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141. Diagnosis and management of primary central nervous system diffuse large B?cell lymphoma

and the trial failed to meet its non‐inferiority end‐point. Therefore, it remains unclear whether WBRT consolidation can be safely omitted for patients in CR (Thiel et al , ). Irreversible, and sometimes disabling, neurocognitive dysfunction is a well‐recognised consequence of WBRT, particularly in those aged >60 years. Indeed, a systematic meta‐analysis found no clear overall benefit, in terms of quality‐adjusted life years, for WBRT in first remission in patients >60 years of age (Prica et al (...) Digits Forward, Backward Span and Sequencing Span (Wechsler, ); Trail Making Test (Parts A and B) Verbal memory Hopkins Verbal Learning Test‐Revised (Benedict et al , ) Hopkins Verbal Learning Test‐Revised or California Verbal Learning Test Standard Form (Delis et al , ) Motor Grooved Pegboard Test (Russell & Starkey, ) Grooved Pegboard Test Quality of life EORTC‐QLQ‐C30 (Aaronson et al , ) BCM 20 (Osoba et al , ) EORTC‐QLQ‐C30 BCM 20 BCM 20, Brain Cancer Module 20; EORTC‐QLQ‐C30, The European

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2018 British Committee for Standards in Haematology

142. 2018 IDSA Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy

refrigeration and storage and the presence of at least 1 adult who can reliably learn and perform sterile infusion technique and communicate with the treatment team. A modified version of the home OPAT model is the Hospital at Home, commonly used in Australia and some European countries and in some US Veteran’s Affairs programs. Here, antibiotics are infused in the home, but a visiting nurse rather than the patient or caregiver performs each administration. The infusion center model delivers OPAT

2018 Infectious Diseases Society of America

143. UK guidelines for managing tuberous sclerosis complex

years. Perform MRI scans more frequently for patients with a large or growing SEGA, or for patients with a SEGA causing ventricular enlargement who remain asymptomatic. Use clinical judgement about when to stop routine MRI scans of the brain in an adult patient with SEGA lesions, taking account of any learning disability, their communication abilities, and the SEGA growth interval. It is believed that the majority of SEGA lesions stop growing in the third decade of life. However, there have been (...) , particularly information on common mental health problems, depression, anxiety, autism spectrum disorder and learning disability. Formally evaluate developmental status at key developmental time points and periods of transition: • Infancy (0–3 years) • Preschool (>3–6 years) • Middle school (>6–11 years) • Adolescence (12–18 years) and as clinically indicated. Ensure that TSC clinics have established links and care pathways with developmental paediatric, educational and Child and Adolescent Mental Health

2019 Tuberous Sclerosis Association

144. Autism spectrum disorder: Warning signs, detection, diagnosis and assessment in children and adolescents

that are global, personalised and coordinated. If possible, this should be accomplished before 4 years of age, to encourage their development and learning in the areas affected by the ASD and reducing associated disabilities. The objective of this work is: to optimise the detection of children and adolescents with signs of ASD or unusual development or at risk of developing an ASD and to harmonise practices and procedures for an initial diagnosis of ASD in children or adolescents under 18 years of age

2018 HAS Guidelines

145. Guideline: counselling of women to improve breastfeeding practices

girls, primiparous (first-time mothers) or carrying multiple pregnancies (when the mother is pregnant with two or more babies); mothers with mental health difficulties; mothers of infants with special needs, e.g. low birth weight or disability; mothers who delivers by caesarean section; breastfeeding in public spaces; and breastfeeding in humanitarian emergencies. Best practice statement ¦ Protection, promotion and support of breastfeeding, in accordance with international guidance, are essential (...) . As a minimum, staff in contact with mothers and children aged under 2 years are trained to be sensitive to psychosocial issues, on nutrition screening and on referral pathways to more specialist support. ¦ More specialist capacity to counsel mothers with heightened needs, such as stressed or traumatized mothers, malnourished infants and mothers, low-birth-weight infants, and infants with disability and feeding difficulties, may be needed. Research gaps Discussions between the members of the WHO guideline

2018 World Health Organisation Guidelines

146. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency

( ), but recent estimates from advanced economies are lower, at 0% to 4% ( ). In regard to morbidity, infants diagnosed through screening have less severe hyponatremia ( ) and tend to have shorter hospitalizations ( , , , ) than infants diagnosed later. Learning disabilities may occur in patients who have had salt-wasting crises ( ). Although salt-wasting males would seem to derive the greatest benefit from screening programs, the delay before correct sex assignment of severely virilized females is also

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2018 Pediatric Endocrine Society

147. Cost-Conscious Growth-Promoting Treatment: When Discretion Is the Better Part of Value

health care costs. Renunciation of sweeping payer rejection of hGH- for-height treatment is strengthened by cost-conscious practices that (1) recommend no treatment for most short children and restrict treatment to severe, likely disabling short stature; (2) initiate hGH treatment only after evidence- based informed assent; (3) utilize alternative less costly and less invasive options when possible; (4) minimize hGH treat- ment duration and dosage; and (5) resist enhancement of normal adult stature (...) of hGH augmentation, in contrast to GH replacement, has relied on height increase as a surrogate measure for improved psychosocial adap- tation. However, assumptions that short stature is psy- chologically disabling, and that taller adult stature due to hGH therapy leads to better psychosocial function, have not been validated [4]. Short-term improvements in psy- chosocial well-being during hGH treatment [5] have not been corroborated by improved adult quality of life (QOL), increased income

2018 Pediatric Endocrine Society

148. Guidelines for the Evaluation and Treatment of Perimenopausal Depression

to depression. Cognition: Depression and menopause itself may exert effects on concentration, thereby making it difficult to disen- tangle individual contributions. 53,57 Subjective complaints of cognitive changes are common during the menopause transition; longitudinal studies from SWAN provide some objective validation to the subjective complaints because they demonstrate a transient impairment in learning during the menopause transition. 68 Concurrent depressive and anxiety symptoms were associated (...) with slower processing speed and anxiety was also associated with worse memory, but no symptom accounted for lower performance in late perimen- opause compared to premenopause. 69 Consistent with SWAN, the POAS demonstrated a decrease in learning and memory as women transitioned through the menopause even after accounting for age, depression, anxiety and other factors that can influence cognition. 70 Midlife women with depres- sion may also present with co-occurring cognitive slowing and deficits

2018 The North American Menopause Society

149. National Clinical Guideline on Adult type 1 diabetes mellitus

diabetes living in Ireland. We hope that the development of a national clinical guideline will provide the diabetes multidisciplinary team, patients and the HSE with a framework that will ensure that adults with type 1 diabetes have equitable access to high quality care, thus improving patient’s outcomes and reducing diabetes complications. 2.2 Clinical and financial impact of type 1 diabetes The complications of type 1 diabetes can result in disability: including vision loss, kidney failure and foot (...) is a common finding among people with diabetes, with an average prevalence of 10%, and increases in incidence as the burden and disability from diabetes complications progresses. When individuals with poor glycaemic control are formally assessed by liaison mental health teams, previously undiagnosed psychiatric disorders such as depression, borderline personality traits, and eating disorders emerge (Doherty et al, 2016). Data from the UK estimates 10% of the entire health budget is spent on diabetes

2018 HIQA Guidelines

150. Care of Adults with Neurofibromatosis Type 1

of NF clinics.) For some patients, a multidisciplinary NF clinic may serve best as a medical home, although all patients should have a primary care physician. In addition, through an NF clinic, patients may more easily learn of research studies aimed to develop novel therapies. To improve clinical care of adults with NF1, future research efforts need to address, among other issues, the sensitivity and specificity of breast MRI and mammography in NF1, the role of whole-body and/or targeted MRI

2018 American College of Medical Genetics and Genomics

151. Pharmacological treatment for memory disorder in multiple sclerosis

of the central nervous system (CNS) and can cause both neurological and neuropsychological disability. Both demyelination and axonal and neuronal loss are believed to contribute to MS‐related cognitive impairment. Memory disorder is one of the most frequent cognitive dysfunctions and presents a considerable burden to people with MS and to society due to the negative impact on function. A number of pharmacological agents have been evaluated in many existing randomised controlled trials for their efficacy (...) language summary available in Pharmacological agents as symptomatic treatment for memory disorder in people with multiple sclerosis This is an update of the Cochrane review "Pharmacologic treatment for memory disorder in multiple sclerosis" (first published in The Cochrane Library 2011, Issue 10). Background Memory disorder is one of the most frequent cognitive impairments (where people have difficulty with thinking, learning and memory) in people with multiple sclerosis (MS), affecting an estimated 40

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2018 European Academy of Neurology

152. British guideline on the management of asthma

at Healthcare Improvement Scotland (HIS) is committed to equality and diversity and assesses all its publications for likely impact on the six equality groups defined by age, disability, gender, race, religion/belief and sexual orientation. SIGN guidelines are produced using a standard methodology that has been equality impact assessed to ensure that these equality aims are addressed in every guideline. This methodology is set out in the current version of SIGN 50, our guideline manual, which can

2016 SIGN

153. Clinical practice guideline for the rehabilitation of adults with moderate to severe TBI - section 1: components of the optimal TBI rehabilitation system

allows. (INESSS-ONF, 2015) REFERENCES: - ERABI Module 3 - Efficacy and Models of Care Following an Acquired Brain Injury, p. 30, 3.3.2 - Leon-Carrion et al. (2013) - Wagner et al. (2003) A 1.3 Rehabilitation programs should have clearly stated admission criteria, which include a traumatic brain injury diagnosis, medical stability, the ability to improve through the rehabilitation process, the ability to learn and engage in rehabilitation and sufficient tolerance for therapy duration. (INESSS-ONF (...) integration. (INESSS-ONF, 2015) Note: The target length of stay should be established based on individuals with similar functional status and availability of resources in the community, and take into account other factors such as the Glasgow Coma Score in the first few days after injury, intracranial surgery, the degree of initial disability, the presence of fractures of the upper and lower extremities or pelvis, and the person’s age. C 2.2 Target length of stay for intensive rehabilitation following

2016 CPG Infobase

154. Recommendation for Record-Keeping

intolerance Dietary restrictions Genitourinary Bladder infections Kidney infections Pregnancy Systemic birth control Sexually transmitted infections Musculoskeletal Arthritis Scoliosis Bone/joint problems Temporomandibular disorders (TMD)—joint pop- ping, clicking, locking, difficulties opening or chewing Integumentary Herpetic/ulcerative lesions Eczema Rash/hives Dermatologic conditions Neurologic Fainting Dizziness Autism spectrum disorder Developmental disorders Learning problems/delays (e.g (...) ., enrollment in special- ized school or individualized education plan) Mental disability Brain injury Cerebral palsy Convulsions/seizures Epilepsy Headaches/migraines Hydrocephaly Shunts—ventriculoperitoneal, ventriculoatrial, ventriculovenous Psychiatric Maltreatment (e.g., physical abuse, sexual abuse, dental neglect, bullying) Alcohol and chemical dependency Emotional disturbance Hyperactivity/attention deficit hyperactivity disorder Pediatric acute-onset neuropsychiatric syndrome (PANS) Obsessive

2017 American Academy of Pediatric Dentistry

155. Assessment, diagnosis and interventions for autism spectrum disorders

, that includes a range of possible developmental impairments in reciprocal social interaction and communication, and also a stereotyped, repetitive or limited behavioural repertoire. Sensory differences may also be a presenting feature. 4 ASD may occur in association with any level of general intellectual/learning ability, and manifestations range from subtle problems of understanding and impaired social function to severe disabilities. 17 Impairments in each of the areas relevant to ASD diagnoses occur (...) until 31 March 2020 and is applicable to guidance produced using the processes described in SIGN 50: a guideline developer’s handbook, 2015 edition ( index.html). More information on accreditation can be viewed at accreditation Healthcare Improvement Scotland (HIS) is committed to equality and diversity and assesses all its publications for likely impact on the six equality groups defined by age, disability, gender, race, religion/belief

2016 SIGN

156. Recommendations on screening for developmental delay CMAJ 2016. DOI:10.1503 /cmaj.151437 D evelopmental delay in children may be transitory or sustained and is character- ized by a significant delay (i.e., perfor- mance 1.5 standard deviations or more below age-expected norms) in one or more of the fol- lowing domains: gross and fine motor skills, speech and language, social and personal skills, activities of daily living and cognition. 1,2 Chil- dren with sustained developmental delay are at higher risk of learning difficulties, behavioural (...) R. Developmental assessment of children. BMJ 2013;346:e8687. 2. Shevell M, Majnemer A, Platt RW, et al. Developmental and functional outcomes at school age of preschool children with global developmental delay. J Child Neurol 2005;20:648-53. 3. Keogh BK, Bernheimer LP, Guthrie D. Children with develop- mental delays twenty years later: Where are they? How are they? Am J Ment Retard 2004;109:219-30. 4. Facts about developmental disabilities. Atlanta: Centers for Disease Control and Prevention

2016 CPG Infobase

157. WHO Guidelines on Integrated Care for Older People (ICOPE)

of Noncommunicable Diseases, Disability, Violence and Injury Prevention); Tarun Dua (WHO Department of Mental Health and Substance Abuse); Manfred Huber (WHO Regional Office for Europe); Silvio Paolo Mariotti (WHO Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention); Maria Alarcos Moreno Cieza (WHO Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention); Alana Margaret Officer (WHO Department of Ageing and Life Course); Juan (...) in the demographics of populations around the world: the proportion of older people in general populations has increased substantially within a relatively short period of time. Numerous underlying physiological changes occur with increasing age, and for older people the risks of developing chronic disease and care dependency increase. By the age of 60 years, the major burden of disability and death arises from age-related losses in hearing, seeing and moving, and conditions such as dementia, heart disease, stroke

2017 World Health Organisation Guidelines

158. Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups

. The anthelminthics most commonly used to treat intestinal worm infections in children are the benzimidazoles (albendazole and mebendazole). Disability-adjusted life years (DALYs) The number of years of healthy life lost attributable to a disease (or group of diseases). DALYs are used as a measure of disease burden and provide a comparative indication of the importance of the disease to public health. Ineligible population A group of individuals not qualified or entitled to receive anthelminthic treatment (...) americanus) – contribute 5.18 million disability- adjusted life-years worldwide in 2010. Globally, an estimated 820 million people are infected with roundworms, 460 million with whipworms and 440 million with hookworms. Although each species has specific characteristics, these soil-transmitted helminthiases are grouped together for control purposes, owing to: (i) similar geographical endemicity and at-risk groups that are affected; (ii) treatment by the same medicines; (iii) the same tools used

2017 World Health Organisation Guidelines

159. Psychiatric reports: preparation and use in cases involving asylum, removal from the UK or immigration detention

to rec- ognise psychological vulnerability. Consideration should be given by the applicant’s legal repre- sentatives as to whether expert evidence (e.g. as to capacity, disability, age or mental health) is required, particularly if there is a dispute over ability to participate in the proceedings (Wilson- Shaw et al, 2012). The Secretary of State for the Home Department (Home Secretary) does not normally seek to adduce expert evidence in asylum claims. The immigration courts may direct (...) for the most vulnerable applicants, such as those with suspected intellectual disability or dementia and those exhibiting pseudo-seizures or dissociation. It is important to exercise the same objectivity as with the applicant, and to be mindful that their friends, housemates or relatives might have their own agenda. The psychiatrist should ensure that the applicant provides informed consent for them to talk to the informant. College Report 199 12 Diagnosis Some diagnoses, such as PTSD or depressive

2016 Royal College of Psychiatrists

160. ABCD position statement on standards of care for management of adults with type 1 diabetes

) to develop the knowledge required to self manage their condition. At diagnosis ? Basic carbohydrate counting ? Insulin management ? Hypoglycaemia ? All aspects of living with diabetes including exercise, driving, work ? Sick day rules Structured education (after 6-12 months) The DAFNE programme was the first to establish the value of structured education. Other programmes are available but the following criteria must be met: ? Written curriculum, evidence based, using principles of adult learning (...) and revision of sick day rules ? Review of insulin regimen ? Further follow up to ensure diabetes management optimised ? Psychological support if required Recommendations Hypoglycaemia ? All people with type 1 diabetes should be asked about hypoglycaemia symptoms and thresholds at each consultation ? People with problematic hypoglycaemia should be offered structured education and hypoglycaemia avoidance training ? If disabling hypoglycaemia persists, offer CSII. ? If CSII is declined, advise to keep

2017 Association of British Clinical Diabetologists


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