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241. Clinical Practice Guidelines on Hypertension

), as they will require two or more drugs for adequate BP control. Grade B, Level 2 + 33 27 Initiate treatment at low doses of drugs, either singly or as a two-drug combination, to minimise side effects. Grade D, Level 4 33 28 If an adequate dose of the first drug used demonstrated limited response or was poorly- tolerated, change to a different drug class instead of increasing the dose of the first drug. Grade A, Level 1 + 33 29 Add a second drug when a single drug fails to achieve target BP. Grade B, Level 1 + 34 6 (...) or angiotensin II receptor blocker (ARB) suggests high circulating levels of renin and angiotensin II. In this situation, look out for bilateral renal artery stenosis. 3,9,10 The identifiable secondary causes of hypertension are listed in Table 4. Table 4 Identifiable secondary causes of hypertension Identifiable secondary causes of hypertension 1. Drug-related and substance-related* causes 2. Chronic kidney disease 3. Renal artery stenosis 4. Primary hyperaldosteronism 5. Hypercortisolism (Cushing’s

2017 Ministry of Health, Singapore

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

-2015-00003-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report. The information (...) and cerebellum of three older men with fragile X syndrome. Mol Autism. 2011;2(1):2. doi: 10.1186/2040-2392-2-2. PMID: 21303513.X-1 653. Greer RD, Pistoljevic N, Cahill C, et al. Effects of conditioning voices as reinforcers for listener responses on rate of learning, awareness, and preferences for listening to stories in preschoolers with autism. Anal Verbal Behav. 2011;27(1):103- 24. PMID: 22532758.X-1, X-3, X-4 D-56 654. Griffith GM, Hastings RP, Oliver C, et al. Psychological well-being in parents

2017 Effective Health Care Program (AHRQ)

243. CRACKCast E110 – Thought Disorders

restraint are immediately necessary for patients who demonstrate aggressive and dangerous behavior Appropriate disposition depends on the etiology of the underlying psychosis, response to treatment, and patient and community safety considerations and, more often than not, includes psychiatric consultation. Welcome to the first of six psychiatry chapters! “Patients with a history of mental illness have a higher rate of emergency department (ED) visits then the general population. Patients with at least (...) erythematosus Temporal (giant cell) arteritis ORGAN FAILURE Hepatic encephalopathy Uremia NEUROLOGIC DISORDERS Alzheimer’s disease Cerebrovascular disease Encephalitis (including HIV infection) Encephalopathies Epilepsy Huntington’s disease Multiple sclerosis Neoplasms Normal-pressure hydrocephalus Parkinson’s disease Pick’s disease Wilson’s disease ENDOCRINE DISORDERS Addison’s disease Cushing’s disease Panhypopituitarism Parathyroid disease Postpartum psychosis Recurrent menstrual psychosis Sydenham’s

2017 CandiEM

244. Management of Uterine Fibroids

), Rockville, MD (Contract No. 290-2015-00003-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. None of the investigators have any affiliations or financial involvement that conflicts with the material presented

2017 Effective Health Care Program (AHRQ)

245. British Association of Dermatologists guidelines for the management of pemphigus vulgaris

a bone density scan early in the course of treatment may be needed. In anticipation of using an adjuvant immunosuppressant, appropriate recommended additional investigations and vacci- nations should be undertaken. A baseline measure of disease activity (see section 91) and quality of life, supplemented by IIF and ELISA titres if facilities exist, will be useful for disease monitoring and judging treatment responses (see sections 90–92). 9.0 Disease monitoring Decisions concerning ongoing disease (...) outcomesarein?uencedbytheintensityofinitialtreatment. 57,74 If there is no response within 5–7 days, it is suggested that the dose should be increased in 50–100% increments until dis- ease control is achieved, de?ned as no new lesions and the onset of healing in pre-existing ones. 9,61,65,71,75 If prednisolone doses above 1 mg kg 1 per day are required, pulsed intravenous cor- ticosteroids should be considered. Treatment failure for oral corticosteroids has been de?ned by international consensus as failure

2017 British Association of Dermatologists

246. Primary & Secondary Prevention of CVD

-morbidities, acceptance of patients towards recommended therapy etc. Every health care provider is responsible to individualise the management of his/her unique patient based on the clinical presentation and management options available locally. REVIEW OF THE GUIDELINE This guideline is issued in 2017 and will be reviewed in 2022 or earlier if important new evidence becomes available. CPG Secretariat Health Technology Assessment Unit Medical Development Division Level 4, Block EI, Parcel E Government (...) of major risk factors for CVD. This is followed by CPGs on the Management of Acute Myocardial Infarction, Heart Failure and Cerebrovascular Accidents. More recently, in 2010, the MOH launched the National Strategic Plan for Non-Communicable Disease (NSP-NCD) in response to the global challenge in combatting NCD in general and CVD in particular. This document is now being updated by the MOH to reflect latest developments in the field and more current global targets set by the World Health Organisation

2017 Ministry of Health, Malaysia

248. Management of Dyslipidaemia

outcome in individual patient care. Every health care provider is responsible for the management of his/her unique patient based on the clinical presentation and management options available locally. REVIEW OF THE GUIDELINE This guideline is issued in 2017 and will be reviewed in about 5 years or earlier if important new evidence becomes available. CPG Secretariat Health Technology Assessment Unit Medical Development Division Level 4, Block EI, Parcel E Government Offices Complex 62590 Putrajaya (...) ) and triglycerides (TG). ? LDL-C is usually calculated by the Freidewald equation which is not valid in the presence of elevated TG (TG > 4.5 mmol/L). ? Both fasting and non-fasting samples may be used for lipid screening. • Dyslipidaemias may be primary or secondary to nephrotic syndrome, obstructive liver disease, hypothyroidism, Cushing’s syndrome, drugs, alcoholism and insulin resistance states such as T2DM and metabolic syndrome. Treatment of the underlying aetiology can lead to an improvement in the lipid

2017 Ministry of Health, Malaysia

250. Management of Diabetes Mellitus in Primary Care

will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every healthcare professional making use of these guidelines is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation. These guidelines are not intended to represent Department of Veterans Affairs or TRICARE policy. Further, inclusion of recommendations (...) . The insulin resistance resulting in T2DM is thought to be due to excess adiposity, especially central distribution of adiposity, but can be due to other factors, such as corticosteroid treatment or Cushing’s syndrome. Gestational diabetes (GDM) is DM present during pregnancy. Other more unusual types of DM also exist, such as maturity onset diabetes of the young (MODY), latent VA/DoD Clinical Practice Guideline for the Management of Type 2 Diabetes Mellitus in Primary Care April 2017 Page 6 of 160

2017 VA/DoD Clinical Practice Guidelines

251. Urotrauma

Strength: Grade B) 5. The surgical team must perform immediate intervention (surgery or angioembolization in selected situations) in hemodynamically unstable patients with no or transient response to resuscitation. (Standard; Evidence Strength: Grade B) 6. Clinicians may initially observe patients with renal parenchymal injury and urinary extravasation. (Clinical Principle) 7. Clinicians should perform follow-up CT imaging for renal trauma patients having either (a) deep lacerations (AAST Grade IV-V (...) , especially those with higher grade injuries. Although devitalized parenchyma has been suggested as a risk factor for development of septic complications, evidence supporting intervention for this radiographic finding is inconclusive. Close Guideline Statement 5 The surgical team must perform immediate intervention (surgery or angioembolization in selected situations) in hemodynamically unstable patients with no or transient response to resuscitation. (Standard; Evidence Strength: Grade B) × Discussion

2017 American Urological Association

253. Guidelines for the Use of Laparoscopy during Pregnancy

. Solid Organ Resection Guideline 18: Laparoscopic adrenalectomy, nephrectomy and splenectomy are safe procedures in appropriately selected pregnant patients (+; Weak). Laparoscopic adrenalectomy during pregnancy has proven effective in the management of primary hyperaldosteronism [162] , Cushing’s syndrome [163-166] , and pheochromocytoma [167-173] . Laparoscopic splenectomy has also become an increasingly accepted surgical approach in pregnancy [174-176] . Gravid patients with antiphospholipid

2017 Society of American Gastrointestinal and Endoscopic Surgeons

254. Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline Full Text available with Trip Pro

gender. (2 |⊕⊕○○) 3.4. We suggest that endocrinologists provide education to transgender individuals undergoing treatment about the onset and time course of physical changes induced by sex hormone treatment. (2 |⊕○○○) 4.0 Adverse outcome prevention and long-term care 4.1. We suggest regular clinical evaluation for physical changes and potential adverse changes in response to sex steroid hormones and laboratory monitoring of sex steroid hormone levels every 3 months during the first year of hormone (...) of including a total hysterectomy and oophorectomy as part of gender-affirming surgery. (Ungraded Good Practice Statement) 5.0 Surgery for sex reassignment and gender confirmation 5.1. We recommend that a patient pursue genital gender-affirming surgery only after the MHP and the clinician responsible for endocrine transition therapy both agree that surgery is medically necessary and would benefit the patient’s overall health and/or well-being. (1 |⊕⊕○○) 5.2. We advise that clinicians approve genital gender

2017 Pediatric Endocrine Society

255. Mepolizumab (Nucala, GlaxoSmithKline plc.) for the Treatment of Severe Asthma with Eosinophilia: Effectiveness, Value, and Value-Based Price Benchmarks

therapies for severe asthma include leukotriene inhibitors, theophylline, and omalizumab. Oral corticosteroids are used for short-term therapy to control asthma exacerbations and chronically for severe asthma that cannot be controlled without these drugs. Physicians try to avoid chronic oral corticosteroid therapy because it is associated with many long-term complications including growth suppression in children, osteoporosis, Cushing’s syndrome, adrenal insufficiency, muscle weakness, diabetes (...) . 15 Studies of mepolizumab dosing and eosinophil response have indicated similar pharmacodynamics between the FDA-approved 100 mg SC dose and the 75 mg IV dose. 16 We searched ClinicalTrials.gov and did not identify any additional trials completed more than two years ago that would have met our inclusion criteria but have not been published. The MENSA trial was a double-blind randomized controlled trial (RCT) of 576 patients ages 12 years and older (mean age 50 years, 57% female, 25% chronic use

2017 California Technology Assessment Forum

256. Glasgow Coma Scale for Field Triage of Trauma: A Systematic Review

(Contract No. 290-2015-00009-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report (...) mild. 14 The 2011 field triage guidelines from the Centers for Disease Control and Prevention (CDC) National Expert Panel recommend transporting patients with tGCS scores of 13 or less to facilities providing the highest level of trauma care. 4 In some circumstances (e.g., trauma victims who are intoxicated, intubated, or whose other injuries influence response) it may not be possible to accurately assess the verbal and eye components of the GCS. In these cases, assessments may be primarily based

2017 Effective Health Care Program (AHRQ)

257. Management of osteoporosis and the prevention of fragility fractures

for an individual case and are subject to change as scientific knowledge and technology advance and patterns of care evolve. Adherence to guideline recommendations will not ensure a successful outcome in every case, nor should they be construed as including all proper methods of care or excluding other acceptable methods of care aimed at the same results. The ultimate judgement must be made by the appropriate healthcare professional(s) responsible for clinical decisions regarding a particular clinical procedure (...) (and probably increases) the prescribers’ professional responsibility and potential liability.” 124 Management of osteoporosis and the prevention of fragility fractures The General Medical Council (GMC) recommends that when prescribing a medicine ‘off label’, doctors should: • be satisfied that there is no suitably licensed medicine that will meet the patient’s need. • be satisfied that there is sufficient evidence or experience of using the medicine to show its safety and efficacy • take responsibility

2015 SIGN

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

Transplantation AUC Area Under the Curve Bor Bortezomib BMI Body Mass Index BMSC Bone marrow stromal cells BTD PACE Bortezomib, Thalidomide, and Dexamethasone plus Cisplatin, Doxorubicin, Cyclophosphamide, and Etoposide CEP Certificate of Suitability of the EP CHMP Committee for Human Medicinal Products CI Confidence Interval CL Total Clearance Cmax Average Maximum Concentration CR Complete Response CTD Cyclophosphamide, Thalidomide, and Dexamethasone CTDa Attenuated Cyclophosphamide, Thalidomide (...) , and Dexamethasone CVAD Cyclophosphamide, Vincristine, Adriamycin and Dexamethasone CYP Cytochrome DCEP Dexamethasone, Cyclophosphamide, Etoposide, and Cisplatin, Dex Dexamethasone DOR Duration of Response EBMT European Group for Blood and Marrow Transplantation EC European Commission ECOG Eastern Cooperative Oncology Group EDQM European Directorate for the Quality of Medicines EFS Event Free Survival GCP Good Clinical Practice GD Gestation days HPLC High performance liquid chromatography HR Hazard Ratio

2016 European Medicines Agency - EPARs

259. Pharmacist-led Chronic Disease Management: A Systematic Review of Effectiveness and Harms Compared to Usual Care

. The ESP CC establishes standard operating procedures for the production of evidence synthesis reports; facilitates a national topic nomination, prioritization, and selection process; manages the research portfolio of each Center; facilitates editorial review processes; ensures methodological consistency and quality of products; produces “rapid response evidence briefs” at the request of VHA senior leadership; collaborates with HSR&D Center for Information Dissemination and Education Resources (CIDER (...) ; 2015. This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the Minneapolis VA Medical Center, Minneapolis, MN, funded by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative. The findings and conclusions in this document are those of the author(s) who are responsible for its contents; the findings and conclusions do not necessarily represent the views

2016 Veterans Affairs Evidence-based Synthesis Program Reports

260. Cervical Cancer: ESMO Clinical Practice Guidelines

invasive cervical cancers but has a particular propensity to spread distantly, which is similar to small-cell carcinoma of the lung. As a result, patients can present with systemic symptoms such as weight loss. In addition, patients may present with a paraneoplastic syndrome such as the syn- drome of inappropriate antidiuretic hormone secretion (SIADH), Cushing syndrome, hypercalcaemia or a neurological disorder. The most commonly involved organs include the liver, adrenals, bone, bone marrow (...) if the patient has a performance status (PS) 2 and no formal contraindications. Cisplatin 50 mg/m 2 every 3 weeks was, for two decades, the standard of care. However, the global ef- ?cacy was disappointing due to a low response rate (20%), short median PFS (2.8–3.2 months) and OS (6.2–8.0 months). Cisplatin-based doublets with topotecan or paclitaxel have demonstrated superiority to cisplatin monotherapy in terms of response rate and PFS [43, 44]. Cisplatin combined with topote- can showed superior OS

2017 European Society for Medical Oncology

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