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Fetal Foot Measurement

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81. Ertugliflozin l-pyroglutamic acid / metformin hydrochloride (Segluromet) - Diabetes Mellitus, Type 2

were measured in the urinary bladder, liver, kidney medulla, and kidney. The radioactivity did not show affinity for pigmented tissues containing melanin and exposure in the non­circumventricular CNS tissues was lower than blood concentrations (Tissue­to­blood ratio = 0.047 to 0.094 for Cmax and 0.064 to 0.12 for AUClast). Placental transfer of radioactivity was widespread with exposures to most fetal tissues, amniotic sac, amniotic fluid, myometrium, and placenta. Highest concentration (...) under the curve AUCinf area under the concentration-time curve from 0 to infinity AUClast area under the concentration –time curve from zero to time of last measurable concentration BCS biopharmaceutical classification system bid twice daily BMD bone mineral density BMI body mass index Broad pool pooled safety data from all seven ertugliflozin phase III studies BUN blood urea nitrogen CFU colony forming units CHMP Committee for Medicinal Products for Human use CI confidence interval cLDA constrained

2018 European Medicines Agency - EPARs

82. Velmanase alfa (Lamzede) - alpha-Mannosidosis

based on applicants’ own tests and studies and/or bibliographic literature substituting/supporting certain test(s) or study(ies). Information on Paediatric requirements Pursuant to Article 7 of Regulation (EC) No 1901/2006, the application included an EMA Decision P/0122/2014 on the agreement of a paediatric investigation plan (PIP). At the time of submission of the application, the PIP P/0122/2014 was not yet completed as some measures were deferred. Information relating to orphan market (...) and the clinical phenotype or a defined genotype-phenotype relationship. Diagnosis A diagnosis is made by measuring the enzymatic activity of alpha-D-mannosidase in white blood cells. If there is a decreased level of the enzyme in comparison to standard levels, a diagnosis can be made. It is thought that this disorder might be under-diagnosed for a few different reasons—the diagnosis is often made late in the disease's progression, symptoms are often mild, or the biochemical diagnosis does not yield conclusive

2018 European Medicines Agency - EPARs

83. Adalimumab (Hyrimoz) - Juvenile Rheumatoid Arthritis, Psoriatic Arthritis, Rheumatoid Arthritis, Ulcerative Colitis, Crohn Disease, Papulosquamous Skin Diseases, Hidradenitis Suppurativa, Ankylosing Spondylitis, Uveitis

effect on adalimumab clearance. The serum levels of free adalimumab (not bound to anti-adalimumab antibodies, AAA) were observed to be lower in patients with measurable AAA. Hepatic or renal impairment Adalimumab has not been studied in patients with hepatic or renal impairment. 5.3 Preclinical safety data Non-clinical data reveal no special hazard for humans based on studies of single dose toxicity, repeated dose toxicity, and genotoxicity. An embryo-foetal developmental toxicity / perinatal (...) -modifying anti-rheumatic drugs including methotrexate has been inadequate. • the treatment of severe, active and progressive rheumatoid arthritis in adults not previously treated with methotrexate. Hyrimoz can be given as monotherapy in case of intolerance to methotrexate or when continued treatment with methotrexate is inappropriate. Adalimumab has been shown to reduce the rate of progression of joint damage as measured by X-ray and to improve physical function, when given in combination

2018 European Medicines Agency - EPARs

84. 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

85. Propranolol

. If you wanted the latest trusted evidence on propranolol or other clinical topics then use Trip today. This page lists the very latest high quality evidence on propranolol and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months. What is Trip? Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care (...) on patients, methods, interventions, outcomes measured, and results using a pre-tested form. Study quality was assessed using two 2017 2. A comparative study of candesartan versus propranolol for migraine prophylaxis: A randomised, triple-blind, placebo-controlled, double cross-over study. 24335848 2016 04 30 2017 02 08 1468-2982 34 7 2014 Jun Cephalalgia : an international journal of headache Cephalalgia A comparative study of candesartan versus propranolol for migraine prophylaxis: A randomised, triple

2018 Trip Latest and Greatest

86. Burosumab (Crysvita) - X-linked hypophosphataemia/hypophosphatemia

albumin ALP alkaline phosphatase API Active Pharmaceutical Ingredient AS Active Substance ATP adenosine triphosphate AUC area under the serum concentration time curve AUC0-8 AUC from zero to infinity AUC0-t AUC from zero to the last detectable time point AUClast AUC from zero to the time of last measured concentration BAL BioAgilytix BALP bone-specific alkaline phosphatase BP Bodily Pain or Blood pressure BPI Brief Pain Inventory BPI-SF Brief Pain Inventory – Short Form BR Batch Record BSV Between (...) certain test(s) or study(ies). Information on Paediatric requirements Pursuant to Article 7 of Regulation (EC) No 1901/2006, the application included an EMA Decision(s) P/0265/2016 on the agreement of a paediatric investigation plan (PIP). At the time of submission of the application, the PIP P/0265/2016 was not yet completed as some measures were deferred. Assessment report EMA/148319/2018 Page 9/130 Information relating to orphan market exclusivity Similarity Pursuant to Article 8 of Regulation (EC

2018 European Medicines Agency - EPARs

87. Guidelines For Professional Ultrasound Practice

and neonatal liver and biliary system (including pancreas and spleen) 70 2.11.2 Paediatric urinary system 74 2.11.3 Paediatric gastro-intestinal tract 75 2.11.4 Neonatal hip 76 2.11.5 Neonatal intracranial ultrasound 77 2.12 Musculoskeletal ultrasound examinations 78 Examination specific guidelines and common scenarios 2.12.1 Shoulder 78 2.12.2 Elbow 84 2.12.3 Wrist and hand 88 2.12.4 Hip 91 2.12.5 Knee 94 2.12.6 Foot and ankle 97 2.12.7 Rheumatology ultrasound examinations 101 2.13 Elastography 111 2.14 (...) of Radiographers (SCoR) document. Standard: ‘A required or agreed level of quality or attainment. A standard is a way of ensuring optimum levels of care or service delivery. Standards promote the likelihood of an ultrasound examination being delivered safely and effectively, are clear about what needs to be done to comply, are informed by an evidence base and are effectively measureable’. Guideline: ‘A general rule, principle or piece of advice. Guidelines provide recommendations on how ultrasound examinations

2018 British Medical Ultrasound Society

88. Responsible, Safe, and Effective Use of Biologics in the Management of Low Back Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines

or low quality observational studies Level IV Limited Evidence obtained from multiple moderate or low quality relevant observational studies Level V Consensus based Opinion or consensus of large group of clinicians and/or scientists for effectiveness as well as to assess preventive measures, adverse consequences, effectiveness of other measures. Modified from: Manchikanti et al. A modified approach to grading of evidence. Pain Physician 2014; 17:E319-E325 (49). Table 2. Guide for strength (...) , only 16% had complete resolution of their back pain and disability at 2 years despite multiple spinal interventions. 4.0 p revaLence of u sage of h eaL th c are ModaLItIes In ManagIng Low Back p aIn Key Question 2. What are the statistics regarding the trends in utilization of treatment modalities? Exploding health care costs are major U.S. and world issues which have led to the implementation of various health care reform measures, regulations, and to the imposition of guidelines which have often

2019 American Society of Interventional Pain Physicians

89. Stillbirth care

. For permissions beyond the scope of this licence, contact: Intellectual Property Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Queensland Clinical Guideline: Stillbirth care Refer to online version, destroy printed copies after use Page 3 of 34 Flow Chart: Stillbirth care Abbreviations: CTG: Cardiotocograph; FGR: fetal growth restriction; GP: General Practitioner; PPM: Private Practice Midwife; PSANZ: Perinatal Society of Australia and New (...) referrals · Complete documentation Communication Labour and birth Consider birthing options · Discuss timing and options for birth with parents–provide written information · Vaginal birth is generally preferable · Consider method of induction relevant to gestation and clinical circumstances (especially obstetric surgical history) · Ensure adequate analgesia · Consider active third stage management Antenatal Diagnosis of fetal death · Diagnose with USS Investigations of fetal death · Refer to Flowchart

2019 Queensland Health

90. Cerebral palsy in under 25s: assessment and management

, particularly outside the home. 1.8.10 Advise parents or carers that intra-oral devices have not been shown to improve eating, drinking and swallowing in children and young people with cerebral palsy. 1.8.11 Use outcome measures important to the child or young person and their parents or carers to review: Cerebral palsy in under 25s: assessment and management (NG62) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 18 (...) and management (NG62) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 20 of 461.10 Optimising nutritional status 1.10.1 Regularly review the nutritional status of children and young people with cerebral palsy, including measuring their height and weight (or consider alternative anthropometric measurements, particularly if height and weight cannot be measured). 1.10.2 Provide timely access to assessment and nutritional

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

91. Use Of Carbapenems In Pregnancy

. Imipenem and meropenem are used for the treatment of severe hospital-acquired infections and polymicrobial infections. Ertapenem is used for the treatment of abdominal and gynaecological infections, pneumonia, and skin and soft tissue foot infections in people with diabetes. There is extremely limited information on the use of carbapenem antibiotics during pregnancy and an evidence-based evaluation of risk to the fetus is therefore not currently possible. Where possible, the results of culture (...) and sensitivity tests should be available before making a treatment choice in accordance with local prescribing guidelines. It is important to ensure adequate treatment of maternal infections in pregnancy as failure to treat may lead to adverse maternal and fetal effects as a consequence of uncontrolled infection or pyrexia. Exposure to carbapenems at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy. Due to the lack of safety data and the likely severity

2020 UK Teratology Information Service

92. Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada

MBBS, PhD, FACP, FRACP, FRCPC, Peter Senior MBBS, PhD, FRCP S210 Retinopathy Filiberto Altomare MD, FRCSC, Amin Kherani MD, FRCSC, Julie Lovshin MD, FRCPC S217 Neuropathy Vera Bril MD, FRCPC, Ari Breiner MD, FRCPC, Bruce A. Perkins MD, MPH, FRCPC, Douglas Zochodne MD, FRCPC S222 Foot Care John M. Embil MD, FRCPC, FACP, Zaina Albalawi MD, FRCPC, Keith Bowering MD, FRCPC, FACP, Elly Trepman MD S228 Sexual Dysfunction and Hypogonadism in Men With Diabetes Richard Bebb MD, ABIM, FRCPC, Adam Millar MD (...) 12: Monofilament Testing in the Diabetic Foot S323 Appendix 13: Diabetes and Foot Care: A Checklist S324 Appendix 14: Diabetic Foot Ulcers—Essentials of Management S325 Appendix 15: Glycated Hemoglobin Conversion ChartCan J Diabetes 42 (2018) A6–A16 Contents lists available at ScienceDirect Canadian Journal of Diabetes journal homepage: www.canadianjournalofdiabetes.com Executive Committee Ron Goldenberg MD FRCPC FACE Sub-Group Chair, Diagnosis & Classification Consultant Endocrinologist North

2018 Diabetes Canada

93. 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

94. Management Of Haemophilia

Synovitis 30 7.2 Joint Arthropathy 31 7.3 Pseudotumour 31 8. INHIBITORS 33 8.1 Treatment of Acute Bleeding 34 8.2 Prophylaxis Therapy 34 8.3 Eradication of Inhibitors 35 9. HOME THERAPY 37 10. ADHERENCE IN HAEMOPHILIA TREATMENT 39 11. SPECIAL SITUATIONS 41 11.1 Surgeries and Invasive Procedures 41 11.2 Management of Pregnant Carrier 42 11.3 Vaccination 43 11.4 Circumcision 43 12. DENTAL CARE 44 12.1 Preventive Dental Measures 44 12.2 Dental Procedures 44 12.3 Management of Oral Bleeding 46 13 (...) . MONITORING 48 13.1 Inhibitors 48 13.2 Bleeding Frequency 48 13.3 Joint Health 49 13.4 Radiological Measures 49 14. IMPLEMENTING THE GUIDELINES 50 14.1 Facilitating and Limiting Factors 51 14.2 Potential Resource Implications 51 REFERENCES 53 Appendix 1 Example of Search Strategy 59 Appendix 2 Clinical Questions 60 Appendix 3 Guidelines on Sample Collection and 62 TransportationManagement of Haemophilia Appendix 4 Recommended Sports/Physical Activities in 63 Haemophilia Appendix 5 Development of Abnormal

2018 Ministry of Health, Malaysia

95. Nausea/vomiting in pregnancy: Scenario: Management

of hypokalaemia or thyrotoxicosis. Consider referring for ultrasonography to identify predisposing factors (for example multiple or molar pregnancy). Measurement of serum human chorionic gonadotrophin is not recommended. Further blood tests (for example full blood count, urea and electrolytes, liver function tests, calcium and phosphate levels, and thyroid function tests) are not routinely recommended in primary care; if they are thought to be necessary, admission to hospital may be more appropriate (...) how treatment is progressing [ ; ]. Measurement of serum human chorionic gonadotrophin Measuring serum human chorionic gonadotrophin is not recommended because it is not thought to be helpful in determining whether vomiting is caused by hyperemesis gravidarum [ ]. Further investigations Expert opinion in a review article suggests that laboratory tests are not needed in women with normal examination findings and no evidence of dehydration [ ]. CKS suggests that if a woman is sufficiently unwell

2018 NICE Clinical Knowledge Summaries

96. Corticosteroids - topical (skin), nose, and eyes: Scenario: Topical treatment

of an adult's body. Body area Number of FTUs Scalp 3 Face and neck 2.5 One hand (front and back including fingers) 1 One arm (including entire hand) 4 Elbows (large plaque) 1 Both soles of feet 1.5 One foot (dorsum and sole) including toes 1.5 One leg (including entire foot) 8 Buttocks 4 Knees (large plaque) 1 Trunk (front) 8 Trunk (back) 8 Genitalia 0.5 Data from: [ ] Basis for recommendation These recommendations are largely based on the National Institute for Health and Care Excellence (NICE) guideline (...) a less potent corticosteroid once the flare-up is under control. Areas where the skin is thin or flexural (such as the face, scrotum, groin, axillae, and submammary area) usually require a corticosteroid preparation. Areas where the skin is thick, owing to either site (palms of the hands and soles of the feet) or from constant scratching (lichenification), usually require more Children and older people are more susceptible to the adverse effects of topical corticosteroids because they have a thinner

2018 NICE Clinical Knowledge Summaries

97. Second Trimester Detailed Anatomic Study

referral to assess for risk of aneuploidy and skeletal dysplasia. ? Confirm that there are four limbs, 12 long bones, two normal hands and two normal feet. ? Confirm opening of hands, and normal foot-ankle orientation. The ultrasound report should include assessment of fetal environment/maternal structures: Amniotic fluid 4 ? Qualitatively assess the amniotic fluid volume and report as: normal, increased, decreased, or absent. ? Use the Chamberlain classi?cation of amniotic ?uid for initial assessment (...) ? The ultrasound report should include a detailed anatomic survey and must include: o Each structure in the standard anatomic survey list in a ‘checklist’ format ? The report must indicate if each of these structures was: o Normal o Abnormal o Not adequately seen (and if so, why) Fetal Head ? Assess and document the following anatomical landmarks: o Shape of the fetal skull o Cavum septum pellucidum o Midline falx o Choroid plexus o Lateral cerebral ventricles: measure width in mm, report in mm if abnormal (10

2018 Accelerating Change Transformation Team

98. 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

99. Management of Pregnancy

? Measure fundal height ? Screen for GDM with one-hour GCT (for women with dumping syndrome, use fasting and two- hour post-prandial glucose value) a ( ) Recommendation 10 ? Perform fetal fibronectin test for women with signs/symptoms of preterm labor ( ) Recommendation 16 ? Assess and educate regarding fetal movement/kick counts and preterm labor symptoms ? Recommend Tdap vaccination for mother and family ? Administer Rh immune globulin to Rh negative pregnant women ? Discuss family planning (...) complications and morbidity • Emphasize the use of patient-centered care (PCC) II. Background A. Description of Pregnancy Pregnancy is the reproductive time during which a developing fetus grows inside of the uterus. It is a time of dramatic change for a developing fetus and a woman’s body. Most pregnancies are uncomplicated and labor results in a normal vaginal birth with a healthy mother and baby. Rarely, complications arise, which have the potential to lead to lifelong implications. As the fetus

2018 VA/DoD Clinical Practice Guidelines

100. CRACKCast E144 – High Altitude Medicine

Concepts All forms of altitude illness can be treated with oxygen and rapid descent . The diagnosis of AMS requires the presence of headache in the setting of recent elevation change to greater than 8000 feet. Additional nonspecific symptoms may include nausea, anorexia, fatigue, and insomnia. Patients with AMS should not ascend further until symptoms improve. Patients with mild HAPE may be treated in place if experience providers and treatment options exist. Patients with moderate HAPE or HACE should (...) . Symptoms can be controls with analgesia (ibuprofen and antiemetics). HAPE may be prevented using nifedipine, inhaled salmeterol, and phosphodiesterase type 5 inhibitors (sildenafil [40 mg every 8 hours] and tadalafil [10 mg every 12 hours]). Temazepam (7.5 mg qhs) can safely improve sleep quality. We will accidentally talk in both feet and meters because Canadian are a weird hybrid bunch. To convert multiple meters by 3 Rosens in Perspective Acute high altitude illnesses, are completely preventable

2018 CandiEM

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