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41. Unusual Cancers of Childhood Treatment (PDQ®): Health Professional Version

patients.[ , ] However, less than 10% of children and adolescents with nasopharyngeal carcinoma presented with distant metastases at diagnosis.[ - ] Prognosis The overall survival of children and adolescents with nasopharyngeal carcinoma has improved over the last four decades; with state-of-the-art multimodal treatment, 5-year survival rates exceed 80%.[ , , , - ] After controlling for stage, children with nasopharyngeal carcinoma have significantly better outcomes than do adults.[ , ] However (...) and analyzed by genome-wide DNA methylation profiling, copy number analysis, immunohistochemistry, and next-generation panel sequencing. Unsupervised hierarchal clustering analysis of DNA methylation data identified the following four distinct clusters:[ ] The largest cluster, which comprised 64% of the samples, had classical histologic features of olfactory neuroblastoma and 10% had recurrent DNMTA3 and TP53 mutations. A second cluster consisted of seven cases with a hypermethylator phenotype and IDH2

2016 PDQ - NCI's Comprehensive Cancer Database

42. Third Universal Definition of Myocardial Infarction

—as little as 20 min, or less in some animal models. 4 It takes several hours before myocardial necrosis can be identi?ed by macroscopic or microscopic post-mortem exam- ination. Complete necrosis of myocardial cells at risk requires at least 2–4 h, or longer, depending on the presence of collateral cir- culation to the ischaemic zone, persistent or intermittent coronary arterial occlusion, the sensitivity of the myocytes to ischaemia, pre- conditioning, and individual demand for oxygen and nutrients. 2

2012 European Society of Cardiology

43. Patient Modesty: Volume 80

published, the topic has been roughly the same and unchanged, essentially, a patient's right for privacy when undressed either in the operating room, procedure room, office exam room or the patient's hospital room. The thread is about the ethical and perhaps legal right for the patient to be able to request and hopefully receive the medical attention by professionals of the patient's desired gender when undergoing a medical examination or procedure. That request to whatever part of the medical system (...) patients has never meant that I was unaware of the concept of modesty especially when applied to genital/rectal areas of the body and breasts in the female. And certainly that is why I always had a female chaperone present with female pelvic exams. But, in my mind, since I got no warnings from my patients, was that they looked at the examination value for their diagnosis and health as trumping any personal modesty issue and accepted that as such. Looking back I am not sure that for some of the requests

2017 Bioethics Discussion Blog

44. Transcranial Electrical Stimulation for mTBI

and post-treatment assessments. Specific Aim 3 will study the relationship among IASIS treatment-related changes in rs-MEG slow-wave imaging, PCS, and neuropsychological measures in Veterans with mTBI. The investigators hypothesize that Reduced MEG slow-wave generation will correlate with reduced total PCS score, individual PCS scores (e.g., sleep disturbance, post-traumatic headache, photophobia, and memory problem symptoms), and improved neuropsychological exam scores between post-IASIS and baseline (...) exams. The success of the proposed research will for the first time confirm that facilitation of slow-wave generation in wakefulness leads to significant therapeutic benefits in mTBI, including an ultimate reduction of abnormal slow-waves accompanied by an improvement in PCS and cognitive functioning. Condition or disease Intervention/treatment Phase Mild Traumatic Brain Injury (mTBI) Post-traumatic Stress Disorder Device: IASIS Micro Current Neurofeedback Not Applicable Study Design Go to Layout

2017 Clinical Trials

45. Inhaled Nitric Oxide After Out-of-Hospital Cardiac Arrest

) [ Time Frame: 90 days after cardiac arrest (+/- 3 days) ] Barthel Index of Independence in Activities of Daily Living scored as a continuous 0-100 at designated time Time to awakening [ Time Frame: Within 4 days of cardiac arrest ] Time in hours until subject is noted to follow commands. Subjects exceeding 96 hours of coma and those that die without awakening will be designated as 100. Methemoglobin level [ Time Frame: Prior to study drug ] Methemoglobin content as proportion (%) of total hemoglobin (...) Inclusion Criteria: Intubated and comatose adult (>18 yo) resuscitated from out-of-hospital cardiac arrest (OHCA)* *Cardiac arrest within an emergency department or outpatient medical center will be included). OHCA includes Emergency Medical Service (EMS) witnessed cardiac arrest. Return of spontaneous circulation (ROSC) within 40 min of CPR initiation Full Outline of Unresponsiveness (FOUR) Brainstem score ≥ 2 (i.e. patient must have pupil OR corneal reflex at the time of ED presentation or within 1h

2017 Clinical Trials

48. CPG for the Management of Invasive Meningococcal Disease

? ltration 95 8.2.4. Extracorporeal membrane oxygenation (ECMO) 95 8.3. Adjuvant therapies 97 8.3.1. Coagulation 97 8.3.2. Immunomodulators 99 8.4. Surgical Management of IMD 101 9. Prognostic and severity factors of IMD 105 9.1. Clinical factors as severity indicators 105 9.2. Severity and mortality risk scoring systems 109 10. Prevention and Control of IMD 113 10.1. Indications for antibiotic prophylaxis 113 10.2. Antibiotics of choice for the prophylaxis of IMD 117 10.3. Meningococcal vaccination (...) or extent of the eruption, eruption progression, presence of fever, stiff neck, irritability or nervousness, lethargy, fatigue, drowsiness, level of consciousness. – Laboratory study: white blood cell count, coagulopathy, CRP, platelets, blood gases, kidney function, liver function, cortisol, glucose, other (CPK, rhabdomyolysis). SEVERITY AND MORTALITY RISK SCORING SYSTEMS 27. In patients with suspected IMD, is there any evidence that the use of any of the following prognostic scales can predict

2013 GuiaSalud

51. Oral anticoagulation with warfarin - 4th edition

be recommended for life‐threatening bleeding. All hospitals and units responsible for anticoagulant care and hospitals performing invasive procedures on patients on warfarin should stock a licensed four‐factor PCC. Recommendation • All hospitals managing patients on warfarin should stock a licensed four‐factor prothrombin complex concentrate ( 1C ). • Emergency anticoagulation reversal in patients with major bleeding should be with 25–50 u/kg four‐factor prothrombin complex concentrate and 5 mg intravenous (...) presentations to Accident and Emergency departments and although national guidelines on the management of head injury exist ( ), these only very briefly deal with the particular problem of patients on warfarin ( ). All patients on warfarin presenting to accident and emergency departments with head injuries, however minor, should have their INR measured. Individuals with loss of consciousness, amnesia or reduced Glasgow Coma scale should have an immediate head computerized tomography (CT) scan. Patients

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2011 British Committee for Standards in Haematology

52. CPG on sleep disorders in childhood and adolescence in primary care

and symptoms (Table 22). D Chervin’s Pediatric Sleep Questionnaire (reduced PSQ) is recommended for helping to establish the diagnosis of suspected obstructive sleep apnea-hypopnea syndrome (OSAHS) (Appendix 6). D In addition, a home video-recording could be requested, which can be assessed using Sivan’s videotape recording score to help with the diagnostic suspicion (Appendix 6). D In the event of the con? rmed clinical suspicion of OSAHS, it is advisable to refer the patient to secondary care or Hospital

2011 GuiaSalud

53. End-of-Life Care During the Last Days and Hours

of life. Some of these prognostic tools (Appendix D) include: ¦ The Palliative Performance Scale (version 2) (Anderson, Downing, Hill, Casorso, & Lurch, 1996) ¦ The Palliative Prognostic Index (Chow et al., 2008; Morito, Tsunoda, Inoue, & Chinara, 1999; Stone, Tierman, & Dooley, 2008). ¦ The Palliative Prognostic Score (Maltoni et al., 1999) In addition to prognostic tools, clinical indicators are another method of identifying individuals who are approaching the last days and hours of life. Specific

2011 Registered Nurses' Association of Ontario

54. Neurological Outcomes After In-Hospital Cardiac Arrest

score is classified according to the point. Good neurological outcome is defined as CPC 1-2 and poor is CPC 3-5. CPC score will be evaluated by neurological examination and the results of other exam. Neurological examination: Neurologist will perform directly until the point of CPC score 1 is confirmed. mental status: ACDU score, FOUR score and Glasgow Coma Scale brain stem reflex: Light reflexes by pupillometer(the NeurOptics® NPi™-100 (Neuroptics Inc., Irvine, CA, USA)) and corneal reflexes motor (...) following cardiac arrest. CPC score is classified according to the point. Good neurological outcome is defined as CPC 1-2 and poor is CPC 3-5. CPC score will be evaluated by neurological examination and the results of other exam. Neurological examination: Neurologist will perform directly until the point of CPC score 1 is confirmed. mental status: ACDU score, FOUR score and Glasgow Coma Scale brain stem reflex: Light reflexes by pupillometer(the NeurOptics® NPi™-100 (Neuroptics Inc., Irvine, CA, USA

2016 Clinical Trials

55. Neuroimaging and Neuropsychological Outcomes in Urea Cycle Disorders

, impairments, and diet history; a physical exam; a full neurological exam; and cognitive and motor testing. During this visit, participants will undergo imaging studies and additional cognitive and motor testing over a 1-2-day period. This will include standard MRI studies and four sessions consisting of functional MRI (fMRI) (CNMC only), diffusion tensor imaging, and 1H magnetic resonance spectroscopy. For the fMRI study, participants perform various motor and behavioral tasks while in the imaging scanner (...) that the diffusion of water is isotropic and unrestricted, or equally restricted, in all directions and with 1 meaning that diffusion occurs along only one axis and is fully restricted along all other directions. Scores closer to 1 are associated with intact white matter while scores closer to 0 are associated with white matter damage. Secondary Outcome Measures : Change in behavioral testing results [ Time Frame: baseline and 2 year follow up ] correlation of the findings from neuroimaging with cognitive

2016 Clinical Trials

56. Stellate Ganglion Blockade in Post-Menopausal Women

-Delay Free Recall, Short-Delay Cued Recall, Long Delay Free Recall, Long Delay Cued Recall, Card Rotation Tests, Finding As, Letter, Semantic and Phonemic Fluency, Logical Memory Subtest of Wechsler Memory Scale (WMS-R/LM-R) Part 1 and (WMS-R/LM-R) Part 2, Mini-Mental State Exam (MMSE), Memory Functioning Questionnaire (MFQ),Closing Question at baseline, 12 weeks (3 months) and 24 weeks (6 months) Composite changes from baseline of scores of measures of mood [ Time Frame: Up to 24 weeks (6 months (...) treatment. safety labs within 30 days of SGB intervention Exclusion Criteria: conditions that preclude SGB or sham intervention (e.g., anatomic abnormalities of the anterior neck or cervical spine ; goiter, cardiac/pulmonary compromise; contralateral (left-sided) phrenic nerve paralysis or diaphragmatic paresis; history of seizure, coma, or stroke; history of neurologic deficit to the brachial plexus or an abnormal brachial plexus neurologic exam; history of Zenker's diverticulum; acute illness

2016 Clinical Trials

57. Family Practice Notebook Updates 2017

not decrease resource use, admissions (surgery, gi) before Abdominal MRI in children is preferred first strategy is faster and more cost-effective, despite being inconclusive in 25% of cases (psych, exam, er) Head imaging is not required for new onset without focal neurologic deficit (expert opinion) Acute psychiatric symptoms in alert adults do not mandate routine lab testing No risk assessment tool can identify those safe for discharge (neuro, cv) Consider even in minor NIH stroke scores <5 Large vessel (...) (e.g. , cerebellar artery) may have low NIH Stroke Score particularly underestimates deficits from cerebellar strokes CTA Head and Neck identifies large vessel and can help inform decision V. Updates: September 2017 (ortho, peds) Evaluation includes , gait exam, limb asymmetry as well as , may be caused by , , may be caused by , and Angular variations include and ing (cv, procedure, ) Stress testing is uncommonly indicated in asymptomatic patients aside from vascular surgery preop, vigorous

2018 FP Notebook

58. Should I Have Meniscus Surgery?

tear or a flap tear — those are the tears tend to remain bothersome. If after four, five, six weeks, you still have the same degree of discomfort and quality of life issues, then you might be a good candidate for surgery, which we call an arthroscopy. Physical therapy can help those of you whose knees feel unstable or weak, and it can help those of you with significant swelling to gain back your motion, stability and strength. Therapy can be beneficial before surgery (pre-habilitation), instead

2016 Howard J. Luks, MD blog

59. Newly Diagnosed with Hepatitis B? Acute or Chronic? Learning the HBV Basics…

of sickness last 2013 on my medical exam for a job here in the Philippines. I had my second Opinion but the result is the same. I never had a test since then. Please reply. Thank you. Hello: There is no cure yet for hepatitis B, however there are two very effective antivirals -– entecavir and tenofovir (Viread) and its TAF formulation that was recently approved by FDA –- that quickly reduce your viral load (HBV DNA) and your risk of liver damage if you should ever need treatment. To find out the latest

2016 hepbblog

60. Family Practice Notebook Updates 2017

not decrease resource use, admissions (surgery, gi) before Abdominal MRI in children is preferred first strategy is faster and more cost-effective, despite being inconclusive in 25% of cases (psych, exam, er) Head imaging is not required for new onset without focal neurologic deficit (expert opinion) Acute psychiatric symptoms in alert adults do not mandate routine lab testing No risk assessment tool can identify those safe for discharge (neuro, cv) Consider even in minor NIH stroke scores <5 Large vessel (...) (e.g. , cerebellar artery) may have low NIH Stroke Score particularly underestimates deficits from cerebellar strokes CTA Head and Neck identifies large vessel and can help inform decision V. Updates: September 2017 (ortho, peds) Evaluation includes , gait exam, limb asymmetry as well as , may be caused by , , may be caused by , and Angular variations include and ing (cv, procedure, ) Stress testing is uncommonly indicated in asymptomatic patients aside from vascular surgery preop, vigorous

2018 FP Notebook

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