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121. Scoliosis ? Child

and with IV contrast Usually Not Appropriate O CT spine area of interest with IV contrast Usually Not Appropriate Varies CT spine area of interest without and with IV contrast Usually Not Appropriate Varies Tc-99m bone scan complete spine Usually Not Appropriate ?? ? ? Variant 2: Child (0 to 9 years of age). Early onset idiopathic scoliosis. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography complete spine Usually Appropriate ?? ? MRI complete spine without IV (...) contrast Usually Appropriate O MRI complete spine without and with IV contrast Usually Not Appropriate O CT spine area of interest with IV contrast Usually Not Appropriate Varies CT spine area of interest without and with IV contrast Usually Not Appropriate Varies CT spine area of interest without IV contrast Usually Not Appropriate Varies Tc-99m bone scan complete spine Usually Not Appropriate ?? ? ? Variant 3: Adolescent (10 to 18 years of age). Adolescent idiopathic scoliosis. No risk factors

2019 American College of Radiology

122. Head Trauma- Child

Head Trauma- Child Date of origin: 2014 ACR Appropriateness Criteria ® 1 Head Trauma — Child American College of Radiology ACR Appropriateness Criteria ® Clinical Condition: Head Trauma — Child Variant 1: Minor head injury (GCS >13) =2 years of age without neurologic signs or high risk factors (eg, altered mental status, clinical evidence of basilar skull fracture). Excluding nonaccidental trauma. Radiologic Procedure Rating Comments RRL* CT head without IV contrast 3 This is a known low-yield (...) be missed by radiographs [1,21]. Therefore, negative radiographs do not obviate the need for further imaging. In assessing more than 1,500 patients who ranged in age from 1 to 18 years. Reed et al [20] determined that evaluation by clinical history and CT without skull radiographs resulted in neither an increase in undetected intracranial injury nor greater overall radiation, suggesting CT can replace radiographs in many instances. Minor Head Injury in Patients =2 Years of Age Without Neurologic Signs

2019 American College of Radiology

123. Paediatric Urology

of the indications and morbidity of circumcision in children. Eur Urol, 1985. 11: 184. 37. Morris, B.J., et al. A ‘snip’ in time: what is the best age to circumcise? BMC Pediatr, 2012. 12: 20. 38. Ross, J.H., Circumcision: Pro and con., in Pediatric urology for the general urologist, J.S. Elder, Editor. 1996, Igaku-Shoin: New York. 39. Weiss, H.A., et al. Complications of circumcision in male neonates, infants and children: a systematic review. BMC Urol, 2010. 10: 2. 40. Homer, L., et al. Meatal stenosis in boys (...) surgery may improve the fertility index in undescended testes: a prospective randomized trial. J Urol, 2005. 173: 974. 72. Cortes, D., et al. Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryptorchidism. J Urol, 2000. 163: 1290. 73. Ritzen, E.M. Undescended testes: a consensus on management. Eur J Endocrinol, 2008. 159 Suppl 1: S87. 74. Kollin, C., et al. Surgical treatment of unilaterally undescended testes: testicular growth after randomization to orchiopexy at age 9 months

2019 European Association of Urology

124. Urological Trauma

evidence to recommendations. BMJ, 2008. 336: 1049. 10. Soreide, K. Epidemiology of major trauma. Br J Surg, 2009. 96: 697. 11. Middleton, P., The trauma epidemic. In: Major Trauma. Smith, J., Greaves, I., Porter, K. (2010) Oxford University Press: Oxford. 12. Thornley, S., et al. Alcohol intake, marijuana use, and sleep deprivation on the risk of falls occurring at home among young and middle-aged adults: a case-crossover study. N Z Med J, 2014. 127: 32. 13. Moore, E.E., et al. Organ injury scaling (...) , CLASSIFICATION & GENERAL MANAGEMENT PRINCIPALS 3.1. Definition and Epidemiology Trauma is defined as a physical injury or a wound to living tissue caused by an extrinsic agent. Trauma is the sixth leading cause of death worldwide, accounting for 10% of all mortalities. It accounts for approximately five million deaths each year and causes disability to millions more [ , ]. About half of all deaths due to trauma are in people aged 15-45 years; trauma is the leading cause of death in this age group [ ]. Death

2019 European Association of Urology

126. Risk factors for breast cancer: A review of the evidence 2018

Genomic changes 11 3.2.2 Epigenetic changes 12 3.2.3 Hormonal influences 12 3.2.4 Metabolic changes 13 3.2.5 The immune system 13 3.2.6 Stem and progenitor cells 13 3.2.7 The tumour microenvironment and interactions with stroma 13 3.3 Windows of susceptibility 14 Breast cancer risk factors 15 4 4.1 General factors 15 4.1.1 Age 15 4.1.2 Geographic location and residence 16 4.1.3 Remoteness and urbanisation 18 4.1.4 Socioeconomic status 19 4.2 Personal characteristics 21 4.2.1 Birthweight 21 4.2.2 (...) polymorphisms 47 4.3.11 STK11 gene mutation 50 4.3.12 TP53 gene mutation 52 4.4 Breast pathology 54 4.4.1 Previous benign breast disease 54 4.4.2 LCIS 55 4.4.3 DCIS 59 4.4.4 Previous primary invasive breast cancer 60 4.5 Endogenous hormones 63 4.5.1 Age at menarche 63 4.5.2 Parity 64 4.5.3 Age at first birth 65 4.5.4 Breastfeeding 67 4.5.5 Age at menopause 68 4.5.6 Circulating hormones—steroids 69 4.5.7 PCOS 72 4.6 Exogenous hormones 74 4.6.1 Hormonal contraception—combined 74 4.6.2 Hormonal contraception

2018 Cancer Australia

127. Brucellosis

culture serological tests CSF analysis CSF culture synovial fluid analysis synovial fluid culture FBC LFTs bone marrow culture tissue biopsy plain film x-rays of affected joints chest x-ray bone scan CT or MRI scan of spine CT or MRI scan of head PCR for detection and diagnosis of Brucella species matrix-assisted laser desorption/ionisation time of flight mass spectrometry (MALDI-TOF-MS) Treatment algorithm ACUTE Contributors Authors Senior Lecturer (Honorary Consultant) Liverpool School of Tropical (...) position of the National Health Service, the National Institute for Health Research, the Department of Health, or Public Health England. Specialist Trainee in Clinical Microbiology Royal Liverpool University Hospital Liverpool UK Disclosures AG is an author of several references cited in this monograph. Consultant in Infectious Diseases Whipps Cross Hospital London UK Disclosures ST declares that she has no competing interests. Peer reviewers Infectious Diseases Consultant Unit of Infectious Diseases

2017 BMJ Best Practice

128. Acute myelogenous leukaemia

of Auer rods From the collection of Drs K. Raj and P. Mehta; used with patient consent [Citation ends]. History and exam pallor ecchymoses or petechiae fatigue dizziness palpitations dyspnoea infections or fever lymphadenopathy hepatosplenomegaly mucosal bleeding skin or testicular mass skin infiltration gingival enlargement bone pain abdominal pain age over 65 years previous treatment with chemotherapy previous haematological dyspoiesis genetic factors constitutional karyotype abnormalities radiation (...) in the peripheral blood and normal haematopoiesis is reduced. Definitive diagnosis requires bone marrow biopsy. Presence of blast cells in ≥20% of the bone marrow cells confirms the diagnosis. Cytogenetic abnormalities are prognostically important and affect patient management. Most patients are treated with chemotherapy induction, consolidation, and maintenance regimens. Haematopoietic stem cell transplantation may also be used in select patients. It is important to rapidly identify acute promyelocytic

2017 BMJ Best Practice

129. Dental Management of Pediatric Patients Receiving Chemotherapy, Hematopoietic Cell Transplantation, and/or Radiation Therapy

of Pediatric Dental Patients Receiving Chemotherapy and/or Radiation and adopted in 1986, this document was last revised in 2013. The revision included a new literature search of the PubMed ® /MEDLINE database using the terms: pediatric cancer, pediatric oncology, hematopoietic cell transplantation, bone marrow transplantation, immunosuppressive therapy, mucositis, stomatitis, chemotherapy, radiotherapy, acute effects, long-term effects, dental care, oral health, pediatric dentistry, practice guideline (...) ; field: all; limits: within the last 10 years, humans, English, birth through age 18. Two thousand sixty- five articles matched these criteria. Ninety-five papers were chosen for review from this list and from the references within selected articles. When data did not appear sufficient or were inconclusive, recommendations were based upon expert and/ or consensus opinion by experienced researchers and clinicians. Keywords Hematopoietic Stem Cell transplantation (HCT), Low-level laser therapy (LLLT

2018 American Academy of Pediatric Dentistry

130. Best Practices for Pain Management in Infants, Children, Adolescents, and Individuals with Special Health Care Needs

physical and psychological consequences for the patient. Appreciation of pediatric pain can help practitioners develop clinical approaches to prevent or substantially relieve dental pain. When pharmacological intervention is necessary to man- age pain, the practitioner must understand the consequences, morbidities, and toxicities associated with the use of specific therapeutic agents. These recommendations are intended to provide dental professionals and other stakeholders with cur- rent best practices (...) in children. 67,68 This tech- nique requires the active cooperation of the patient and is most effective when used for children over eight years old. 57 Hypnosis Hypnotherapy aims to alter sensory experiences and dissociate from pain experiences, and hypnosis is best for school-aged or older children. 26 There is strong evidence that hypnosis is effective in reducing needle-related pain and distress in chil- dren and adolescents. 66,69 There is no evidence that hypnosis alone is capable of producing

2018 American Academy of Pediatric Dentistry

131. Responsible use of high-risk medical devices: the example of 3D printed medical devices

the procedure. 3 In February 2012, with the help of a 3D printer, doctors and engineers at Hasselt University successfully performed the world’s first patient-specific prosthetic jaw transplant for an 83-year-old woman suffering from a chronic bone disease.” 4 Today, Leuven University Hospital, routinely simulate orthognathic surgical cases in 3D-software, design and print the surgical templates on high-end 3D printers in the hospital. This occurs in over 150 patients per year. A full-time engineering team

2018 Belgian Health Care Knowledge Centre

132. Payment methods for hospital stays with a large variability in the care process

. psychiatry 22 Hospital payment methods for variable and complex care KCE Report 302 In Germany, all exclusion mechanisms are applied (see Figure 5). The German DRG system defines 45 DRGs (in 13 major diagnostic categories or MDCs) without a national cost-weight, including for example bone narrow transplant patients and tuberculosis patients. Furthermore 192 products/services, including 96 pharmaceuticals, are excluded, which accounted for 2 billion € in 2014 (about 3% of total payments). It is also (...) /departments are reimbursed on either case-based or per diem payments for their services. In the USA-Medicare Part A, there is clear focus on the exclusion of local- hospitals/departments and cancer-hospitals/departments (Figure 6). Children’s hospitals are also excluded – but this is reasoned by the nature of the Medicare insurance scheme (insurance covers people who are age 65 or under 65 and disabled). Medicare pays excluded hospitals for inpatient care on the basis of their Medicare allowable incurred

2018 Belgian Health Care Knowledge Centre

133. Urological Trauma

evidence to recommendations. BMJ, 2008. 336: 1049. 10. Soreide, K. Epidemiology of major trauma. Br J Surg, 2009. 96: 697. 11. Middleton, P., The trauma epidemic. In: Major Trauma. Smith, J., Greaves, I., Porter, K. (2010) Oxford University Press: Oxford. 12. Thornley, S., et al. Alcohol intake, marijuana use, and sleep deprivation on the risk of falls occurring at home among young and middle-aged adults: a case-crossover study. N Z Med J, 2014. 127: 32. 13. Moore, E.E., et al. Organ injury scaling (...) , CLASSIFICATION & GENERAL MANAGEMENT PRINCIPALS 3.1. Definition and Epidemiology Trauma is defined as a physical injury or a wound to living tissue caused by an extrinsic agent. Trauma is the sixth leading cause of death worldwide, accounting for 10% of all mortalities. It accounts for approximately five million deaths each year and causes disability to millions more [ , ]. About half of all deaths due to trauma are in people aged 15-45 years; trauma is the leading cause of death in this age group [ ]. Death

2018 European Association of Urology

135. Paediatric Urology

of the indications and morbidity of circumcision in children. Eur Urol, 1985. 11: 184. 37. Morris, B.J., et al. A ‘snip’ in time: what is the best age to circumcise? BMC Pediatr, 2012. 12: 20. 38. Ross, J.H., Circumcision: Pro and con., in Pediatric urology for the general urologist, J.S. Elder, Editor. 1996, Igaku-Shoin: New York. 39. Weiss, H.A., et al. Complications of circumcision in male neonates, infants and children: a systematic review. BMC Urol, 2010. 10: 2. 40. Homer, L., et al. Meatal stenosis in boys (...) surgery may improve the fertility index in undescended testes: a prospective randomized trial. J Urol, 2005. 173: 974. 72. Cortes, D., et al. Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryptorchidism. J Urol, 2000. 163: 1290. 73. Ritzen, E.M. Undescended testes: a consensus on management. Eur J Endocrinol, 2008. 159 Suppl 1: S87. 74. Kollin, C., et al. Surgical treatment of unilaterally undescended testes: testicular growth after randomization to orchiopexy at age 9 months

2018 European Association of Urology

136. Cabozantinib (Cabometyx) - advanced renal cell carcinoma (RCC)

Cabozantinib (Cabometyx) - advanced renal cell carcinoma (RCC) Published 08 October 2018 1 cabozantinib, 20mg, 40mg, and 60mg film-coated tablets (Cabometyx ® ) SMC2095 Ipsen Ltd UK 7 September 2018 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHSScotland. The advice is summarized as follows: ADVICE: following a full submission assessed under the end of life process (...) kinases, including vascular endothelial growth factor (VEGF), and hepatocyte growth factor receptor protein (MET). Inhibition of these kinases may inhibit tumour growth, angiogenesis, metastatic progression and pathological bone remodeling. 1, 2 The indication under review is an extension to the licensed indication for the treatment of renal cell carcinoma (RCC). Cabozantinib has previously been accepted by the SMC for the treatment of advanced RCC in adults following prior VEGF-targeted therapy

2018 Scottish Medicines Consortium

137. Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update

of characteristics of this systematic review on treatment of patients with early rheumatoid arthritis Population Key Inclusion Criteria: Adult outpatients, 19 years of age or older, with an early RA diagnosis, defined as 1 year or less from disease diagnosis Key Exclusion Criteria: Adolescents and adults with RA greater than 1 year from diagnosis ES-2 Drug Therapies Approved by FDA for RA Included in the Review Corticosteroid: Methylprednisone, prednisone (PRED), prednisolone (PNL) Conventional synthetic DMARD (...) to AEs • Serious c AEs • Specific d AEs 4. Benefits and harms of drug therapies in subgroups of patients Subgroups of patients defined by: • Age • Sex • Race or ethnicity • Disease activity • Prior treatment • Concomitant therapies • Coexisting conditions Timing of Review Beginning Search Date: January 2011 End Search Date: October 5, 2017 ES-3 Overview of Important Studies Underway Six trials either ongoing or completed, but findings not yet published. • One trial of ETN plus MTX versus a treat

2018 Effective Health Care Program (AHRQ)

138. Dolutegravir rilpivirine (Juluca) - For the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults who are virologically suppressed (HIV-1 RNA copies <50 copies/mL) on a stable antiretroviral regimen

Dolutegravir rilpivirine (Juluca) - For the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults who are virologically suppressed (HIV-1 RNA copies <50 copies/mL) on a stable antiretroviral regimen Published 10 September 2018 1 dolutegravir 50mg / rilpivirine 25mg film-coated tablets (Juluca ® ) SMC2091 ViiV Healthcare Ltd. 10 August 2018 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug (...) and Therapeutic Committees (ADTCs) on its use in NHS Scotland. The advice is summarised as follows: ADVICE: following a full submission dolutegravir / rilpivirine film-coated tablet (Juluca ® ) is accepted for use within NHSScotland. Indication under review: The treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults who are virologically-suppressed (HIV-1 RNA 50 copies/mL in the 6-month period before screening and no more than one instance of viral load >50 copies/mL but <200 copies/mL

2018 Scottish Medicines Consortium

139. BHIVA/BASHH guidelines on the use of HIV pre-exposure prophylaxis (PrEP)

(PEPSE) 65 6.4.2 HIV testing 65 6.4.3 Acute HIV infection 65 6.4.4 Assessment of renal function 65 6.4.5 STI screen 66 6.4.6. Assessment of viral hepatitis status 66 6.4.7 References 68 6.5 Other considerations 70 6.5.1 Women who are pregnant or trying to conceive 70 6.5.2 Bone health 70 6.5.3 References 70 6.6 Prescribing PrEP 71 6.6.1 What to use 71 6.6.2 Lead-in period 71 6.6.3 Frequency of dosing to attain benefit 71 6.6.4 On-demand dosing 71 6.6.5 Indications for post-exposure prophylaxis (...) following suboptimal adherence to PrEP 72 6.6.5 References 73 BHIVA/BASHH guidelines on the use of PrEP 4 7 Clinical follow-up and monitoring on treatment 75 7.1 Overview 75 7.2 Continued prescribing 75 7.3 Assessing adherence and adverse events 75 7.4 Management of short-term side effects 75 7.5 Monitoring on PrEP 77 7.5.1 HIV testing 77 7.5.2 Management of HIV seroconversion 77 7.5.3 STI screening 78 7.5.4 Viral hepatitis 78 7.5.5 Renal monitoring 78 7.5.6 Pregnancy testing 79 7.5.7 Bone monitoring 79

2018 British Association for Sexual Health and HIV

140. I heard a snap! Clay Shoveler’s Fracture

rotation, flexion, and extension. He also has exquisite, sharp tenderness on palpation over the C6 vertebrae. Initial Impression and Investigations While on history you had suspected a cervical sprain or strain, due to his midline tenderness over C6 and age you decide to obtain a x-ray of his cervical spine. Uh-oh, what happened to Reginald? Image courtesy of: Dr Chris O’Donnell (https://radiopaedia.org/cases/barbell-injury-to-cervical-spine-c6-clay-shoveler-fracture-1) Clay Shoveler’s Fracture (...) these fractures when the heavy clay that they tossed over their shoulder was stuck to their long-handled shovel causing a sudden flexion force on the neck and back muscles 2 . Exam and Investigations Patients with this injury present with sharp pain between the shoulder blades that is worsened with palpation. They may also have pain with neck movement and unilateral upper back pain 3 . The Clay Shoveler fracture can usually be seen on plain film lateral radiograph. CT can be performed if clinical suspicion

2018 CandiEM

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