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Fetal Foot Measurement

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61. Acute pain management: scientific evidence (3rd Edition)

with spinal cord injury 248 9.2 Simple analgesics for the treatment of migraine 266 9.3 Table of triptans 267 9.4 Pooled effectiveness data from emergency department studies of the treatment of migraine 296 10.1 Acute pain intensity measurement tools — neonates 344 10.2 Composite scales for infants and children 345 10.3 Self-report tools for children 346 11.1 ADEC drug categorisation according to fetal risk 387 11.2 Categorisation of drugs used in pain management 388 11.3 The breastfeeding patient (...) AND MEASUREMENT OF PAIN AND ITS TREATMENT 35 2.1 Assessment 35 2.2 Measurement 36 2.2.1 Unidimensional measures of pain 37 2.2.2 Functio nal impact of acute pain 39 2.2.3 Multidi mensional measures of pain 39 2.2.4 Patients with special needs 40 2.3 Outcome measures in acute pain management 41 2.3.1 Outcome measures 41 References 43xii Acute Pain Management: Scientific Evidence CONTENTS 3. PROVISION OF SAFE AND EFFECTIVE ACUTE PAIN MANAGEMENT 47 3.1 Education 47 3.1.1 Patients 47 3.1.2 Staff 48 3.2

2015 National Health and Medical Research Council

62. Core Competencies for Management of Labour

options • Selecting appropriate interventions to promote maternal/fetal/newborn wellbeing • Interpreting laboratory test and ultrasound results and taking appropriate action • Promoting normal labour and birth • Keeping mother and baby together • Promoting early skin-to- skin contact • Demonstrating self- awareness of own attitudes and beliefs about labour support strategies and use of comfort measures and/or pain relief optionsCore Nursing Practice Competencies: Managing Labour 5 Perinatal Services (...) and expectations for labour support Review antenatal and clinical records Demographic information Obstetrical history Family history Medical/surgical history History of mental health History of present pregnancy, including LMP and EDD Laboratory and ultrasound results Birth and feeding plan Assess psychosocial and cultural factors Check maternal vital signs and urine dipstick Measure symphysis-fundal height Palpate abdomen to assess fetal lie, size, presentation, position, attitude and descent Confirm fetal

2014 British Columbia Perinatal Health Program

63. Prenatal Screening for Down Syndrome, Trisomy 18, and Open Neural Tube Defect

trimester ultrasound 2 are some of the options available for prenatal genetic screening? The risks for fetal Down syndrome, trisomy 18, and open neural tube defects (ONTDs) are calculated using a combination of variables which may include: biochemical serum markers collected from blood work, maternal age, maternal ethnicity, maternal weight, maternal diabetic status, maternal smoking, and, if available, nuchal translucency (NT) ultrasound measurement? There are four different screening tests: SIPS, IPS (...) trimester), aberrant right subclavian artery, or more than one marker, referral to Medical Genetics is recommended? 2? If ultrasound detects ventriculomegaly, referral to the Fetal Diagnosis Service is recommended? 3? If ultrasound detects isolated pyelectasis, abnormal femur / foot ratio (= 0?9) or echogenic intracardiac focus (EICF), Down syndrome risk based on SIPS / IPS / Quad result and ultrasound finding should be recalculated using the T21 risk calculator (www.perinatalservicesbc.ca/health

2014 British Columbia Perinatal Health Program

64. Chickenpox

, usually about 5 days after the onset of the rash. The virus persists in sensory nerve ganglia of the dorsal root. Years later, it can reactivate and cause herpes zoster (shingles). Chickenpox is usually a self-limiting disease in healthy children. Complications include: Bacterial skin infection, most common in young children. Lung involvement, more common in adults. In pregnancy, severe maternal chickenpox and fetal varicella syndrome. In later pregnancy, varicella can result in neonatal chickenpox (...) subjects from the age of 9 months. See . Goals and outcome measures Goals and outcome measures Goals Goals To support primary healthcare professionals to: Accurately diagnose chickenpox. Advise on self-care and infection control for people with chickenpox. Minimize the severity and duration of chickenpox symptoms. Reduce the likelihood of complications of chickenpox. Admit to hospital, refer, or seek specialist advice as appropriate. Outcome measures Outcome measures No outcome measures were found

2018 NICE Clinical Knowledge Summaries

65. Corticosteroids - topical (skin), nose, and eyes

alerts New safety alerts No new safety alerts issued since 1 June 2015. Changes in product availability Changes in product availability No changes in product availability since 1 June 2015. Goals and outcome measures Goals and outcome measures Goals Goals To support primary healthcare professionals to: Ensure that people receiving topical corticosteroids, intranasal corticosteroids, and corticosteroid eye preparations in primary care are properly managed and monitored. Outcome measures Outcome (...) measures No outcome measures were found during the review of this topic. Audit criteria Audit criteria No audit criteria were found during the review of this topic. QOF indicators QOF indicators No QOF indicators were found during the review of this topic. QIPP - Options for local implementation QIPP - Options for local implementation No QIPP indicators were found during the review of this topic. NICE quality standards NICE quality standards No NICE quality standards were found during the review

2018 NICE Clinical Knowledge Summaries

66. The Dangerous Allure of Breech Birth at Home – and a Problematic New Paper

about the editorial process of the journal that published and promoted it? Babies are usually born head first. That’s called vertex or cephalic presentation. The head nestles into the bottom of the womb, and once head and shoulders emerge, the rest of the body tends to slip out fairly easily afterwards. only happens in 3 to 4% of full-term births. It means the baby is coming bottom first, or, less often, foot or knee. It is complicated in comparison to head first. The baby is more likely to get (...) of the risks associated with post-term birth, twin pregnancy and breech presentation, and a lack of response to fetal distress. Our dataset had one of the higher rates of death published for planned breeches at home: 1 in 14 died. All the studies with more than a few breech births reported I found while preparing this post showed much higher rates of death for breech babies than vertex. There aren’t many, though, given that most home birth midwives won’t go ahead if they know the baby is breech

2018 Absolutely Maybe

67. Comparing preoperative dating and postoperative dating for second trimester surgical abortions. (PubMed)

measurements. We assigned preoperative GA by ultrasonography for unknown last menstrual period (LMP) or when discrepancy between sonographic and LMP dating exceeded 7 days (<15-6/7 weeks), 10 days (16 to 21-6/7 weeks) or 14 days (22 to 23-6/7 weeks). We determined postoperative GA using fetal foot length pathology standards published by Streeter in 1920 and Drey et al. in 2005. We performed regression analysis to estimate the relationship between pre- and postoperative estimates of GA and to assess (...) demographic effects on these estimates, and χ2 tests to assess whether fetal foot lengths were concordant with, larger than or smaller than the expected range for the preoperative GA.The 469 patients analyzed had a median preoperative GA of 19-4/7 weeks (range 14-0/7 to 23-6/7 weeks). Preoperative dating highly correlated with postoperative dating using both pathology standards (r2=0.95, p<.001), without any clinically relevant effect by body mass index (Streeter and Drey, p=.79), parity (Streeter p=.89

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2019 Contraception

68. Ocrelizumab (Ocrevus) - multiple sclerosis

Units F/T Freeze/Thaw; Assessment report EMA/790835/2017 Page 5/180 Fab Antigen Binding Portion Of Immunoglobulin Molecule FBS Fetal Bovine Serum Fc Fragment crystallisable Fc?RIIIa Fc gamma receptor IIIa FcRn neonatal Fc receptor FTIR Fourier Transform Infrared Spectroscopy FVIP filtered viral inactivation pool GPMF Genentech Production Manufacturing Facility HC Heavy Chain; HCCF Harvested Cell Culture Fluid HCP Host Cell Protein HEPES 4-(2-hydroxyethyl)-1-piperazine ethane sulfonic acid HMWS High (...) ATA anti-therapeutic antibody AUC area under the concentration-time curve AUC last area under the concentration-time curve from time 0 to the last measurable concentration AUC inf area under the concentration-time curve from time 0 to infinity AUC t area under the concentration-time curve within a dosing interval BCC basal cell carcinoma BLA Biologics License Application BLQ below the limit of quantification BMI body mass index BSA body surface area CCOD clinical cut-off date CDC complement

2018 European Medicines Agency - EPARs

69. Childhood Extracranial Germ Cell Tumors Treatment (PDQ®): Health Professional Version

(brain). Non-seminomatous GCT. Yolk sac tumor (endodermal sinus tumor). Choriocarcinoma. Embryonal carcinoma. Gonadoblastoma. Teratoma and yolk sac tumor. Mixed GCT (contains at least two of the malignant histologies listed above). (Refer to the PDQ summary on for information about the treatment of intracranial germ cell tumors.) Incidence Childhood GCTs are rare in children younger than 15 years, accounting for approximately 3% of cancers in this age group.[ - ] In the fetal/neonatal age group, most (...) the sacrum), mediastinum, and retroperitoneum. Diagnostic and Staging Evaluation Diagnostic evaluation of GCTs includes imaging studies and measurement of tumor markers. In suspected cases, tumor markers can suggest the diagnosis before surgery and/or biopsy. This information can be used by the multidisciplinary team to make appropriate treatment choices. Tumor markers Yolk sac tumors produce alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-hCG) is produced by all choriocarcinomas

2017 PDQ - NCI's Comprehensive Cancer Database

70. Childhood Soft Tissue Sarcoma Treatment (PDQ®): Health Professional Version

influencing survival. Semin Surg Oncol 9 (6): 524-31, 1993 Nov-Dec. [ ] Zeytoonjian T, Mankin HJ, Gebhardt MC, et al.: Distal lower extremity sarcomas: frequency of occurrence and patient survival rate. Foot Ankle Int 25 (5): 325-30, 2004. [ ] Benesch M, von Bueren AO, Dantonello T, et al.: Primary intracranial soft tissue sarcoma in children and adolescents: a cooperative analysis of the European CWS and HIT study groups. J Neurooncol 111 (3): 337-45, 2013. [ ] Weiss SW, Goldblum JR: Miscellaneous tumors (...) in seven infants with molecular-genetic analysis. Fetal Pediatr Pathol 30 (5): 329-37, 2011. [ ] Evans HL: Low-grade fibromyxoid sarcoma: a clinicopathologic study of 33 cases with long-term follow-up. Am J Surg Pathol 35 (10): 1450-62, 2011. [ ] Alaggio R, Collini P, Randall RL, et al.: Undifferentiated high-grade pleomorphic sarcomas in children: a clinicopathologic study of 10 cases and review of literature. Pediatr Dev Pathol 13 (3): 209-17, 2010 May-Jun. [ ] Staging and Grading Systems

2017 PDQ - NCI's Comprehensive Cancer Database

71. Stivarga (regorafenib hydrate)

packaging 36 months Accelerated Pilot scale, 3 lots 40°C 75%RH PTP packaging 6 months In accelerated testing, non-conformance to the specification was found in * of 3 lots at 6 months (while the acceptance criteria for the purity [related substance (Related Substance A)] is ?****%, the actual value measured was ****%). Thus, a test under the intermediate conditions was conducted, and non-conformance to the specification (the actual value measured for the purity 7 [related substance (Related Substance (...) inhibitory effect of regorafenib was evaluated in athymic mice ("nude mice") by subcutaneous implantation of human colorectal cancer cell lines, Colo-205, HT-29, and HCT-15. After the implanted tumor weight reached 75 to 144 mg (5-7 days after implantation), regorafenib was orally administered once daily (QD) at the doses of 3, 10, 29, and 96 mg/kg for 9 days, and the tumor weight was measured (the figure below). In nude mice with Colo-205 and HT-29 cell lines, 10 and 29 mg/kg of regorafenib inhibited

2013 Pharmaceuticals and Medical Devices Agency, Japan

72. Organization of diabetes care

, such as a physician, nurse specialist or pharmacist, using an interprofessional team in primary routine management, expansion of professional role (e.g. nurse or pharmacist has a more active role in monitoring or adjusting medications). Team-based care Care by a multidisciplinary and interprofessional team with specific training in diabetes. Continuous quality improvement Techniques for examining and measuring clinical processes, designing interventions, testing their impacts and then assessing the need (...) and population data to facilitate efficient and effective care. May provide timely reminders for providers and patients, identify relevant sub-populations for proactive care, facilitate individual patient care planning, share information with patients and providers to coordinate care or monitor performance of practice team and care system. Clinician reminders Paper-based or electronic system to prompt health-care professionals to recall patient-specific information (e.g. A1C) or do a specific task (e.g. foot

2013 CPG Infobase

73. Richard Lehman’s journal review—6 March 2017

Richard Lehman’s journal review—6 March 2017 Richard Lehman's journal review—6 March 2017 - The BMJ ---> Richard Lehman reviews the latest research in the leading medical journals. NEJM 2 Mar 2017 Vol 376 “Subclinical hypothyroidism” in pregnancy Observational studies have shown an association between high levels of thyroid stimulating hormone (TSH, or thyrotropin) or low levels of free thyroxine (T4) or both in mothers and lowered measures of intelligence in their children. As so often happens (...) Scandinavian countries, there is no signal for adverse neonatal outcomes or congenital malformations associated with exposure to neuraminidase inhibitors during embryo-fetal life. Adiposity and cancer Nature has designed us to hold on to excess fat in case we can’t find enough food. It never designed us to live sedentary lives amidst plenty, though that is what most humans do given the chance. People who get fat early in life certainly have a reduced life expectancy compared with those who don’t

2017 The BMJ Blog

74. Pediatric Pulmonary Hypertension

to diagnose, to moni- tor the disease progression of, and to treat children with PAH. 4 Pediatric PH is distinct from adult PH in several ways. Most important, pediatric PH is intrinsically linked to issues of lung growth and development, including many prena- tal and early postnatal influences. 3 The development of PH in the neonate and young infant is often related to impaired functional and structural adaptation of the pulmonary circula- tion during transition from fetal to postnatal life. The timing (...) circulation and basic mechanisms of disease. It also identified factors that limit the ability to perform clinical trials in children with PH or related PVD, including the lack of established biomarkers that can predict disease risk, severity, and disease progression. We cur- rently lack sufficient outcome measures that are applicable to Table 1. PH: Definitions PH mPAP =25 mm Hg in children >3 mo of age at sea level PAH mPAP =25 mm Hg PAWP 3 WU × M 2 IPAH or isolated PAH PAH with no underlying disease

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2015 American Heart Association

75. State-of-the-Art Methods for Evaluation of Angiogenesis and Tissue Vascularization

of therapeutic strategies to either promote or inhibit vessel growth depends on reproducible measures and end points in experimental models that are relevant for the treatment of human diseases. Accordingly, the selection of an appropriate experimental model is critical to study specific aspects of the molecular and cellular mechanisms that are of physiological or pathological relevance. This scientific statement summarizes in vitro assays and in vivo models suitable for gaining insights into the basic

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2015 American Heart Association

76. Pediatric Pulmonary Hypertension: ATS/AHA Clinical Practice Guidelines

important, pediatric PH is intrinsically linked to issues of lung growth and development, including many prena- tal and early postnatal influences. 3 The development of PH in the neonate and young infant is often related to impaired functional and structural adaptation of the pulmonary circula- tion during transition from fetal to postnatal life. The timing of pulmonary vascular injury is a critical determinant of the subsequent response of the developing lung to such adverse stimuli, including (...) or related PVD, including the lack of established biomarkers that can predict disease risk, severity, and disease progression. We cur- rently lack sufficient outcome measures that are applicable to Table 1. PH: Definitions PH mPAP =25 mm Hg in children >3 mo of age at sea level PAH mPAP =25 mm Hg PAWP 2 WU/m 2 IPAH or isolated PAH PAH with no underlying disease known to be associated with PAH Referred to as HPAH with positive family or genetic evaluation PHVD Broad category that includes forms of PAH

2015 American Thoracic Society

77. Adult Sinusitis

have greater activity limitations, work limitations, and social limitations. The overall annual productivity cost for refractory CRS is estimated at $10,077 per patient. CRS can also have a substantial impact on health-related quality of life. Patients with CRS referred to otolaryngologists score significantly lower on measures of bodily pain and social functioning than do those with angina, back pain, congestive heart failure, and chronic obstructive pulmonary disease. Similarly, patients with CRS (...) with the specific sinuses involved. Last, patient complaints of nasal obstruction correlate with objective measures, such as rhinomanometry or nasal peak flow rate. Since the usual clinical dilemma is to differentiate ABRS from VRS, the specificity of ABRS symptoms has typically been studied in this context. The antecedent history of viral URI likely contributes to the specificity of these symptoms for ABRS, but the extent to which this is true has not been quantified. Similarly, although the differential

2015 American Academy of Otolaryngology - Head and Neck Surgery

78. Gestational diabetes mellitus

Diagnosis of GDM 15 2.7 Diabetes in Pregnancy 15 2.7.1 Standardisation of HbA1c measurement 15 3 Antenatal care 16 3.1 Maternal surveillance 17 3.2 Fetal surveillance 18 3.3 Psychosocial support 18 3.4 Self-monitoring 19 3.5 Medical nutrition therapy 20 3.6 Physical activity 21 3.6.1 Cautions and contraindications for physical activity 22 4 Pharmacological therapy 23 4.1 Metformin 23 4.2 Insulin therapy 24 4.2.1 Insulin type by glycaemic abnormality 24 4.3 Hypoglycaemia 25 4.4 Education for safe self (...) • There is limited evidence or consensus regarding specific antepartum tests or their frequency 54 • Monitoring type and frequency is influenced by the presence of other pregnancy complications (e.g. antepartum haemorrhage, preeclampsia, fetal growth restriction) as well as severity of maternal hyperglycaemia 24 • Fetal abdominal circumference (AC) greater than or equal to 75% for gestational age, measured at 29 to 33 weeks gestation, correlates with an increased risk for birth of an LGA infant 55 Fetal growth

2015 Queensland Health

79. Integrated sensor-augmented pump therapy systems for managing blood glucose levels in type 1 diabetes (the MiniMed Paradigm Veo system and the Vibe and G4 PLATINUM CGM system)

to continuously measure interstitial glucose levels (every few minutes) and allow immediate real-time adjustment of insulin therapy. The systems produce alerts if the glucose levels become too high or too low. The MiniMed Paradigm Veo system can also automatically suspend insulin delivery if there is no response to a low-glucose warning. Integrated sensor-augmented pump therapy systems for managing blood glucose levels in type 1 diabetes (the MiniMed Paradigm Veo system and the Vibe and G4 PLATINUM CGM system (...) quality of life in the short-term but can also hinder treatment adherence and good glycaemic control. 3.6 Long-term complications of chronically elevated blood glucose levels include retinopathy and blindness, peripheral and autonomic nephropathy, renal failure, ischaemic heart disease, stroke, neuropathy, and foot ulceration. 3.7 Diabetes that complicates pregnancy is also becoming more common, and it is estimated that up to 5% of about 700,000 women who give birth in England and Wales each year have

2016 National Institute for Health and Clinical Excellence - Diagnostics Guidance

80. Acute Pain Management: Scientific Evidence

factors for the development of postoperative acute persistent pain. Trends Anaesth Critical Care 4: 67–70. Shipton EA (2014b) The transition of acute postoperative pain to chronic pain: Part 2 - Limiting the transition. Trends Anaesth Critical Care 4: 71–75. Vidaeff AC, Saade GR, Belfort MA (in press) Interpreting a randomized trial report: evidence-based practice for the clinician. J Matern Fetal Neonatal Med. Walsh M, Woodhouse LJ, Thomas SG, Finch E (2011) Strategies aimed at preventing chronic (...) influences on sensitivity to pain 29 1.7.3 Drug metabolism 31 References 33 2. ASSESSMENT AND MEASUREMENT OF PAIN AND PAIN TREATMENT 43 2.1 Assessment 43 2.2 Measurement 45 2.2.1 Unidimensional measures of pain 45 2.2.2 Functional impact of acute pain 46 2.2.3 Multidimensional measures of pain 47 2.2.4 Patients with special needs 48 2.3 Outcome measures in acute pain management 49 2.3.1 Outcome measures 49 References 51xiv Acute Pain Management: Scientific Evidence 3. PROVISION OF SAFE AND EFFECTIVE

2015 Clinical Practice Guidelines Portal

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