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Emergency Medicine Pitfalls

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61. Management of Stroke in Neonates and Children

of telestroke or telemedicine as a specific way of bringing expertise to emergency providers who may have less experience with acute focal deficits and stroke in children. Telestroke has been effective in adult stroke medicine and has been used in other settings in pediatric cardiovascular care. Pediatric stroke specific guidelines should be developed at the local, regional, and national levels. To leverage regional stroke expertise, partnerships between emergency medical services, comprehensive stroke (...) and plays a role in angiogenesis. Maternal factors that may be associated with perinatal AIS include primiparity or a history of infertility, chorioamnionitis, oligohydramnios, premature rupture of membranes, vacuum extraction, emergency cesarean section, coagulation disorders, and preeclampsia. Individuals with presumed perinatal ischemic stroke have similar risk factors. , The likelihood of neonatal AIS increases dramatically with an increasing number of risk factors, but in many individuals

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2019 American Heart Association

62. What Is the Accuracy of Physical Examination, Imaging, and the LRINEC Score for the Diagnosis of Necrotizing Soft Tissue Infection? (SRS diagnosis)

characteristics. No single element of the physical examination, radiography, or the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score has suf?cient sensitivity to exclude necrotizing soft tissue infection. EBEM Commentators Michael D. April, MD, DPhil Brit Long, MD Department of Emergency Medicine San Antonio Uniformed Services Health Education Consortium Fort Sam, Houston, TX Jestin N. Carlson, MD, MS, and Alan Jones, MD, serve as editors of the SRS series. Editor’s Note: This is a clinical (...) characteristics of one or more of INFECTIOUS DISEASE/SYSTEMATIC REVIEW SNAPSHOT 22 Annals of Emergency Medicine Volume 73, no. 1 : January 2019Of 2,290 initial citations, the au- thors included 23 studies including 16 retrospective cohort studies, 2 prospective cohort studies, and 5 retrospective case- control studies. Pooled sensitivity values for physical examination ?ndings ranged from 21.0% for hypotension to 46.0% for fever (Table). The sensitivity of CT presence of fascial edema, fascial enhancement

2018 Annals of Emergency Medicine Systematic Review Snapshots

63. ESC/ESH Management of Arterial Hypertension

million), and ischaemic stroke (1.5 million). Both office BP and out-of-office BP have an independent and continuous relationship with the incidence of several CV events [haemorrhagic stroke, ischaemic stroke, myocardial infarction, sudden death, heart failure, and peripheral artery disease (PAD)], as well as end-stage renal disease. Accumulating evidence is closely linking hypertension with an increased risk of developing atrial fibrillation (AF), and evidence is emerging that links early elevations (...) ventricular. There is also emerging evidence that an increase in serum uric acid to levels lower than those typically associated with gout is independently associated with increased CV risk in both the general population and in hypertensive patients. Measurement of serum uric acid is recommended as part of the screening of hypertensive patients. The SCORE system only estimates the risk of fatal CV events. The risk of total CV events (fatal and non-fatal) is approximately three times higher than the rate

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2018 European Society of Cardiology

64. ACR–ASNR–SPR Practice Parameter for the Performance and Interpretation of Magnetic Resonance (MR) Spectroscopy of the Central Nervous System

is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of this document. However, a practitioner who employs an approach substantially different from the guidance in this document is advised to document in the patient record information sufficient to explain the approach taken. The practice of medicine involves not only the science, but also the art of dealing with the prevention, diagnosis, alleviation (...) be needed to achieve a successful examination. If sedation is necessary, it should be administered by appropriately certified personnel (see the ACR–SIR Practice Parameter for Sedation/Analgesia). C. Facility Requirements Appropriate emergency equipment and medications must be immediately available to treat adverse reactions associated with administered medications. The equipment and medications should be monitored for inventory and drug expiration dates on a regular basis. The equipment, medications

2019 American Society of Neuroradiology

65. Diagnosis and Treatment of Early Stage Testicular Cancer

patients with low-stage disease is limiting the burden of therapy and treatment-related toxicity without compromising cancer control. Thus, surveillance has assumed an increasing role among those with cancer clinically confined to the testis. Likewise, paradigms for management have undergone substantial changes in recent years as evidence regarding risk stratification, recurrence, survival, and treatment-related toxicity has emerged. Methodology The systematic review utilized to inform this guideline (...) , paradigms for management have undergone substantial change in recent years as evidence regarding risk stratification, recurrence, survival, and treatment-related toxicity has emerged. Urologists are frequently the initial treating clinician for men with newly diagnosed testis cancer and thus play a crucial role in counseling and treatment decision making. This clinical practice guideline provides evidence-based recommendations for clinicians regarding the diagnosis, staging, treatment selection

2019 American Urological Association

66. BSG consensus guidelines on the management of inflammatory bowel disease in adults

& barney.hawthorne@wales.nhs.uk Dr Chris Lamb Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH. United Kingdom Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP. United Kingdom Tel: +44 191 282 0135 Fax: +44 191 282 0523 Dr Barney Hawthorne Department of Gastroenterology, University Hospital of Wales, Cardiff, CF14 4XW. United Kingdom Tel: +44 2920 (...) Thomas' NHS Foundation Trust, London, SE1 9RT, UK 14. Barts Health NHS Trust, London, E1 1BB, UK 15. Barts and the London School of Medicine and Dentistry, London, E1 2AT, UK 16. Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK 17. University of Leeds, Leeds, LS2 9JT, UK 18. New Road Surgery, Hertfordshire, WD3 6HD, UK 19. University of Cambridge, Cambridge, CB2 0SP, UK 20. Systematic Research Ltd. 78 Loughborough Road, Quorn, Leics LE12 8DX, UK 21. Royal College of Surgeons in Ireland (RCSI

2019 British Society of Gastroenterology

67. WHO Guideline: recommendations on digital interventions for health system strengthening

devices, orthotics and prosthetics. Telemedicine, remote care and mobile health are helping us transform health by delivering care in people’s homes and strengthening care in health facilities. Artificial intelligence is being used to give paraplegic patients improved mobility, to manage road traffic and to develop new medicines. Machine learning is helping us to predict outbreaks and optimize health services. Propelled by the global ubiquity of mobile phones, digital technologies have also changed (...) is that they are evolving rapidly; so will this guideline. As new technologies emerge, new evidence will be used to refine and expand on these recommendations. WHO is significantly enhancing its work in digital health to ensure we provide our Member States with the most up-to-date evidence and advice to enable countries to make the smartest investments and achieve the biggest gains in health. Ultimately, digital technologies are not ends in themselves; they are vital tools to promote health, keep the world safe

2019 World Health Organisation Guidelines

68. Chronic Pelvic Pain

cystitis: an ESSIC proposal. Eur Urol, 2008. 53: 60. 12. Longstreth, G.F., et al. Functional bowel disorders. Gastroenterology, 2006. 130: 1480. 13. Guyatt, G.H., et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. Bmj, 2008. 336: 924. 14. Guyatt, G.H., et al. What is "quality of evidence" and why is it important to clinicians? Bmj, 2008. 336: 995. 15. Phillips B, et al. Oxford Centre for Evidence-based Medicine Levels of Evidence. Updated by Jeremy Howick (...) . Eur Urol, 2008. 53: 33. 69. Hanno, P., et al. Bladder Pain Syndrome Committee of the International Consultation on Incontinence. Neurourol Urodyn, 2010. 29: 191. 70. Yoon, B.I., et al. Clinical courses following acute bacterial prostatitis. Prostate Int, 2013. 1: 89. 71. Giamberardino, M.A., et al. Viscero-visceral hyperalgesia: characterization in different clinical models. Pain, 2010. 151: 307. 72. Wesselmann, U., et al. Emerging Therapies and Novel Approaches to Visceral Pain. Drug Discov Today

2019 European Association of Urology

69. Prostate Cancer

. Eur Urol, 2018. S0302: 30752. 3. Guyatt, G.H., et al. What is “quality of evidence” and why is it important to clinicians? BMJ, 2008. 336: 995. 4. Guyatt, G.H., et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008. 336: 924. 5. Phillips, B., et al. Oxford Centre for Evidence-based Medicine Levels of Evidence. Updated by Jeremy Howick March 2009. 6. Guyatt, G.H., et al. Going from evidence to recommendations. BMJ, 2008. 336: 1049. 7. Van den (...) food and prostate cancer risk: systematic review and meta-analysis. Int J Food Sci Nutr, 2015. 66: 587. 42. Chen, P., et al. Lycopene and Risk of Prostate Cancer: A Systematic Review and Meta-Analysis. Medicine (Baltimore), 2015. 94: e1260. 43. Rowles, J.L., 3rd, et al. Processed and raw tomato consumption and risk of prostate cancer: a systematic review and dose-response meta-analysis. Prostate Cancer Prostatic Dis, 2018. 21: 319. 44. Ilic, D., et al. Lycopene for the prevention and treatment

2019 European Association of Urology

70. Urinary Incontinence

: 501. 5. Nambiar, A.K., et al. EAU Guidelines on Assessment and Nonsurgical Management of Urinary Incontinence. Eur Urol, 2018. 6. Guyatt, G.H., et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008. 336: 924. 7. Guyatt, G.H., et al. What is “quality of evidence” and why is it important to clinicians? BMJ, 2008. 336: 995. 8. Phillips B, et al. Oxford Centre for Evidence-based Medicine – Levels of Evidence (March 2009). 2009. 9. Guyatt, G.H., et

2019 European Association of Urology

71. Renal Cell Carcinoma

. Fernández-Pello Montes, F. Hofmann, T. Kuusk, R. Tahbaz TABLE OF CONTENTS REFERENCES 1. Ljungberg, B., et al. Renal cell carcinoma guideline. Eur Urol, 2007. 51: 1502. 2. Ljungberg, B., et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol, 2015. 67: 913. 3. Guyatt, G.H., et al. What is “quality of evidence” and why is it important to clinicians? BMJ, 2008. 336: 995. 4. Guyatt, G.H., et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ (...) , 2008. 336: 924. 5. Phillips B, et al. Oxford Centre for Evidence-based Medicine Levels of Evidence. Updated by Jeremy Howick March 2009. 1998. 6. Guyatt, G.H., et al. Going from evidence to recommendations. BMJ, 2008. 336: 1049. 7. Vogel, T., et al. Imaging in Suspected Renal Cell Carcinoma: A Systematic Review. Clin Genitourin Cancer, 2018. 8. Fernández-Pello, S., et al. A Systematic Review and Meta-analysis Comparing the Effectiveness and Adverse Effects of Different Systemic Treatments for Non

2019 European Association of Urology

72. Male Hypogonadism

., et al. What is “quality of evidence” and why is it important to clinicians? Bmj, 2008. 336: 995. 3. Guyatt, G.H., et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. Bmj, 2008. 336: 924. 4. Phillips, B., et al. Oxford Centre for Evidence-based Medicine Levels of Evidence. Updated by Jeremy Howick March 2009. 5. Guyatt, G.H., et al. Going from evidence to recommendations. Bmj, 2008. 336: 1049. 6. ‘t Hoen, L., et al. What are the risks of major (...) of Testosterone Deficiency: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med, 2016. 13: 1787. 10. Kaufman, J.M., et al. The decline of androgen levels in elderly men and its clinical and therapeutic implications. Endocr Rev, 2005. 26: 833. 11. Wu, F.C., et al. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab, 2008. 93: 2737. 12

2019 European Association of Urology

73. Male Infertility

guidelines on Male Infertility: the 2012 update. Eur Urol, 2012. 62: 324. 3. Guyatt, G.H., et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008. 336: 924. 4. Guyatt, G.H., et al. What is “quality of evidence” and why is it important to clinicians? BMJ, 2008. 336: 995. 5. Phillips B, et al. Oxford Centre for Evidence-based Medicine Levels of Evidence. Updated by Jeremy Howick March 2009. 1998. 6. Guyatt, G.H., et al. Going from evidence (...) -ejaculated sperm. Hum Reprod, 2011. 26: 1752. 34. Carrell, D.T. The clinical implementation of sperm chromosome aneuploidy testing: pitfalls and promises. J Androl, 2008. 29: 124. 35. Johnson, M.D. Genetic risks of intracytoplasmic sperm injection in the treatment of male infertility: recommendations for genetic counseling and screening. Fertil Steril, 1998. 70: 397. 36. Clementini, E., et al. Prevalence of chromosomal abnormalities in 2078 infertile couples referred for assisted reproductive techniques

2019 European Association of Urology

74. Guidelines of care for the management of primary cutaneous melanoma

Cancer . 2012 ; 48 : 2375–2390 The available evidence was evaluated by using a unified system called the Strength of Recommendation Taxonomy (SORT), which was developed by editors of the US family medicine and primary care journals (ie, American Family Physician, Family Medicine, Journal of Family Practice, and BMJ USA ). x 7 Ebell, M.H., Siwek, J., Weiss, B.D. et al. Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. J Am Board Fam (...) or those in cosmetically or functionally sensitive areas. Newer noninvasive techniques (eg, reflectance confocal microscopy [RCM], as well as electrical impedance spectroscopy, gene expression analysis, optical coherence tomography, and others [see the section Emerging Diagnostic Technologies]) can also be considered as these become more readily available. x 10 Pellacani, G., Pepe, P., Casari, A., and Longo, C. Reflectance confocal microscopy as a second-level examination in skin oncology improves

2019 American Academy of Dermatology

75. Headache

in an ambulatory family practice setting disclosed that most scans were ordered because the clinician suspected that a tumor (49%) or a subarachnoid hemorrhage (SAH) (9%) might be present. Fifty-nine (17%) were ordered because of patient expectation or medicolegal concerns [22]. When considering such a common disorder as headache, indications for imaging use become relevant. This is particularly true in the face of emerging and rapidly evolving technologies in use today [23-26]. In frequent conditions (...) University Hospital, Indianapolis, Indiana. 2 Panel Chair, Mallinckrodt Institute of Radiology, Saint Louis, Missouri. 3 Panel Vice- chair, Mayo Clinic Jacksonville, Jacksonville, Florida. 4 Emory Healthcare, Atlanta, Georgia. 5 University of Illinois College of Medicine, Chicago, Illinois, American Association of Neurological Surgeons/Congress of Neurological Surgeons. 6 Hampton Roads Radiology Associates, Norfolk, Virginia. 7 Emory Universtiy, Atlanta, Georgia. 8 Mount Sinai School of Medicine, New

2019 American College of Radiology

76. Concise practice guidance on the prevention and management of accidental awareness during general anaesthesia

of accidental awareness during general anaesthesia Membership of the working party J. J Pandit 1 , T. M Cook 2 , S. Shinde 3 , K. Ferguson 4 , J. Hitchman 5 , W. Jonker 6 , P . M Odor 7 , T. Meek 8 1 Consultant, Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Trust, Oxford, UK (Co-Chair, Working Party on behalf of the Royal College of Anaesthetists) 2 Consultant, Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK (on behalf of Royal College (...) of Anaesthetists) 3 Consultant, Department of Anaesthesia, North Bristol NHS Trust (Co-Chair, Working Party on behalf of the Association of Anaesthetists) 4 Consultant, Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK (on behalf of the Safe Anaesthesia Liaison Group) 5 Chartered Architect (retired), Lay Member, Royal College of Anaesthetists, London, UK 6 Consultant, Department of Anaesthesia, Intensive Care and Pain Medicine, Sligo University Hospital, Sligo, Ireland (on behalf of the College

2019 Association of Anaesthetists of GB and Ireland

77. Clinically Suspected Vascular Malformation of the Extremities

, University of Michigan Health System, Ann Arbor, Michigan. e Mayo Clinic, Rochester, Minnesota. f Tufts University School of Medicine, Boston, Massachusetts; Society for Vascular Surgery. g Massachusetts General Hospital, Boston, Massachusetts. h University of Alabama at Birmingham, Birmingham, Alabama. i Mayo Clinic, Rochester, Minnesota. j University of Michigan Health System, Ann Arbor, Michigan. k UT Southwestern Medical Center, Dallas, Texas. l UT Southwestern Medical Center, Dallas, Texas. m (...) [3,6,20]. Although MRI is generally considered high yield for evaluating lesion extent and often can distinguish between the various types of vascular malformations and soft-tissues masses, its evaluation of flow dynamics and intralesional vascular anatomy is limited when compared with MRA [3]. MRA Extremity MRA has emerged as the preferred modality for assessing vascular malformations, particularly in patients with a vascular murmur and suspected high-flow malformation, due to its exceptional ability

2019 American College of Radiology

78. ACR–ASNR Practice Parameter for the Performance of Computed Tomography (CT) of the Brain

to publication of this document. However, a practitioner who employs an approach substantially different from the guidance in this document is advised to document in the patient record information sufficient to explain the approach taken. The practice of medicine involves not only the science, but also the art of dealing with the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis (...) ) Perfusion in Neuroradiologic Imaging [133]. B. Patient monitoring equipment and facilities for cardiopulmonary resuscitation, including vital signs monitoring equipment, support equipment, should be immediately available. Appropriate emergency equipment and medications must be immediately available to treat adverse reactions associated with administered medications. The equipment and medications should be monitored for inventory and drug expiration dates on a regular basis. The equipment, medications

2019 American Society of Neuroradiology

79. ACR–ASNR–SPR Practice Parameter for the Performance and Interpretation of Cervicocerebral Computed Tomography Angiography (CTA)

by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of this document. However, a practitioner who employs an approach substantially different from the guidance in this document is advised to document in the patient record information sufficient to explain the approach taken. The practice of medicine involves not only the science, but also the art of dealing with the prevention, diagnosis, alleviation, and treatment of disease (...) an assessment of the vasculature of interest, the end-organ, and adjacent tissues. Appropriate emergency equipment and medications must be immediately available to treat adverse reactions associated with administered medications. The equipment and medications should be monitored for inventory and drug expiration dates on a regular basis. The equipment, medications, and other emergency support must also be appropriate for the range of ages and sizes in the patient population. VIII. RADIATION SAFETY

2019 American Society of Neuroradiology

80. ACR–ASNR–SPR Practice Parameter for the Performance of Computed Tomography (CT) Perfusion in Neuroradiologic Imaging Revised

, limitations of available resources, or advances in knowledge or technology subsequent to publication of this document. However, a practitioner who employs an approach substantially different from the guidance in this document is advised to document in the patient record information sufficient to explain the approach taken. The practice of medicine involves not only the science, but also the art of dealing with the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity (...) , and diseases of the central nervous system, spine, and head and neck and the subtle findings for which urgent therapy may be warranted, such as in acute stroke. Additionally, supervising physicians should have appropriate knowledge of alternative imaging methods, including the use of and indications for such specialized studies as angiography, ultrasonography, MRI, and nuclear medicine studies. 3. The physician should be familiar with the appropriate requirements for patient preparation for the examination

2019 American Society of Neuroradiology

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