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Fetal Foot Measurement

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81. Optimal Use of Ionizing Radiation in Cardiovascular Imaging

. Appropriateness of Medical Radiation ... - 3.CURRENT TRENDS IN PATIENT AND MEDICAL PERSONNEL RADIATION EXPOSURE FROM CARDIOVASCULAR PROCEDURES ... - 3.1. Trends in Patient and Medical Personnel Radiation Exposure - 3.2. Potential Consequences of Patient and Medical Personnel Radiation Exposure ... - 4.THE MANY MEASURES OF RADIATION - 4.1. Radiation Exposure and Dose Metrics ... - 4.2. Challenges in Relating Radiation Exposure and Dose to Risk of Detrimental Effects - 4.3. Types of Ionizing Radiation Used (...) in Medical Imaging - 4.3.1. X-Rays and Gamma Rays . - 4.3.2. Positrons . - 4.4. Relationships Between Exposure and Absorbed Dose . - 4.4.1. Exposure From External Beams ... - 4.4.2. Exposure From Radionuclides - 4.5. Estimating Effective Dose - 4.6. Synopsis of Measures of Radiation Exposure and Dose ... ... - 5.HOW RADIATION CAN HARM PEOPLE ... . - 5.1. Mechanism of Radiation-Induced Biological Effects ... ... - 5.2. Types of Radiation-Induced Health Effects .. ... - 5.2.1. Tissue Reactions (Formerly

2018 American College of Cardiology

82. CRACKCast Episode 183 – The Immunocompromised Patient

tachypnea or tachycardia, mental status changes, metabolic acidosis, increased volume requirements, rapid changes in serum glucose or sodium concentration, or acute abdominal pain. In neutropenic cancer patients, most severe infections and almost all instances of bacteremia occur when the neutrophil count is less than 100 cells/mL. In neutropenic patients, the temperature should be measured orally or tympanically, not rectally. In neutropenic cancer patients, pneumonia and anorectal infection are more (...) the respiratory or gastrointestinal tract. Immunoglobulin E (IgE), surface of mast cells and basophils responsible for immediate-type hypersensitivity reactions important in defense against helminthic pathogens. IgG widely distributed in tissues accounts for 75% of the total immunoglobulin mass. It crosses the placenta and provides fetal immunity during the first 6 months of life Congenital or acquired deficiencies of IgG lead to infection with encapsulated organisms Complement complex interaction of 30

2018 CandiEM

83. Neonatal stabilisation for retrieval

service capability · Seek advice: o Contact RSQ o Phone 1300 799 127 Maternal risk · Severe hypertensive disorder · Antepartum haemorrhage · Other care requirements beyond service’s CSCF Fetal risk · Threatened preterm birth · Fetal anomalies · FGR · Multiple pregnancy · Other care requirements beyond service’s CSCF Yes Yes No No CSCF: Clinical services capability framework; FGR: Fetal growth restriction; QCG: Queensland Clinical Guidelines; RSQ: Retrieval Services Queensland Queensland Clinical (...) Preterm 90–95% o Term 92–98% · Measure preductally– right hand Signs of respiratory distress? Baby breathing spontaneously? Yes No No Yes Commence CPAP · MAP: 8 cm H 2 O · Check capillary blood gas · Observe for CPAP failure · O 2 to maintain oxygen saturations · O 2 /air: o Flow 8–10 L/minute o Humidified/warm (37 ºC) · Refer to QCG: o Neonatal respiratory distress including CPAP o Neonatal resuscitation Signs of CPAP failure · O 2 requirement > 50% · Increased work of breathing · Respiratory

2018 Clinical Practice Guidelines Portal

84. CRACKCast E180 – Labor & Delivery

weeks’ gestation, any medical assessment should include the mother and fetus because fetal viability becomes established near that time. False labour (Braxton Hicks contractions) True labour ● Small, uncoordinated uterine contractions ● No escalation of frequency or duration ● No cervical dilation or effacement ● Intact membranes ● Relieved with analgesia, ambulation and change in activity ● Cyclic coordinated contractions ● Escalation of frequency, duration and severity ● Ruptured membranes (...) becomes firmer and rises; the umbilical cord lengthens 5 to 10 cm; or there is a sudden gush of blood. Laceration repair Oxytocin infusion Uterine checks ending with a completely dilated, fully effaced cervix. Ends with the delivery of the baby Ends with placental delivery First hour post delivery Watch for PPH! 3) List 3 techniques for monitoring the fetus. Clinical monitoring External electronic fetal monitoring Ultrasonography Let’s go through them in more detail: Clinical monitoring No real time

2018 CandiEM

85. Resuscitation - neonatal

antibody known to cause haemolytic disease in the fetus or baby especially if fetal anaemia or hydrops fetalis present) · Polyhydramnios and oligohydramnios · Reduced fetal movement before onset of labour · Congenital abnormalities which may affect breathing, cardiovascular function or other aspects of perinatal transition · Intrauterine infection · Hydrops fetalis Intrapartum 1 · Abnormal fetal patterns on cardiotocograph (CTG) o Refer to Queensland Clinical Guideline: Intrapartum fetal surveillance 3 (...) Positive pressure ventilation PPROM Preterm prelabour rupture of membranes RhD Rh Blood Type D (Rh positive) SpO2 Peripheral capillary oxygen saturation UVC Umbilical venous catheter Definitions Acrocyanosis Blue hands and feet due to inadequate circulation of blood and oxygen to the extremities normally found in the first few hours after birth. Cold stress Temperature between 36.0 °C and 36.4°C Corrected age Gestation plus postnatal age in weeks Hyperthermia Temperature greater than 37.5 °C Mild

2018 Queensland Health

86. Appropriate Use Criteria: Imaging of the Abdomen & Pelvis

. AIM Specialty Health. All Rights Reserved. 2 Table of Contents Description and Application of the Guidelines 3 Administrative Guidelines 4 Ordering of Multiple Studies 4 Pre-test Requirements 5 Abdominal & Pelvic Imaging 6 CT of the Abdomen 6 MRI of the Abdomen 15 MRCP of the Abdomen 20 CTA/MRA of the Abdomen 22 CTA Abdominal Aorta and Bilateral Illiofemoral Lower Extremity Run-off 26 CT of the Pelvis 28 MRI of the Pelvis 35 Fetal MRI 41 CTA/MRA of the Pelvis 43 CT of the Abdomen & Pelvis (...) for headache ¾ MRI brain and MRA brain for headache ¾ MRI cervical spine and MRI shoulder for pain indications ¾ MRI lumbar spine and MRI hip for pain indications ¾ MRI or CT of multiple spine levels for pain or radicular indications ¾ MRI foot and MRI ankle for pain indications ¾ Bilateral exams, particularly comparison studies There are certain clinical scenarios where simultaneous ordering of multiple imaging studies is consistent with current literature and/or standards of medical practice

2018 AIM Specialty Health

87. CRACKCast E171 – Pediatric Cardiac Disorders

of Cardiac Disorders in Infants and Children) See Box 170.3 (Key Elements to Elicit in the History of a Child with a Known Cardiac Disorder) Let’s start this sauna-sweat-shop episode with a little anatomy review: Trace the path of the RBC during foetal circulation, and describe the changes that occur following delivery. Oxygen flow: mom’s lungs/body/placenta → umbilical vein → ductus venosus → fetal heart (through IVC) → right atrium → shunted to the left atrium by the patent foramen ovale → left (...) ventricle → aorta → directed to the fetal coronary and cerebral circulations. Deoxygenated blood: SVC → RA → RV → pulmonary artery → patent ductus arteriosus* (PVR > SVR)→ mixes with well oxygenated blood in the descending aorta. * Fetal pulmonary vascular resistance (PVR), however, is higher than fetal systemic vascular resistance (SVR); this forces deoxygenated blood to mostly bypass the fetal lungs (see Fig. 170.1). This poorly oxygenated blood enters the aorta through the patent ductus arteriosus

2018 CandiEM

88. Imaging Guidelines

. National Council on Radiation Protection and Measurements report shows substantial medical exposure increase. Radiology. 2009; 253(2): 293-296. 9. Wellis VM. Pediatric Anesthesia and Pain Management Practice Guidelines for the MRI and MRT. Palo Alto: Lucile Packard Children’s Hospital, Stanford University Medical Center, Department of Anesthesia and Pain Management. Available at: http://med.stanford.edu/content/dam/sm/ pedsanesthesia/documents/mri.pdf. Published 1998, Accessed April 12, 2018. 10

2018 American College of Surgeons

89. CRACKCast E157 – Iron and Heavy Metals

, coagulopathy Rapid absoption from portal system with resultant oxidative damage 5 Obstructive 3-6 weeks Pyloric or bowel scarring, obstruction Healing of the injured GI mucosa Gross, Large, Systemic Ingestions of Iron, Have Killed Otters. Curious George’s Last Snack Hemorrhaged His GUTS. A few key points: The presence of gastrointestinal symptoms suggests a potentially serious ingestion, whereas absence of gastrointestinal symptoms is usually reassuring. A serum iron concentration measured at 3 to 5 hours (...) after ingestion is the most useful laboratory test to evaluate the potential severity of an iron overdose. Sustained-release or enteric-coated preparations may have erratic absorption, so the serum concentration should be repeated at 6 to 8 hours after ingestion. Because iron is rapidly cleared from the serum and deposited in the liver, the concentration of iron after a substantial ingestion may be deceptively low if it is measured many hours after its peak absorption. Iron’s toxic effects come from

2018 CandiEM

90. Chenodeoxycholic acid sigma-tau - cerebrotendinous xanthomatosis

Conference of Harmonisation IEC Independent Ethic Committee LCA Lithocholic acid LDH Lactic Dehydrogenase MedDRA Medical Dictionary for Regulatory Activities MEPs Motor Evoked Potentials MMRM Mixed Model for Repeated Measures MMSE Mini Mental State Examination MRI Magnetic Resonance Imaging NCS Non-clinically Significant PT Preferred Term PTH Parathyroid Hormone RBC Red Blood Cell SAE Serious Adverse Event SAP Statistical Analysis Plan SAS Statistical Analysis System SD Standard Deviation SI (...) substances have been quantified by TLC, but a more accurate HPLC method will be used from now on as requested by the CHMP. The HPLC method will also be used to measure assay (previously determined via acid-base determination) henceforward. So far the new HPLC method has only been used to measure long term stability data from one batch for up 12 months. Data on two additional batches for up to 12 months has been requested by CHMP. Full compliance with the proposed specification was reported

2017 European Medicines Agency - EPARs

92. Low Back Pain, Adult Acute and Subacute

of fear-avoidance beliefs occur early in low back patients (Coudeyre, 2007). George et al. (2015) found that psychological risk status, depressive symptoms and pain intensity were predictive of six-month recovery status. Further- more, elevated fear-avoidance, kinesiophobia and depressive symptoms co-occurred with nonrecovery at six months (George, 2015). Objective measurement of a range of yellow flags can be captured by a validated, comprehensive and reli - able tool such as the STarT Back Tool (...) , and include test and measures that assess neurologic, musculoskeletal and biomechanical dysfunction. The following are components of the low back pain exam: • Neurologic evaluation, including reflex sensation, and neural tension and strength - straight leg raising - ability to walk on heels and toes - symmetrical great toe extensor strength • Palpation of related structures • Assessment of posture • Evaluation of lumbar spine range of motion (quantity and quality, asymmetry/inconsistency) • Evaluation

2018 Institute for Clinical Systems Improvement

93. Perinatal Mortality Guideline

before, during or after birth, starting at greater than or equal to 20 weeks of gestation and ending 7 completed days after birth. Gestational Age – Fetal age or duration of pregnancy measured from the first day of the last normal menstrual period, and expressed in completed days or weeks. Gestation may be determined from LMP , data from early ultrasound, or from combining the two. The current BC recommendation is to use the first ultrasound after 7 weeks gestation to date the pregnancy unless timed (...) space; poly/syndactyly and rocker-bottom deformity 3. Investigation and Assessment of Stillbirth, cont’d.13 Perinatal Mortality Guideline Stillbirth Autopsy and Request: Information for Practitioners What the Requesting Practitioner Can Expect From a Stillbirth Autopsy A stillbirth autopsy is meant to examine for anatomical causes of death or disease states based on fetal and placental examination and may not be definitive in situations where the underlying cause is external to the fetus or placenta

2017 British Columbia Perinatal Health Program

94. BHIVA guidelines on the management of HIV in pregnancy and postpartum

group included two patient representatives who were involved in all aspects of the guideline development. BHIVA guidelines on the management of HIV in pregnancy and postpartum 8 1.3 Dissemination and implementation The following measures have been/will be undertaken to disseminate and aid implementation of the guidelines: • E-publication on the BHIVA website and in the journal HIV Medicine; • Publication in HIV Medicine; • Shortened version including concise summary of recommendations; • E-learning (...) should not be delayed because of pregnancy, to protect both maternal and fetal health. All women should have commenced cART by week 24 of pregnancy. In women with a history of preterm delivery (PTD) it may be prudent to start cART as soon as possible after the first trimester to maximise time on cART prior to delivery although there are no supporting data and avoidance of PIs associated with PTD may be considered (see section 6.6). 6.3 Woman is not already on cART: what to start 6.3.1 Women

2019 British HIV Association

95. Anthropometric measurements as predictors of cephalo-pelvic disproportion: Can the diagnostic accuracy be improved? (Abstract)

height, foot size, inter-trochanteric diameter and bis-acromial diameter showed the highest positive predictive values for CPD. Combining some maternal measurements with estimates of fetal weight increased predictive values modestly, which are likely to be greater if the estimates of fetal weight are close to the actual birth weight. Based on multivariate analysis the risk factors for CPD in our population were foot length ≤23cm, inter-trochanteric diameter ≤30cm and estimated fetal weight ≥3 (...) Anthropometric measurements as predictors of cephalo-pelvic disproportion: Can the diagnostic accuracy be improved? We assessed the efficacy of maternal anthropometric measurements and clinical estimates of fetal weight in isolation and in combination as predictors of cephalopelvic disproportion (CPD).Prospective cohort study.Tertiary care teaching hospital, two affiliated hospitals with facilities for conducting cesarean delivery and seven affiliated primary care facilities with no operation

2011 Acta Obstetricia et Gynecologica Scandinavica

96. Episcissors-60 for guided mediolateral episiotomy

giving birth for the first time. The episiotomies were given for clinical indications such as prolonged second stage of labour, foetal distress and instrumental delivery. Episiotomies were done by doctors and post-delivery suture angles were measured at an unspecified time after birth. Length of cut and distance from the caudal (lower) end of the cut to the anus were also measured. The average post-delivery suture angle achieved with the Episcissors-60 was 40.2 degrees, compared to an average post (...) was clinically indicated (by foetal distress, prolonged second stage of labour or maternal exhaustion). Women who were indicated for instrumental delivery were excluded from the study. Episiotomies were done by 2 experienced obstetricians using the angled version of Episcissors-60. Twenty four women had cephalic deliveries (head first) and 1 woman had a vaginal breech delivery (buttocks or feet first). Before suturing, per rectal examinations were done to detect any OASIs. The median post-delivery suture

2015 National Institute for Health and Clinical Excellence - Advice

97. 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

98. Prosthetic and Amputee Rehabilitation - Standards and Guidelines (3rd Edition)

Recommendations and scope of provision of prosthetics for ex-servicemen with service attributable injury 57 10. Miscellaneous topics 61 Counselling 61 Outcome Measures 62 Cosmesis 66 Limbs for Leisure 68 Water Activity Limbs 69 Section II Standards for Amputee and Prosthetic Rehabilitation (3 rd Edition) 71 APPENDICES 79 Appendix 1 – Membership of the Working Party 79 Appendix 2 – Glossary of terms 81 Appendix 3 - Useful addresses 83 Introduction BSRM Working Party Report – Amputee and Prosthetic (...) . Clinical Reference Groups (CRG) were set up to advise NHS England. The CRG for Complex Disability Equipment, which included Prosthetic/Amputee Rehabilitation Services for National Commissioning led on the development of the service specifications for commissioning. 4,5 Other services under this umbrella were assistive electronic technology and assistive communication aids. This CRG was also tasked to formulate clinical service delivery models, care pathways, and outcome measures from April 2013 onwards

2018 British Society of Rehabilitation Medicine

99. BTS guideline for oxygen use in adults in healthcare and emergency settings.

or cardiovascular support or CPR should be managed with left lateral tilt or manual uterine displacement (ideally to the left) to improve cardiac output and oxygen delivery ( grade D ). The use of oxygen supplementation during intrauterine fetal resuscitation during labour was widespread in the past but there is no evidence of benefit. There is weak evidence of harm to the fetus if supplemental oxygen is given for long periods during uncomplicated labour. Overall, the use of oxygen during labour is only (...) of Hypoxaemia and Hypercapnia Fully trained clinicians should assess all acutely ill patients by measuring respiratory rate, pulse rate, blood pressure and temperature and assessing circulating blood volume and anaemia (see section 7 in the original guideline document). Expert assistance from specialists in intensive care or from other disciplines should be sought at an early stage if patients are thought to have major life-threatening illnesses and clinicians should be prepared to call for assistance when

2017 National Guideline Clearinghouse (partial archive)

100. VA/DoD clinical practice guideline for the management of type 2 diabetes mellitus in primary care.

a regimen including basal insulin and short-acting meal time or basal insulin and correction insulin for non-critically ill hospitalized patients with type 2 diabetes. ( Weak for; Reviewed, New-added ) The Work Group suggests providing medication education and diabetes survival skills to patients before hospital discharge. ( Weak for; Reviewed, Amended ) Selected Complications and Conditions The Work Group recommends performing a comprehensive foot risk assessment annually. ( Strong for; Not Reviewed (...) the pregnancy and referred to a maternal fetal medicine provider (when available) before, or as early as possible, once pregnancy is confirmed. ( Strong for; Not Reviewed, Amended ) Refer to the original guideline document for considerations for pharmacological therapy. Definitions The relative strength of the recommendation is based on a binary scale, "Strong" or "Weak." A strong recommendation indicates that the Work Group is highly confident that desirable outcomes outweigh undesirable outcomes

2017 National Guideline Clearinghouse (partial archive)

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