Chemistry, American College of Clinical Pharmacy, International Society for Thrombosis and Haemostasis, and American Society of Health-System Pharmacists. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
Clipping is a handy way to collect and organize the most important slides from a presentation. New Rochelle, NY, September 30, 2014--Levothyroxine (L-T4), long the standard of care for treating hypothyroidism, is effective in most patients, but some individuals do not regain optimal health on L-T4 monotherapy.
The task force concluded that levothyroxine should remain the standard of care for treating hypothyroidism, noting that no consistently strong evidence supports the superiority of alternative therapies. Thyroid, the official journal of the American Thyroid Association, is an authoritative peer-reviewed journal published monthly online with Open Access options and in print. The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. Mary Ann Liebert, Inc., publishers is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Diabetes Technology & Therapeutics, Journal of Women's Health, Journal of Men's Health, and Metabolic Syndrome and Related Disorders. For more than 10 years, a key guideline for treatment of high cholesterol in the United States was the Adult Treatment Panel III (ATP III), published by the National Heart, Lung, and Blood Institute (NHLBI) in 2002 and updated in 2004.
The new guideline has a slightly more complicated process for determining the prescribing of statins for cholesterol management. For patients who fit one of these four categories, statin treatment should be initiated at either high intensity or moderate intensity, depending upon which category is met.
Another major change in the 2013 guideline is the departure from the Framingham risk-assessment tool. Pharmacists should expect an increase in the number of patients taking statins, especially high-intensity therapies. The World Health Organization released new guidelines on Sunday, June 30 at the International AIDS Society meeting in Kuala Lumpur.
WHO’s new guidelines are based largely on recent studies suggesting people with HIV who start treatment before their immune systems weaken, live longer. Robert Grant, Professor of Medicine at University of California San Francisco, comments on the hope that the “Mississippi Baby” case is bringing to researchers. The program Ending the Epidemic: Science Advances on AIDS laid out the prospects of another recent HIV success story. Sign up for our free newsletter to see exclusive features and be the first to get news and updates on upcoming WSF programs.
VTE, the formation of blood clots in the vein, is a dangerous and potentially deadly medical condition and is a leading cause of death and disability worldwide. The guideline presents stronger recommendations and weaker suggestions for treatment based on the best available evidence, and identifies gaps in our knowledge and areas for future research,” said lead author Clive Kearon, MD, McMaster University.
Since publication of the 9th edition, new studies show that NOACs are as effective as VKA therapy with reduced risk of bleeding and increased convenience for patients and health-care providers. Based on recent evidence, the 10th edition suggests not to routinely use compression stockings to prevent postthrombotic syndrome in patients with acute DVT.

The 10th edition suggests which patients diagnosed with isolated subsegmental pulmonary embolism (SSPE) should, and should not, receive anticoagulant therapy. They emphasize that the recommendations are intended to guide physicians' clinical decision-making on thyroid hormone replacement therapy for individual patients. The Journal publishes original articles and timely reviews that reflect the rapidly advancing changes in our understanding of thyroid physiology and pathology, from the molecular biology of the cell to clinical management of thyroid disorders. ATA is an international membership medical society with over 1,700 members from 43 countries around the world.
Its biotechnology trade magazine, Genetic Engineering & Biotechnology News (GEN), was the first in its field and is today the industry's most widely read publication worldwide.
As a result of this emphasis on clinically meaningful endpoints, the guideline focuses on agents with the highest-quality evidence, namely, high-intensity statin therapy. What is the evidence for LDL cholesterol (LDL-C) and non–HDL-C goals for secondary prevention of atherosclerotic cardiovascular disease (ASCVD)? For primary and secondary prevention, what is the impact on lipid concentrations, effectiveness, and safety of specific cholesterol-modifying drugs used for lipid management in general and selected subgroups?
The 2013 guideline takes a much different approach, in that more clinical judgment is required of the physician. High-intensity statin therapy is a dosage that lowers LDL-C by an average of ≥50%, whereas moderate-intensity therapy lowers LDL-C by 30% to 50%.
Instead, a new risk-assessment tool, the Pooled Cohort Equations, was developed by the Risk Assessment Work Group. The new guidelines advise that statin therapy be optimized prior to using add-on medications. Because of this, many patients will be reluctant to start a high-intensity statin medication, such as atorvastatin or rosuvastatin.
Pharmacists can play a pivotal role in helping patients understand the changes inherent in the new guideline, and in addressing their concerns, as well.
Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report.
The case of a baby girl with HIV who was treated aggressively within 30 hours of birth suggests early treatment could prevent the virus from ever getting a foothold. Referred to as “The Berlin Patient,” Timothy Ray Brown is the only person considered cured of HIV. But right now, only about 60 percent of people who need the life-saving drugs are getting them. In this latest evidence-based guideline, Antithrombotic Therapy for VTE Disease: CHEST Guideline, from the American College of Chest Physicians, experts provide 53 updated recommendations for appropriate treatment of patients with VTE. Postthrombotic syndrome is a chronic condition of the leg with swelling, pain, skin discoloration, and even ulcers. An expert task force of the American Thyroid Association on thyroid hormone replacement reviewed the latest studies on L-T4 therapy and on alternative treatments to determine whether a change to the current standard of care is appropriate, and they present their recommendations in the article "Guidelines for the Treatment of Hypothyroidism," published in Thyroid, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers and the official journal of the American Thyroid Association (ATA). Bianco, with colleagues from the Clinical and Translational Science sub-committees, coauthored the Guidelines on behalf of the American Thyroid Association Task Force on Thyroid Hormone Replacement. I think they will be used extensively by all clinical endocrinologists, especially by our members," says Hossein Gharib, MD, President of the ATA, Professor of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. The Thyroid journal program also includes the monthly highly valued abstract and commentary publication, Clinical Thyroidology (Editor-in-Chief Jerome M. A complete list of the firm's more than 80 journals, books, and newsmagazines is available on the Mary Ann Liebert, Inc., publishers website.

Other agents recommended in previous guidelines did not have sufficient evidence for inclusion.
Previously, the steps for deciding the need for treatment intervention were relatively straightforward. The Pooled Cohort Equations are used to calculate the 10-year risk of ASVCD.1,3 This assessment is recommended only for those patients who do not fall into group 1 or group 2. This translates to increased pharmacist intervention in terms of communicating with the patient about side effects or checking for potential drug interactions between the statin and other medications. This may require that pharmacists intervene with physicians who are unfamiliar with the new guidelines, offering suggestions for optimizing one statin treatment rather than having the patient on multiple types of cholesterol-lowering agents. It is the pharmacist’s duty to educate the patient and ease any worries the patient may have. In the past, WHO recommended countries start treating people with HIV when their T-cell count fell to 350. Earlier this year, doctors announced the “Mississippi Baby” was apparently cured after stopping medication for a year with no signs of infection. Though the strategy could ultimately result in fewer HIV infections and deaths in the future, costs for earlier treatments will be expensive. In the 9th edition, compression stockings were routinely suggested as a preventive measure in these patients. Hershman, MD), and a videojournal companion to Thyroid, VideoEndocrinology (Editor Gerard Doherty, MD). The ATA promotes thyroid awareness and information through its online Clinical Thyroidology for the Public (distributed free of charge to over 11,000 patients and public subscribers) and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish.
The new guideline recommends that moderate- or high-intensity statins be used in four populations: patients with a history of cardiovascular disease, elevated cholesterol, diabetes mellitus, or high cardiovascular risk according to Pooled Cohort Equations. This also creates the opportunity for more pharmacy-run clinics with lipid management to be opened, allowing pharmacists to provide services such as checking patient cholesterol and liver-enzyme concentrations to ensure adherence to and safety of statin regimens. Thus, pharmacists should become familiar with tables of equivalent statin regimens in order to make suggestions to increase a statin dosage or switch patients to a statin that may better help them reach their goals. Not only is it important to provide thorough patient counseling when the patient first picks up the medication, it is equally important to follow up with the patient. AIDS investigators think that the WHO guidelines are a step in the right direction, but implementing them will be a challenge. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet.
Pharmacists can play a critical role in helping patients understand the new recommendations. In addition to children younger than five years of age, WHO says pregnant and breast-feeding women, people whose partners are uninfected, and those who also have tuberculosis or hepatitis B also should get AIDS drugs as soon as they’re diagnosed with HIV. The guidelines mean an additional nine million people in developing countries now will be eligible for treatment.

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