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Femoral Neck Stress Fracture

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161. Opioid Treatments for Chronic Pain

of addiction, 22 overdose, 22 fractures, 23-25 falls 24,26 and cardiovascular events; 27 a new study also found an association between opioid use and risk of all-cause mortality. 27 New observational studies were also consistent with the 2014 AHRQ report in finding associations between higher doses of opioids and risks of overdose, addiction, and endocrinological adverse events; 22,23,26-29 new studies also found an association between higher dose and increased risk of incident or refractory depression (...) Res. 2018;11:1087-93. doi: https://dx.doi.org/10.2147/JPR.S149830. PMID: 29922084. 13. Furlan AD, Malmivaara A, Chou R, et al. 2015 Updated Method Guideline for Systematic Reviews in the Cochrane Back and Neck Group. Spine (Phila Pa 1976). 2015 Nov;40(21):1660-73. doi: 10.1097/brs.0000000000001061. PMID: 26208232. 14. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011 Oct 18;155(8):529-36. doi: 10.7326

2020 Effective Health Care Program (AHRQ)

162. Noninvasive Nonpharmacological Treatment for Chronic Pain

for common chronic pain conditions. Key Messages • Interventions that improved function and/or pain for =1 month: o Low back pain: Exercise, psychological therapy, spinal manipulation, low-level laser therapy, massage, mindfulness-based stress reduction, yoga, acupuncture, multidisciplinary rehabilitation (MDR) o Neck pain: Exercise, low-level laser, mind-body practices, massage, acupuncture o Knee osteoarthritis: Exercise, cognitive behavioral therapy (CBT) o Hip osteoarthritis: Exercise, manual (...) report) and from September 2017 through September 2019 (for this update report), reference lists, ClinicalTrials.gov, and our previous report. Review methods. Using predefined criteria, we selected randomized controlled trials (RCTs) of noninvasive nonpharmacological treatments for five common chronic pain conditions (chronic low back pain; chronic neck pain; osteoarthritis of the knee, hip, or hand; fibromyalgia; and tension headache) that reported results for a at least 1 month postintervention. We

2020 Effective Health Care Program (AHRQ)

163. Overview of sport-related injuries

that requires swift diagnosis and treatment to prevent irreversible spinal cord injury and long-term disability. Acute spinal cord injury should be suspected in any patient following trauma, particularly when the trauma is to the head or neck and when the patient is unresponsive due to hypotension and has respiratory compromise. Can occur as a result of spine trauma, vertebral compression fracture, intervertebral disc herniation, primary or metastatic spinal tumour, or infection. The resulting spinal cord (...) subluxation or dislocation, labral tears, chondral injuries, and fractures. Chronic/overuse causes include bursitis, tendonitis, athletic pubalgia (sports hernia), osteitis pubis, snapping hip syndrome, and stress fractures. Holderbaum D, Haqqi TM, Moskowitz RW. Genetics and osteoarthritis: exposing the iceberg. Arthritis Rheum. 1999;42:397-405. http://onlinelibrary.wiley.com/doi/10.1002/1529-0131%28199904%2942:3%3C397::AID-ANR1%3E3.0.CO;2-X/pdf http://www.ncbi.nlm.nih.gov/pubmed/10088759?tool

2018 BMJ Best Practice

164. Overview of musculoskeletal pain

/jama/fullarticle/197628 http://www.ncbi.nlm.nih.gov/pubmed/14612481?tool=bestpractice.com Related conditions Condition Description Chronic fibrosing condition characterised by insidious, progressive, and severe restriction of both active and passive shoulder range of motion. Many patients experience shoulder pain, but shoulder pain is not an essential component of adhesive capsulitis. Although other fractures around and including the ankle can occur (such as distal tibial plafond fractures (...) ), the term 'ankle fracture' generally refers to the medial, lateral, or posterior malleolus. An inflammatory arthritis predominantly affecting the sacroiliac joints and axial spine. Inflammatory back pain is the hallmark clinical feature. This is defined as back pain/stiffness, which is worse in the morning and improves with exercise. Injury typified by sudden, painful, audible 'pop' noise. Patient typically presents with inability to return to activity, joint instability, and rapid development

2018 BMJ Best Practice

165. Adalimumab (Hefiya) - Juvenile Rheumatoid Arthritis, Hidradenitis Suppurativa, Psoriasis, Ankylosing Spondylitis, Uveitis

substance is stable under the recommended conditions. Supporting information on accelerated and stress stability data and data from thermal freeze/thaw cycles as well as photo-stability data have been provided. Comparability exercise for Active Substance The development activities include the initial development of the AS manufacturing process, the following scale up and transfer from the pilot scale to the manufacturing scale at different plants and lines. Comparability was demonstrated in data between (...) , and additional sampling demonstrate that the manufacturing process is reliable and delivers product of consistent quality. Hold and process times have been defined and are supported by adequate microbiological and physicochemical hold time studies. Adequacy of the established shipment conditions was verified by a transport validation study which included four shipments of Hefiya FP PFS from Mylan to Cook using qualified shipment containers and shippers. A potential impact of mechanical stress on quality

2018 European Medicines Agency - EPARs

166. Adalimumab (Halimatoz) - Juvenile Rheumatoid Arthritis, Psoriatic Arthritis, Rheumatoid Arthritis, Hidradenitis Suppurativa, Psoriasis, Ankylosing Spondylitis, Uveitis

-term stability data. The results demonstrate that Halimatoz active substance is stable under the recommended conditions. Supporting information on accelerated and stress stability data and data from thermal freeze/thaw cycles as well as photo-stability data have been provided. Comparability exercise for Active Substance The development activities include the initial development of the AS manufacturing process, the following scale up and transfer from the pilot scale to the manufacturing scale (...) FP PFS from Mylan to Cook using qualified shipment containers and shippers. A potential impact of mechanical stress on quality and integrity of Halimatoz bulk PFS was sufficiently addressed by a second transport validation study. A continued process verification program is in place to ensure process consistency throughout the life-cycle. To validate the assembly and packaging process three process runs were performed at Cook for each the NSD and AI. The presented AQL, IPC, functional testing

2018 European Medicines Agency - EPARs

167. Menopause

. Osteoporosis Osteoporosis is a condition of the skeleton in which bone strength is compromised, predisposing the woman to an increased risk of fracture (NOS, 2017). In the UK, 1-in-3 women and 1-in-12 men over the age of 50 will suffer a fragility fracture due to osteoporosis (Torgeson et al., 2001). The most common fracture sites are the femoral neck, forearm and spine (NICE, 2017c). As oestrogen levels decline, the risk of osteoporosis increases. The disease leads to weakness in the skeleton which can (...) continue for many years afterwards. Psychological problems It is unclear why psychological symptoms occur at the menopause, and these may well have little to do with hormonal fluctuations. Life stresses at this age, as well as past problems, are an obvious causative factor. Many women do not realise that the following symptoms are very normal at this stage of life and fear they may be on the verge of a breakdown: • loss of confidence • depressed mood • irritability • forgetfulness • difficulty

2018 Royal College of Nursing

169. Pharmacological Management of Osteoporosis in Postmenopausal Women Full Text available with Trip Pro

-risk thresholds for other age groups ( ). In the United States, pharmacological therapy is recommended for postmenopausal women with hip or vertebral fractures; those with T-scores of −2.5 or less in the femoral neck, total hip, or lumbar spine; and those with T-scores of −1 to −2.5 and a 10-year probability of ≥20% for major osteoporotic fractures or ≥3% for hip fractures based on the US-adapted FRAX tool ( ). BMD T-score is defined as the number of SDs from the mean BMD of white females age 20 (...) to 29 years in the Third National Health and Nutrition Examination Survey database. For the treatment of osteoporosis, only lumbar spine, total hip, and femoral neck BMD T-scores are usually considered. Data suggest that a recent fracture (within the past 2 years) is a better predictor of imminent fracture risk ( i.e. , risk of fracture within the next 2 years) than is a distant fracture history (>5 years ago) ( , ). This is true for recent vertebral fractures ( , ) as well as nonvertebral fractures

2019 The Endocrine Society

171. AIM Clinical Appropriateness Guidelines for Joint Surgery

and placement of a prosthesis anchored to the bone. Numerous implants composed of various biomaterials have been approved by the U.S. Food and Drug Administration (FDA) for use in hip arthroplasty. The goal of the procedure is long-term pain relief and restoration of function. Degenerative joint disease, or osteoarthritis, is the most common condition leading to the need for THA. Other conditions that may also cause significant hip joint damage include neoplasm, femoral fracture, avascular necrosis (...) Surgery 21 3. Department of Veterans Affairs DoDN-SMoHaKOWG, VA/DoD clinical practice guideline for the non-surgical management of hip and knee osteoarthritis., (2014) Washington DC, 126. 4. Goyal N, Chen AF, Padgett SE, et al. Otto Aufranc Award: A Multicenter, Randomized Study of Outpatient versus Inpatient Total Hip 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

2019 AIM Specialty Health

172. Extremity imaging

scenario: ? Evaluation of acute shoulder pain following initial radiographs when imaging is required to establish the diagnosis and the patient is a candidate for corticosteroid or anesthetic injection IMAGING STUDY - MRI upper extremity joint Imaging of the Extremities Copyright © 2019. AIM Specialty Health. All Rights Reserved. 16 - CT may be utilized when MRI contraindicated Trauma Fracture Note: Sites at high risk for fracture include femoral neck/proximal femur, tibia (anterior/lateral), great toe (...) to persons of all ages. See the Coding section for a list of modalities included in these guidelines. Technology Considerations In general, conventional radiographs should be obtained prior to advanced imaging. Computed tomography (CT) is often the preferred modality for evaluation of displaced fractures and subluxations, whereas stress fractures and some incomplete and non-displaced fractures may be better imaged with magnetic resonance imaging (MRI) or radionuclide bone scintigraphy. Tendons

2019 AIM Specialty Health

173. Child Abuse, Elder Abuse, and Intimate Partner Violence

fracture except a parietal fracture that is isolated, unilateral, nondiastatic, linear When more than 1 variable was present, the sensitivity was 96% and the specificity was 46% Predicting Abusive Head Trauma (PredAHT) 17 Hospitalized children under 3 years old presenting with an intracranial injury Cases where etiology of injury was deemed “indeterminate” 6 features are used in the tool: head or neck bruising, seizure, apnea, rib fracture, long bone fracture, retinal hemorrhage With more than 3 (...) trauma cases: Consequence of medical staff missing milder forms of physical abuse. Pediatr Emerg Care. 2008; 24(12): 816-21. 6. Dalton HJ, Slovis T, Helfer RE, Comstock J, Scheurer S, Riolo S. Undiagnosed Abuse in Children Younger Than 3 Years with Femoral Fracture. American Journal of Diseases of Children. 1990; 144(8): 875-8. 7. Sheets LK, Leach ME, Koszewski IJ, Lessmeier AM, Nugent M, Simpson P . Sentinel injuries in infants evaluated for child physical abuse. Pediatrics. 2013; 131(4): 701-7. 8

2019 American College of Surgeons

174. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures

a pragmatic standpoint, once this ABCD-DBCD model can be scientifically validated, decision-making for the use of GI interventional procedures on cardiometabolic risk reduction will be based on complication risk assessments, rather than just hemoglobin A1C (A1C), BMI, or other simplistic metrics. Quality of life was reported in two RCTs and was improved in the patients undergoing bariatric surgery (33, 34). The impact of bariatric surgery on skeleton and fracture risk has also been recently studied (47-49 (...) . (2019*). Patients with a body mass index (BMI) =35 kg/m 2 and one or more severe obesity-related complications remediable by weight loss, including type-2 diabetes (T2D), high risk for T2D (insulin resistance, prediabetes, and/or metabolic syndrome), poorly controlled hypertension, nonalcoholic fatty liver disease/nonalcoholic steatohepatitis, obstructive sleep apnea, osteoarthritis of the knee or hip, and urinary stress incontinence, should be considered for a bariatric procedure (Grade C; BEL 3

2019 American Association of Clinical Endocrinologists

175. AACE/ACE Guidelines for Management of Growth Hormone Deficiency in Adults and Patients Transitioning from Pediatric to Adult Care

-term rhGH treatment improves outcomes such as cardiovascular mortality and fracture rates remains to be fully established. On the other hand, the incidence of diabetes mellitus (DM) in adults on long-term rhGH thera- py has been shown to be increased in some studies (39,40), while others have not observed any change after long-term treatment (30,41). Furthermore, even after over 20 years of rhGH replacement aimed at normalizing serum IGF-1 levels in adults with GHD, there are no robust data

2019 American Association of Clinical Endocrinologists

176. Treatment for Acute Pain: An Evidence Map

reviews: sickle cell crisis 39 Appendixes Appendix A. Key Informant Discussion Questions Appendix B. Search Strategy Appendix C. Key Informant Call Summaries Appendix D. Intervention Categorization Appendix E. Excluded References Appendix F. Evidence Tables: Postoperative Postdischarge Pain Appendix G. Evidence Tables: Dental Procedures and Oral Surgery Appendix H. Evidence Tables: Acute Back Pain Appendix I. Evidence Tables: Acute Neck Pain Appendix J. Evidence Tables: Fractures Appendix K. Evidence (...) by the Agency for Healthcare Research and Quality (AHRQ) in the statement of work: • Postoperative pain (after discharge from hospital or surgical facility) • Musculoskeletal pain o Back pain o Neck pain o Fracture • Dental pain • Renal colic (episodic pain) • Migraines (episodic pain) • Sickle cell crisis (episodic pain) We will also attempt to map the evidence with regard to specific populations provided by AHRQ in the statement of work as relevant. These subpopulations are important because of specific

2019 Effective Health Care Program (AHRQ)

177. Chronic Pelvic Pain

. Pitfalls of the medical paradigm in chronic pelvic pain. Baillieres Best Pract Res Clin Obstet Gynaecol, 2000. 14: 525. 82. Sharpe, M., et al. "Unexplained" somatic symptoms, functional syndromes, and somatization: do we need a paradigm shift? Ann Intern Med, 2001. 134: 926. 83. Malykhina, A.P. Neural mechanisms of pelvic organ cross-sensitization. Neuroscience, 2007. 149: 660. 84. Sanford, M.T., et al. The role of environmental stress on lower urinary tract symptoms. Curr Opin Urol, 2017. 27: 268. 85 (...) subtypes of chronic pelvic pain and how subtypes differ in health status and trauma history. Am J Obstet Gynecol, 2006. 195: 554. 90. Meltzer-Brody, S., et al. Trauma and posttraumatic stress disorder in women with chronic pelvic pain. Obstet Gynecol, 2007. 109: 902. 91. Iglesias-Rios, L., et al. Depression and Posttraumatic Stress Disorder Among Women with Vulvodynia: Evidence from the Population-Based Woman to Woman Health Study. Journal of Women's Health (15409996), 2015. 24: 557. 92. Anderson, A.B

2019 European Association of Urology

179. Management of Non-neurogenic Male LUTS

and fracture with the initiation of a prostate-selective alpha antagonist: a population based cohort study. BMJ, 2015. 351: h5398. 145. Chang, D.F., et al. Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg, 2005. 31: 664. 146. Chatziralli, I.P., et al. Risk factors for intraoperative floppy iris syndrome: a meta-analysis. Ophthalmology, 2011. 118: 730. 147. van Dijk, M.M., et al. Effects of alpha(1)-adrenoceptor antagonists on male sexual function. Drugs, 2006. 66: 287

2019 European Association of Urology

180. Treatment for Acute Pain: An Evidence Map (Draft)

with Fractures 25 Visceral Pain 27 Renal Colic 27 Orofacial Pain 30 Dental Pain 30 Episodic Pain Conditions 30 Acute Migraine 30 Sickle Cell Crisis 37 Discussion 39 Limitations 41 Tables Table 1. Eligible Systematic Reviews and Relevant Studies: All Acute Pain Conditions 10 Table 2. Current Guidelines: Treatment for Postoperative Pain 12 Table 3. Current Guidelines: Treatments for Acute Back Pain 15 Table 4. Current Guidelines: Treatments for Acute Neck Pain 21 Table 5. Current Guidelines: Treatments (...) in Systematic Reviews: Acute Neck Pain 24 Figure 6. Comparisons addressed in Systematic Reviews and New Trials: Fractures 26 Figure 7. Comparisons addressed in Systematic Reviews and New Trials: Renal Colic 29 vii Figure 8. Comparisons addressed in Systematic Reviews: Acute migraine in adults-placebo controlled RCTs in adults 33 Figure 9. Comparisons addressed in Systematic Reviews and New Trials: Acute migraine in adults-active controlled 34 Figure 10. Comparisons addressed in Systematic Reviews and New

2019 Effective Health Care Program (AHRQ)

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