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Dysuria in Children

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161. Clinical Practice Guidelines on Prevention, Diagnosis and Management of Tuberculosis

, and well defined. 38 5.1.4 Chest radiographic screening in children Refer to 10.2 Chest radiographic screening in children 69-74 5.1.5 Chest radiographic screening in pregnancy 75 With the very low foetal dose of radiation associated with a chest radiograph, the associated risks of childhood cancer is very low ( 59 years of age 15-20 mg/kg max 1g daily50 7.2 Initiation of treatment GPP Patients with chest radiographic findings that suggest active disease may be commenced on tuberculosis treatment even (...) laboratory diagnosis 41 7 Treatment of tuberculosis 48 8 Public health screening and infection control 70 9 Tuberculosis contact investigations and screening 78 10 Tuberculosis in children - specific considerations 85 11 Cost-effectiveness issues 89 12 Clinical quality improvement 90 Appendix 1 Recommendations for sputum collection 91 Annex 1 MD 532 Notification of Tuberculosis 93 Annex 2 MD 117 Treatment Progress Report 95 References 97 Self-assessment (MCQs) 112 Workgroup members 114 ContentsD Foreword

2016 Ministry of Health, Singapore

162. Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis

toddlers and preschool-age children), acute appendicitis is often diagnosed after perforation has occurred. 42-44 Children have a thinner appendiceal wall and less developed omentum, and thus may not readily wall off a perforation. In addition, many common childhood illnesses have symptoms similar to those of early acute appendicitis. Young children may also have difficulty communicating about their discomfort or describing their symptoms. 11 In addition, the use of modalities that involve ionizing (...) , Canada Tyler Hughes, M.D. McPherson Hospital McPherson, KS Douglas Katz, M.D., FACR Vice Chairman of Research and Education Winthrop Radiology Associates Winthrop-University Hospital, Department of Radiology Director of Body CT, Winthrop-University Hospital Mineola, NY Anupam Kharbanda, M.D., M.Sc. Director of Research, Emergency Services Associate PEM Fellowship Director Department of Pediatric Emergency Medicine Children’s Hospitals and Clinics of Minnesota Minneapolis, MN Susan Promes, M.D

2016 Effective Health Care Program (AHRQ)

163. Male Urethral Stricture

statements of Strong, Moderate, or Conditional Recommendation based on risks and benefits were developed. Additional information is provided as Clinical Principles and Expert Opinions when insufficient evidence existed. Guideline Statements Diagnosis/Initial Management 1. Clinicians should include urethral stricture in the differential diagnosis of men who present with decreased urinary stream, incomplete emptying, dysuria, urinary tract infection (UTI), and after rising post void residual. (Moderate (...) tend to be located in the bulbar and posterior urethra. Preoperative Assessment Presentation Patients with urethral stricture most commonly present with decreased urinary stream and incomplete bladder emptying but may also demonstrate UTI, epididymitis, rising post-void residual urine volume or decreased force of ejaculation. Additionally, patients may present with urinary spraying or dysuria. 10 Patient Reported Outcomes Measures Patient reported measures (PRMs) help elucidate the presence

2016 American Urological Association

164. Diagnosis, Evaluation and Follow-up of Asymptomatic Microhematuria (AMH) in Adults

2011. Data from studies published after the literature search cut-off will be incorporated into the next version of this guideline. Preclinical studies (e.g., animal models), pediatric studies, commentary, and editorials were excluded. Review article references were checked to ensure inclusion of all possibly relevant studies. Multiple reports on the same patient group were carefully examined to ensure inclusion of only non-redundant information. The review yielded an evidence base of 192 articles

2016 American Urological Association

165. Surgical Management of Stones: AUA/Endourology Society Guideline

Managers' Network (PMN) Patient Safety and Quality of Care Accreditations and Reporting Patient Education Surgical Management of Stones: AUA/Endourology Society Guideline (2016) AUA/Endourological Society Guideline: Published 2016 The purpose of this clinical guideline is to provide a clinical framework for the surgical management of patients with kidney and/or ureteral stones. Index patients discussed include adult, pediatric, and pregnant patients with ureteral or renal stones. [pdf] Panel Members (...) with symptomatic caliceal diverticular stones, endoscopic therapy (URS, PCNL, laparoscopic, robotic) should be preferentially utilized. Strong Recommendation; Evidence Level Grade C 45. Staghorn stones should be removed if attendant comorbidities do not preclude treatment. Clinical Principle Treatment for Pediatric Patients with Ureteral or Renal Stones 46. In pediatric patients with uncomplicated ureteral stones ≤10 mm, clinicians should offer observation with or without MET using α-blockers. (Index Patient

2016 American Urological Association

166. Management of Chronic Pain in Survivors of Adult Cancers Full Text available with Trip Pro

Dyspareunia, vaginal pain Dysuria Eye pain Oral pain and reduced jaw motion Paresthesias Scleroderma-like skin changes Surgical pain syndromes Lymphedema Postamputation phantom pain Postmastectomy pain Postradical neck dissection pain Postsurgery pelvic floor pain Post-thoractomy pain/frozen shoulder Postsurgery extremity pain (eg, sarcoma) Recommendation 1.4. Clinicians should evaluate and monitor for recurrent disease, second malignancy, or late-onset treatment effects in any patient who reports new

2016 American Society of Clinical Oncology Guidelines

167. WHO guidelines for the treatment of Chlamydia trachomatis

FOR THE TREATMENT OF CHLAMYDIA TRACHOMATIS STI Guideline Development Group (GDG): Chairpersons: Judith Wasserheit, Holger Schünemann and Patricia Garcia Members: * 8 ' @W K D WD ? H F W VO \ P S K R L G W L VVX H D Q GW U D F K R P D H \ HL Q I H F W L R Q CLINICAL PRESENTATION Genital infections due to C. trachomatis are DV \ P SW R P DW L FL QD S S U R [ L P DWH O \ RIZR P H QD Q G RIP H Q (2). Symptoms of uncomplicated chlamydial infection in women include abnormal vaginal discharge, dysuria, and post (...) -coital and intermenstrual bleeding. Common clinical signs on speculum examination include cervical friability and discharge. Symptomatic men usually present with urethral discharge and dysuria, sometimes accompanied by testicular pain. If left untreated, most genital infections will resolve spontaneously with no sequelae but they may result in severe complications, mainly in young women. Infection can ascend to the upper reproductive tract and can F D X V HS H O Y L FL Q A D P P D W R U \G LVH D VHH

2016 World Health Organisation Guidelines

168. WHO guidelines for the treatment of Neisseria gonorrhoeae

Training in Human Reproduction HSV-2 herpes simplex virus type 2 IM intramuscular MSH Management Sciences for Health MSM men who have sex with men NAATs nucleic acid amplification tests PICO population, intervention, comparator, outcome POCT point-of-care test STI sexually transmitted infection UNAIDS Joint United Nations Programme on HIV/AIDS UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund WHO World Health Organization1 WHO GUIDELINES FOR THE TREATMENT OF NEISSERIA (...) GONORRHOEAE EXECUTIVE SUMMARY Sexually transmitted infections (STIs) are a major public health problem worldwide, affecting quality of life and causing serious morbidity and mortality. STIs have a direct impact on reproductive and child health through infertility, cancers and pregnancy complications, and they have an indirect impact through their role in facilitating sexual transmission of human immunodeficiency virus (HIV) and thus they also have an impact on national and individual economies. More than

2016 World Health Organisation Guidelines

169. WHO guidelines for the treatment of Genital Herpes Simplex Virus

HSV herpes simplex virus HSV-1 herpes simplex virus type 1 HSV-2 herpes simplex virus type 2 MSH Management Sciences for Health MSM men who have sex with men NAAT nucleic acid amplification test PICO population, intervention, comparator, outcome POCT point-of-care diagnostic test STI sexually transmitted infection UNAIDS Joint United Nations Programme on HIV/AIDS UNDP United Nations Development Programme UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund WHO World Health (...) Organization ABBREVIATIONS AND ACRONYMS1 WHO GUIDELINES FOR THE TREATMENT OF GENITAL HERPES SIMPLEX VIRUS EXECUTIVE SUMMARY Sexually transmitted infections (STIs) are a major public health problem worldwide, affecting quality of life and causing serious morbidity and mortality. STIs have a direct impact on reproductive and child health through infertility, cancers and pregnancy complications, and they have an indirect impact through their role in facilitating sexual transmission of human immunodeficiency

2016 World Health Organisation Guidelines

170. GreenLight XPS for treating benign prostatic hyperplasia

and Healthcare Products Regulatory Agency Professor Janelle Y Professor Janelle Y ork orke e Lecturer and Researcher in Nursing, University of Manchester Dr Amber Y Dr Amber Y oung oung Consultant Paediatric Anaesthetist, Bristol Royal Hospital for Children GreenLight XPS for treating benign prostatic hyperplasia (MTG29) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 26 of 30NICE lead team Each medical technology assessment (...) Prostate Symptom Score [IPSS] and International Prostate Symptom Score Quality of Life [IPSS- QOL], change in prostate volume, maximum flow rate [Qmax], post-void residual volume [PVR]) duration of catheterisation rate of dysuria (pain) quality of life length of hospital stay frequency of completion as a day-case rate of re-admission procedural blood loss and blood transfusion need rate of transurethral resection of the prostate (TURP) syndrome rate of capsular perforation device-related adverse events

2016 National Institute for Health and Clinical Excellence - Medical technologies

171. Male external catheters in adults

questions formulated by the Working Group (Chapter 14). Limitations of December 2014 search: • English language • Adults • Human studies • Age = 19 years • 2004-2014 Exclusion criteria during abstract selection: • Non-English-language studies • Conference proceedings • Paediatric studies • Use of MECs for diagnostic reasons It was a policy decision to restrict the search in the way described. After screening the records retrieved from the search of December 2014 (limited to 2004-2014), it was decided (...) bacteriuria that can be applied to all kinds of UTIs and in all circumstances. [9] 3.2.1 Asymptomatic bacteriuria Asymptomatic bacteriuria is diagnosed if two cultures of the same bacterial strain, taken = 24 h apart, show bacteriuria of = 105 CFU/ml uropathogens. [9] Asymptomatic bacteriuria should not be treated with antibiotics. 3.2.2 Symptomatic bacteriuria Symptomatic UTI is defined as a significant number of microorganisms in the urine that occurs together with symptoms such as dysuria, urgency

2016 European Association of Urology Nurses

172. Trichomoniasis

worldwide. Complications include perinatal complications (preterm delivery and/or low birthweight infant), infertility, and enhanced HIV transmission. Up to 50% of women with trichomoniasis have no symptoms. When present, common symptoms include vaginal discharge, vulval itching, dysuria, and offensive odour. Of men with trichomoniasis, 15–50% are asymptomatic and usually present as sexual partners of infected women. The most common symptoms are urethral discharge and/or dysuria. The diagnosis

2016 NICE Clinical Knowledge Summaries

173. Suprapubic urinary catheter

record ( ). The child’s doctor must be informed if the child: is unable to pass urine ( ) has dysuria ( ) if the entry site leaks on their first micturition The entry site must be observed for haemorrhage and urine leakage ( ). If either occurs, pressure must be applied and the child’s doctor informed ( ). The dressing should be removed after 24 hours ( ). Once the site is healed a dressing will no longer be required. The appropriate children’s community nursing team must be informed on admission (...) ( ) Suprapubic catheterisation must only be performed when absolutely necessary and be for the minimum possible time, usually three to 28 days. However, long-term use is suitable for some children ( ). Suprapubic catheters must always be managed using a non-touch technique ( ). It is recommended that all catheters and securing devices are latex free ( ). The child may experience discomfort from the catheter, even if it is the correct size and correctly positioned. Analgesia should be given as prescribed

2014 Publication 1593

174. Xigduo - dapagliflozin / metformin

) of Directive 2001/83/EC – relating to applications for new fixed combination products. The application submitted is a new fixed combination medicinal product, composed of administrative information, complete quality data, non-clinical and clinical data based on applicants’ own tests and studies and/or bibliographic literature substituting/supporting certain tests or studies. Information on Paediatric requirements Pursuant to Article 7 of Regulation (EC) No 1901/2006, the application included an EMA

2014 European Medicines Agency - EPARs

175. Dapagliflozin (Farxiga)

, MPH NDA 202293; FARXIGA (dapagliflozin) 4 7.5.5 Drug-Drug Interactions 124 7.6 Additional Safety Evaluations 124 7.6.1 Human Carcinogenicity 124 7.6.2 Human Reproduction and Pregnancy Data 124 7.6.3 Pediatrics and Assessment of Effects on Growth 124 7.6.4 Overdose, Drug Abuse Potential, Withdrawal and Rebound 124 7.7 Additional Submissions / Safety Issues 125 8 POSTMARKET EXPERIENCE 125 9 APPENDICES 126 9.1 Literature Review/References 126 9.2 Labeling Recommendations 128 9.3 Advisory Committee (...) Pharmacodynamics SOC System Organ Class PDUFA Prescription Drug User Fee Act ST Short-Term PeRC Pediatric Research Committee SU Sulfonylurea PK Pharmacokinetics T1DM Type 1 Diabetes Mellitus Reference ID: 3426720Clinical Review Frank Pucino, PharmD, MPH NDA 202293; FARXIGA (dapagliflozin) 8 PPG Post Prandial Glucose T2DM Type 2 Diabetes Mellitus PREA Pediatric Research Equity Act TBL Total Bilirubin PT Preferred Term TCC Transitional Cell Carcinomas PVD Peripheral Vascular Disease TEAE Treatment-Emergent

2014 FDA - Drug Approval Package

176. Triumeq - abacavir/dolutegravir/lamivudine (ABC/DTG/3TC)

creatinine compared to baseline values were performed. SINGLE Overall, throughout the 96-week treatment period, the incidence of renal related AEs (regardless of severity, causality) was 6% in the DTG group vs. 7% in the Atripla group. The event rates at Week 48 were 4% and 5% in the DTG and Atripla treatment arms, respectively. By preferred terms, the most common AE (regardless of severity, causality) at Week 96 was dysuria (1% in each arm). Other AEs reported in at least 2 subjects receiving DTG (...) for Postmarketing Risk Evaluation and Management strategies No postmarketing risk management activities are required for this application. Recommendation for other Postmarketing Requirements and Commitments The following PMRs are recommended: 1. Deferred pediatric trial under PREA for the treatment of HIV-1 infection in pediatric subjects from 12 to <18 years of age. Evaluate the safety and antiviral activity of ABC/DTG/3TC FDC in pediatric subjects with safety and virologic response assessed over at least 24

2014 FDA - Drug Approval Package

177. Ureteric stent

perform a hand wash and dry hands thoroughly record the procedure and volume of urine in the child’s health records ( ) The child and family must be reminded that pain may be experienced as the kidney pelvis fills up and during the first micturition. The child’s first micturition must be documented on the fluid balance chart and in the child’s health care record ( ). The child's doctor must be informed if the child: is unable to pass urine ( ) has dysuria or loin pain if the entry site leaks (...) on their first micturition ( pressure should be applied) ( ) The dressing should be removed after 24 hours ( ). O nce the site is healed a dressing will no longer be required. Discharge The child’s parents should be advised to contact the ward if, once discharged, they have concerns about the wound site ( ). The family must be told to contact the ward if the child experiences any of the following problems: if the child is unable to pass urine ( ) the child has dysuria or loin pain ( ) Rationale Rationale 1

2014 Publication 1593

178. New Zealand Guideline for the Management of Gonorrhoea

Partner notification 39 Management of sexual partners/contacts 39 Management of gonorrhoea in children 40 Testing for N. gonorrhoeae in prepubertal children 40 When should N. gonorrhoeae testing be undertaken in prepubertal children? 41 Which specimens should be taken, and which tests should be requested? 41 Additional testing 42 Gonorrhoea typing 42 NAAT 42 Management of gonorrhoea in prepubertal children (excluding neonates) 42 For uncomplicated anogenital and pharyngeal gonorrhoea (not in neonates (...) , gonorrhoea is the second most common bacterial STI after chlamydia. The primary sites of infection are the urethra, rectum, pharynx and conjunctiva in both genders and the endocervix in the female. In infants, the conjunctiva is the most common site of infection. N. gonorrhoeae has traditionally been detected by culture, before measurement of antibiotic susceptibilities. This method is highly specific for N. gonorrhoeae but is time consuming and subjective, and it relies on organism viability, which

2014 New Zealand Sexual Health Society

179. UK National Guidelines on the Management of infection with Chlamydia Trachomatis

Clinical Features The majority of individuals with chlamydial infection are asymptomatic. 24 However symptoms and signs include the following: Women Symptoms: - Increased vaginal discharge - Post-coital and intermenstrual bleeding - Dysuria - Lower abdominal pain 8 - Deep dyspareunia Signs: - Mucopurulent cervicitis with or without contact bleeding - Pelvic tenderness - Cervical motion tenderness Men Symptoms (may be so mild as to be unnoticed): - Urethral discharge - Dysuria Signs: - Urethral (...) be considered in all infants who develop conjunctivitis within 30 days of birth. 130 In view of the fact that infection may occur at multiple sites, oral therapy is recommended. Diagnosis of neonatal chlamydia infection The diagnosis is most frequently made on clinical grounds, as the results of tests are not routinely immediately available. Although NAAT testing is not validated, its widespread use in the diagnosis of rectal and pharyngeal infection in adults suggests that it should be effective

2015 British Association for Sexual Health and HIV

180. Neuro-urology

. Complications of neuro-urological symptoms (infections) account for a major cause of mortality in MSA [31]. Brain tumors 26.8/100,000/yr in adult (> 19 yrs) (17.9 benign, 8.9 malignant) [32]. Neuro-urological symptoms vary according to tumour location. Incontinence occurs mainly in frontal location (part of frontal syndrome or isolated in frontal location) [33]. Voiding dyfunction may occur in other location. Mental retardation and cerebral palsy Intellectual disability in children is a very heterogenous (...) group: including perinatal injury, materno- foetal infections, metabolic disease, genetic disorders and cerebral palsy Mental retardation other than cerebral palsy Cerebral Palsy: 3.1-3.6/1,000 in children aged 8 yrs [34]. Incontinence: In 65% of severe and profoundly retarded adult patients [35, 36]. DO and impaired contractility also reported. 89% incontinence, 70% uninhibited detrusor contraction at urodynamic examination. Recurrent urinary tract infection and radiologic abnormalities in > 10

2015 European Association of Urology

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