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

-counseled patient who has been refractory to first- and second-line OAB treatments. The patient must be able and willing to return for frequent post-void residual evaluation and able and willing to perform self- catheterization if necessary. Standard (Evidence Strength Grade B) 19. Clinicians may offer peripheral tibial nerve stimulation (PTNS) as third-line treatment in a carefully selected patient population. Recommendation (Evidence Strength Grade C) 20. Clinicians may offer sacral neuromodulation (...) were also added to the database. Given that the AHRQ report included limited information regarding use of neuromodulation therapies, including sacral neuromodulation (SNS) and peripheral tibial nerve stimulation (PTNS) (also known as posterior tibial nerve stimulation) and limited information regarding the use of intravesical onabotulinumtoxinA to treat non-neurogenic OAB patients, additional searches were performed to capture this literature and relevant data were added to the database. The AUA

2019 American Urological Association

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

-line treatment in the carefully-selected and thoroughly-counseled patient who has been refractory to first- and second-line OAB treatments. The patient must be able and willing to return for frequent post-void residual evaluation and able and willing to perform self-catheterization if necessary. Standard (Evidence Strength Grade B) 19. Clinicians may offer peripheral tibial nerve stimulation (PTNS) as third-line treatment in a carefully selected patient population. Recommendation (Evidence Strength (...) to the database. Given that the AHRQ report included limited information regarding use of neuromodulation therapies, including sacral neuromodulation (SNS) and peripheral tibial nerve stimulation (PTNS) (also known as posterior tibial nerve stimulation) and limited information regarding the use of intravesical onabotulinumtoxinA to treat non-neurogenic OAB patients, additional searches were performed to capture this literature and relevant data were added to the database. The AUA update literature review

2019 American Urological Association

23. Psychiatric Aspects of Infertility

and increase their risk for recurrent episodes of psychiatric illness (Fortin et al. 1972; Harlow et al. 1999; Harlow et al. 2003; Lolak et al. 2005; Singata-Madliki et al. 2016). © Copyright, American Psychiatric Association, all rights reserved. Selective estrogen receptor modulators (SERMs)—such as clomiphene citrate and tamoxifen—and aromatase inhibitors—such as letrozole—are commonly used for ovarian stimulation and for off-label use in men to increase spermatogenesis (Steiner et al. 2005; Rambhatla (...) , examinations, tests, and the prolonged pursuit of parenthood often for years without success (de Klerk et al. 2007). More research is indicated to further elucidate the connection between infertility interventions and psychiatric implications. Psychotropic Medications and Infertility Theoretically, psychotropic medications may influence the reproductive function in both men and women. This may occur by affecting the levels of neurotransmitters, such as dopamine, serotonin and GABA, that are involved

2019 American Psychiatric Association

24. Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings

insufficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2016;101:364–89. 27 Haus E. Chronobiology in the endocrine system. Adv Drug Deliv Rev 2007;59(9-10):985–1014. 28 Murphy H, Livesey J, Espiner EA, et al. The low dose ACTH test-a further word of caution. J Clin Endocrinol Metab 1998;83:712–3. 29 Wade M, Baid S, Calis K, et al. Technical details influence the diagnostic accuracy of the 1 microg ACTH stimulation test. Eur J Endocrinol 2010;162:109–13. 30 Cartaya J, Misra M (...) . The low-dose ACTH stimulation test: is 30 minutes long enough? Endocr Pract 2015;21:508–13. 31 Hindmarsh PC. Management of the child with congenital adrenal hyperplasia. Best Pract Res Clin Endocrinol Metab 2009;23:193–208. 32 Mitchell AL, Napier C, Asam M, et al. Saving lives of in-patients with adrenal insufficiency: implementation of an alert scheme within the Newcastle-upon- Tyne Hospitals e-Prescribing platform. Clin Endocrinol 2014;81:937–8. 33 Schweiger B, Zeitler P , Eppley S, et al. Using

2019 Pediatric Endocrine Society

25. Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder

mental health disorders associated with PTSD, repetitive transcranial magnetic stimulation, and ketamine. 13,14 Whereas recent CPGs and reviews exist, providing a single, updatable source of PTSD treatment studies would be useful for clinicians, researchers, and policymakers. Therefore, the purpose of this project is to systematically identify and abstract data from RCTs of PTSD interventions to support development of a new data repository of PTSD treatment research. These data, when available (...) . Pradhan B, Kluewer D'Amico J, Makani R, et al. Nonconventional interventions for chronic post-traumatic stress disorder: Ketamine, repetitive trans-cranial magnetic stimulation (rTMS), and alternative approaches. J Trauma Dissociation. 2016;17(1):35-54. doi: 10.1080/15299732.2015.1046101. PMID: 26162001. 14. Rasmusson AM, Marx CE, Jain S, et al. A randomized controlled trial of ganaxolone in posttraumatic stress disorder. Psychopharmacology (Berl). 2017 Aug;234(15):2245-57. doi: 10.1007/s00213- 017

2019 Effective Health Care Program (AHRQ)

26. Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association

to the pharmacological properties of the drug. Most clinical trials report the numbers of patients stopping the study medication because of any adverse event. The difference between the test agent and placebo is a good measure of the overall tolerability of the agent, provided that the blind remains secure throughout the trial. 1.2. Randomized Controlled Trials In the evaluation of the safety of a drug used long term, the most reliable data are derived from properly designed and conducted large, long-term, double (...) -blind, placebo-controlled randomized trials. The great advantage of this form of investigation is that bias is controlled by random allocation to treatment. There can still be random error, and sometimes other issues within the control of the investigator such as inadequate follow-up or ineffective blinding, but in a well-planned and executed RCT, the results are determined solely by allocation to the test treatment or the control. Most statin RCTs, especially the largest of such trials, were

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2019 American Gastroenterological Association Institute

27. Screening and Management of the Hyperandrogenic Adolescent

ofnonclassiccongenitaladrenalhyperplasia.Supplemen- tal testing includes a corticotropin (formerly adrenocor- ticotropic hormone [ACTH]) stimulation test for confirmation of nonclassic congenital adrenal hyperpla- sia and DHEAS to rule out adrenal neoplasm; this may be appropriate in cases of rapid onset of virilization (15). Computed tomography scans to evaluate the adrenal glands should be obtained for patients with markedly elevated DHEAS levels. Alternatively, adrenal ultraso- nography can be offered if adrenal glands can be visual- ized (...) for nonclassic congenital adrenal hyperplasia with a 17- hydroxyprogesterone test. Elevation of the free or total testosterone level higher than the adult female normative values is a key diagnostic feature of biochemical hyperandrogenism. Because treatment is indicated only when symptoms are distressing to the patient, the degree to which acne or hirsutism bothers the patient should be assessed. Before initiation of any medical therapy, expectations of treatment should be discussed

2019 American College of Obstetricians and Gynecologists

28. Screening and Management of the Hyperandrogenic Adolescent

ofnonclassiccongenitaladrenalhyperplasia.Supplemen- tal testing includes a corticotropin (formerly adrenocor- ticotropic hormone [ACTH]) stimulation test for confirmation of nonclassic congenital adrenal hyperpla- sia and DHEAS to rule out adrenal neoplasm; this may be appropriate in cases of rapid onset of virilization (15). Computed tomography scans to evaluate the adrenal glands should be obtained for patients with markedly elevated DHEAS levels. Alternatively, adrenal ultraso- nography can be offered if adrenal glands can be visual- ized (...) for nonclassic congenital adrenal hyperplasia with a 17- hydroxyprogesterone test. Elevation of the free or total testosterone level higher than the adult female normative values is a key diagnostic feature of biochemical hyperandrogenism. Because treatment is indicated only when symptoms are distressing to the patient, the degree to which acne or hirsutism bothers the patient should be assessed. Before initiation of any medical therapy, expectations of treatment should be discussed

2019 American College of Obstetricians and Gynecologists

29. Cognitive modulation of endocrine responses to CRH stimulation in healthy subjects. (PubMed)

controlled or examined in psychiatric studies using biological probes of the HPA axis. To test the hypothesis that psychological factors might complicate HPA study results even in direct, pharmacological challenge paradigms, endocrine responses to corticotropin-releasing hormone (CRH) were examined under two different cognitive preparation conditions.Healthy subjects (n=32) received standard instructions or a cognitive intervention (CI) prior to injection with CRH and placebo, given on separate days (...) in pharmacological activation paradigms, including CRH stimulation tests. The factors manipulated by the CI (novelty/familiarity, control and coping) may have particular salience to the HPA axis. Differential sensitivity to such factors could impact results in studies applying biological HPA probes to psychiatric populations.Copyright 2009 Elsevier Ltd. All rights reserved.

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2010 Psychoneuroendocrinology Controlled trial quality: uncertain

30. Effects of Hormone Stimulation on Brain Scans for Cushing s Disease

the tumors more active. Objectives: - To test the use of hormone stimulation to improve brain scans for Cushing s disease tumors. Eligibility: - Individuals at least 8 years of age who will be having surgery to remove Cushing s disease tumors. Design: Participants will be screened with a medical history, physical exam, blood and urine tests, and imaging studies. They will have three brain scans before surgery. The first scan is a magnetic resonance imaging scan to show a full picture of the brain (...) table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 30 participants Allocation: Randomized Intervention Model: Single Group Assignment Masking: Single (Participant) Primary Purpose: Diagnostic Official Title: Prospective Evaluation of the Effect of Corticotropin-Releasing Hormone Stimulation on 18F-Fludeoxyglucose High-Resolution Positron-Emission Tomography in Cushing's Disease Study Start Date : October 11, 2011 Actual Primary Completion Date : January 30

2011 Clinical Trials

31. 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 (...) newborn screens for congenital adrenal hyperplasia we recommend referral to pediatric endocrinologists (if regionally available) and evaluation by cosyntropin stimulation testing as needed. (1|⊕⊕⊕○) 3.2 In symptomatic individuals past infancy, we recommend screening with an early-morning (before 8 am ) baseline serum 17-hydroxyprogesterone measurement by liquid chromatography–tandem mass spectrometry. (1|⊕⊕⊕○) 3.3 In individuals with borderline 17-hydroxyprogesterone levels, we recommend obtaining

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2018 Pediatric Endocrine Society

32. Evaluation and Management of Testosterone Deficiency

), sex hormone-binding globulin ([SHBG], 44%, tightly-bound), corticotropin- binding globulin (4%, loosely-bound), and approximately 2% circulates as free testosterone. 9 The free and loosely-bound testosterone fractions combined are known as bioavailable testosterone. Testosterone assays are plagued by variability in results. This variability is expressed as a coefficient of variation (CV), which is a measure of precision. 10 In order to express this precision of assay test results, two measures (...) by producing luteinizing hormone (LH), which targets the Leydig cells in the testes stimulating them to produce testosterone. Serum testosterone and the downstream hormone E2 are involved in the feedback mechanism to the hypothalamus and pituitary to suppress LH production. In homeostasis, LH levels are typically low. With worsening Leydig cell function, there is a reduction in the feedback mechanism resulting in elevation of LH levels (hypergonadotropic hypogonadism). In conditions where LH

2018 American Urological Association

33. 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 (...) hyperplasia we recommend referral to pediatric endocrinologists (if regionally available) and evaluation by cosyntropin stimulation testing as needed. (1|⊕⊕⊕○) 3.2 In symptomatic individuals past infancy, we recommend screening with an early-morning (before 8 am ) baseline serum 17-hydroxyprogesterone measurement by liquid chromatography–tandem mass spectrometry. (1|⊕⊕⊕○) 3.3 In individuals with borderline 17-hydroxyprogesterone levels, we recommend obtaining a complete adrenocortical profile after

2018 The Endocrine Society

34. The role of immunotherapy in IVF: a guideline

-CSF; glucocorticoid/s; GM-CSF; granulocyte colony-stimulating factor; harm; HLA; HLA antigens; hu- man leukocyte antigen; Humira; ICSI; IL-10; IL-17; IL-27; immune modulatory; immune therapy; immunoglobulins, intravenous; immunoglobulins/therapeutic use; immu- nologic tests; immunomodulation; immunomodulatory; immunosuppression;immunotherapy;invitrofertilisation; in vitro fertilization; interleukin-10; interleukin-17; interleukin-27; intracytoplasmic sperm injection; intrali- pid; intralipid (...) to improved live-birth outcome. While some of these medica- tions (e.g., aspirin and corticosteroids) have been used for many years and are relatively low cost, others (e.g., intravenous fat emulsions and granu- locyte colony–stimulating factor [G- CSF]) are newer, of higher cost, and with risks that have been poorly char- acterized. It is imperative that physi- cians providing ART treatments have a full understanding of the potential risks and bene?ts associated with adjuvant immunotherapy in order

2018 Society for Assisted Reproductive Technology

35. Intermittent Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists for Asthma

included outcomes that fell into the categories below, using definitions provided by the study. • Asthma exacerbations o Requiring systemic (oral and/or parenteral) corticosteroids, requiring hospitalization, requiring emergency room (ER) visit, requiring intensive care unit or intubation, or as defined by the study 5 o Asthma-related hospitalizations, ER visits, urgent care and outpatient visits • Death o All-cause, asthma-specific • Asthma control o Composite Measures: Asthma Control Test (ACT (...) outcomes. Peto’s odds ratio (OR) and 95 percent confidence intervals were estimated for binary outcomes with rare events ( 50 percent considered substantial. 25 Publication bias was assessed using funnel plot inspection and Egger’s 7 weighted regression test when 10 or more trials were pooled

2018 Effective Health Care Program (AHRQ)

36. Guidelines for the Diagnosis and Management of Critical Illness-Related Corticosteroid Insufficiency (CIRCI) in Critically Ill Patients (Part I)

profile. Earlier shock resolution has been shown to lead to lower mortality ( ). However, no studies compared the prognostic value of hemodynamic response to hydrocortisone versus the 250-μg ACTH test for the diagnosis of CIRCI. Meta-analyses examined only differences in mortality rates with corticosteroid treatment between those with and without documented CIRCI ( ). Thus, the task force could only recommend the use of the 250-μg ACTH stimulation test to diagnose CIRCI. | 6. Is corticotropin level (...) superior to the 250-μg ACTH stimulation test for the diagnosis of CIRCI? Recommendation: We suggest against using corticotropin levels for the routine diagnosis of CIRCI (conditional recommendation, low quality of evidence). Rationale: The plasma corticotropin level is determined by corticotropin release from the anterior pituitary gland into the systemic circulation. Normally, plasma concentrations of corticotropin and cortisol change in opposite directions. In primary adrenal insufficiency, plasma

2017 Society of Critical Care Medicine

37. Childhood and Adolescent Adversity and Cardiometabolic Outcomes: A Scientific Statement From the American Heart Association

adversity may increase the risk of cardiometabolic (and other) diseases: behavioral, mental health, and biological. Behavioral Factors Evidence suggests that childhood adversity is associated with adverse health behaviors that increase the risk of cardiometabolic disease, including smoking, overeating, consumption of energy-dense foods, and inactivity. , , The association of childhood adversity with these behaviors was first tested by Felitti et al. In their retrospective ACE study, Felitti et al (...) childbirth would also capture intergenerational adversity and perinatal programming. Limited Identification of Mechanisms As discussed, childhood adversity may provoke unhealthy behaviors and poor mental health or produce neurobiological alterations that initiate relevant pathophysiological processes. Few studies have explicitly tested the mechanisms linking childhood adversity and cardiometabolic disease with comprehensive mediation models. Moreover, no study of which we are aware has tested a range

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2017 American Heart Association

38. Interventions Targeting Sensory Challenges in Children with Autism Spectrum Disorder - An Update

and high ROB) of interventions with sensory-related components (tactile stimulation exercises, weighted blankets) reported few significant differences between treatment groups. Conclusions. Some interventions targeting sensory challenges may produce modest short-term ( 70), both groups received active treatment that included either SI therapy or eclectic group therapy. 39 Treatment lasted for 8 to 10 months. Participants in the SI group improved significantly more than those in the control group

2017 Effective Health Care Program (AHRQ)

39. Neofordex - dexamethasone. To treat adults with multiple myeloma

II, or give the monohydrate. Form I, the more stable form, can only be generated from Form II at high temperature, but not from the hydrated forms. Intrinsic Dissolution Rates (IDR) of the different polymorphs were studied. The morphology of the active substance produced by the active ingredient manufacturer is determined and controlled by an XRPD method with a test and control limits included within the specification for the active substance. Specification The control tests comply (...) with the specification and test methods of the Ph. Eur. Monograph for dexamethasone acetate and additional test mentioned in the CEP. Additional specifications have also been set for particle size (laser diffraction) and polymorphism (XRPD). All additional methods have been adequately validated and described according to ICH Q2. Control limits for particle size distribution and morphology are justified in view of the characteristics of the batch of active substance used for the bioequivalence study. Batch analysis

2016 European Medicines Agency - EPARs

40. Guideline on the management of premature ovarian insufficiency

) antibodies should be performed in women with POI of unknown cause or if an immune disorder is suspected. In patients with a positive TPO-Ab test, thyroid stimulating hormone (TSH) should be measured every year. C 10 There is insufficient evidence to recommend routinely screening POI women for diabetes. D There is no indication for infection screening in women with POI. D The possibility of POI being a consequence of a medical or surgical intervention should be discussed with women as part (...) for at least 4 months, and ? an elevated FSH level > 25 IU/l on two occasions > 4 weeks apart. GPP What are the known causes of POI and how should they be investigated? Chromosomal analysis should be performed in all women with non-iatrogenic Premature Ovarian Insufficiency. C Gonadectomy should be recommended for all women with detectable Y chromosomal material. C Fragile-X premutation testing is indicated in POI women. B The implications of the fragile-X premutation should be discussed before the test

2015 European Society of Human Reproduction and Embryology

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