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Cerebral Spinal Fluid

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181. Head and neck imaging

Tumor/Soft Tissue Mass 12 Cholesteatoma 12 Neck mass 12 Parathyroid adenoma 13 Thyroid nodule or thyromegaly (goiter) 13 Tumor – not otherwise specified 14 Nasal Indications 14 Anosmia 14 Cerebrospinal fluid leak 14 Foreign body 14 Mucocele of the paranasal sinus 14 Nasal airway obstruction refractory to medical therapy 14 Nasal or sinus polyposis 14 Recurrent epistaxis 14 Orbital Indications 14 Absence of red reflex (pediatric only) 15 Dysconjugate gaze 15 Exophthalmos or proptosis 15 Extraocular (...) practice. These include: ? Oncologic imaging – Considerations include the type of malignancy and the point along the care continuum at which imaging is requested ? Conditions which span multiple anatomic regions – Examples include certain gastrointestinal indications or congenital spinal anomalies Repeated Imaging In general, repeated imaging of the same anatomic area should be limited to evaluation following an intervention, or when there is a change in clinical status such that imaging is required

2019 AIM Specialty Health

182. Appropriate Use Criteria: Imaging of the Brain

of the Guidelines 4 Administrative Guidelines 5 Ordering of Multiple Studies 5 Simultaneous Ordering of Multiple Studies 5 Repeated Imaging 5 Pre-Test Requirements 6 History 6 Imaging of the Brain 7 General Information/Overview 7 Scope 7 Technology Considerations 7 Definitions 8 Clinical Indications 9 Congenital and Developmental Conditions 9 Ataxia, congenital or hereditary 9 Developmental delay (Pediatric only) 9 Congenital cerebral anomalies 10 Infection 10 Infection 10 Inflammatory Conditions 11 Multiple (...) literature and/or standards of medical practice. These include: ? Oncologic imaging – Considerations include the type of malignancy and the point along the care continuum at which imaging is requested ? Conditions which span multiple anatomic regions – Examples include certain gastrointestinal indications or congenital spinal anomalies Repeated Imaging In general, repeated imaging of the same anatomic area should be limited to evaluation following an intervention, or when there is a change in clinical

2019 AIM Specialty Health

183. Baclofen

, a gamma-aminobutyric acid (GABA) agonist, has been used in oral form to treat spasticity for some time (...) , but it has a variable effect on spasticity and the dose is limited by the unwanted effect of excessive sedation. Intrathecal baclofen produces higher local concentrations in cerebrospinal fluid at a fraction of the equivalent oral dose and avoids this excessive sedation. OBJECTIVES: To determine whether intrathecal baclofen is an effective treatment for spasticity in children with cerebral (...) Spasticity from the upper motor neuron syndrome can result from a variety of conditions affecting the cortex or spinal cord (...) . Some of the more common conditions associated with spasticity include spinal cord injury, cerebral palsy, and post-stroke syndrome. In this study we compared the efficacy and safety of baclofen vs tolperisone in spasticity. One hundred fifty patients with cerebral palsy or post stroke or spinal cord injury associated spasticity were enrolled in present study. Group I

2018 Trip Latest and Greatest

184. Handbook on tuberculosis laboratory diagnostic methods in the European Union

forming units CSF Cerebral spinal fluid CRI Colorimetric redox indicator CXR Chest X-ray DNA Deoxyribonucleic acid DST Drug susceptibility testing EEA European Economic Area ENP European Neighbourhood Policy EPTB Extrapulmonary tuberculosis ERLN-TB European Reference Laboratory Network for Tuberculosis (2010–2014) ERLTB-Net European Reference Laboratory Network for Tuberculosis (from 2014) EQA External quality assessment EU European Union HEPA filter High-efficiency particulate air filter HPF High (...) steps 104 10.1 Introduction 104 10.2 General considerations regarding the diagnosis of tuberculosis 104 10.3 Specific considerations regarding diagnosis of tuberculosis 105 10.3.1 Pulmonary material 105 10.3.2 Pleural material 106 10.3.3 Lymphadenitis material 106 10.3.4 Gastric juice 106 10.3.5 Peritoneal fluid 106 10.4 Information flow from microbiologist to physician and instructions regarding tuberculosis diagnosis 106 References 107 Annex 1. Network partners 109 Figures Figure 1. Biohazard

2018 European Centre for Disease Prevention and Control - Technical Guidance

186. Syphilis in pregnancy

syphilis 31 o Do not delay treatment to achieve USS · Include on request form: o Relevant history (e.g. serology, gestation, treatment) · Request assessment of: o Placental size o Amniotic fluid volume (single deepest pocket) o Middle cerebral artery (MCA) Doppler velocity o Liver size and echodensity Ongoing monitoring · Suspect fetal infection if there are characteristic findings on USS after 20 weeks in a woman with syphilis requiring treatment in pregnancy 24,28 · Formulate a plan about ongoing (...) Syphilis serology reactive?Queensland Clinical Guideline: Syphilis in pregnancy Refer to online version, destroy printed copies after use Page 4 of 31 Flow Chart: Baby care CNS: central nervous system. CSF: cerebrospinal fluid, ELFT: electrolyte and liver function test, FBC: full blood count, IgM: Immunoglobulin M, IM: intramuscular injection, IV: intravenous, PCR: Polymerase Chain Reaction, QSSS: Queensland syphilis surveillance service, VDRL: venereal disease research laboratory, >: greater than

2019 Queensland Health

187. Primary postpartum haemorrhage

if available · POC pathology (iSTAT, Hemocue) if no onsite laboratory Initial fluid resuscitation (use warmed IV fluids/warming devices) · IV cannula (x 2) 14–16G (consider intraosseous if unattainable) · Avoid crystalloid IV > 1–2 L · Limit synthetic colloid use (if used then : greater than Refer to online version, destroy printed copies after use Page 3 of 35 Queensland Clinical Guideline: Primary postpartum haemorrhage Flow Chart: Massive haemorrhage protocol (MHP) Queensland Clinical Guidelines (...) · Fibrinogen concentrate or cryoprecipitae to maintain fibrinogen > 2.5 g/L · FFP 2 units MHP PACK 2 · RBC 4 units · Fibrinogen concentrate or cryoprecipitate to maintain fibrogen > 2.5 g/L · FFP 2 units · Platelets 1 adult dose · If ionised calcium 35° C · pH > 7.2 · Base excess minus 6 to positive 6 · Lactate 1.1 mmol/L · Platelets > 50 x 10 9 /L · PT/aPPT 2.5 g/L Optimise · Oxygenation · Cardiac output · Tissue perfusion · Temperature (actively warm woman and fluid) · Metabolic state Monitor (30?60

2019 Queensland Health

188. Headache

for headache in the setting of papilledema is quite broad. It includes any mass such as abscess, primary or metastatic tumors, hematoma, cerebral edema, communicating or obstructive hydrocephalus, idiopathic intracranial hypertension (IIH), dural venous sinus thrombosis, and entities that result in increased cerebrospinal fluid (CSF) production [101]. MRI of the head with and without contrast is the imaging study of choice. CT of the head with contrast may be appropriate if MRI is contraindicated (...) . If there is a suspicion for SAH, gradient echo (GRE), susceptibility-weighted imaging (SWI), and fluid-attenuated inversion recovery (FLAIR) sequences should be included. Alternatively, noncontrast CT imaging may be indicated to exclude acute intracranial hemorrhage. In nonacute situations, magnetic resonance angiography (MRA) of the brain without contrast is the most commonly performed technique to assess intracranial arteries. It is still controversial whether MRA without or with contrast is more sensitive

2019 American College of Radiology

189. ACR–ASNR–SCBT-MR Practice Parameter for the Performance of Magnetic Resonance Imaging (MRI) of the Adult Spine

. Preprocedure assessment for vertebroplasty and kyphoplasty d. Amyloid deposition in the spine e. Cerebrospinal fluid (CSF) leak, intracranial hypotension f. Spinal cord herniation g. Symptoms that create the concern for the presence of any of the above disorders h. Follow up of findings seen on other imaging examinations III. SAFETY GUIDELINES AND POSSIBLE CONTRAINDICATIONS See the ACR Practice Parameter for Performing and Interpreting Magnetic Resonance Imaging (MRI), the ACR Manual on Contrast Media (...) the presence of infections in other spinal regions, such as the facet joints, meninges, and spinal cord. MRI is useful to characterize postoperative changes, including fluid collections and bone and soft-tissue abnormalities that may suggest infection. C. Spinal Cord Herniation Spinal cord herniation is a rare cause of myelopathy that has been increasingly recognized. While it is rare, it can be diagnosed preoperatively on MRI with resolution of symptoms after surgery, thereby making it essential

2019 American Society of Neuroradiology

190. ACR–ASNR–SPR Practice Parameter for the Performance of Myelography and Cisternography

to control the direction of the needle. If possible, the bevel of the needle should be parallel to the vertical plane of the dura in order to minimize transverse cutting of dural fibers. When the dura is traversed, a change in resistance is often, but not always, perceived. The stylet is then slowly removed to check for cerebrospinal fluid return. At this point, opening pressure can be measured, and/or cerebral spinal fluid sampling can be performed prior to contrast injection. 3. A nonionic iodinated (...) be used in a similar fashion for similar indications; however, such media are not presently FDA approved for this purpose. Following the introduction of a sufficient quantity of intrathecal contrast medium, the needle is withdrawn. With the aid of a tilting table, the opacified cerebrospinal fluid (CSF) is positioned in the desired region of the spinal subarachnoid space (lumbar, thoracic, or cervical) or in the intracranial basal cisterns, and appropriate radiographic/fluoroscopic (conventional

2019 American Society of Neuroradiology

191. ACR–ASNR–SPR Practice Parameter for the Performance and Interpretation of Magnetic Resonance Imaging (MRI) of the Brain

.) Additional techniques that may be useful under the appropriate clinical circumstances include 3-dimensional imaging techniques [202-205], neuronavigation and intraoperative MRI [64,96,105,206], magnetization transfer imaging [207-211], cerebral spinal fluid (CSF) flow study using phase-contrast pulse sequences [212], and variations of single shot fast-spin- echo or turbo spin-echo imaging. It is the responsibility of the supervising physician to determine whether additional pulse sequences (...) double-blind placebo-controlled study of gadopentetate dimeglumine as an MR contrast agent: evaluation in patients with cerebral lesions. AJR 1989;152:813-823. 113. Fukuoka H, Hirai T, Okuda T, et al. Comparison of the added value of contrast-enhanced 3D fluid- attenuated inversion recovery and magnetization-prepared rapid acquisition of gradient echo sequences in relation to conventional postcontrast T1-weighted images for the evaluation of leptomeningeal diseases at 3T. AJNR 2010;31:868-873. 114

2019 American Society of Neuroradiology

192. ACR–ASNR Practice Parameter for the Performance of Non-Breast Magnetic Resonance Imaging (MRI) Guided Procedures

to guide/monitor procedures in near-real time can be classified under the following major categories: 1. Biopsy and aspiration The general indications for image-guided percutaneous tissue sampling can be reviewed in the ACR– SIR–SPR Practice Parameter for the Performance of Image-Guided Percutaneous Needle Biopsy (PNB) and the ACR–SIR–SPR Practice Parameter for Specifications and Performance of Image-Guided Percutaneous Drainage/Aspiration of Abscesses and Fluid Collections (PDAFC). Since MRI guidance (...) of Image-Guided Percutaneous Needle Biopsy (PNB) and the ACR–SIR–SPR Practice Parameter for Specifications and Performance of Image-Guided Percutaneous Drainage/Aspiration of Abscesses and Fluid Collections (PDAFC). Relative contraindications to percutaneous thermal tumor ablation include, but are not limited to: 1. Large size of the targeted tumor. There is no universal cut-off diameter for eligibility for percutaneous thermal ablation. However, the larger the tumor the greater the likelihood

2019 American Society of Neuroradiology

194. Neuro-urology

. Aruga, S., et al. Effect of cerebrospinal fluid shunt surgery on lower urinary tract dysfunction in idiopathic normal pressure hydrocephalus. Neurourol Urodyn, 2018. 37: 1053. 31. Singh, A., et al. Global prevalence and incidence of traumatic spinal cord injury. Clin Epidemiol, 2014. 6: 309. 32. Weld, K.J., et al. Association of level of injury and bladder behavior in patients with post-traumatic spinal cord injury. Urology, 2000. 55: 490. 33. Kondo, A., et al. Neural tube defects: prevalence (...) Association of Urology (EAU) Guidelines on Neuro-Urology. Eur Urol, 2015. 5. Nosseir, M., et al. Clinical usefulness of urodynamic assessment for maintenance of bladder function in patients with spinal cord injury. Neurourol Urodyn, 2007. 26: 228. 6. Panicker, J.N., et al. Lower urinary tract dysfunction in the neurological patient: clinical assessment and management. Lancet Neurol, 2015. 14: 720. 7. Guyatt, G.H., et al. GRADE: an emerging consensus on rating quality of evidence and strength

2019 European Association of Urology

195. Male Infertility

al. Value of detecting leukocytospermia in the diagnosis of genital tract infection in subfertile men. Fertil Steril, 1998. 70: 315. 209. Krieger, J.N., et al. Seminal fluid findings in men with nonbacterial prostatitis and prostatodynia. J Androl, 1996. 17: 310. 210. Weidner, W., et al. Semen parameters in men with and without proven chronic prostatitis. Arch Androl, 1991. 26: 173. 211. Condorelli, R.A., et al. Chronic prostatitis and its detrimental impact on sperm parameters: a systematic

2019 European Association of Urology

198. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: an AUA/SUFU Guideline

about OAB, the benefits versus risks/burdens of the available treatment alternatives and the fact that acceptable symptom control may require trials of multiple therapeutic options before it is achieved. Clinical Principle Treatment: First-Line Treatments: Behavioral Therapies 6. Clinicians should offer behavioral therapies (e.g., bladder training, bladder control strategies, pelvic floor muscle training, fluid management) as first line Approved by the AUA Board of Directors April 2019 Authors (...) -muscarinics with extreme caution in patients with impaired gastric emptying or a history of urinary retention. Clinical Principle 14. Clinicians should manage constipation and dry mouth before abandoning effective anti-muscarinic therapy. Management may include bowel management, fluid management, dose modification or alternative anti- muscarinics. Clinical Principle 15. Clinicians must use caution in prescribing anti-muscarinics in patients who are using other medications with anti- cholinergic properties

2019 American Urological Association

199. Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache

a normal head CT is a long-standing diagnostic 507 regimen that will occasionally reveal alternative diagnoses. If the LP is no longer performed, these 508 diagnoses may be missed, particularly in patients for whom other diagnoses remain in the 509 differential, eg, meningitis. 510 • The use of the recommendation could result in a rare missed SAH. 511 512 Key words/phrases for literature searches: headache, migraine, subarachnoid hemorrhage, brain 513 angiography, cerebral angiograph, computed (...) tomography, computed tomographic angiography, neuroimaging, 514 brain imaging, functional neuroimaging, neuroradiography, brain radiography, brain scan, diagnostic imaging, 515 lumbar puncture, lumbar tap, spinal puncture, spinal tap, emergency, emergency health service, hospital 516 emergency service, emergency ward, emergency medicine, emergency care, emergency treatment, emergency 517 department, emergency room, emergency service, and variations and combinations of the key words/phrases. 518 Searches

2019 American College of Emergency Physicians

200. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults

: Behavioral Therapies 6. Clinicians should offer behavioral therapies (e.g., bladder training, bladder control strategies, pelvic floor muscle training, fluid management) as first line therapy to all patients with OAB. Standard (Evidence Strength Grade B) 7. Behavioral therapies may be combined with pharmacologic management. Recommendation (Evidence Strength Grade C) Second-Line Treatments: Pharmacologic Management 8. Clinicians should offer oral anti-muscarinics or oral β 3 -adrenoceptor agonists (...) by the treating ophthalmologist and should use anti-muscarinics with extreme caution in patients with impaired gastric emptying or a history of urinary retention. Clinical Principle 14. Clinicians should manage constipation and dry mouth before abandoning effective anti-muscarinic therapy. Management may include bowel management, fluid management, dose modification or alternative anti-muscarinics. Clinical Principle 15. Clinicians must use caution in prescribing anti-muscarinics in patients who are using

2019 American Urological Association

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