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Appearance, Behavior and Attitude Exam

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241. Estrogen and Progesterone Receptor Testing in Breast Cancer

. There are limited data on the overall benefit of endocrine therapies for patients with these results, but they currently suggest possible benefit, so patients are considered eligible for endocrine treatment. There are data that suggest invasive cancers with these results are heterogeneous in both behavior and biology and often have gene expression profiles more similar to ER-negative cancers.” FIG 2. Case examples to illustrate stain intensity and percentage interpretation. Examples of invasive cancers (...) results). (C) Case negative for ER expression (×400) both in the in the invasive cancer and the internal control duct (asterisks). The assay should be repeated and an investigation for potential causes of negative internal controls performed (including both preanalytic and analytic factors). If internal controls remain negative and this issue appears isolated to this sample, the test should be reported as “cannot be determined” (indeterminate; uninterpretable because of negative internal controls

2020 American Society of Clinical Oncology Guidelines

242. Treatment of Patients with Schizophrenia

medical illness) • Exposure to physical, sexual, or emotional trauma • Exposure to violence or aggressive behavior, including combat exposure or childhood abuse • Legal or disciplinary consequences of past aggressive behaviors Examination, Including Mental Status Examination • General appearance and nutritional status • Height, weight, and body mass index (BMI) • Vital signs • Skin, including any stigmata of trauma, self-injury, or drug use • Coordination and gait • Involuntary movements (...) substance use, a psychiatric treatment history, an assessment of physical health, an assessment of psychosocial and cultural factors, a mental status examination including cognitive assessment, and an assessment of risk of suicide and aggressive behaviors, as outlined in APA's Practice Guidelines for the Psychiatric Evaluation of Adults (3rd edition). 2. APA recommends (1C) that the initial psychiatric evaluation of a patient with a possible psychotic disorder include a quantitative measure to identify

2020 American Psychiatric Association

243. Clinical practice guideline for evaluation of psychosocial factors influencing recovery from adult orthopaedic trauma

on a clinician’s independent medical judgment, given the individual patient’s specific clinical circumstances. Disclosure Requirement In accordance with AAOS policy, all individuals whose names appear as authors or contributors to this clinical practice guideline filed a disclosure statement as part of the submission process. All panel members provided full disclosure of potential conflicts of interest prior to voting on the recommendations contained within this clinical practice guideline. Funding Source (...) from adult orthopaedic trauma. In addition to providing clinical practice recommendations, this guideline also highlights limitations of the current literature and areas that require future research. This clinical practice guideline addresses psychosocial factors influencing clinical, functional, and quality of life recovery following military and civilian adult orthopaedic trauma. This guideline is intended to be used by all qualified and appropriately trained clinicians and surgeons involved

2020 American Academy of Orthopaedic Surgeons

244. Clinical practice guideline for limb salvage or early amputation

CPG eAppendix ACCEPTABILITY: High FEASIBILITY: Moderate (Dependent on payor status, policy and patient resources) FUTURE RESEARCH: Additional studies examining the specific association between the type (e.g. PT, OT, behavioral health interventions) and volume of care (number and duration) and resulting outcomes are needed. These data would help optimize the care pathway following traumatic limb injury, particularly in the context of multi-system or multi-limb injury, community reintegration (...) . Disclosure Requirement In accordance with AAOS policy, all individuals whose names appear as authors or contributors to this clinical practice guideline filed a disclosure statement as part of the submission process. All panel members provided full disclosure of potential conflicts of interest prior to voting on the recommendations contained within this clinical practice guideline. Funding Source This clinical practice guideline was funded exclusively through a research grant provided by the United

2020 American Academy of Orthopaedic Surgeons

245. Management of Chronic Kidney Disease

, office evaluation could also include assessment of a post-void residual using either a catheter or a bladder ultrasound. Finally, the physical exam should include assessment for clues to common underlying causes of renal disease and for signs of common co-morbid conditions. Findings include those suggesting underlying connective tissue disorders or evidence of microvascular complications of diabetes (such as retinopathy), as well as a complete cardiovascular examination to assess for signs (...) the CKD-EPI equation) and urine studies for the presence or absence of albuminuria. [IC] • Ultrasound imaging for structural kidney disease may be helpful in certain populations. [IID] Treatment • Lifestyle modifications (dietary management, weight management, physical activity) are the initial components of treatment and secondary prevention. [IA] • Blockade of the renin angiotensin aldosterone system with either an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker

2020 University of Michigan Health System

246. Adjuvant Systemic Chemotherapy for Stage II and III Colon Cancer Following Complete Resection

? There was agreement among the Working Group members that the overall certainty of the evidence was moderate. ? Although the Working Group looked at OS, disease-free survival, adverse events and quality of life, OS was considered to be the most important outcome, followed by adverse events. The Working Group was unanimous in their opinion that patients would also value the increased survival benefit of adjuvant chemotherapy, although patient input was not sought. ? The Working Group valued OS over toxicity when (...) was high except for the age data, which were considered to be of moderate certainty. ? Although the Working Group looked at OS, disease-free survival, adverse events and quality of life, OS was considered to be the most important outcome, followed by adverse events. The Working Group was unanimous in their opinion that patients would also value the increased survival benefit of adjuvant chemotherapy, although patient input was not sought. The Working Group valued OS over toxicity when drafting

2019 Cancer Care Ontario

247. Organizational Guideline for the Delivery of Stereotactic Radiosurgery for Brain Metastasis in Ontario

Date: August 27, 2019 For information about this document, please contact Arjun Sahgal the lead author, through the PEBC via: Phone: 905-527-4322 ext. 42822 Fax: 905 526-6775 E-mail: ccopgi@mcmaster.ca For information about the PEBC and the most current version of all reports, please visit the CCO website at http://www.cancercare.on.ca/ or contact the PEBC office at: Phone: 905-527-4322 ext. 42822 Fax: 905 526-6775 E-mail: ccopgi@mcmaster.ca PEBC Report Citation (Vancouver Style): Sahgal A, Kellett (...) Follow-up The following are strongly recommended for a follow-up program for SRS patients in Ontario: ? Follow-up of SRS patients should consist of routine clinical visits for the first year (every 2-3 months); second and third year (every 3-4 months); and, thereafter, as determined by the MCC Qualifying Statements for Recommendation 6 ? A routine clinical visit incorporates a standard imaging examination – MRI and preferably with volumetric axial sequences ? Interpretation of follow-up imaging

2019 Cancer Care Ontario

248. Artificial intelligence and health report

strategies result in meaningful outcomes – beyond publications. Industry perspective Pamela Spence, Global Health Sciences and Wellness Industry Leader and Life Sciences Industry Leader at Ernst & Young, introduced the area from an industry perspective. She observed that medicine is moving from a clinical science supported by data to a data science that will be supported by clinicians. Behaviour change is an area where AI and new digital technologies may be transformative. Many smaller companies (...) public funders, charities and industry to maximise the value of research to patients and the economy. The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government. Opinions expressed in this report do

2019 Academy of Medical Sciences

249. Infection Control for Haemodialysis Units

controls in the haemodialysis unit. BACKGROUND The introduction of penicillin for the treatment of Staphylococcus aureus in the 1940s is widely recognised as one of the greatest medical achievements of the 20th century. Within a few short years, penicillin-resistant Staph aureus had appeared, and its rapid increase led to the introduction of methicillin for penicillin–resistant staph treatment in 1959. Although not recognised at the time, Methicillin-resistant Staph aureus (MRSA) had also emerged (...) acquisition with direct person-to-person transmission playing a smaller role than previously thought [8]. A number of health services have ceased surveillance screening and are adopting models of care based more on standard precautions-style concepts. In the meantime, a number of United States of America (US) jurisdictions influenced no doubt by the Centers for Disease Control and Prevention (CDC) 2007 guideline that predated these trials, continue to mandate screening and reporting [9]. Within

2019 KHA-CARI Guidelines

250. Economic evaluations of pre- and post-exposure prophylaxis for HIV

of life (33), and the efficacy and cost of PrEP (32, 33). Review authors concluded that delivery of PrEP to key populations at highest risk of HIV appeared to be the most cost-effective approach. They cautioned, however, that included studies did not consider any extra costs related to identifying and engaging these populations— and executing these strategies may pose a challenge for decision makers (1). Another review summarized cost-effectiveness studies of introducing PrEP in both high- and low (...) benefits in terms of the general impact on well-being, or “utilities”). A common measure of utility is the quality-adjusted life year (QALY), which combines the estimated quantity of life years that are gained or saved as a result of a health intervention, with some judgment as to the quality of those years (6). Cost-utility analysis is somewhat more sophisticated than cost-effectiveness analysis as it is able to compare very different health programs to one another, such as surgical, pharmaceutical

2019 Ontario HIV Treatment Network

251. Traumatic Brain Injury and Dementia

features to dementia – such as memory disturbances, behavior and personality changes, and Parkinsonism – but is currently thought to be a distinct clinical entity with a distinct pattern of brain pathology detectable upon autopsy, 19 including atrophy in the frontal and temporal lobes, widened ventricles, dilated and bifurcated septum pellucidums, and accumulation of proteins such as tau. 20 Research on CTE to date primarily focuses on autopsy examinations, which is outside of this scope of this report (...) populations and adding a few key studies in Veterans. This review found that although no study has directly compared dementia rates in Veterans and non-Veterans in the same sample, estimates from 2 separate sources suggest that dementia rates appear similar in Veterans (10.7%) and non-Veterans (range, 8.8% to 11.6%) aged 65 years and older. No studies were identified on the comparative prevalence of dementia among younger ( 21,913) Dementia prevalence is likely similar between US Veterans (10.7

2019 Veterans Affairs Evidence-based Synthesis Program Reports

252. Handbook on designing and implementing an immunisation information system

interventions that produce major health benefits. They are vulnerable to changes in public confidence and opinion. Recently, immunisation programmes have been subject to controversy that has hampered uptake for some vaccines. Mitigating this controversy requires real-life demonstration of the efficacy and excellent safety profile of vaccinations within short timeframes. IIS are an essential tool for the timely documentation of the health benefits of immunisation. Progress in technology has enabled (...) public health interventions that produce major health benefits. They are vulnerable to changes in public confidence and opinion. Immunisation programmes may be subject to controversy that has prevented achieving high uptake for some vaccines. Mitigating these controversies requires near to real- time demonstration of the efficacy and favourable safety profile of vaccines to reassure all concerned stakeholders, from the patient to the healthcare professionals. The technology to set up an IIS has been

2019 European Centre for Disease Prevention and Control - Technical Guidance

253. Public health guidance on prevention and control of blood-borne viruses in prison settings

a given intervention is accessible to the target population (availability of good health services within reasonable reach and when needed) Active case finding Interventions aimed at promoting early diagnosis by means of provider- initiated systematic offer for testing, at entrance and/or during stay (including at release) Client-initiated testing Testing which is voluntary and performed as the result of individual’s health- seeking behaviour, triggered by symptoms development or other reasons (i.e (...) and every drug dose by an ’observer’ acceptable to the patient and the health system [7] Evidence-based guideline A guideline that is largely based on the scientific literature to generate a recommendation; good clinical practices or expert opinions could be used to supplement the scientific literature Feasibility The degree to which it is feasible to implement an intervention in terms of time, money, or other circumstances Harm reduction interventions Interventions aiming at reducing the harm/risk (e.g

2019 European Centre for Disease Prevention and Control - Public Health Guidance

254. Public health guidance on screening and vaccination for infectious diseases in newly arrived migrants within the EU/EEA

and Prevention CHB Chronic hepatitis B CXR Chest X-ray DALY Disability-adjusted life year DTaP-IPV-Hib Diphtheria, tetanus, pertussis, polio, and Haemophilus influenzae type b EACS European AIDS Clinical Society EASL European Association for the Study of the Liver EU/EEA European Union/European Economic Area ELISA Enzyme-linked immunosorbent assay GRADE Grading of recommendations assessment, development and evaluation HBcAb Hepatitis B core antibody HBsAg Hepatitis B surface antigen HBV Hepatitis B virus HCC (...) Prevention of mother-to-child transmission PWID People who inject drugs QALY Quality-adjusted life year RBV Ribavirin RIF Rifampicin RCT Randomised controlled trial RDT Rapid diagnostic test TB Tuberculosis TST Tuberculin skin test UN United Nations UNAIDS Joint United Nations Programme on HIV/AIDS VCT Voluntary counselling and testing VPD Vaccine-preventable diseases WHO World Health Organization Public health guidance on screening and vaccination for infectious diseases in newly arrived migrants

2019 European Centre for Disease Prevention and Control - Public Health Guidance

255. Community-based mental health and wellbeing support for refugees

to scales of trauma symptomology, parenting attitudes and quality of life. All but one program reported improvements. 36 Worth noting are two Australian based programs, which utilised a different approach to accessing participants and are reported in grey literature. “New Roots” 56 , which sought to improve general health and wellbeing and “Tell Your Story” 52 , which sought to increase knowledge of mental health, reduce associated stigma and increase help seeking, focused on male refugees from Arabic (...) Café Fairfield Inc (PCFI): Fairfield High School 92 6 COMMUNITY-BASED MENTAL HEALTH AND WELLBEING SUPPORT FOR REFUGEES | SAX INSTITUTE Abbreviations ASeTTS = Association for Sevice to Torture and Trauma Survivors (Western Australia) CBT = Cognitive Behavioural Therapy EC= Evidence Check IPT= Interpersonal Psychotherapy NET= Narrative Exposure Therapy NHMRC = National Health and Medical and Research Council PSS = Psychosocial Support PTSD= Posttraumatic Stress Disorder QPASTT = Queensland Program

2019 Sax Institute Evidence Check

256. Public health guidance on HIV, hepatitis B and C testing in the EU/EEA

Men who have sex with men NAT Nucleic acid test NICE National Institute for Health and Care Excellence NSP Needle and syringe programme OptTEST Optimising Testing and Linkage to Care for HIV Across Europe OST Opioid substitution treatment PEP Post-exposure prophylaxis PHC Primary healthcare PLHIV People living with HIV PrEP Pre-exposure prophylaxis PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses PWID People who inject drugs QALY Quality-adjusted life year RCT Randomised (...) on the streets, stay in a shelter, mission, single-room occupancy facility, abandoned building or vehicle or live in any other unstable or non-permanent situation. Incremental cost-effectiveness ratio (ICER): Measure used in cost-effectiveness studies to represent value of intervention compared against an alternative (comparator). ICER is calculated by dividing difference in total costs of two interventions by measure of health outcome, e.g. quality-adjusted life year (QALY, see below). ICER determines

2019 European Centre for Disease Prevention and Control - Public Health Guidance

257. Programmatic management of latent tuberculosis infection in the European Union

which seeks to improve the adherence of people to tuberculosis treatment by having health workers, family members, or community members directly observing the taking of anti-tuberculosis drugs [3]. Education Any programme that improve the knowledge, skills, attitudes, or behaviour of the target group. Education of patients is defined as counselling (see above) while ‘training’ is used for education of healthcare workers (see below). Enablers Things or measures that assist patients in adhering (...) to a group for their consideration, to examine acceptability or feasibility of any particular component or to build consensus for public policy [54]. In a classic Delphi approach, participants usually discuss in multiple, mostly anonymous, Delphi rounds. Results of each round are summarised and reported back to the participants, who may reconsider their first opinions based on the feedback. This particular modified Policy Delphi process included three steps: • Before the ad hoc scientific panel meeting

2019 European Centre for Disease Prevention and Control - Public Health Guidance

258. Cardiovascular Benefits and Harms of Step Therapy in the Treatment of Type 2 Diabetes in Adults with and without Atherosclerotic Cardiovascular Disease

(Appendix G Table 2), but only one trial and no observational studies examine the risk of pancreatitis from SGLT-2 inhibitors. Based on limited data, there do not appear to be a clinically significant risks of serious hypoglycemia or renal function from SGLT-2 inhibitors. 7 Limitations We completed a focused but up-to-date look at both the CVD benefits and serious harms of GLP-1 agonists and SGLT-2 inhibitors. Our understanding of CVD benefits is primarily limited by the small number cardiovascular (...) trials (Table 8) are generally consistent with findings from a 2018 systematic review and network meta-analysis by Zheng and colleagues 5 pooling all trials evaluating these two classes of medications with at least 12 weeks follow-up. Trials included in the Zheng review were not limited to participants with metformin failure, nor was it required that trials be designed or powered to assess CVD outcomes. This network meta-analysis examined the same outcomes reported here; however, it did not analyze

2019 Kaiser Permanente National Guideline Program

259. France has delisted anti-dementia agents

Cochrane: Could it be resuscitated? New Products Herpes zoster subunit vaccine Shingrix:Judgment Reserved Baloxavir (Xofluza®) for Influenza: No Value No difference from Tamiflu in efficacy, and suppresses immunity Adverse Reactions New evidence of severe abnormal behaviors/psychiatric reactions to oseltamivir(Tamiflu) Critical Review Cochrane review on HPV vaccine should be revised: News CONTENTS (December 2018, Vol. 4, No. 12) 30 31 37 40 41 50 Volume 4 Page 30 · MED CHECK - TIP Decembar 2018/ Vol.4 (...) HECK -The Informed Prescriber Translated from the Editorial in Med Check-TIP (in Japanese) Nov 2018 ; 18 (127) process, the board decided on the expulsion. Based on the minimum number stipulated by the Articles of Association, six board members are enough to run the board. However, if at least 13 members are needed as explained in Cochrane’s website (now it has been changed), the current board is illegitimate. Moreover, the current governing board does not represent the opinions of the entire

2019 Med Check - The Informed Prescriber

260. Heart Failure - Systolic Dysfunction

use of hawthorn in treating heart failure. Hawthorn (crataegus) has been studied in a moderate-sized placebo controlled trial of HF patients and was shown to be safe, but did not impact mortality. In one small-sized study it may have improved exercise capacity at high doses. Mind-body exercises (Tai Chi and yoga). Incorporation of mind-body exercises as part of a therapeutic life style choice can be a consideration for heart failure patients. Mind-body exercises represent an alternative exercise (...) decreased the rate of incident heart failure or heart failure death among a group of 30,000 Swedish women without a history of coronary artery disease. Intake at higher doses worsened outcomes. If patients want to incorporate chocolate as part of their therapeutic life style choice, the amount consumed should be limited (chocolate is high in calories and fat) and the type of chocolate should probably have high concentration of cocoa solids. Coenzyme Q10. Based on the limited data available, coenzyme Q10

2020 University of Michigan Health System

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