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61. Idelalisib for treating refractory follicular lymphoma

with progression and death. These include, but are not Idelalisib for treating refractory follicular lymphoma (TA604) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 15 of 30limited to, the components of FLIPI I and FLIPI II, notably: age, serum beta 2 microglobulin levels, bone marrow involvement, size of the largest involved lymph node, haemoglobin levels and the presence of bulky disease. Other factors include time (...) daily. Treatment is continued until disease progression or unacceptable toxicity. Price Price The list price for idelalisib is £3,114.75 per pack of 60 x 150 mg film-coated tablets (excluding VAT, company submission). The company has a commercial arrangement for idelalisib, which would apply if the technology had been recommended. Idelalisib for treating refractory follicular lymphoma (TA604) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions

2019 National Institute for Health and Clinical Excellence - Technology Appraisals

62. Spondyloarthritis in over 16s: diagnosis and management

infection). 1.1.4 Be aware that axial spondyloarthritis: affects a similar number of women as men can occur in people who are human leukocyte antigen B27 (HLA-B27) negative may be present despite no evidence of sacroiliitis on a plain film X-ray. Referr Referral for suspected axial spondyloarthritis al for suspected axial spondyloarthritis 1.1.5 If a person has low back pain that started before the age of 45 years and has lasted for longer than 3 months, refer the person to a rheumatologist (...) for a spondyloarthritis assessment if 4 4 or more or more of the following additional criteria are also present: low back pain that started before the age of 35 years (this further increases the likelihood that back pain is due to spondyloarthritis compared with low back pain that started between 35 and 44 years) waking during the second half of the night because of symptoms buttock pain improvement with movement improvement within 48 hours of taking non-steroidal anti-inflammatory drugs (NSAIDs) Spondyloarthritis

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

63. Evaluation of the Thoracic and Lumbar Spine in Blunt Trauma

hip, you are planning to get plain films of the lumbar spine. Again, you wonder if this is sufficient, or if you need to get more advanced imaging (such as a CT) to evaluate for fracture. The first patient gets a “pan-scan” and is found to have isolated facial bone fractures, for which he is evaluated by ENT and eventually discharged home. The second patient is found to have no fractures on plain films, feels much better after ibuprofen, and also goes home. You still have questions about your (...) of pain, tenderness to palpation, deformity, or neurologic deficit 3.Age ≥ 60 Future research will be needed to validate this rule in multiple settings, and should be aimed at determining the impact of the rule to ensure it improves outcomes or reduces unnecessary imaging without worsening outcomes. Until then, it seems reasonable to continue using clinical acumen to determine who needs imaging of the thoracic or lumbar spine following blunt trauma, with a lower threshold to at least get plain films

2019 Washington University Emergency Medicine Journal Club

64. Acute Kidney Injury (AKI)

sample ? systolic BP 15 years old) population [7]. There appears to be an increasing incidence of AKI with age [8]. In addition, AKI appears to be becoming more common when assessed over even short periods of time; Hsu et al, for instance, showed the incidence of non-dialysis requiring AKI amongst a large population of hospitalised patients to have increased from 323 to 522 per 100 000 person-years between 1996 and 2003, alone [8]. These changes may be explained by more aggressive medical (...) and surgical interventions in an aging and increasingly co-morbid population who are more vulnerable to AKI as a complication of such treatments[9, 10]. When corrected for disease acuity there is at least some evidence that hospital survival from AKI is increasing [11] although longer term mortality rates appear to be unchanged and may, Renal Association Clinical Practice Guideline Acute Kidney Injury (AKI) - August 2019 22 it has been speculated, actually represent increased use of early discharge

2019 Renal Association

65. Istradefylline (Nourianz) - Parkinson's disease

of top 3 TEAEs Related to Dizziness, Hypotension or Orthostatic Table 44. Incidence of A Subject Experiencing at Least One TEAE Belonging to the Cardiac SOC Table 47. Treatment-Emergent Adverse Events, Grouped Occurring by Age Group = 65 49.0 (75) 51.3 (446) 47.3 (424) 52.9 (82) 46.6 (471) 48.3 (1564) = 75 8.5 (13) 13.6 (118) 10.2 (91) 12.9 (20) 11.4 (115) 11.4 (369) Race American Indian or Alaska Native 0 0.4 (3) 0.1 (1) 0 0.1 (1) 0.2 (5) Asian 2.6 (4) 29.1 (253) 32.8 (294) 1.9 (3) 28.7 (290) 27.1 (...) : September 6, 2017 for all NDAs and BLAs Reference ID: 4482736 Reference ID: 4484018 21 Clinical Review Natalie Branagan, MD NDA 022075 Nourianz/istradefylline of North America (77%). Pool 8 was similar to Pool 1 with respect to gender and age but was different with respect to race and region. Males made up 50.5% of the population and the median age of the population was 65 years. Asians made up a higher percentage of the population (64.1%). A higher percentage of the population was located outside

2019 FDA - Drug Approval Package

66. Trastuzumab (Ogivri) - breast cancer or stomach cancer

carried out. In a population pharmacokinetic analysis, age and renal impairment were not shown to affect trastuzumab disposition. Paediatric population There is no relevant use of trastuzumab in the paediatric population. Method of administration Trastuzumab loading dose should be administered as a 90-minute intravenous infusion. Do not administer as an intravenous push or bolus. Trastuzumab intravenous infusion should be administered by a healthcare provider prepared to manage anaphylaxis (...) 2 ). The incidence of symptomatic cardiac dysfunction was 1.7 % in the trastuzumab arm. Clinical experience is limited in patients above 65 years of age. Infusion-related reactions (IRRs) and hypersensitivity Serious IRRs to trastuzumab infusion including dyspnoea, hypotension, wheezing, hypertension, bronchospasm, supraventricular tachyarrhythmia, reduced oxygen saturation, anaphylaxis, respiratory distress, urticaria and angioedema have been reported (see section 4.8). Pre-medication may

2019 European Medicines Agency - EPARs

67. Osteochondritis dissecans

onset, non-specific joint pain, exacerbation of symptoms with exercise (especially stair- or hill-climbing), recurrent effusion, catching or locking. Radiographs: minimum of 2 views of the involved joint (more specified for knee and ankle) performed for diagnosis. While the aetiology remains unclear, early recognition is essential as many treatment options exist. Definition Osteochondritis dissecans is an acquired, potentially reversible idiopathic lesion of subchondral bone resulting (...) of dorsiflexed ankle or anterolateral aspect of plantar-flexed ankle effusion present locking of joint catching of joint decreased range of motion knee involvement, age 10 to 15 years elbow involvement, age 11 to 21 years talus involvement, second to fourth decade absence of history of trauma involving the knee or elbow antalgic gait in osteochondritis dissecans involving the knee or talus external rotation gait in osteochondritis dissecans involving the knee relieving factors: non-steroidal anti

2018 BMJ Best Practice

68. Chronic lymphocytic leukaemia

, the disorder is called small lymphocytic lymphoma. History and exam shortness of breath and fatigue lymphadenopathy splenomegaly hepatomegaly presence of risk factors B symptoms recurrent infections petechiae age over 60 years male sex white ethnicity family history of CLL Diagnostic investigations WBC count with differential blood film haemoglobin platelet count flow cytometry fluorescent in situ hybridisation (FISH) molecular genetic analysis direct antiglobulin test (DAT) immunoglobulin levels bone (...) Chronic lymphocytic leukaemia Chronic lymphocytic leukaemia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Chronic lymphocytic leukaemia Last reviewed: February 2019 Last updated: February 2018 Summary An indolent haematological cancer that occurs with increasing age. Usually presents with absolute lymphocytosis as an incidental finding on routine FBC or with asymptomatic lymphadenopathy. Diagnosed by FBC

2018 BMJ Best Practice

69. Extrapulmonary tuberculosis

node fine-needle aspiration (FNA) pleural fluid analysis ascitic fluid analysis bone films CSF analysis urinalysis nucleic acid amplification test (NAAT) lymph node biopsy pleural biopsy synovial biopsy liver biopsy bone marrow biopsy blood culture peritoneal biopsy gastric aspirate bronchoscopy thoracoscopy susceptibility testing interferon-gamma release assays (IGRAs) genotyping HIV test empiric treatment CT scan chest or abdomen colonoscopy pericardial fluid analysis pericardial biopsy Treatment (...) by Mycobacterium tuberculosis . In many cases, M tuberculosis infection becomes latent before progression to active TB disease. Patients who are infected but who have no clinical, bacteriological, or radiographic evidence of active TB are said to have latent TB infection. When there is progression from latent infection to active disease, it most commonly involves the lungs and is communicable in this form, but may affect almost any organ system including the lymph nodes, CNS, bones/joints, genito-urinary tract

2018 BMJ Best Practice

70. Adhesive capsulitis

shoulder instability) negative relocation test (to further exclude anterior shoulder instability) negative Kim test (to exclude posteroinferior labral lesion of the shoulder) age 40 to 70 years diabetes mellitus prior hx of adhesive capsulitis shoulder pain and immobilisation previous shoulder surgery female sex thyroid disease Diagnostic investigations plain film radiographs MRI/MR arthrogram shoulder CT arthrogram Treatment algorithm ACUTE Contributors Authors Complex Shoulder Knee and Sports Surgery (...) Adhesive capsulitis Adhesive capsulitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Adhesive capsulitis Last reviewed: February 2019 Last updated: April 2018 Summary Affects 2% to 5% of the population, slightly more common in women than in men, and most common in people between 40 and 70 years of age. Recent history of traumatic shoulder injury, prior surgery to affected shoulder, diabetes mellitus, thyroid

2018 BMJ Best Practice

71. Cutaneous T-cell lymphoma

cells on blood film skin biopsy polymerase chain reaction (PCR) for T-cell receptor flow cytometry basic metabolic panel LFTs serum LDH human T-cell lymphotropic virus (HTLV)-I serology bone marrow biopsy lymph node biopsy CT scan HIV test FDG-PET scan Treatment algorithm ONGOING Contributors Authors Professor of Targeted Therapy and Oncology University of Manchester Manchester Academic Health Sciences Centre Manchester UK Disclosures TMI declares that he has no competing interests. Consultant (...) lesions unilesional acral site involvement lymphadenopathy constitutional symptoms palmar-plantar keratoderma alopecia leonine facies onychodystrophy hepatomegaly ectropion bullous, granulomatous, ichthyosiform, and purpuric lesions age >60 years male gender black ethnicity (mycosis fungoides); white ethnicity (Sézary's syndrome) exposure to infectious agents chromosomal abnormality environmental exposure to industrial chemicals, herbicides, pesticides Diagnostic investigations FBC screen for Sézary's

2018 BMJ Best Practice

72. Plantar fasciitis

-static dyskinesia pain exacerbated by walking barefoot pain improved with non-steroidal anti-inflammatory drug (NSAID) use no hx of acute injury to the heel self-limiting pain unilateral heel pain positive dorsiflexion-eversion test positive Windlass test negative Tinel's sign obesity equinus pes planus pes cavus age >40 years old hx of prolonged standing runners Diagnostic investigations foot x-ray technetium (Tc-MDP 3-phase) bone scan MRI HLA-B27 rheumatoid factor ultrasound Treatment algorithm (...) Plantar fasciitis Plantar fasciitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Plantar fasciitis Last reviewed: February 2019 Last updated: March 2018 Summary Most commonly affects people between 40 and 60 years of age who are overweight or obese. Also occurs in 10% of runners. Diagnosis is usually based on a thorough history and physical examination. There is no laboratory test that can confirm or rule out

2018 BMJ Best Practice

73. Osteochondritis dissecans

onset, non-specific joint pain, exacerbation of symptoms with exercise (especially stair- or hill-climbing), recurrent effusion, catching or locking. Radiographs: minimum of 2 views of the involved joint (more specified for knee and ankle) performed for diagnosis. While the aetiology remains unclear, early recognition is essential as many treatment options exist. Definition Osteochondritis dissecans is an acquired, potentially reversible idiopathic lesion of subchondral bone resulting (...) of dorsiflexed ankle or anterolateral aspect of plantar-flexed ankle effusion present locking of joint catching of joint decreased range of motion knee involvement, age 10 to 15 years elbow involvement, age 11 to 21 years talus involvement, second to fourth decade absence of history of trauma involving the knee or elbow antalgic gait in osteochondritis dissecans involving the knee or talus external rotation gait in osteochondritis dissecans involving the knee relieving factors: non-steroidal anti

2018 BMJ Best Practice

74. Vitamin D deficiency

sunlight exposure increased skin pigmentation age >50 years inadequate dietary and supplemental vitamin D intake malabsorption obesity medication use genetic mutations tumour chronic kidney disease granulomatous disorders primary hyperparathyroidism hyperthyroidism Diagnostic investigations serum 25-hydroxyvitamin D serum alkaline phosphatase serum calcium fasting serum phosphate plain-film radiographs of knees and wrists intact PTH serum 1,25-dihydroxyvitamin D bone density (DEXA) scan Treatment (...) not typically present with overt clinical signs and symptoms until the deficiency is severe and prolonged. Children with established vitamin D deficiency present with features of rickets (skeletal abnormalities, developmental delay, failure to thrive), whereas adults present with signs and symptoms of osteomalacia (bone pain and tenderness, proximal muscle weakness reported as difficulty in rising from a sitting position). In addition to the skeletal effects, it is now recognised that vitamin D deficiency

2018 BMJ Best Practice

75. Optimisation of RIZIV – INAMI lump sums for incontinence

or drugs) 120 4.4 ESTIMATING THE NUMBER OF PEOPLE WITH UNTREATED INCONTINENCE 130 5 INTERNATIONAL PERSPECTIVE 131 5.1 INTRODUCTION 131 5.2 METHODS 131 5.3 SELECTION OF COUNTRIES 131 5.4 CROSS-COUNTRY ANALYSIS 132 5.4.1 Absorbent materials: included or excluded from the health benefit basket 132 5.4.2 Absorbent materials: eligible indications and age groups 134 5.4.3 Reimbursement method 140 5.4.4 Strengths and weaknesses of different reimbursement methods 144 5.4.5 Patient classification (...) FORM WITH KATZ SCALE 199 APPENDIX 2. REQUEST FORM FOR “SMALL LUMP SUM” FOR INCONTINENCE 200 ? APPENDIX TO CHAPTER 4 201 APPENDIX 1. NUMBER AND TYPE OF ADMISSIONS, AGE AND SEX PER APR-DRG (2014) 201 APPENDIX 2. TEN MOST FREQUENT PROCEDURE PERFORMED PER MDC (2014) 202 APPENDIX 3. SELECTION CRITERIA TO EXTRACT EPS DATA 2008-2015 204 APPENDIX 4. VARIABLES DERIVED FROM EPS VARIABLES (2015) 214 APPENDIX 5. VOLUME (DDD), REIMBURSEMENTS (€) AND NUMBER OF PATIENTS FOR URINARY FREQUENCY AND INCONTINENCE

2019 Belgian Health Care Knowledge Centre

76. Haematological cancers: improving outcomes

malignancy if patients with an established or previous malignancy have suspected relapse or disease progression. [new 2016] [new 2016] 1.1.7 If an urgent treatment decision is needed and local diagnostic workup will not reduce the speed or quality of the SIHMDS assessment and integrated reporting, local diagnostic laboratories should process and report on blood film, bone marrow aspirate and cerebrospinal fluid cytology specimens. [new 2016] [new 2016] 1.1.8 SIHMDS should release individual laboratory (...) quality management system be formally accredited as a SIHMDS by a recognised independent organisation be managed by a single trust/organisation assess the clinical benefit and the financial and resource impact of new diagnostic and therapeutic technologies before introducing them have a central reception point for all specimens have a full range of age-appropriate specialist haematology and haematopathology input for diagnosis and the authorisation of integrated reports Haematological cancers

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

77. Sunlight exposure: risks and benefits

for children and young people oung people Children under 6 months of age should be kept out of direct strong sunlight. Between March and October in the UK, children and young people need their skin protecting. They should cover up with suitable clothing, be encouraged to spend time in the shade (particularly between 11am and 3pm) and wear sunscreen. The parents and carers of children younger than 5 should be given advice on vitamin D supplements (see NICE's guideline on vitamin D: increasing supplement use (...) days absence because of sunburn or other adverse effects (Sun protection: advice for employers of outdoor workers Health and Safety Executive). Cover the needs of all at-risk groups (see recommendation 1.1.1). T ailor advice according to skin type and age. T ailor advice according to needs and circumstances. This includes people for whom English is not a first language, from lower socioeconomic groups, with specific cultural needs, or with a disability. Encourage people to manage their own risk

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

78. Fractures (non-complex): assessment and management

, standards and laws (including on consent and mental capacity), and safeguarding. Recommendations apply to both children (under 16s) and adults (16 or over) unless otherwise specified. Some recommendations on management depend on whether the growth plate of the injured bone has closed (skeletal maturity). The age at which this happens varies. In practice, healthcare professionals use clinical judgement to determine whether a bone is skeletally mature. When a recommendation depends on skeletal maturity (...) (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 14 of 18Conte Context xt The annual incidence of fractures in Britain is about 3.6% and the lifetime prevalence nearly 40%. Most of the 1.8 million fractures that occur in England each year are non-complex, and include a wide range of injuries over the complete age range from infancy to old age. Many different bones can be involved and the mechanisms of injury are many and varied. The range of treatment options is also wide

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

79. Management of Blunt Force Bladder Injuries

the same sensitivity and specificity at detecting bladder injury as the criterion standard plain film cystography. The committee recommends that the clinician may choose either imaging modality to diagnose bladder injury based on patient condition, imaging requirements for other associated injuries, and equipment availability. Interpreting CT cystography could be less affected by overlying bone fragments caused by pelvic fracture, spine boards, or military antishock trousers that may be present (...) published from January 1975 to July 2016 using the medical subject headings and keywords listed (Figure, Supplemental Digital Content 1, ). All randomized controlled trials, observational studies, and retrospective studies were considered. Studies of adult patients (age, ≥18 years) sustaining blunt abdominal/pelvic trauma were included. Letters to the editor, book chapters, reviewed articles, studies on pediatric patients, penetrating trauma, and case series of less than 20 patients were excluded. Three

2019 Eastern Association for the Surgery of Trauma

80. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV

Emergency Plan for AIDS Relief (PEPFAR), the United States Centers for Disease Control and Prevention, the United States Agency for International Development and Unitaid provided funding for developing these guidelines. viii SUMMARY OF KEY TERMS Age groups and populations The following definitions for adults, adolescents, children and infants are used in these guidelines for the purposes of implementing recommendations for specific age groups. It is acknowledged that countries may have other definitions (...) under national laws: An adult is a person older than 19 years of age. An adolescent is a person aged 10–19 years of age. A child is a person 1–9 years of age. An infant is a child younger than one year of age. A neonate is an infant younger than four weeks of age. Adolescent girls and women of childbearing potential Adolescent girls and women of childbearing potential are defined as premenopausal females capable of becoming pregnant. Nuceloside Reverse Transcriptase Inhibitor (NRTI) Antiretroviral

2019 World Health Organisation HIV Guidelines

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