Nonpharmacologic airway clearance techniques are used to reduce the sequelae of obstructive secretions. We systematically reviewed comparative studies of nonpharmacologic interventions that health professionals can employ to achieve mucus clearance in hospitalized or postoperative patients without cystic fibrosis, over the age of 12 months. We searched MEDLINE and other databases from 1990 to 2...

We present an update of our experience with the ketogenic diet (KD) in patients with Dravet syndrome (DS) to evaluate the efficacy and tolerability and our short experience with vagus nerve stimulation (VNS) in the treatment of this syndrome. Between March 1, 1990 and May 31, 2007, 59 patients who met diagnostic criteria for DS were studied in our department. Twenty-four of them were placed on ...

RESULTS: We included 9 studies with 640 children. Considerable heterogeneity across studies precluded meta-analysis. We found no RCTs for physical movement, multidisciplinary treatment, or alternative medicine. Some evidence shows that fiber may be more effective than placebo in improving both the frequency and consistency of stools and in reducing abdominal pain. Compared with normal fluid int...

Mission statement. The Quality Standards Subcommittee (QSS) of the American Academy of Neurology (AAN) is charged with developing practice parameters for physicians. This practice parameter summarizes the results from the four evidence-based reviews on the management of patients with migraine: specifically, acute, preventive, and nonpharmacologic treatments for migraine, and the role of neuroim...

The need for critical care and the experience of being treated in the intensive care unit may be a traumatic event with long-lasting psychological consequences for the patient and family. Research has identified patients who are at risk of developing posttraumatic stress disorder after an intensive care unit stay. This article reviews pharmacologic and nonpharmacologic strategies, including the...

OBJECTIVES After participating in the CME activity, primary care physicians should be able to: 1. Describe clinical features of fibromyalgia syndrome (FMS) 2. Understand the technique of tender point examination 3. Evaluate a patient with widespread pain and make a diagnosis of FMS based on the syndrome’s characteristics 4. Recognize that concomitant conditions are often present and should be a...

1. Evaluate symptoms to accurately classify a patient with urinary incontinence (UI). 2. Apply an understanding of the pathophysiology and risk factors for UI to patient care. 3. Evaluate the most recent clinical evidence for pharmacologic and nonpharmacologic treatment of UI. 4. Design a patient-specific treatment plan to achieve optimal outcomes in an elderly patient with UI. 5. Assess for re...

Table of other common abbreviations. 1. Apply knowledge of the incidence, etiologies, and assessment of pain to the treatment of critically ill patients. 2. Develop evidence-based pain management strategies that include both nonpharmacologic and pharmacologic interventions and that account for transitions of care. 3. Design a pain control strategy for unique patient populations. 4. Evaluate sho...

The challenge in acute stroke is still to reperfuse as early as possible the ischemic territory. Since fibrinolytic therapies have a limited window with potential risk of bleeding, having a nonpharmacologic mean to recruit vessels in area surrounding necrosis might be useful. We propose here to use antigravity suit inflated at "venous" pressure levels to shift blood towards thoracic and brain t...

OBJECTIVES To test the comparative effectiveness of 2 nonpharmacologic pain-relieving interventions administered alone or in combination across time for repeated heel sticks in preterm infants. METHODS A multicenter randomized controlled trial in 3 NICUs in Switzerland compared the effectiveness of oral sucrose, facilitated tucking (FT), and a combination of both interventions in preterm infa...