Antithrombotic and thrombolytic therapy: from evidence to application: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.


:This chapter about implementation strategies for practice guidelines is part of the 7th ACCP Conference on Antithrombotic and Thrombolytic Therapy: Evidence Based Guidelines. Grade 1 recommendations are strong and indicate that the benefits do, or do not, outweigh risks, burden, and costs. Grade 2 suggests that feasibility, acceptability and cost related to implementation strategies may lead to different choices depending on the practice setting (for a full understanding of the grading see Guyatt et al, CHEST 2004; 126:179S-187S). To encourage uptake of guidelines to reduce thrombosis, we recommend that appreciable resources be devoted to distribution of educational material (Grade 2B). We suggest that few resources be devoted to educational meetings (Grade 2B), to audit and feedback (Grade 2B), or to educational outreach visits (Grade 2B) to encourage uptake of the guidelines. We suggest that appreciable resources be devoted to computer reminders (Grade 2A) and to patient-mediated interventions (Grade 2B) to encourage uptake of the guidelines. This review suggests that there are few implementation strategies that are of unequivocal, consistent benefit, and that are clearly and consistently worth resource investment. Fully informed decisions will require additional research to identify effective guideline implementation strategies to optimize antithrombotic and thrombolytic therapy.






Schünemann HJ,Cook D,Grimshaw J,Liberati A,Heffner J,Tapson V,Guyatt G




Has Abstract


2004-09-01 00:00:00




3 Suppl












  • Effects of hypercapnia on BP in hypoalbuminemic and Nagase analbuminemic rats.

    abstract:STUDY OBJECTIVE:To determine if animals with abnormally low albumin levels are more susceptible to the effects of hypercapnia on BP compared to normal animals. DESIGN:Prospective, controlled laboratory experiment. SETTING:University research laboratory. ANIMALS:Eighteen male Sprague-Dawley rats: 6 rats 10 to 12 week...


    pub_type: 杂志文章


    authors: Gómez JL,Gunnerson KJ,Song M,Li J,Kellum JA

    更新日期:2007-05-01 00:00:00

  • Treatment of stage IIIA non-small cell lung cancer.

    abstract::Stage IIIA non-small cell lung cancer represents a relatively heterogeneous group of patients with metastatic disease to the ipsilateral mediastinal (N2) lymph nodes and also includes T3N1 patients. Presentations of disease range from apparently resectable tumors with occult microscopic nodal metastases to unresectabl...


    pub_type: 指南,杂志文章,实务指引,评审


    authors: Robinson LA,Wagner H Jr,Ruckdeschel JC,American College of Chest Physicians.

    更新日期:2003-01-01 00:00:00

  • Pseudopseudotumor of the lung. Hepatic herniation into the right major fissure imitating a pseudotumor on chest roentgenogram.

    abstract::A young man presented to us with an asymptomatic ovoid mass which appeared to be in the right major fissure. The roentgenographic appearance of the lesion was that of a pseudotumor. The computerized tomography scan suggested tissue density leading to exploration. At surgery, we found the mass to be a portion of liver ...


    pub_type: 杂志文章


    authors: Fanta CH,Kacoyanis GP,Koster JK Jr,McFadden ER Jr

    更新日期:1980-08-01 00:00:00

  • Formoterol suspension aerosol. Comparison with formoterol solution aerosol for 12 weeks in asthmatic patients.

    abstract:UNLABELLED:Formoterol solution aerosol has proved to be a fast and long-acting beta 2-sympathicomimetic drug in many clinical trials. The physical stability, however, was such that storage needed to be at 4 degrees C to 8 degrees C before first use; afterwards, the aerosol could be used for another three months at room...


    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Maesen FP,Nakratzas G,Bantje TA,Prins J,Zweers PG

    更新日期:1992-11-01 00:00:00

  • Cardiogenic shock secondary to Tako-tsubo syndrome after debridement of malignant endobronchial obstruction.

    abstract::Transient left ventricular (LV) dysfunction syndrome, or Tako-tsubo syndrome, occurs following intense emotional or physical stress and simulates the clinical presentation of an acute myocardial infarction. We report a case of a 77-year-old man with esophageal adenocarcinoma with local invasion of the central airways ...


    pub_type: 杂志文章


    authors: Guerrero J,Majid A,Ernst A

    更新日期:2009-01-01 00:00:00

  • Reversal of central sleep apnea using nasal CPAP.

    abstract::Based on the theory that obstructive (OSA) and central (CSA) sleep apneas share common pathophysiologic mechanisms, we attempted to treat eight patients with predominantly CSA by continuous positive airway pressure (CPAP). All patients exhibited repetitive episodes of CSA and mixed sleep apneas (MSA) in the supine pos...


    pub_type: 杂志文章


    authors: Issa FG,Sullivan CE

    更新日期:1986-08-01 00:00:00

  • A simplified insertion technique for tracheobronchial silicone stents.

    abstract::In many patients with central airway obstruction due to extrinsic compression or malacia, insertion of tracheobronchial stents can provide effective and permanent relief. Of the various types of prostheses described, the silicone Dumon-Artemis stents (Medicore, Brussels, Belgium) are probably the most efficient. The u...


    pub_type: 杂志文章


    authors: Noppen M,Dhondt E,Meysman M,Monsieur I,Gepts E,Vincken WG

    更新日期:1994-08-01 00:00:00

  • Increasing renal blood flow: low-dose dopamine or medium-dose norepinephrine.

    abstract:BACKGROUND AND OBJECTIVES:Many clinicians believe that low-dose dopamine (LDD) [2 micro g/kg/min] increases renal blood flow (RBF) and medium-dose norepinephrine (MD-NE) [0.4 micro g/kg/min] decreases RBF. They also believe that MD-NE might induce mesenteric and/or coronary ischemia. In fact, the effects of these drugs...


    pub_type: 杂志文章


    authors: Di Giantomasso D,Morimatsu H,May CN,Bellomo R

    更新日期:2004-06-01 00:00:00

  • Epidemiology and outcomes of clostridium difficile-associated disease among patients on prolonged acute mechanical ventilation.

    abstract:PURPOSES:Patients receiving prolonged acute mechanical ventilation (PAMV), although comprising a third of all mechanical ventilation (MV) patients, consume two-thirds of all the resources allocated to MV, and their numbers are projected to double by 2020. By virtue of their prolonged hospital length of stay (median LOS...


    pub_type: 杂志文章


    authors: Zilberberg MD,Nathanson BH,Sadigov S,Higgins TL,Kollef MH,Shorr AF

    更新日期:2009-09-01 00:00:00

  • Catamenial pneumothorax: a prospective study.

    abstract:OBJECTIVES:To evaluate the incidence of catamenial pneumothorax (CP) among women who have been referred for the surgical treatment of spontaneous pneumothorax (SP) and to study its pathogenic mechanisms. DESIGN:A prospective study of women of reproductive age who have been referred to our center for the surgical treat...


    pub_type: 杂志文章


    authors: Alifano M,Roth T,Broët SC,Schussler O,Magdeleinat P,Regnard JF

    更新日期:2003-09-01 00:00:00

  • The early detection of second primary lung cancers by sputum immunostaining. LCEWDG Investigators. Lung Cancer Early Detection Group.

    abstract:STUDY OBJECTIVE:To determine whether monoclonal antibody (Mab) detection of tumor-associated antigen expressed on sputum epithelial cells precedes clinical presentation of second primary lung cancer. DESIGN SETTING/PARTICIPANTS: Eleven oncology centers collaborate in the accrual of 1,000 patients with stage I non-small...


    pub_type: 杂志文章,多中心研究


    authors: Tockman MS,Erozan YS,Gupta P,Piantadosi S,Mulshine JL,Ruckdeschel JC

    更新日期:1994-12-01 00:00:00

  • Nutrition in the ICU: an evidence-based approach.

    abstract::Providing artificial nutrition is an important part of caring for critically ill patients. However, because of a paucity of robust data, the practice has been highly variable and often based more on dogma than evidence. A number of studies have been published investigating many different aspects of critical care nutri...


    pub_type: 杂志文章,评审


    authors: Desai SV,McClave SA,Rice TW

    更新日期:2014-05-01 00:00:00

  • The Coronavirus Disease 2019 Pandemic's Effect on Critical Care Resources and Health-Care Providers: A Global Survey.

    abstract:BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic has severely affected ICUs and critical care health-care providers (HCPs) worldwide. RESEARCH QUESTION:How do regional differences and perceived lack of ICU resources affect critical care resource use and the well-being of HCPs? STUDY DESIGN AND METHODS:Betw...


    pub_type: 杂志文章


    authors: Wahlster S,Sharma M,Lewis AK,Patel PV,Hartog CS,Jannotta G,Blissitt P,Kross EK,Kassebaum NJ,Greer DM,Curtis JR,Creutzfeldt CJ

    更新日期:2020-09-11 00:00:00

  • Paradoxic improvement in regional wall motion during high-dose dobutamine stress echocardiography. A marker for hibernating myocardium?

    abstract::Dobutamine stress echocardiography detects myocardial ischemia by inducing regional left ventricular systolic dysfunction. Augmentation of wall motion in hypokinetic segments has also been noted with low-dose dobutamine, suggesting myocardial viability. We report a case of regional ventricular improvement during high-...


    pub_type: 杂志文章


    authors: Krauss D,Feldman T,Marcus RH,Resnekov L,Lang RM

    更新日期:1994-07-01 00:00:00

  • Intravegetation antimicrobial distribution in aortic endocarditis analyzed by computer-generated model. Implications for treatment.

    abstract::The distribution of antibiotics into cardiac valvular tissues is incompletely understood. By integrative computer modeling, we have used previously obtained pharmacokinetic data in experimental endocarditis to characterize aminoglycoside distribution within various geographic sectors of aortic vegetations of rabbits a...


    pub_type: 杂志文章


    authors: Bayer AS,Crowell D,Nast CC,Norman DC,Borrelli RL

    更新日期:1990-03-01 00:00:00

  • Cancer genetics and cell and molecular biology. Is this the way forward?

    abstract::Lung cancer, the most prevalent cancer in the western world, is predominantly caused by smoking and thus perceived as a "self-inflicted" disease. Nevertheless, only 20% of smokers develop lung cancer. This review examines the concept of high-risk populations and screening. It looks at developments in the molecular epi...


    pub_type: 杂志文章


    authors: Smyth JF

    更新日期:1996-05-01 00:00:00

  • A comparison of ipratropium and albuterol vs albuterol alone for the treatment of acute asthma.

    abstract::To evaluate the role of inhaled ipratropium bromide in acute asthma, a double-blind study of 384 emergency department patients compared the effect of the combination of ipratropium and albuterol with that of albuterol alone. Patients were randomized to receive nebulizer treatments with either 2.5 mg of albuterol or 2....


    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Karpel JP,Schacter EN,Fanta C,Levey D,Spiro P,Aldrich T,Menjoge SS,Witek TJ

    更新日期:1996-09-01 00:00:00

  • Continuous positive airway pressure and supplemental oxygen in the treatment of cardiogenic pulmonary edema.

    abstract::The efficacy of continuous positive airway pressure (CPAP) administered with a face mask was compared to oxygen supplementation in 40 patients with acute cardiogenic pulmonary edema. Baseline arterial blood gas values and pH, heart rate, respiratory rate, and blood pressure were recorded after patients breathed 28 per...


    pub_type: 杂志文章


    authors: Väisänen IT,Räsänen J

    更新日期:1987-09-01 00:00:00

  • Pneumonia due to Haemophilus influenzae among mechanically ventilated patients. Incidence, outcome, and risk factors.

    abstract::Incidence and potential risk factors for pneumonia due to Haemophilus influenzae in adults treated with mechanical ventilation in a medical-surgical ICU were investigated. Diagnosis was established in 91 episodes and H influenzae was isolated in 20 of them. Mean onset of ventilator-associated pneumonia (VAP) due to H ...


    pub_type: 杂志文章


    authors: Rello J,Ricart M,Ausina V,Net A,Prats G

    更新日期:1992-11-01 00:00:00

  • The effects of acetazolamide on the ventilatory response to high altitude hypoxia.

    abstract::Acetazolamide treatment ameliorates the symptoms of AMS; however, the mechanism by which this occurs is unclear. To examine the effects of acetazolamide on oxygenation, CO2 responsiveness and ventilatory pattern during acute exposure to HA, we studied two groups of subjects at SL and following rapid (less than 8 h) tr...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Burki NK,Khan SA,Hameed MA

    更新日期:1992-03-01 00:00:00

  • Long-term reproducibility of respiratory gas exchange measurements during exercise in patients with stable cardiac failure.

    abstract::Present-day technology has greatly facilitated the monitoring of respiratory gas exchange in the clinical exercise laboratory. Despite the growing use of these techniques to assess the severity and progression of disease or therapeutic response in patients with heart failure, the long-term reproducibility of oxygen up...


    pub_type: 杂志文章


    authors: Janicki JS,Gupta S,Ferris ST,McElroy PA

    更新日期:1990-01-01 00:00:00

  • Implications of lower- and upper-limb training procedures in patients with chronic airway obstruction.

    abstract::In assessing the effectiveness of lower-limb and upper-limb nonspecific physical training, we have considered 3 objectives in this study: (1) determination of clinical and functional actual state in patients with chronic airway obstruction (CAO), before and after training; (2) determination of the tests, level of work...


    pub_type: 杂志文章,评审


    authors: Gimenez M,Predine E,Marchand M,Servera E,Ponz JL,Polu JM

    更新日期:1992-05-01 00:00:00

  • Long-term outcome of pulmonary rehabilitation in patients with COPD.

    abstract:BACKGROUND:This study investigates the long-term benefits of pulmonary rehabilitation in terms of health-related quality of life (HRQL). Such information is of particular importance in developing strategies for aftercare at home which aim to maintain the initial improvements seen after rehabilitation. METHODS:Criteria...


    pub_type: 杂志文章


    authors: Ketelaars CA,Abu-Saad HH,Schlösser MA,Mostert R,Wouters EF

    更新日期:1997-08-01 00:00:00

  • Successful Healing of Tracheal Radionecrosis: Role of Hyperbaric Oxygen Therapy.

    abstract::Hyperbaric oxygen therapy, the administration of 100% oxygen at pressures > 1 atm, is believed to promote wound healing by increasing angiogenesis and collagen synthesis. To our knowledge, this treatment modality has never been described in patients with tracheal radionecrosis. Here, we report the case of a 55-year-ol...


    pub_type: 杂志文章


    authors: Ariza-Prota M,Morales A,Grajeda J,López-Lisbona R,Cubero N,Dorca J,Rosell A

    更新日期:2016-12-01 00:00:00

  • Lung MRI as a possible alternative to CT scan for patients with primary immune deficiencies and increased radiosensitivity.

    abstract:BACKGROUND:Patients with common variable immunodeficiency (CVID) suffer from respiratory infections leading over time to permanent lung damage. Increased radiosensitivity has been described, and clinicians should consider a risk-benefit assessment when ordering a CT scan, in that the exact level of "safe" radiation exp...


    pub_type: 杂志文章


    authors: Serra G,Milito C,Mitrevski M,Granata G,Martini H,Pesce AM,Sfika I,Bonanni L,Catalano C,Fraioli F,Quinti I

    更新日期:2011-12-01 00:00:00

  • Bronchogenic cancer in patients under 40 years old. The experience of a Latin American country.

    abstract::Lung cancer in young patients is increasing in frequency, as documented by data from the United States, Canada, Japan, and European countries. However, to date and to our knowledge, there have not been any reports from Latin America on this topic. The published reports show that lung cancer in young patients is associ...


    pub_type: 杂志文章


    authors: Green LS,Fortoul TI,Ponciano G,Robles C,Rivero O

    更新日期:1993-11-01 00:00:00

  • Acetaminophen-induced eosinophilic pneumonia.

    abstract::We present the first case (to our knowledge) of acetaminophen-induced eosinophilic pneumonia. Although the patient had taken an acetaminophen-containing combination drug, Kinuya-chinnetsu, for only three days, the abnormal shadow on his chest radiograph continued for about a month. Lymphocyte stimulation tests showed ...


    pub_type: 杂志文章


    authors: Kondo K,Inoue Y,Hamada H,Yokoyama A,Kohno N,Hiwada K

    更新日期:1993-07-01 00:00:00

  • Two aerosolized nitric oxide adducts as selective pulmonary vasodilators for acute pulmonary hypertension.

    abstract:STUDY OBJECTIVES:To determine the selective vasodilatory effects of two inhaled "NONOate" aerosols in a closed chest pig model of acute pulmonary hypertension (APH). METHODS:APH was induced by IV infusion of the prostaglandin H(2)/thromboxane A(2) receptor agonist (U46619). Aerosolized diethylenetriamine nitric oxide ...


    pub_type: 杂志文章


    authors: Lam CF,van Heerden PV,Ilett KF,Caterina P,Filion P

    更新日期:2003-03-01 00:00:00

  • Unruptured congenital aneurysm of the left sinus of Valsalva presenting as acute right ventricular failure.

    abstract::A patient with unruptured congenital aneurysm of the left coronary sinus of Valsalva presented with acute right-sided heart failure due to right ventricular outflow tract obstruction. The mechanism for such an acute presentation may have been a sudden increase in the size of the aneurysm. The surgical importance of th...


    pub_type: 杂志文章


    authors: D'Silva SA,Dalvi BV,Lokhandwala YY,Kale PA,Tendolkar AG

    更新日期:1992-02-01 00:00:00

  • Global Initiative for Chronic Obstructive Lung Disease 2011 symptom/risk assessment in α1-antitrypsin deficiency.

    abstract:BACKGROUND:The new GOLD (Global Initiative for Chronic Obstructive Lung Disease) strategy recommends use of the COPD Assessment Test (CAT) or modified Medical Research Council (mMRC) scale to assess symptoms in COPD against "risk" as assessed by spirometry or exacerbation frequency. We aimed to determine the concordanc...


    pub_type: 杂志文章


    authors: Pillai AP,Turner AM,Stockley RA

    更新日期:2013-10-01 00:00:00