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Emergency Medicine Pitfalls

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121. SNMMI Procedure Standard for General Imaging 6.0

SNMMI Procedure Standard for General Imaging 6.0 SNM Procedure Guideline for General Imaging V6.0 1 Society of Nuclear Medicine (SNM) is an international scientific and professional organization founded in 1954 to promote the science, technology and practical application of nuclear medicine. Its 16,000 members are physicians, technologists and scientists specializing in the research and practice of nuclear medicine. In addition to publishing journals, newsletters and books, the Society also (...) sponsors international meetings and workshops designed to increase the competencies of nuclear medicine practitioners and to promote new advances in the science of nuclear medicine. The SNM will periodically define new procedure guidelines for nuclear medicine practice to help advance the science of nuclear medicine and to improve the quality of service to patients throughout the United States. Existing procedure guidelines will be reviewed for revision or renewal, as appropriate, on their fifth

2018 Society of Nuclear Medicine and Molecular Imaging

122. Preschool Multiple-Breath Washout Testing: A Technical Statement

(G.L.H.); 0000-0003-1828-0058 (A.H.); 0000-0002- 0877-9579 (R.J.); 0000-0001-5515-3053 (C.M.); 0000-0001-6684-3527 (K.G.N.); 0000-0003-3789-1241 (J.E.P.); 0000-0002-8105-614X (M.R.); 0000-0003-3471-5664 (F.S.); 0000-0003-0394-1933 (P.S.); 0000-0001-6485-007X (P.M.G.); 0000-0003-4057-6592 (F.R.). Correspondence and requests for reprints should be addressed to Paul D. Robinson, M.B. Ch.B., Ph.D., Department of Respiratory Medicine, Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145 (...) function tests, such as spirometry, remain technically challenging and relatively insensitive in identifying early airway disease in conditions such as CF (16–18). MBW for this age group has emerged as a feasible outcome measure for interventional studies and an area of interest for clinicians exploring its utility in clinical care. A Cystic Fibrosis Foundation report, based on the discussions within a workshop hosted by the North American CF Foundation and Therapeutics Development Network, concluded

2018 American Thoracic Society

123. Perioperative Management of Obstructive Sleep Apnea and Obesity Hypoventilation Syndrome: A Workshop Report

and mortality from sleep-disordered breathing in the perioperative period (1). Adverse perioperative outcomes of patients with OSA or OHS include anoxic brain injury or death in rare circumstances (2), and may be preventable. During the development of the Society of Anesthesia and Sleep Medicine (SASM) Guidelines on Preoperative Screening and Assessment of Adult Patients with Obstructive Sleep Apnea, hereafter referred to as the SASM guidelines, it became clear that further research was necessary to improve (...) surgeries to correct OSA (i.e., upper airway surgery). Methods This single-day workshop was held on May 13, 2016 at the American Thoracic Society Conference in San Francisco, California. The workshop was chaired by N. Ayas and F.Chung,hereafterreferredtoastheChairs. The structure of this workshop report was conceivedasaninitiativetocomplementthe recently published SASM guidelines (1). The Chairs brought together researchers from anesthesia, sleep medicine, and respirology to identify the limitations

2018 American Thoracic Society

124. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology

and the American Society for Microbiology J Michael Miller Microbiology Technical Services, LLC, Dunwoody, Georgia Correspondence: J. M. Miller, Microbiology Technical Services, LLC, PO Box 88212, Dunwoody, GA 30338 ( ). Search for other works by this author on: Matthew J Binnicker Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota Search for other works by this author on: Sheldon Campbell Yale University School of Medicine, New Haven (...) , Connecticut Search for other works by this author on: Karen C Carroll Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland Search for other works by this author on: Kimberle C Chapin Department of Pathology, Rhode Island Hospital, Providence Search for other works by this author on: Peter H Gilligan Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill Search for other works by this author on: Mark D Gonzalez Department of Pathology

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2018 Infectious Diseases Society of America

125. Evaluation and Treatment of Hirsutism in Premenopausal Women

is similar to that recommended by other groups, including the following: the American Association of Clinical Endocrinologists ( ), the American Society for Reproductive Medicine ( ), the French Endocrine Society ( ), and the Androgen Excess and PCOS Society ( ). Values and preferences Our suggestion for testing for hyperandrogenemia in all women with hirsutism places a relatively high value on the identification of treatable underlying hyperandrogenic diseases. Our suggestion for not testing

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2018 The Endocrine Society

126. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0 with the exception that the SUV max is used in the United States as the quantitative measurement

R.Boellaard(*) : O.S.Hoekstra DepartmentofRadiology &Nuclear Medicine,VUUniversity MedicalCentre,DeBoelelaan 1117,1081HVAmsterdam,The Netherlands R.Delgado-Bolton DepartmentofDiagnosticImaging(Radiology)andNuclear Medicine,SanPedroHospitalandCentreforBiomedicalResearchof LaRioja(CIBIR),UniversityofLaRioja,Logroño,LaRioja,Spain W.J.G.Oyen : E. Visser DepartmentofRadiology&NuclearMedicine,RadboudUniversity NijmegenMedicalCentre,Nijmegen,TheNetherlands F. Giammarile (...) will help promote the appropriate use of FDG PET/CT imaging and in- crease the value of publications and, therefore, their contribution to evidence-based medicine. Moreover, con- sistency in numerical values between platforms and institutes that acquire the data will potentially enhance the role of semiquantitative and quantitative image in- terpretation. Precision and accuracy are additionally im- portant as FDG PET/CT is used to evaluate tumour response as well as for diagnosis, prognosis and staging

2018 Society of Nuclear Medicine and Molecular Imaging

127. Hypofractionated Radiation Therapy for Localized Prostate Cancer

(GRADE) methodology, which is an explicit, systematic approach to defining the recommendation strength and quality of evidence. 19,20 When available, high-quality data formed the basis of the statements in accordance with the National Academy of Medicine (formerly Institute of Medicine) standards. 21 When necessary, expert opinion supplemented the evidence. Recommendations were classified as "strong" or "conditional." A strong recommendation indicates the task force was confident the benefits

2018 American Urological Association

128. Adult Urodynamics

and Reporting Patient Education Adult Urodynamics: AUA/SUFU Guideline (2012) Published 2012 This guideline developed by AUA in collaboration with the Society for Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction is intended to review the literature regarding the use of urodynamic testing in common lower urinary tract symptoms (LUTS) conditions. It presents the principles of application and technique to guide the clinician in the role of urodynamics in complex LUTS disorders. [pdf] [pdf (...) In some instances, the review revealed insufficient publications to address certain questions from an evidence basis; therefore, some statements are provided as Clinical Principles or as Expert Opinion with consensus achieved using a modified Delphi technique if differences of opinion emerged. 6 A Clinical Principle is a statement about a component of clinical care that is widely agreed upon by urologists or other clinicians for which there may or may not be evidence in the medical literature. Expert

2018 American Urological Association

129. Diagnosis, Evaluation, and Management of High Blood Pressure in Children and Adolescents

older than 6 years and among 90% of children older than 15 years. – Patients with secondary HTN tend to be younger and are more likely to have abnormal serum creatinine, renal ultrasonography, and echocardiography findings. Youth with secondary causes of HTN may be at greater risk for hypertensive emergency and require more immediate management and intervention. PICOT 3 What is the optimal goal SBP and/or DBP for children and adolescents? What nonpharmacologic and pharmacologic therapies (...) David Kaelber, MD, PhD, FAAP, Co-chair, Council on Clinical Information Technology and Section on Medicine-Pediatrics Carissa M. Baker-Smith, MD, MS, MPH, FAAP, Fellow of the American Heart

2018 American Academy of Pediatrics

130. Hypofractionated Radiation Therapy for Localized Prostate Cancer

Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Karen Hoffman, MD Anderson Cancer Center, Houston, TX; Mark K. Buyyounouski, Stanford University, Stanford; Palto Alto VA Health System, Palo Alto, CA; Caroline Patton, American Society for Radiation Oncology, Arlington, VA; Daniel Barocas, Vanderbilt University Medical Center, Nashville, TN; Soren Bentzen, University of Maryland School of Medicine, Baltimore, MD; Michael Chang, Hunter Holmes McGuire VA Medical Center and Virginia (...) of Recommendations Assessment, Development, and Evaluation (GRADE) methodology, which is an explicit, systematic approach to defining the recommendation strength and quality of evidence. , When available, high-quality data formed the basis of the statements in accordance with the National Academy of Medicine (formerly Institute of Medicine) standards. When necessary, expert opinion supplemented the evidence. Recommendations were classified as “strong” or “conditional.” A strong recommendation indicates the task

2018 American Society of Clinical Oncology Guidelines

131. Neonatal stabilisation for retrieval

securely o Observe cannula site hourly for patency, redness and infiltration · Use UVC o Consider insertion if: § Peripheral IV cannulation is unsuccessful § Baby is critically unwell or LBW o Use double lumen catheter (if available) o Secure with suture and tape o Observe site for redness, leakage and dislodgement o Confirm position on X-ray prior to infusing fluids except when using for emergency resuscitation · Routine umbilical arterial catheter or peripheral arterial line insertion not required (...) ) negative blood (if available) o For emergency transfusions administer group O RhD negative blood · Avoid rapid administration of fluids in preterm babies as this has been associated with an increase with intraventricular haemorrhage 59 · Continue to infuse maintenance fluids Inotrope 48 · If hypotension persists after fluid replacement, consider inotropic support · Consult with a neonatologist prior to commencing · Administer inotropes via: o UVC (preferable)—check position on X–ray o Peripheral IV

2018 Clinical Practice Guidelines Portal

132. Neonatal jaundice

26 7.1 Acute and chronic bilirubin encephalopathy 26 7.1.1 Acute bilirubin encephalopathy 26 7.1.2 Chronic bilirubin encephalopathy 27 7.2 Bilirubin induced neurologic dysfunction 27 7.3 Bilirubin-induced auditory toxicity 28 8 Other treatments 28 8.1 Treatments of no benefit 28 8.2 Emerging research 29 9 Discharge planning 30 References 31 Appendix A Nomogram: Jaundice management for baby greater than 38 weeks gestation 34 Appendix B Nomogram: Jaundice management for baby 35+0 to 37+6 weeks (...) . Treatments of no benefit 28 Table 24. Emerging research 29 Table 25. Parent information 30 Refer to online version, destroy printed copies after use Page 6 of 40 Queensland Clinical Guideline: Neonatal jaundice 1 Introduction Jaundice is one of the most common conditions requiring medical attention in newborn babies. 18 Approximately 60% of term and 80% of preterm babies develop jaundice in the first week of life. 19 In 2015 in Queensland 3.2% of all babies born had jaundice requiring phototherapy. 20

2018 Queensland Health

133. Right Lower Quadrant Pain : Suspected Appendicitis

. Levy, MD k ; Daniele Marin, MD l ; Courtney Moreno, MD m ; Christine M. Peterson, MD n ; Christopher D. Scheirey, MD o ; Alan Siegel, MD, MS p ; Martin P. Smith, MD q ; Stefanie Weinstein, MD r ; Laura R. Carucci, MD. s Summary of Literature Review Introduction/Background Appendicitis is the most common surgical pathology responsible for right lower quadrant (RLQ) abdominal pain presenting to emergency departments in the United States, where the incidence continues to increase despite reports (...) to increase diagnostic performance and decrease the dependence on CT, and modified CT protocols. All of these procedures are currently being investigated. DWI sequences are well established in stroke and tumor imaging but are finding ever-increasing applications in abdominal conditions, in part due to echo planar imaging, which increases the speed of acquisition and reduces a Virginia Tech Carilion School of Medicine, Roanoke, Virginia. b The University of South Florida Morsani College of Medicine, Tampa

2018 American College of Radiology

135. Management of Crohn's Disease in Adults

recommendations are based on the data available at the time of the production of the document and may be updated with pertinent scienti? c developments at a later time. SUPPLEMENTARY MATERIAL is linked to the online version of the paper at Am J Gastroenterol 2018; 113:481–517; doi: 10.1038/ajg.2018.27; published online 27 March 2018 1 Department of Medicine, Division of Gastroenterology, Hospital of the University of Pennsylvania, Perelman School of Medicine of the University (...) of Pennsylvania , Philadelphia , Pennsylvania , USA ; 2 Division of Gastroenterology and Hepatology, Mayo Clinic , Rochester , Minnesota , USA ; 3 Department of Medicine, Division of Gastroenterology, University of North Carolina Chapel Hill , Chapel Hill , North Carolina , USA ; 4 Department of Gastroenterology and Hepatology, Cleveland Clinic , Cleveland , Ohio , USA ; 5 Department of Medicine, Division of Gastroenterology, California Paci? c Medical Center , San Francisco , California , USA ; 6 Dr Henry D

2018 American College of Gastroenterology

136. Imaging Guidelines

Trauma Centers 101 21. Dealing with Incidental Findings 105 22. Performance Improvement and Implementation 109 Acronyms 111 Appendix 112 Expert Panel 113 2INTRODUCTION Radiologic imaging remains a critical tool of emergency and trauma providers for the initial assessment of patients presenting with injury. With the introduction of the Advanced Trauma Life Support® (ATLS®) course by the American College of Surgeons (ACS) Committee on Trauma (COT) in the early 1980s, chest and pelvic radiographs became (...) , providers must avoid the pitfall of over-utilizing MDCT imaging to definitively identify the source of hemorrhage already confirmed from previously performed images and avoid delay in operative hemorrhage control. Incorporate all the following principles for best practice trauma MDCT acquisition: z Have the MDCT scanner physically located as close to the trauma bay as possible; z Make MDCT imaging available 24/7/365 with trauma patient priority access to the scanner before patients with non life

2018 American College of Surgeons

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

, 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 (...) and breast cancer risk has been evaluated extensively in epidemiological studies, with an emerging consensus for a weak, positive association. One large Canadian study found a nonsignificant trend toward increased breast cancer risk in premenopausal women who were active smokers or began smoking before their first pregnancy. Moreover, several studies reported an increased breast cancer risk associated with smoking for long durations and initiation early in life. The association between passive

2018 American Heart Association

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

, Department of Internal Medicine I, University Hospital 2 Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany 3 Department of Clinical Epidemiology 4 Department of Clinical Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, the Netherlands 5 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark 6 Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA (...) 7 Endocrine Oncology and Nuclear Medicine, Institut Gustave Roussy, Villejuif, France 8 INSERM UMR 1185, Faculté de Médecine, Le Kremlin-Bicêtre, Université Paris Sud, Paris, France 9 Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Medical Oncology, University of Brescia at ASST Spedali Civili, Brescia, Italy 10 Department of Pathology, Erasmus MC University Medical Center, Rotterdam, the Netherlands 11 Department of Pathology, University Medical Center

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2018 European Society of Endocrinology

139. 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

2018 European Association of Urology

140. 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

2018 European Association of Urology

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