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Femoral Neck Stress Fracture

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201. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Full Text available with Trip Pro

of health care practitioners Marketing and distribution of app using and Physical Therapy National Outcomes Data Registry Support the ongoing usage of data registry for common musculoskeletal conditions of the head and neck region Logical Observation Identifiers Names and Codes mapping Publication of minimal data sets and their corresponding Logical Observation Identifiers Names and Codes for the head and neck region on Non-English versions of the guidelines and guideline implementation tools (...) 4 (severely abnormal, full-thickness osteochondral injury). The most frequent localizations of cartilage lesions were to the medial femoral condyle and the patellar articular surface. Medial meniscal tears (37%) and ACL ruptures (36%) were the most common injuries concomitant with articular cartilage injuries. Evidence Update Meniscus Tear patterns of the knee meniscus can be classified as either traumatic tears or degenerative tears. Younger active participants are more likely to sustain

2018 American Physical Therapy Association

202. Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services

and admission rates 69 Figure 14 – Outline of the statistical trend model 71 Figure 15 – Overview of time periods 72 Figure 16 – Observed evolution and forecasts for hospital inpatient stays 83 Figure 17 – Expected change in ALOS between 2014 and 2025 for important MDCs (left panel) and important APR-DRGs (right panel) 86 Figure 18 – Projected change in ALOS by APR-DRG-SOI for APR-DRGs 301 ‘Hip joint replacement’, 302 ‘Knee joint replacement’ and 347 ‘Other back and neck disorders, fractures and injuries

2017 Belgian Health Care Knowledge Centre

203. Occupational Therapy for people Undergoing total hip replacement

, as a guideline development topic, was identified by the Royal College of Occupational Therapists Specialist Section – Trauma and Orthopaedics (RCOTSS – Trauma and Orthopaedics). A decision was made to focus the guideline on total hip replacement both as an elective procedure and following trauma (i.e. fractured neck of femur). While it is recognised that there are differences for the service user having elective compared with trauma surgery, the role of the occupational therapist and the care pathway (...) evidence 2017] 1A Reduced demand on support services 26. It is suggested that there are potential benefits in including informal carers in pre-operative assessment/education, and post-operative intervention, to maximise service user independence and reduce carer stress. (Chow 2001 [C]) 2C It is additionally recommended that occupational therapists use the audit tool that is available to support this guideline (see section 8) to audit against the above recommendations. 6 Occupational therapy for adults

2018 Publication 1554

204. Proposals for a further expansion of day surgery in Belgium

high on the political agenda of many countries. 6 a “An Enhanced Recovery After Surgery (ERAS) programme represents an interdisciplinary model, designed with the intention of safely hastening postoperative recovery by easing the stress response. Inevitably, postoperative complications impede recovery. However, several factors other Barriers to day-surgery growth Yet, despite the growth in day surgery worldwide, several factors may impede the establishment of day surgery or may slow a further (...) , in cultures where day surgery is new, it is important to educate patients on the advantages. 6 than morbidity delay recuperation in postoperative patients, namely: pain; gut dysfunction, and immobility. Rehabilitation pathways apply evidence-based principles of care, focusing on the optimization of postoperative analgesia, early feeding, and ambulation to reduce stress and organ dysfunction.” 7 KCE Report 282 Proposals for a further expansion of day surgery in Belgium 13 ? Deficient local, home

2017 Belgian Health Care Knowledge Centre

205. Clinical Practice Guideline on the Management of Osteoarthritis of the Hip

require surgical treatment for osteoarthritis of the hip have developed the condition naturally over time due to a variety of risk factors or in an accelerated fashion due to prior trauma about the hip. Osteoarthritis is the imbalance of breakdown and repair of tissues within a synovial joint. The etiology of osteoarthritis is varied and includes genetic factors, trauma, femoral and acetabular morphology, overuse, and infection. INCIDENCE AND PREVALENCE Twenty-seven million adults (more than 10 (...) such that surgical treatment is required include joint degeneration over time due to hereditary vulnerability, femoral and acetabular bone morphology, large body mass, certain occupations, and past trauma affecting the joint or subchondral bone adjacent to the joint. For information regarding the evidence base behind various risk factors, please refer to the recommendations within this document regarding risk stratification. EMOTIONAL AND PHYSICAL IMPACT Older adults with self-reported osteoarthritis of the hip

2017 American Academy of Orthopaedic Surgeons

206. Guidelines for the use of imaging in the management of patients with myeloma Full Text available with Trip Pro

represent treatment response Trauma Osteoporotic fracture (especially vertebral body, ribs, sacrum) Stress fracture, Bone infarcts (especially femoral head) Degenerative joint disease Orthopaedic devices and surgical interventions Diffuse bone marrow uptake Positive: intensity > normal liver but reactive changes can give similar appearances Correlation with MRI or bone marrow biopsy advised as appropriate Negative: intensity ≤ normal liver Positive: heterogeneous uptake > normal liver Equivocal (...) in the vertebrae (Mahnken et al , ; Hur et al , ). Therefore, bone changes can be identified earlier and potential instabilities and fracture risks estimated with greater reliability (Horger et al , ; Zamagni & Cavo, ), particularly in areas where it is difficult to survey by plain X‐ray, e.g. scapulae and sternum. Given the recently revised classification of multiple myeloma, CT scanning is a suitable option for patients with suspected smouldering myeloma, but is not necessary in straightforward MGUS patients

2017 British Committee for Standards in Haematology

208. 2017 AHA/ACC Key Data Elements and Definitions for Ambulatory Electronic Health Records in Pediatric and Congenital Cardiology: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards Full Text available with Trip Pro

to occur. The other domains include: congenital heart defect nomenclature, adult congenital heart disease, critical care, cardiomyopathy, cardiac transplantation, pulmonary hypertension, congenital cardiac surgery, echocardiography, diagnostic and interventional catheterization, exercise stress testing and physiology, electrophysiology, cardiac magnetic resonance imaging, fetal physiology, perfusion, and cardiac anesthesia. The reason that this domain was chosen first was that there are other nascent

2017 American Heart Association

209. AIUM Practice Parameter for the Performance of a Musculoskeletal Ultrasound Examination

adequate penetration. The examination may involve a complete assessment of 1 or more of the 4 anatomic regions of the hip described below or may be limited to a specific anatomic structure, depending on the clinical presentation. Color and power Doppler imaging may be useful in detecting hyperemia within the joint or surrounding structures. 1. Anterior—In the supine position, a sagittal oblique plane parallel to the long axis of the femoral neck is used for evaluating the femoral head and neck (...) , the medial edge of the transducer should be angled slightly inferiorly. The teres major tendon can also be identified in the short axis by placing the transducer in a longitudinal plane at the surgical neck of the humerus where it inserts and scanning medially along the inferior border of the scapula. Throughout the examination of the rotator cuff, the cuff should be compressed with the transducer to detect nonretracted tears. When evaluating for rotator cuff tears, comparison with the contralateral side

2017 American Institute of Ultrasound in Medicine

210. Female Athlete Triad

clearance for sport participation. † Some dietary restriction as evidenced by self-report or low/inadequate energy intake on diet logs. ‡ Current or past history. § 90% EW or greater; absolute BMI cut-offs should not be used for adolescents. ll Weight-bearing sport. ¶ High-risk skeletal sites associated with low BMD and delay in return to play in athletes with one or more components of the triad include stress reaction or fracture of trabecular sites (femoral neck, sacrum, pelvis). Reprinted from De (...) the long-term effect on low bone density is of paramount importance because BMD may stabilize and improve after nutritional needs are restored; however, it still may not return to normal age-appropriate levels. For example, in adulthood, a 10% decrease in BMD is associated with a 2–3-fold increase in risk of fracture (5). Importantly, amenorrheic athletes have a 2–4-fold increased risk of stress fracture compared with eumenorrheic athletes ( ). Amenorrheic athletes also have 10–20% less lumbar spine

2017 American College of Obstetricians and Gynecologists

211. Imaging Program Guidelines: Pediatric Imaging

Imaging Program Guidelines: Pediatric Imaging Clinical Appropriateness Guidelines: Advanced Imaging Imaging Program Guidelines: Pediatric Imaging Effective Date: November 20, 2017 Proprietary Guideline Last Revised Last Reviewed Administrative 07-26-2016 07-26-2016 Head and Neck 11-01-2016 11-01-2016 Chest 08-27-2015 07-26-2016 Abdomen and Pelvis 11-01-2016 11-01-2016 Spine 08-27-2015 07-26-2016 Extremity 08-27-2015 07-26-2016 Copyright © 2017. AIM Specialty Health. All Rights Reserved 8600 W (...) Bryn Mawr Avenue South Tower – Suite 800 Chicago, IL 60631 P . 773.864.4600 www.aimspecialtyhealth.comTable of Contents – Pediatrics | Copyright © 2017. AIM Specialty Health. All Rights Reserved. 2 Table of Contents Description and Application of the Guidelines 4 Administrative Guidelines 5 Ordering of Multiple Studies 5 Pre-test Requirements 6 Head & Neck Imaging 7 CT of the Head – Pediatrics 7 MRI of the Head/Brain – Pediatrics 14 CTA/MRA Head: Cerebrovascular – Pediatrics 21 Functional MRI (fMRI

2017 AIM Specialty Health

212. AIM Clinical Appropriateness Guidelines for Joint Surgery

, or osteoarthritis, is the most common condition leading to the need for THA. Other conditions that may also cause significant hip joint damage includeneoplasm, femoral fracture, avascular necrosis (osteonecrosis), inflammatory arthritis (e.g., rheumatoid arthritis) and developmental hip dysplasia. This document addresses hip arthroplasty when performed as an elective, non-emergent procedure and not as part of the care of an acute fracture (excluding fracture of implant and periprosthetic fracture). General (...) Arthroplasty. Clinical orthopaedics and related research. 2017;475(2):364-72. 5. Hagel A, Siekmann H, Delank KS. Periprosthetic femoral fracture - an interdisciplinary challenge. Dtsch Arztebl Int. 2014;111(39):658-64. 6. Kort NP, Bemelmans YF, van der Kuy PH, et al. Patient selection criteria for outpatient joint arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2016. 7. National Institute for Health and Care Excellence, Hip fracture: management, (2011) 8. Nelson AE, Allen KD, Golightly YM, et al

2017 AIM Specialty Health

213. Pelvic Girdle Pain in the Antepartum Population: Physical Therapy Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health From the Section on Women's Health and the Orthopaedic Section of the American Full Text available with Trip Pro

. The incidence of DRA in the antepartum population in the third trimester is 66%, with the occurrence in the postpartum population at 39% after 7 weeks to several years. , I. Differential diagnosis of PGP should consider the presence of hip dysfunction including the possibility of a femoral neck stress fracture due to transient osteoporosis. Studies have demonstrated that average bone mineral density decreases with loss of trabecular bone of 1.8% to 3.4% in the lumbar spine, 3.2% ± 0.5% at the entire hip (...) , Massachusetts Lennox Hoyte MD—OB/Gyn, University of South Florida Medical Group, Tampa, Florida Tonya Satteson, BA, Bulter, Pennsylvania (consumer) | Classification The primary ICD-10 codes and conditions associated with PGP during pregnancy are as follows: R10.2, pelvic pain; M54.5, low back pain (LBP); M53.3, sacrococcygeal disorders not elsewhere classified; O26.9, pregnancy-related condition, unspecified; R29.3, abnormal posture; M48.48, fatigue (stress) fracture of vertebra, sacral and sacrococcygeal

2017 American Physical Therapy Association

214. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain Full Text available with Trip Pro

education units Continuing education units available for physical therapists and athletic trainers through JOSPT Educational webinars for health care practitioners Guideline-based instruction available for practitioners on Mobile and web-based app of guideline for training of health care practitioners Marketing and distribution of app using and Physical Therapy National Outcomes Data Registry Support the ongoing usage of data registry for common musculoskeletal conditions of the head and neck region (...) Logical Observation Identifiers Names and Codes mapping Publication of minimal data sets and their corresponding Logical Observation Identifiers Names and Codes for the head and neck region on Non-English versions of the guidelines and guideline implementation tools Development and distribution of translated guidelines and tools to JOSPT 's international partners and global audience via Classification The primary International Classification of Diseases 10th revision (ICD-10) codes and conditions

2017 American Physical Therapy Association

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

thromboembolism (VTE), and death events were reported. These events were more frequent in transgender females. However, the quality of the evidence was low. The second review summarized the available evidence regarding the effect of sex steroids on bone health in transgender individuals and identified 13 studies. In transgender males, there was no statistically significant difference in the lumbar spine, femoral neck, or total hip BMD at 12 and 24 months compared with baseline values before initiating (...) masculinizing hormone therapy. In transgender females, there was a statistically significant increase in lumbar spine BMD at 12 months and 24 months compared with baseline values before initiation of feminizing hormone therapy. There was minimal information on fracture rates. The quality of evidence was also low. Introduction Throughout recorded history (in the absence of an endocrine disorder) some men and women have experienced confusion and anguish resulting from rigid, forced conformity to sexual

2017 Pediatric Endocrine Society

216. European Society of Endocrinology Clinical practice guidelines for the care of girls and women with Turner syndrome

in Turner syndrome R 4.1. We recommend that an infant or child is examined with transthoracic echocardiography (TTE) at the time of diagnosis, even if the fetal echocardiogram or postnatal cardiac examination was normal (⨁⨁◯◯). R 4.2. We recommend that girls or women with aortic dilatation and/or bicuspid aortic valve be counseled to seek prompt evaluation if they are experiencing acute symptoms consistent with AoD, such as chest, neck, shoulder, back or flank discomfort, particularly if it is sudden (...) care delivery system, the pediatric and adult health care teams establish a workflow to support a coordinated transition process (⨁⨁◯◯). R 5.4. We suggest that pediatric endocrinologists and their care teams encourage peer-to-peer (and parent-to-parent) contact with TS support and advocacy organizations to enhance knowledge and confidence, reduce stress and distress and promote the reciprocal sharing of experiences (⨁⨁◯◯). 6. Health surveillance for comorbidities throughout the lifespan R 6.1. We

2017 European Society of Endocrinology

217. CRACKCast E058 – Ankle and Foot

Malleolar Fracture Bi mall eolar fractures: *unstable Caused by an oblique shearing force May still be non-operative if stable. May need a CT scan to figure the subtle #’s Tri malleolar fractures: Medial, lateral AND posterior malleoli All need ORIF Open fractures: Irrigation, reduction ABx, tetanus Ancef, Gentamycin Add Clindamycin or Penicillin G for soil contamination (for Clostridium) Pilon fractures Distal tibial metaphysis (falls) Look for calcaneus, tibial plateau, femoral neck, acetabulum (...) to instability Clinical FEATURES: History: mechanism of injury; onset of pain and swelling; weight bearing ability; “pop” noise 2) List Ankle stress tests Phyiscal exam: LOOK; FEEL pulses/max tenderness areas/sensation; MOVE + weight bear Frequently missed injuries: ?syndesmosis, fibular head #, fifth MT #, achilles tendon rupture; peroneal tendon rupture Stress tests: Of questionable significance in the ER Potential utility in a distal fibular fracture with deltoid complex pain Anterior drawer test Assesses

2017 CandiEM

218. CRACKCast E087 – Peripheral Arteriovascular Disease

disease processes that affect arteries: Disease process Pathophysiology Notes Atherosclerosis ●Begins with the formation of an atheroma = a fibrofatty plaque. Usually extends into the intima. ●These lipid-cores with fibrous caps usually calcify – leading to brittle crystalline vessels. ● These can ulcerate and produce cholesterol emboli and/or lead to in-situ thrombosis. ● Commonly affects large and medium sized vessels, especially around branch points. ● Aortoilliac, femoral, popliteal, coronary (...) ) ●A blood clot or foreign body that is carried to a distant site from its point of origin. ● Most are arterial thromboembolisms and originate in the heart. (e.g. post MI, AFib). ●Other sources include bacterial emboli, tumour material, foreign bodies, etc. ● Sudden occlusion of an artery that doesn’t have collateral circulation = bad ●Embolic occlusion occurs commonly at femoral and popliteal branch points. ●Watch for life threatening reperfusion injury. ● Atheroembolism: cholesterol, calcium, platelets

2017 CandiEM

219. Uptravi (selexipag) - pulmonary arterial hypertension

manufacturing process, therefore the CHMP recommended that further stability data from the first three continuous Process Verification Batches to demonstrate consistent quality of the active substance should be provided. The stability of the active substance was also investigated one batch under stress conditions according to the Notes for Guidance Q1A (R2) and ICH Q1B. Samples were exposed to heat and moisture, light (solid state and solution), acidic, basic and oxidising conditions. Hydrolysis occurred (...) % w/w of the core tablet) poses a challenge to the manufacturing process. Considering this and the type of the dosage form it was deemed reasonable that the critical quality attributes were the uniformity of the blends during the manufacture, the content uniformity of the tablets (both coated and uncoated) and the comparison of the dissolution behaviour of the tablets. In addition, degradation of the active substance (particularly when stored under stress conditions) was detected and related

2016 European Medicines Agency - EPARs

220. Resources for earthquakes

the independent comparisons of surgical and non-surgical interventions for treating femoral shaft fractures. Furthermore, there is insufficient evidence on whether long term function as an outcome differs between the surgical and conservative interventions of thigh bone fractures in children and adolescents. However, evidence from the comparison between surgical and conservative treatment shows that surgery resulted in low rates of malunion although it may be associated with serious adverse events. Similarly (...) , internal nailing may help speed up recovery. Femoral shaft fracture, although uncommon, are serious injuries that affect the quality of life of both the children and their carers which may result in long term morbidity. The treatment, often in-hospital care, of the femoral shaft fractures range from surgical fixations to conservative treatment associated with prolonged immobilisation. The aim of this review was to assess the benefits and harms of interventions for treating femoral shaft fractures

2016 Evidence Aid

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