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Femoral Neck Stress Fracture

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161. Clinical practice guideline for evaluation of psychosocial factors influencing recovery from adult orthopaedic trauma

similar numbers of extremity wounds and fractures, accounting for approximately 54% of all wounds (Cross, 2011, Owens, 2007). Combat-related extremity injuries are extremely costly, accounting 10 View background material via the PRF CPG eAppendix for approximately two-thirds of initial hospitalization costs and estimated disability payments (Cross, 2011, Masini, 2009). Risk Factors and Emotional/Physical Impact Anxiety, post-traumatic stress disorder (PTSD), depression, premorbid psychiatric (...) adult orthopedic trauma. 3. Ethical issues associated with no screening given that cognitive, emotional, and social aspects of recovery are to be expected based on human illness behavior. 4. Ethical issues associated with no treatment given the evidence that cognitive behavioral therapy and its derivatives (as well as psychotherapy and medication) are effective at alleviating stress and psychological distress and fostering optimal cognitive coping strategies. 12 View background material via the PRF

2020 American Academy of Orthopaedic Surgeons

162. 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)

163. 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)

164. AACE Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis

with permission from Mechanick JI, et al. Endocr Pract. 2017;23:1006-1021 (1).6 Postmenopausal Osteoporosis Guidelines, Endocr Pract. 2020;26(Suppl 1) Copyright © 2020 AACE (Grade B; BEL 2). Osteoporosis is also diagnosed based on a T-score of -2.5 or lower in the lumbar spine (antero- posterior), femoral neck, total hip, or 1/3 radius (33% radius), even in the absence of a prevalent fracture (Grade B; BEL 4, upgraded by consensus). When the initial diagnosis of osteoporosis is made according to a T-score (...) ) or osteoporosis (9). The average femoral neck T-score by dual-energy X-ray absorptiometry (DXA) for 75-year-old women is -2.5, meaning that more than half of women age 75 and older meet the criterion for osteoporosis (10). More than 20% of postmenopausal women have prevalent vertebral fractures (11). Although these guidelines focus only on the evaluation and treat- ment of osteoporosis in postmenopausal women, osteo- porosis may affect men as well as women before and after menopause. Q1. How Is Fracture Risk

2020 American Association of Clinical Endocrinologists

165. 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

166. 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

167. 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

168. 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

169. 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

171. 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

173. 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

174. 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

175. 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

176. 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

177. 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

178. 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)

179. 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

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