Don’t recommend percutaneous feeding tubes in advanced dementia; prefer oral assisted feeding instead.
In advanced dementia, the use of percutaneous feeding tubes does not increase survival, does not lower the risk of aspiration pneumonias, does not improve the healing of existing pressure ulcers (instead, it increases their risk); it augments phsycological stress, the...
Do not stent a stenotic renal artery unless there is refractory hypertension or declining renal function.
Renal artery stenting requires excellent expertise because it may cause rupture, dissection or thrombosis of the artery. Furthermore, there is no difference between best medical treatment and stenting, according to recent studies.
Do not perform open or endovascular treatment of lower limb lesions unless there is disabling claudication, critical limb ischemia or diabetic foot.
Treating a stenotic or occluded artery of the lower limbs that does not cause symptoms is inappropriate. There is no evidence that such a treatment would improve the evolution of the disease. Any treatment may expose the patient to the risk of relapse, often with a...
Don’t recommend enteral nutrition (PEG, percutaneous endoscopic gastrostomy or naso-gastric feeding tube) in patients with advanced dementia; instead offer oral assisted feeding.
Enteral nutrition is aimed at maintaining or improving patient quality of life and functionality, and prolonging survival. In patients with severe dementia, functional decline and comorbidities may suggest poor long-term benefits from enteral nutrition. Furthermore,...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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