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GIMBE^®

Workshop
Decisioni Cliniche
e Prove di Efficacia
Seconda edizione

Riccione, 26-27 marzo 2004

in collaborazione con

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Appropriatezza e sicurezza delle eparine a basso peso molecolare. Siamo certi di seguire le migliori evidenze?
Conduttori: Antonino Cartabellotta, Alessandro Di Pasquale
Discussant: Modesto Fantini, Ettore Ranocchi, Eros Tiraferri

• Slides

• Evidence appraised

  • Linee guida

    • SISET - Società Italiana per lo Studio dell'Emostasi e Trombosi

      • Diagnosi, Profilassi e Terapia del Tromboembolismo Venoso, 2003

      • Profilassi del tromboembolismo venoso in chirurgia ortopedica maggiore, 2002

    • SIGN - Scottish Intercollegiate Guidelines Network

      • Prophylaxis of venous thromboembolism. October 2002

    • American College of Chest Physicians

      • Heparin and Low-Molecular-Weight Heparin Mechanisms of Action, Pharmacokinetics, Dosing, Monitoring, Efficacy, and Safety. Chest 2001;119: 64S-94S

      • Prevention of Venous Thromboembolism. Chest 2001;119:132S-175S

    • American Heart Association

      • Guide to anticoagulant therapy: Heparin : a statement for healthcare professionals from the American Heart Association. Circulation 2001;103:2994-3018

    • College of American Pathologist

      • Platelet count monitoring and laboratory testing for heparin-induced thrombocytopenia. Arch Pathol Lab Med 2002;126:1415-23

  • Evidence summaries

    • Jackson N. Comparative incidence of heparin-induced thrombocytopenia syndrome (HITS) with unfractionated heparin and low molecular weight heparin. Centre for Clinical Effectiveness (CCE), November 2002

  • Revisioni sistematiche

  • Non-Cochrane

    • O'Donnell M, Linkins LA, Kearon C, et al. Reduction of out-of-hospital symptomatic venous thromboembolism by extended thromboprophylaxis with low-molecular-weight heparin following elective hip arthroplasty: a systematic review. Arch Intern Med 2003;163:1362-6 [abstract]

    • McCart GM, Kayser SR. Therapeutic equivalency of low-molecular-weight heparins. Ann Pharmacother 2002;36:1042-57 [abstract]

    • Hull RD, Pineo GF, Stein PD, et al. Extended out-of-hospital low-molecular-weight heparin prophylaxis against deep venous thrombosis in patients after elective hip arthroplasty: a systematic review. Ann Intern Med 2001;135:858-869.

      • Record DARE

    • Eikelboom JW, Quinlan DJ, Douketis JD. Extended-duration prophylaxis against venous thromboembolism after total hip or knee replacement: a meta-analysis of the randomised trials. Lancet 2001;358:9-15. [abstract]

      • Record DARE

    • Cohen AT, et al. Extended thromboprophylaxis with low molecular weight heparin reduces symptomatic venous thromboembolism following lower limb arthroplasty. A meta-analysis. Thromb Haemost 2001;85:940-1 [abstract]

    • van der Heijden JF, Prins MH, Buller HR. Low-molecular-weight heparins: are they interchangeable? Haemostasis. 2000;30 Suppl 2:148-57 [abstract]

      • Record DARE

  • Revisioni non sistematiche

    • O'Shea SI, Ortel TL. Issues in the utilization of low molecular weight heparins. Semin Hematol 2002;39:172-8

    • Boneu B, de Moerloose P. How and when to monitor a patient treated with low molecular weight heparin. Semin Thromb Hemost 2001;27:519-22 [abstract]

    • Duplaga BA, Rivers CW, Nutescu E. Dosing and monitoring of low-molecular-weight heparins in special populations. Pharmacotherapy 2001;21:218-34 

  • Ricerca primaria (RCTs ed altri studi)

  • Warkentin TE, Kelton JG. Temporal aspects of heparin-induced thrombocytopenia. N Engl J Med 2001;344:1286-92

La depressione in Medicina Generale: cono-sciamo solo la punta dell’iceberg?
Conduttori: Antonino Cartabellotta, Alessandro Di Pasquale
Discussant: Angelo Fioritti, Silvio Guidi, Giovanni Piraccini

• Slides

• Evidence appraised

  • Linee guida

    • U.S. Preventive Services Task Force. Screening for depression: recommendations and rationale. Ann Intern Med 2002;136:760-4

    • Prodigy.Depression. April, 2003

    • American Psychiatric Association. Practice guideline for the treatment of patients with bipolar disorder. April, 2002

    • British Association for Psychopharmacology. Evidence-based guidelines for treating depressive disorders with anti-depressants. March, 2000

  • Evidence summaries

    • Pignone MP, Gaynes BN, Rushton JL, et al. Screening for depression in adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2002;136:765-76

      • AHRQ Evidence-report

    • Improving the recognition and management of depression in primary care. Effective Health Care Bulletin, 2002

  • Revisioni sistematiche

  • Cochrane

  • Guaiana G, Barbui C, Hotopf M. Amitriptyline versus other types of pharmacotherapy for depression. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

  • Barbui C, Hotopf M, Freemantle N, et al. Treatment discontinuation with selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants (TCAs) In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

  • Furukawa TA, Streiner DL, Young LT. Antidepressant and benzodiazepine for major depression. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

  • Geddes JR, Freemantle N, Mason J, Eccles MP, Boynton J. Selective serotonin reuptake inhibitors (SSRIs) versus other antidepressants for depression. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

  • Furukawa T, McGuire H, Barbui C. Low dosage tricyclic antidepressants for depression. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

  • Non-Cochrane

    • Gilbody S, Whitty P, Grimshaw J, Thomas R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA 2003;289:3145-51

    • Gilbody SM, House AO, Sheldon TA. Routinely administered questionnaires for depression and anxiety: systematic review. BMJ 2001;322:406-9

    • van Weel-Baumgarten EM, Schers HJ, van den Bosch WJ, van den Hoogen HJ, Zitman FG. Long-term follow-up of depression among patients in the community and in family practice settings. A systematic review. J Fam Pract 2000;49:1113-20

  • Revisioni non sistematiche

    • Sutherland JE, Sutherland SJ, Hoehns JD. Achieving the best outcome in treatment of depression. J Fam Pract 2003;52:201-9

    • Nease DE Jr, Maloin JM. Depression screening: a practical strategy. J Fam Pract 2003;52:118-24

    • Remick RA. Diagnosis and management of depression in primary care: a clinical update and review. CMAJ 2002;167:1253-60

Trattamento dell’osteoporosi: è davvero tutto chiaro? Prove di efficacia e trial comparativi
Conduttori: Antonino Cartabellotta, Alessandro Di Pasquale
Discussant: Marco Grassi, Andrea Tarroni, Michele Zini

• Slides

• Evidence appraised

  • Linee guida

    • Institute for Clinical Systems Improvement (ICSI).Diagnosis and treatment of osteoporosis. July, 2003

    • SIGN - Scottish Intercollegiate Guidelines Network. Management of osteoporosis, June 2003

    • American Association of Clinical Endocrinologist (AACE). Postmenopausal osteoporosis, November 2003

    • The North American Menopause Society.Management of postmenopausal osteoporosis, March 2002

    • Royal College of Physicians. Osteoporosis Clinical guidelines for prevention and treatment, 2001

    • Committee of Scientific Advisors of the International Osteoporosis Foundation.The use of biochemical markers of bone turnover in osteoporosis. Osteoporos Int. 2000;11 Suppl 6:S2-17

  • Evidence summaries

    • Bruyere O, Edwards J, Reginster JY. Fracture prevention in postmenopausal women. Clinical Evidence, March 2004 (search date May 2003)

  • Technology assessment

    • Treatment of established osteoporosis: a systematic review and cost–utility analysis. Health Technology Assessment 2002; Vol. 6: No. 29

    • Biochemical markers for bone turnover in osteoporosis. Bloomington, MN: Institute for Clinical Systems Improvement (ICSI), 2001

  • Revisioni sistematiche

  • Cochrane

    • Cranney A, et al. Risedronate for the prevention and treatment of postmenopausal osteoporosis. (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

    • Cranney A, et al. Etidronate for treating and preventing postmenopausal osteoporosis (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

    • Shea B, et al. Calcium supplementation on bone loss in postmenopausal women (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

    • Gillespie WJ, et al. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

  • Non-Cochrane

    • van Staa TP, Leufkens HG, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 2002;13:777-87 [abstract]

  • Revisioni non sistematiche

    • Seeman E, Eisman JA. Treatment of osteoporosis: why, whom, when and how to treat. Med J Aust 2004;180:298-303

    • Delmas PD. Treatment of postmenopausal osteoporosis. Lancet 2002;359:2018-26

    • Kanis JA.Diagnosis of osteoporosis and assessment of fracture risk. Lancet 2002;359:1929-36

    • Seeman E. Pathogenesis of bone fragility in women and men. Lancet 2002;359:1841-50

    • Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002;359:1761-7

  • Ricerca primaria (RCTs ed altri studi)

  • Matsumoto H, et al. Effects of inhaled corticosteroid and short courses of oral corticosteroids on bone mineral density in asthmatic patients: a 4-year longitudinal study. Chest. 2001;120:1468-73

  • Documenti regolatori

    • EMEA. Public Statement" del suo Comitato Scientifico, il CPMP, sull’uso della Terapia Ormonale Sostitutiva (TOS).

Organizzazione, informazione, formazione: la difficile gestione integrata dello scompenso cardiaco
Conduttori: Antonino Cartabellotta, Alessandro Di Pasquale
Discussant: Fernanda Bastiani, Paolo Baldazzi, Michele Senni

• Slides

• Evidence appraised

  • Linee guida Scompenso Cardiaco

    • National Institute for Clinical Excellence (NICE) and Royal College of Physicians (RCP). Chronic heart failure: management of chronic heart failure in adults in primary and secondary care. July 2003

    • European Society of Cardiology (ESC). Guidelines for the Diagnosis and Treatment of Chronic Heart Failure. Eur Heart J 2001;22:1527-1560

    • American College of Cardiology/American Heart Association (ACC(AHA). ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult. November 2001

      National Heart Foundation of New Zealand. A Guideline for the Management of Heart Failure: health professionals guide. December 2001

    • Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO). Linee Guida sullo Scompenso Cardiaco. 1997

  • Linee guida Fibrillazione Atriale

    • Snow V, et al. Management of newly detected atrial fibrillation: a clinical practice guideline from the American Academy of Family Physicians and the American College of Physicians. Ann Intern Med 2003;139:1009-17

    • McNamara RL, et al. Management of atrial fibrillation: review of the evidence for the role of pharmacologic therapy, electrical cardioversion, and echocardiography. Ann Intern Med 2003;139:1018-33

  • Evidence summaries

    • Heart Failure. Clinical Evidence, March 2004 (Last search, October 2002)

  • Revisioni sistematiche

  • Non-Cochrane

    • Phillips CO, et al. Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis. JAMA 2004;291:1358-67

    • McAlister FA, et al. A systematic review of randomized trials of disease management programs in heart failure  Am J Med 2001;110(5):378-384. [abstract] - (Record DARE)

Sindrome metabolica e rischio cardiovascolare: la strada passa sempre per il diabete? Conduttori: Antonino Cartabellotta, Alessandro Di Pasquale
Discussant: Paolo Angelini, Mario Parenti, Luigi Rusconi

• Slides

• Evidence appraised

• Linee guida

  • American College of Rheumatology

    • Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum 1999;42:1785-96

    • Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725

    • The 1982 Revised Criteria of the Classification of Systemic Lupus Erythematosus. Arthritis Rheum 1982;25:1271-7

  • College of American of Pathology. Guidelines for clinical use of the antinuclear antibody test and tests for specific autoantibodies to nuclear antigens. Arch Pathol Lab Med 2000;124:71-81

• Evidence summaries

  • Mazanec DJ, Kantor SM. Systemic Lupus Erythematosus. In: Diagnostic Strategies for Common Medical Problems. 1999:419-428.

• Revisioni non sistematiche

  • Gill JM, et al. Diagnosis of systemic lupus erythematosus. Am Fam Physician 2003;68:2179-86

  • Ruiz-Irastorza G, et al . Systemic lupus erythematosus. Lancet 2001;357:1027-32