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Cholesterol Education Resources

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201. What is the evidence on the policy specifications, development processes and effectiveness of existing front-of-pack food labelling policies in the WHO European Region?

credible; • develop the scope of FOPL policies based on stakeholder engagement and formative research to ensure that the right policy is chosen for the population; • explore ways to overcome issues with uptake of the FOPL system in the marketplace, including through mandatory implementation; • support implementation through the development of guidance documents for industry to facilitate label adoption and public education initiatives to stimulate consumer demand for the label and improve awareness (...) of energy, saturated and trans-unsaturated (trans) fatty acids, sodium and free sugars and low intakes of fruits, vegetables and polyunsaturated fatty acids. Such dietary practices contribute to metabolic risk factors, including high blood pressure, high body mass index (commonly referred to as overweight and obesity), high fasting plasma glucose and high total cholesterol, which, in turn, increase risk for diet-related NCDs, including type 2 diabetes mellitus, cardiovascular diseases and some types

2018 WHO Health Evidence Network

202. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency

) to improve the positive predictive value of congenital adrenal hyperplasia screening. (1|⊕⊕○○) Technical remark: Laboratories utilizing liquid chromatography–tandem mass spectrometry should participate in an appropriate quality assurance program. Additionally, clinicians should realize that immunoassays lead to more false-positive results. Thus, if laboratory resources do not include liquid chromatography–tandem mass spectrometry, a cosyntropin stimulation test should be performed to confirm diagnosis (...) educating patients and their guardians and close contacts on adrenal crisis prevention and increasing the dose of glucocorticoid (but not mineralocorticoid) during intercurrent illness. (1|⊕⊕⊕○) 4.11 We recommend equipping every patient with congenital adrenal hyperplasia with a glucocorticoid injection kit for emergency use and providing education on parenteral self-administration (young adult and older) or lay administration (parent or guardian) of emergency glucocorticoids. (1|⊕⊕⊕○) Monitoring

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2018 The Endocrine Society

203. Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions

for cardiovascular disease prevention in adults with and without common risk factors , ( ). The USPSTF recommends that clinicians screen for obesity in children 6 years or older and offer or refer them to a comprehensive, intensive behavioral intervention (B recommendation). Useful Resources The Community Preventive Services Task Force recommends multicomponent interventions that use technology-supported coaching or counseling to help adults lose weight and maintain weight loss. Other Considerations Research (...) Angeles); Maureen G. Phipps, MD, MPH (Brown University, Providence, Rhode Island); Michael Silverstein, MD, MPH (Boston University, Boston, Massachusetts); Melissa A. Simon, MD, MPH (Northwestern University, Evanston, Illinois); Chien-Wen Tseng, MD, MPH, MSEE (University of Hawaii, Honolulu, and Pacific Health Research and Education Institute, Honolulu, Hawaii); John B. Wong, MD (Tufts University, Medford, Massachusetts). Copyright and Source Information Conflict of Interest Disclosures: All authors

2018 U.S. Preventive Services Task Force

204. The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis

therapy should be made by a consultant rheumatologist. Following national initiatives and guidance, patients and/or their carers should be actively involved in the decision making processes. (ii) Patients should be provided with education about their treatment to promote self-management (grade 1B, SOA 99%). A Cochrane review in 2002 demonstrated that education had a positive effect in terms of both patient reported outcome and objective measures of clinical response; however, the benefits were (...) not observed during a longer duration of follow-up [ ]. The Department of Health has estimated that the average cost of education and self-management is £125/person and would save costs of £244/person on average [ ]. Rheumatologists should therefore offer patients with IA the opportunity to discuss their condition and the risks and benefits of treatments both at diagnosis and throughout the course of their disease. Patients with IA should be offered verbal and written information to improve

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2018 British Society for Rheumatology

205. Cardiovascular Health in Turner Syndrome: A Scientific Statement From the American Heart Association

years. The specific management of many cardiovascular conditions, both congenital and acquired, is the same as in the general population. For these conditions, established guidelines should be followed. The purpose here is to highlight the instances in which there are unique cardiovascular risks involved in TS and to provide guidance for their monitoring and management. Working Group In July 2016, the Turner Resource Network hosted an international meeting of experts to make recommendations (...) -specific z score of >3 should not participate in any competitive sports. Girls or women with TS who are ≥15 years of age with an ascending ASI >2.3 cm/m 2 should not participate in any competitive sports. Transition Transition is a process to optimize lifelong functioning and potential with high-quality, developmentally appropriate, and uninterrupted health care from adolescence to adulthood. To be successful, this process should attend to the medical, psychosocial, educational, and vocational needs

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2018 American Heart Association

206. Evaluation and Management of Testosterone Deficiency

. Ramanathan, PhD; Ronald W. Lewis, MD Copyright © 2018 American Urological Association Education and Research, Inc.® 2 American Urological Association (AUA) Guideline Statements Diagnosis of Testosterone Deficiency 1. Clinicians should use a total testosterone level below 300 ng/dL as a reasonable cut-off in support of the diagnosis of low testosterone. (Moderate Recommendation; Evidence Level: Grade B) 2. The diagnosis of low testosterone should be made only after two total testosterone measurements (...) Recommendation; Evidence Level: Grade B) Evaluation and Management of Testosterone Deficiency Copyright © 2018 American Urological Association Education and Research, Inc.® 3 14. Patients should be informed that testosterone therapy may result in improvements in erectile function, low sex drive, anemia, bone mineral density, lean body mass, and/or depressive symptoms. (Moderate Recommendation; Evidence Level: Grade B) 15. Patients should be informed that the evidence is inconclusive whether testosterone

2018 American Urological Association

207. Routine Assessment and Promotion of Physical Activity in Healthcare Settings: A Scientific Statement From the American Heart Association

feedback indicates higher likelihood of use if located in the vitals section as opposed to social history or other EHR sections. The organization has an internal Wiki web page that provides resources for the EVS implementation and patient resources for increasing PA. Also desirable is combining the EVS with clinical decision support system features to enable adequate risk stratification and provision of appropriate patient education material tailored to the patient’s clinical diagnosis and preferences (...) impact of regular PA on traditional cardiovascular risk factors explains a significant portion of its salutatory impact. These favorable effects on traditional risk factors include increasing high-density lipoprotein cholesterol, reducing body mass index, improving insulin sensitivity, and reducing blood pressure, which, although often modest, significantly reduce risk at the population level. However, a significant portion of the cardiovascular benefits of habitual PA are independent of its effects

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2018 American Heart Association

208. CRACKCast E172 – Pediatric Gastrointestinal Disorders

is more commonly caused by cholestasis rather than biliary obstruction. Pigment gallstones are more common than cholesterol stones in children. Biliary tract disease is usually diagnosed with right upper quadrant ultrasound imaging; management strategies are similar to those for adults. Rosens in Perspective Gastrointestinal disorders are tough! Non-verbal children can present with virtually any set of symptomatology! It may be helpful to organize these varied gastrointestinal diseases by patient age (...) here at this slideshare resource: [11] Describe the “Rule of 2” for Meckel’s Diverticulum Meckel’s diverticulum traditionally follow so-called the rule of 2’s. The diverticulum is 2 cm wide, 2 cm long, and located within 2 feet of the ileocecal valve. Moreover, the condition occurs in 2% of the population, and only 2% of affected patients ever become symptomatic. Of symptomatic patients, 50% manifest symptoms by the age of 2 years, and most present by the age of 20 years. [12] What are 3 common

2018 CandiEM

209. Neonatal jaundice

clinicians are responsible for: · Providing care within the context of locally available resources, expertise, and scope of practice · Supporting consumer rights and informed decision making, including the right to decline intervention or ongoing management · Advising consumers of their choices in an environment that is culturally appropriate and which enables comfortable and confidential discussion. This includes the use of interpreter services where necessary · Ensuring informed consent is obtained

2018 Queensland Health

210. Improving Quality of Life: Substance Use and Aging

topics. It also emphasizes the need for a complete continuum of age-specific care, including substance use guidelines and treatment services tailored to the specific needs of this demographic, backed by improved training and education on how to detect and assess problematic substance use in older adults. Through the evidence presented in this report, we are hoping to jumpstart a national conversation about substance use by older adults. And as with any conversation, the words we use are critically (...) on Substance Use and Addiction 3 Substance Use In Canada—Improving Quality of Life: Substance Use and Aging About Substance Use in Canada Since 2005, Substance Use in Canada (formerly Substance Abuse in Canada) has shone a spotlight on key contemporary issues related to substance use and identified specific areas for action in both policy and practice. Each report in the series is intended for a broad audience that includes policy makers, program development personnel, researchers, educators and health

2018 Canadian Centre on Substance Abuse

211. Diet and the Gut

that are nutritionally deficient in one or more respects. It is vital, therefore, that whenever possible the medical practitioner should engage the services of a skilled nutritionist/dietitian to evaluate a given individual’s nutritional status, instruct the patient on new diet plans, and monitor progress. It is also incumbent on gastroenterologists to become educated on modern dietary practices as they relate to gastrointestinal health and disease. We hope that this guideline will become a valuable resource (...) those who suffer from gastrointestinal ailments—rightly perceive their diet as being a major determinant of such symptoms and seek guidance on optimal dietary regimens. Many medical practitioners, including gastroenterologists, are unfortunately often ill-prepared to deal with such issues. This is a reflection of the lack of education on the topic of diet and nutrition in many curricula. Dietary changes have the potential to alleviate symptoms, but they may also result in regimens

2018 World Gastroenterology Organisation

212. Continuous glucose monitoring (CGM real-time) and flash glucose monitoring (FGM) as personal, standalone systems in patients with diabetes mellitus treated with insulin

, ongoing, and organized care delivered by a team of skilled healthcare providers. The majority of care can be provided at the primary care level with basic interventions involving medication, health education and counselling, and consistent follow-up. A periodic referral for spe- cialist care is required in order to perform more complicated interventions (for example, compre- hensive eye examinations, laser and surgical treatment of eye complications, complex kidney function tests, and tests (...) of the heart and arteries in the limbs). All cases of acute cardiovascular disease, diabetic coma, kidney failure, and infected foot ulcers should be managed in a hospital. Patient education is an important component of diabetes management since the effectiveness of diabetes management ultimately depends on patient compliance with recommendations and treat- ment [16]. National guidelines and management protocols developed for (or adapted to) individual settings are useful tools in achieving a standardized

2018 EUnetHTA

213. Cardiovascular Disease and Breast Cancer: Where These Entities Intersect: A Scientific Statement From the American Heart Association

of this remains suboptimal despite large-scale public education campaigns. Awareness is particularly low in racial and ethnic minority communities. , CVD and breast cancer have individually received significant publicity with media campaigns (such as the Red Dress and Pink Ribbon campaigns); however, there is inadequate public awareness of the coexistence of common risk factors associated with these 2 conditions. Although cardiology and oncology are often considered separate medical fields (...) , with advancements in cancer care, survivors could develop latent cardiac effects secondary to the cancer treatment, which can include chemotherapy, radiotherapy, and targeted therapy (eg, trastuzumab). The field of cardio-oncology has emerged in response to the need to provide the best cancer care without compromising cardiovascular health. Societal committees and new organizations have rapidly emerged to address patients’ needs, including clinical care, research, and education. , Recent societal publications

2018 American Heart Association

214. 2018 guidelines for the early management of patients with acute ischemic stroke

imaging ED Emergency department EMS Emergency medical services EVT Endovascular therapy GA General anesthesia GWTG Get With The Guidelines HBO Hyperbaric oxygen HR Hazard ratio ICH Intracerebral hemorrhage IPC Intermittent pneumatic compression IV Intravenous LDL-C Low-density lipoprotein cholesterol LMWH Low-molecular-weight heparin LOE Level of evidence LVO Large vessel occlusion M1 Middle cerebral artery segment 1 M2 Middle cerebral artery segment 2 M3 Middle cerebral artery segment 3 MCA Middle

2018 American Academy of Neurology

215. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

Door-to-needle DVT Deep vein thrombosis DW-MRI Diffusion-weighted magnetic resonance imaging ED Emergency department EMS Emergency medical services EVT Endovascular therapy GA General anesthesia GWTG Get With The Guidelines HBO Hyperbaric oxygen HR Hazard ratio ICH Intracerebral hemorrhage IPC Intermittent pneumatic compression IV Intravenous LDL-C Low-density lipoprotein cholesterol LMWH Low-molecular-weight heparin LOE Level of evidence LVO Large vessel occlusion M1 Middle cerebral artery segment

2018 American Heart Association

216. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency

other methods ( e.g. , genotyping) to improve the positive predictive value of congenital adrenal hyperplasia screening. (1|⊕⊕○○) Technical remark: Laboratories utilizing liquid chromatography–tandem mass spectrometry should participate in an appropriate quality assurance program. Additionally, clinicians should realize that immunoassays lead to more false-positive results. Thus, if laboratory resources do not include liquid chromatography–tandem mass spectrometry, a cosyntropin stimulation test (...) with congenital adrenal hyperplasia, we recommend educating patients and their guardians and close contacts on adrenal crisis prevention and increasing the dose of glucocorticoid (but not mineralocorticoid) during intercurrent illness. (1|⊕⊕⊕○) 4.11 We recommend equipping every patient with congenital adrenal hyperplasia with a glucocorticoid injection kit for emergency use and providing education on parenteral self-administration (young adult and older) or lay administration (parent or guardian) of emergency

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2018 Pediatric Endocrine Society

217. European Society of Endocrinology Clinical Practice Guidelines on the management of adrenocortical carcinoma in adults

not all recommended tests and treatments, or both, might be available. Thus, the recommendations have certainly been interpreted in the context of available resources/treatment in the community, in which the patient is being seen. 3.4 Summary of methods used for guideline development The methods used have been described in more detail previously ( ). In short, the guideline used GRADE (Grading of Recommendations Assessment, Development and Evaluation) as a methodological base. The first step

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2018 European Society of Endocrinology

218. Management of Diabetic Foot

Stratification 8 3. REFERRAL 10 3.1 Foot Protection Team 10 3.2 Multidisciplinary Foot Care Team 10 4. PREVENTION 12 4.1 Patient Education 12 4.2 Metabolic Control 12 4.3 Preventive Foot Wear 13 4.4 Preventive Surgery 15 5. TREATMENT 17 5.1 Pharmacotherapy 17 5.2 Wound Management 19 5.3 Rehabilitation 24 6. MONITORING AND FOLLOW-UP 26 7. CHARCOT NEUROARTHROPATHY 27 8. IMPLEMENTING THE GUIDELINES 29 8.1 Facilitating and Limiting Factors 29 8.2 Potential Resource Implications 29Management of Diabetic Foot (...) (Second Edition) TABLE OF CONTENTS No. Title Page REFERENCES 31 Appendix 1. Example of Search Strategy 35 Appendix 2. Clinical Questions 35 Appendix 3. Semmes-Weinstein Monofilament Examination 38 Appendix 4. Diabetic Foot Assessment Form 39 Appendix 5. University of Texas Classification 41 Appendix 6. Patient Education Materials 42 Appendix 7. Footwear Advice 45 Appendix 8. Treatment of Neuropathic Pain 46 in Diabetic Foot Appendix 9. Types of Infections in Diabetic Foot 50 and Suggestions

2018 Ministry of Health, Malaysia

219. Adult Type 1 diabetes mellitus

process) Margaret Humphreys Clinical Specialist Diabetes Dietitian /National HSE Structured Patient Education Co-ordinator Cathy Breen Senior Dietitian Diabetes Mary Finn Senior Dietitian Diabetes Karen Townsend Clinical Nurse Specialist Diabetes Pauline O’Hanlon Clinical Nurse Specialist Diabetes Mary O’Scannail Clinical Nurse Specialist Diabetes Helen Twamley Clinical Nurse Specialist Diabetes Integrated Care Prof Brian McGuire Professor of Clinical Psychology Eilis Kearney Clinical Pharmacist 1 (...) summary 16 2.15 Summary budget impact analysis 17 2.16 Monitoring, evaluation and audit 18 2.17 Plan to update this National Clinical Guideline 18 Section 3: National Clinical Guideline recommendations 19 3.1 Diagnosis and early care planning 19 3.2 Support and individualised care 21 3.3 Education and information 22 3.4 Dietary management 23 3.5 Physical activity 25 3.6 Blood glucose management 25 3.7 Insulin therapy 28 3.8 Insulin delivery 30 3.9 Referral for islet or pancreas transplantation 31 3.10

2018 National Clinical Guidelines (Ireland)

220. Care of Adults with Neurofibromatosis Type 1

available elsewhere. 7 In childhood,NF1 Disclaimer: This practice resource is designed primarily as an educational resource for medical geneticists and other clinicians to help them provide quality medical services. Adherence to this practice resource is completely voluntary and does not necessarily assure a successful medical outcome. This practice resource should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed (...) ., for cholesterol, colonoscopy, for cervicalcancer)andvaccinationschedulesshouldbefollowed, regardless of NF1 diagnosis. Supplemental Resources lists useful websites and organizations. Although it is important to always consider NF1-associated etiologies for a new sign or symptom, common explanations will remain common (e.g., most hypertension is essential and not pheochromocytoma- related, most back pain will not be due to an MPNST, most headaches will not be tumor-associated). Repeated patient

2018 American College of Medical Genetics and Genomics

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