National Danish guidelines for the diagnosis and treatment of irritable bowel syndrome (IBS) in adult patients in secondary and tertiary care have been approved by the Danish Society for Gastroenterology and Hepatology. IBS can be a positive diagnosis in patients fulfilling the Rome III criteria for IBS with no alarm signals, a normal physical examination and a normal CRP and hemoglobin. In pat...

BACKGROUND There is currently a political enthusiasm for the development and use of clinical guidelines despite, paradoxically, there being relatively few healthcare issues that have a sound research evidence base. As decisions have to be made even where there is an undetermined evidence base and that limiting recommendations to where evidence exists may reduce the scope of guidelines, thus lim...

is arguably the most misunderstood of punctuation tools. ask someone about comma rules and even those who begin with confidence are likely to trail off apologetically. This is because comma use is not fully explained by rules; it depends in part on taste. But, as David Crystal insists in his history of punctuation, variation in comma use is neither infinite nor totally idiosyncratic [1]. It tur...

This guideline offers recommendation on the management of a range of vulval disorders which may present to genitourinary medicine (GUM) clinics. Vulval disorders represent a disparate group of conditions with a variety of causes, affecting a particular anatomical site and may affect women of any age. These guidelines concentrate on a selected group of conditions, whichmay bemanaged by genitouri...

Scope and Purpose The main objective is to aid recognition of the signs and symptoms and complications of vulval conditions which may present in Genitourinary Medicine clinic attendees. This guideline offers recommendations on the diagnostic tests and treatment regimes needed for the effective management of the following vulval conditions: Vulval lichen sclerosus Vulval lichen planus Vulval der...

The main purpose of this guideline is to offer recommendations on the diagnosis, treatment and health promotion principles for the effective management of chancroid. It is aimed primarily to assist in the management of people aged 16 years and older presenting to services offering Level 3 care in sexually transmitted infection (STI) management within the UK. However, the principles of the recom...

INTRODUCTION The practice-guideline process of collecting, critically appraising, and synthesizing available evidence, then developing expert panel recommendations based on appraised evidence, makes it possible to provide high-quality care for patients. Unwanted variability in the quality and rigor of evidence summaries and Clinical Practice Guidelines has been a long-standing challenge for cli...

OBJECTIVE The objective of this study was to establish an evidence-based clinical practice guideline for the primary management of obstetrical brachial plexus injury (OBPI). This clinical practice guideline addresses 4 existing gaps: (1) historic poor use of evidence, (2) timing of referral to multidisciplinary care, (3) Indications and timing of operative nerve repair and (4) distribution of e...

Developing pressure ulcers is a painful and distressing event for patients, and one that can be prevented. The National Institute for Health and Care Excellence pressure ulcer guideline has recently been updated to cover the prevention and management of this condition. This article focuses on the recommendations that are relevant to nurses, covering areas such as risk assessment, skin assessmen...