Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.
  • Checklist for standardized reporting of drug-drug interaction management guidelines

    3 July 2018

    Purpose: Inconsistencies and omissions in drug-drug interaction (DDI) management guidelines may lead to harm and suboptimal therapy. The purpose of this study was to define a checklist for DDI management guidelines to help developers produce high-quality guidelines that will support healthcare providers in clinical practice. Methods: We carried out a two-round Delphi process with an international panel of healthcare providers, most of whom are pharmacists involved in providing DDI information, in order to select those items that should be addressed in DDI management guidelines (including grading systems that could be used). Results: Twenty-three panellists reached consensus on 19 items in two main domains. These were consolidated into a checklist of 15 elements for standardized reporting in management guidelines. For each element a description is provided to specify what information should be documented in that specific element. Conclusions: It was possible to reach a broad consensus on which relevant items should be included in a checklist for the development of DDI management guidelines. © 2013 Springer-Verlag Berlin Heidelberg.

  • Laughter and MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful): narrative synthesis.

    3 July 2018

    OBJECTIVE: To review the beneficial and harmful effects of laughter. DESIGN: Narrative synthesis. DATA SOURCES AND REVIEW METHODS: We searched Medline (1946 to June 2013) and Embase (1974 to June 2013) for reports of benefits or harms from laughter in humans, and counted the number of papers in each category. RESULTS: Benefits of laughter include reduced anger, anxiety, depression, and stress; reduced tension (psychological and cardiovascular); increased pain threshold; reduced risk of myocardial infarction (presumably requiring hearty laughter); improved lung function; increased energy expenditure; and reduced blood glucose concentration. However, laughter is no joke-dangers include syncope, cardiac and oesophageal rupture, and protrusion of abdominal hernias (from side splitting laughter or laughing fit to burst), asthma attacks, interlobular emphysema, cataplexy, headaches, jaw dislocation, and stress incontinence (from laughing like a drain). Infectious laughter can disseminate real infection, which is potentially preventable by laughing up your sleeve. As a side effect of our search for side effects, we also list pathological causes of laughter, among them epilepsy (gelastic seizures), cerebral tumours, Angelman's syndrome, strokes, multiple sclerosis, and amyotrophic lateral sclerosis or motor neuron disease. CONCLUSIONS: Laughter is not purely beneficial. The harms it can cause are immediate and dose related, the risks being highest for Homeric (uncontrollable) laughter. The benefit-harm balance is probably favourable. It remains to be seen whether sick jokes make you ill or jokes in bad taste cause dysgeusia, and whether our views on comedians stand up to further scrutiny.

  • Evidence-based Medical Monitoring: From Principles to Practice

    3 July 2018

    Monitoring is a major component of management of chronic diseases such as diabetes, cardiovascular disease, arthritis and depression. Yet poor monitoring means healthcare costs are rising. This book discusses how monitoring principles adopted in other spheres such as clinical pharmacology and evidence-based medicine can be applied to chronic disease in the global setting. With contributions from leading experts in evidence-based medicine, it is a ground-breaking text for all involved in delivery of better and more effective management of chronic illnesses. © 2008 Blackwell Publishing.