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121. Therapy for Stage IV Non–Small-Cell Lung Cancer Without Driver Alterations

, the selectedcourseofactionshouldbeconsideredbythetreating providerinthecontextoftreatingtheindividualpatient.Useof theinformationisvoluntary.ASCOprovidesthisinformationon an“as is” basis and makes no warranty, express or implied, regarding the information. ASCO speci?cally disclaims any warranties of merchantability or ?tness for a particular use or purpose. ASCO assumes no responsibility for any injury or damagetopersonsorpropertyarisingoutoforrelatedtoany use of this information, or for any errors or omissions. Ontario Health (Cancer Care Ontario

2020 Cancer Care Ontario

122. Clinical care of severe acute respiratory infections – Tool kit

external bleeding Apply pressure, deep wound packing or tourniquet as indicated. Signs of tamponade (poor perfusion, distended neck veins, mu ed heart sounds) Give IV uids, oxygen. Disability D Signs of brain injury (AMS with wound, deformity or bruising of head/face) Immobilize cervical spine, check glucose, give nothing by mouth. ? Will need neurosurgical care Signs of open skull fracture (as above, with blood or uid from the ears/nose) As above, and give IV antibiotics per local protocol. REMEMBER (...) University School of Medicine, Nashville, TN, United States of America); Sabine Heinrich (Berlin, Germany); Michael Ison (Northwestern University, Chicago, IL, United States of America); Arjun Karki (Patan Academy of Health Sciences, Kathmandu, Nepal); John Luce (San Francisco General Hospital, San Francisco, California, United States of America); Lung Injury Knowledge Network, National Heart, Lung, and Blood Institute (Bethesda, MD, United States of America); Kirsten Lunghi (San Francisco General

2020 WHO Coronavirus disease (COVID-19) Pandemic

123. CSC Expert Consensus on Principles of Clinical Management of Patients with Severe Emergent Cardiovascular Diseases during the COVID-19 Epidemic

.com Zuyi Yuan, MD Department of Cardiology The First Affiliated Hospital of Xi’an Jiaotong University No.277 West Yanta Road, Xi'an 710061, China Tel: +86-13571828319 Email: ‡ The Chinese Medical Association takes no responsibility for the accuracy of the translation from the published Chinese original and is not liable for any errors which may occur. No responsibility is assumed, and responsibility is hereby disclaimed, by the Chinese Medical Association for any injury (...) and standard biomarkers for cardiac injury are preferred. If cardiac mechanical complications are suspected, bedside echocardiography may be considered. It is recommended that all patients should undergo lung CT examination to evaluate for imaging features typical of COVID-19. The parameters of CT scan and associated disinfection and quarantine measures should adhere to the recently released consensus [17] . Chest X-ray is not recommended because of a high rate of false negative diagnosis. (II) Referral

2020 Covid-19 Ad hoc guidelines

124. Ketamine Procedural Sedation for Children in EDs

the mouth or pharynx • Patients with severe psychological problems such as cognitive or motor delay or severe behavioural problems • Significant cardiac disease (angina, heart failure, malignant hypertension) • Intracranial hypertension with CSF obstruction • Intra-ocular pathology (glaucoma, penetrating injury) • Previous psychotic illness • Uncontrolled epilepsy • Hyperthyroidism or Thyroid medication • Porphyria Box 3. Examples of potential procedures where ketamine maybe employed • Suturing (...) • Fracture reduction / manipulation • Joint reduction • Burn management • Incision and Drainage of abscess • Tube thoracostomy placement • Foreign body removal • Wound exploration / irrigation Ketamine Procedural Sedation for Children in The Emergency Department (Feb 2020) 15 • Prior adverse reaction to ketamine • Altered conscious level due to acute illness or injury • Drug / alcohol intoxication Side Effects • Mild agitation (20%) • Hypersalivation and lacrimation (<10%), evidence suggests co

2020 Royal College of Emergency Medicine

125. Paediatric Trauma: Stabilisation of the Cervical Spine

and prolonged immobilisation. - Raising the intracranial pressure in children with traumatic brain injury (although the studies all involve small numbers of adults and show only small rises in pressure which may not be clinically significant)[5][6][7][8]. The lack of evidence of benefit and concerns surrounding potential harm have led the Advanced Paediatric Life Support Group [9], Resuscitation Council UK [10] and International Liaison Committee On Resuscitation (ILCOR) [11][12] to recommend that semi (...) collar on cerebrospinal fluid pressure,” Anaesthesia. 1994. [6] G. Davies, C. Deakin, and A. Wilson, “The effect of a rigid collar on intracranial pressure,” Injury, 1996. [7] J. C. Kolb, R. L. Summers, and R. L. Galli, “Cervical collar-induced changes in intracranial pressure,” Am. J. Emerg. Med., 1999. [8] R. J. Mobbs, M. A. Stoodley, and J. Fuller, “Effect of cervical hard collar on intracranial pressure after head injury,” ANZ J. Surg., 2002. [9] A. L. S. Group, “Advanced Paediatric Life Support

2020 Royal College of Emergency Medicine

126. Assisted Vaginal Birth

be considered individually. The threshold to intervene may be lower where several factors coexist. Medical indications include cardiac disease, hypertensive crisis, cerebral vascular disease or malformations, myasthenia gravis and spinal cord injury. Forceps and vacuum extraction are contraindicated before full dilatation of the cervix. Forceps can be used for the after‐coming head of the breech. The vacuum extractor is contraindicated with a face presentation. Fetal bleeding disorders (for example (...) of recommendation: GPP Obstetricians should be aware of the increased risk of obstetric anal sphincter injury (OASI) following sequential use of instruments. [New 2020] Grade of recommendation: C When should attempted forceps birth be discontinued and how should a discontinued forceps procedure be managed? Discontinue attempted forceps birth where the forceps cannot be applied easily, the handles do not approximate easily or if there is a lack of progressive descent with moderate traction. [New 2020] Grade

2020 Royal College of Obstetricians and Gynaecologists

127. Frequently asked questions about resuscitation during COVID-19

for the performance of resuscitation on patients who are neither confirmed nor suspected cases of COVID-19. *follow regional health authority or organisational guidelines. Q4 HOW SHOULD THE COVID-19 PANDEMIC IMPACT THE PERFORMANCE OF DEFIBRILLATION? Early defibrillation by bystanders before EMS arrival provides the adult patient with the best chances of survival. Early restoration of spontaneous circulation through defibrillation of adults by bystanders will reduce the severity of brain injury and potentially

2020 Australian Resuscitation Council

128. Evidence Report for Investigating symptoms of lung cancer: a guide for all health professionals

by this copyright notice, all other rights are reserved, and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from Cancer Australia to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Publications and Copyright contact officer, Cancer Australia, Locked Bag 3, Strawberry Hills, NSW 2012. Disclaimer Cancer Australia does not accept any liability for any injury (...) , in brain, bone, liver or skin) • signs of pleural effusion. effusion”. - new or changed cough - chest and/or shoulder pain - shortness of breath - hoarseness - weight loss/loss of appetite - persistent or recurrent chest infection - fatigue - deep vein thrombosis (DVT) - abnormal chest signs - finger clubbing - cervical and/or supraclavicular lymphadenopathy - features suggestive of lung cancer metastasis (for example, in brain, bone, liver or skin) - signs of pleural effusion - thrombocytosis

2020 Cancer Australia

129. Investigating symptoms of lung cancer: a guide for all health professionals

lymphadenopathy Features suggestive of lung cancer metastasis (e.g. brain, bone, liver or skin) Pleural effusion Thrombocytosis Investigating symptoms of lung cancer - a guide for all health professionals Persistent or unexplained haemoptysis Signs of superior vena caval obstruction High clinical suspicion of lung cancer Chest X-ray normal* Chest CT scan normal Monitor for persistent symptoms Persistent symptoms No change visible but symptoms persist Change visible, or no previous imaging available Urgently (...) warranting further investigation – darker shades indicating higher suspicion of lung cancer Symptoms/indications for specialist referral Symptoms/indications for ED referral © Cancer Australia 2020 ILC 05/20 within 2 weeks within 6 weeks within 2 weeks OPTIMAL TIMEFRAMES FOR REFERRAL Cancer Australia does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information. Cancer Australia develops material based on the best available evidence; however it cannot

2020 Cancer Australia

130. Canadian guideline for Parkinson disease

and written form. n Discussions should aim to achieve a balance between providing realistic information and promoting optimism. n Families and caregivers should be informed about the condition and available support services. DIAGNOSIS AND PROGRESSION n Parkinson disease should be suspected in anyone with tremor, stiness, slowness, balance problems or gait disorders. n CT or MRI brain scanning should not be routinely used to diagnose Parkinson disease. n Patients, especially young, who request genetic (...) testing should be assessed by a movement disorders specialist. n No therapies are eective for slowing or stopping brain degeneration in Parkinson disease. NONMOTOR FEATURES n Botulinum toxin A helps control drooling. n Drug therapy for low blood pressure includes midodrine, udrocortisone and domperidone. n Management of depression should be tailored to the individual and their current therapy. n Dementia should not exclude a diagnosis of Parkinson disease, even if present early. n Rapid eye movement

2019 CPG Infobase

131. CCS/CHFS Heart Failure Guidelines: Clinical Trial Update on Functional Mitral Regurgitation, SGLT2 Inhibitors, ARNI in HFpEF, and Tafamidis in Amyloidosis Full Text available with Trip Pro

G.W. Lindenfeld J. Abraham W.T. et al. Transcatheter mitral-valve repair in patients with heart failure. N Engl J Med. 2018; 379 : 2307-2318 trial enrolled 614 patients after optimization of GDMT (only one-third of the screened patients were eventually randomized; ) with longer (2-year) follow-up. Trial participants had higher brain natriuretic peptide (BNP) concentrations (mean, 1043 vs 800 ng/L), smaller indexed LV end-diastolic volume (101 ± 34 mL/m 2 ), and more severe FMR (mean effective

2020 Canadian Cardiovascular Society

132. Risk reduction and management of delirium

solely to alcohol and illicit substances use. It also excludes delirium in children. 1.2.2 Common comorbidities Common comorbidities which have been considered when reviewing the evidence for this guideline are: • critical illness • dementia • depression • frailty • head injury • learning disability • Parkinson’s disease • cerebrovascular disease. 1.2.3 Definitions The International Classification of Diseases, version 10 (ICD-10) defines delirium as, “An aetiologically nonspecific organic cerebral (...) . • First consider acute, life-threatening causes of delirium, including low oxygen level, low blood pressure, low glucose level, and drug intoxication or withdrawal. • Systematically identify and treat potential causes (medications, acute illness, etc), noting that multiple causes are common. • Optimise physiology, management of concurrent conditions, environment (reduce noise), medications, and natural sleep, to promote brain recovery. • Specifically detect, assess causes of, and treat agitation

2019 SIGN

133. Canadian guidelines on opioid use disorder among older adults

) . As well, during opioid withdrawal, pain can return to old healed injury sites (called withdrawal-associated injury site pain), and it may take weeks to months for pain sensitivity to normalize after opioids are discontinued (Rieb et al ., 2016; 2018) . These issues are particularly important for older adults, since 30% to 40% of older adults suffer from chronic pain, a condition that becomes increasingly prevalent until the age of 85 . As the baby boomer population ages, the use of opioids to treat (...) , as well as negative emotional states during times of abstinence . These behaviors and affective states correspond to changes in brain chemistry and function, particularly in the mesolimbic system, hippocampus, amygdala, and prefrontal cortex (Volkow & Koob, 2018) . Opioids can cause a type of Pavlovian conditioning, with a learned association between drug use and the physiologic and perceptual effects of the drug . This can lead to craving (or the urge for pain relief) and/or altered opioid use

2019 CPG Infobase

134. Guidelines for diagnosing and managing pediatric concussion

Neurotrauma Foundation (ONF) is a health research organization that focuses on the practical application of research to improve the lives of people with an acquired brain inquiry or spinal cord injury, and the prevention of neurotrauma injuries. Through strategic research funding activity and the building of relationships with numerous partners and stakeholders, the ONF fosters, gathers and applies research knowledge to increase the effectiveness and use of prevention, and to improve the systems of care (...) group. These guidelines also do not apply to children/adolescents who have moderate-to-severe closed head injuries, moderate-to-severe developmental delays, neurological disorders, penetrating brain injuries or brain damage from other causes, such as injuries at birth or in infancy. General Directions for Clinical Use We expect that children/adolescents who have sustained a head injury will visit a health care professional soon after the incident for a primary assessment. In this scenario, health

2019 CPG Infobase

135. Canadian Cardiovascular Society/Canadian Cardiac Transplant Network Position Statement on Heart Transplantation: Patient Eligibility, Selection, and Post-Transplantation Care Full Text available with Trip Pro

. Diggs B.S. Welke K. et al. Impact of single-ventricle physiology on death after heart transplantation in adults with congenital heart disease. Ann Thorac Surg. 2012; 94 ( [discussion: 7-8] ) : 1281-1287 Brain natriuretic peptide (BNP) has been studied but normal and prognostically significant values in ACHD patients with different anatomical considerations are not well defined. Haberger S. Hauser M. Braun S.L. et al. Prognostic value of plasma B-type natriuretic peptide in the long-term follow-up

2020 Canadian Cardiovascular Society

136. Parkinson?s disease in adults

disease and their carers 5 1.2 Diagnosing Parkinson's disease 6 1.3 Pharmacological management of motor symptoms 7 1.4 Managing and monitoring impulse control disorders as an adverse effect of dopaminergic therapy ... 11 1.5 Pharmacological management of non-motor symptoms 13 1.6 Pharmacological neuroprotective therapy 16 1.7 Non-pharmacological management of motor and non-motor symptoms 17 1.8 Deep brain stimulation and levodopa–carbidopa intestinal gel 19 1.9 Palliative care 19 Putting (...) Parkinson's disease in people presenting with tremor, stiffness, slowness, balance problems and/or gait disorders. [2006] [2006] 1.2.2 If Parkinson's disease is suspected, refer people quickly and untreated to a specialist with expertise in the differential diagnosis of this condition. [2006, [2006, amended 2017] amended 2017] Clinical and post-mortem diagnosis Clinical and post-mortem diagnosis 1.2.3 Diagnose Parkinson's disease clinically, based on the UK Parkinson's Disease Society Brain Bank Clinical

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

137. Mental health of adults in contact with the criminal justice system

, primarily of self-harm. The ACCT process is necessarily prescriptive and it is vital that all stages are followed in the timescales prescribed. Mental health of adults in contact with the criminal justice system (NG66) © NICE 2019. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 27 of 39Acquired cognitiv Acquired cognitive impairment e impairment Any cognitive impairment that develops after birth, including traumatic brain injury (...) health assessment. No: record no action needed. Mental health of adults in contact with the criminal justice system (NG66) © NICE 2019. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 8 of 39Ph Physical injuries ysical injuries 3. Has the person received any physical injuries over the past few days, and if so: what were they how were they treated? Yes: assess severity of injury, any treatment received and record any significant

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

139. Diagnosis and Management of Acute Pulmonary Embolism Full Text available with Trip Pro

fractures and joint replacements, and spinal cord injury are strong provoking factors for VTE. , Cancer is a well-recognized predisposing factor for VTE. The risk of VTE varies with different types of cancer; , pancreatic cancer, haematological malignancies, lung cancer, gastric cancer, and brain cancer carry the highest risk. , Moreover, cancer is a strong risk factor for all-cause mortality following an episode of VTE. Oestrogen-containing oral contraceptive agents are associated with an elevated VTE (...) Assessment of pulmonary embolism severity and the risk of early death 18 5.1 Clinical parameters of pulmonary embolism severity 18 5.2 Imaging of right ventricular size and function 18 5.2.1 Echocardiography 18 5.2.2 Computed tomographic pulmonary angiography 19 5.3 Laboratory biomarkers 19 5.3.1 Markers of myocardial injury 19 5.3.2 Markers of right ventricular dysfunction 19 5.3.3 Other laboratory biomarkers 19 5.4 Combined parameters and scores for assessment of pulmonary embolism severity 20 5.5

2019 European Society of Cardiology


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