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Fetal Foot Measurement

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101. 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

102. Treatment for Bipolar Disorder in Adults: A Systematic Review

Aripiprazole Venlafaxine Lithium Ziprasidone and Mood Stabilizers Mood Stabilizers alone (placebo) Psychosocial Interventions Psychoeducation Inactive* Comparators Psychoeducation Active** Comparators CBT Inactive Comparators CBT (for Relapse, Global Function, Other Measures of Function) Active Comparators Systematic or Collaborative Care (for Depression, Mania, Global Function, Other Measures of Function) Inactive Comparators Family or Partner Interventions Inactive Comparators Family or Partner (...) to placebo, and those using olanzapine reported more clinically significant weight gain. Lithium showed short-term benefit for acute mania and longer time to relapse to any mood episode in adults with BD-I versus placebo. Of all acute mania treatments, lithium treatment was closest to reaching a clinically meaningful difference for all the participants as measured by the MID. Evidence was generally insufficient for benefits from nondrug interventions for adults with BD. Low-strength evidence showed

2018 Effective Health Care Program (AHRQ)

103. Drug Therapy for Early Rheumatoid Arthritis: A Systematic Review Update

C. Benefits and harms of biologic DMARDs for early RA treatment ES-8 Table 1. Corticosteroids and disease-modifying antirheumatic drugs (DMARDs) approved by the U.S. Food and Drug Administration 3 Table 2. Eligibility criteria for review of treatments for early rheumatoid arthritis 7 Table 3. Outcomes and hierarchy of preferred measures for data abstraction 10 Table 4. Definitions of the grades of overall strength of evidence 13 Table 5. Number of studies included for each KQ, by drug therapy (...) previously used MTX specifically: 58 19 and 79 20 percent of patients in two studies, and three studies (all trials) enrolling samples that were entirely MTX resistant (i.e., 100% prior use). 8-10 All included studies enrolled patients with moderate to high disease activity at baseline as measured with mean or median Disease Activity Score (DAS) 28 scores (range of 0 to 10); ES-4 DAS28 scores in these studies ranged from 3.4 to 7.1. A DAS28 score of 3.2 is the threshold for low disease activity; a score

2018 Effective Health Care Program (AHRQ)

104. Environmental Factors Associated with Increased Rat Populations: A Focused Practice Question

by the World Health Organization (WHO) was to identify the public health risks posed by various urban pests and appropriate measures to prevent and control them. The WHO invited international experts in various fields including pests, pest-related diseases and pest management to provide evidence to develop policies to manage and reduce the risk of exposure to urban pests including rodents. The quality of the literature review was rated as weak to moderate. There was a chapter in this report on commensal (...) provides education to residents on prevention and control measures. The PHI may also work in collaboration with the municipal by-law department if a private residential property is the source of a rat infestation. In Canada, communicable diseases are identified by the federal, provincial and territories’ governments as priorities for monitoring and control efforts 2 . Each year National Notifiable disease data are voluntarily submitted by the provinces and territories through the Canadian Notifiable

2018 Peel Health Library

105. 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

106. 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

107. 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

109. 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

110. 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

111. 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

112. 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

113. 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

114. 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

115. Prevalence and associated factors of birth defects among newborns in sub-Saharan African countries: a systematic review and meta-analysis Full Text available with Trip Pro

anomalies [ ]. It is also supported by an experimental study conducted to evaluate the toxicological consequences of chloroquine and ethanol on the developing rat fetus which has shown a teratogenic effect of anti-malarias causing structural birth defects such as cleft palate, wrist drop, clubbed foot and brain liquefaction [ ]. It, therefore, appears that pregnant women taking both prescribed and non-prescribed drugs which have the ability to pass through placental barrier may disturb the normal (...) supplementation, maternal history of disease and maternal history of medication) if two or more studies have mentioned them as risk factors. For every associated risk factor, to compute the odds ratio, the data from the primary studies were extracted in the form of two by two tables. Outcome measurements: this systematic review and meta-analysis have two major outcomes. The primary outcome was prevalence of birth defects among newborn infants in sub-Saharan African countries. The second outcome of the study

2020 Pan African Medical Journal

116. A SYSTEMATIC REVIEW OF RESEARCH FINDINGS ON BUFFALO HEALTH AND PRODUCTION PUBLISHED DURING THE LAST SIX DECADES IN BANGLADESH Full Text available with Trip Pro

performances of different types of buffaloes. The productive and reproductive performances are the important considerations to determine the profitability of buffaloes, which influences the economics of milk production in dairy animals. The productive and reproductive parameters are maintained to increase the milk production per animal. Average daily milk yield The average milk yield of buffaloes during lactation period which can be measured in liter / day by using the formula: Average milk yield (liter (...) and rebreeding so as to maintain a post-partum barren interval close to 60 days. Measurement of progesterone is an indirect method for early pregnancy diagnosis. Estrus cycle indicate that the milk or serum progesterone concentrations reach a maximum level 13-14 days after estrus and if the animal is pregnant, these continue to remain elevated up to day 21 after fertilization and beyond. These high levels of progesterone in serum or milk between days 18 and 24 after AI form the basis of establishment

2020 Journal of Veterinary Medical and One Health Research

117. Cutaneous melanoma

induction are unknown. 4 Sunburn is mainly due to ultraviolet B (UVB) (280 to 320 nm) radiation, implicating UVB as a contributing factor to the pathogenesis of melanoma. There is accumulating evidence for the role of ultraviolet A (UVA) (and sunbeds) in the pathogenesis of melanoma. 6 3.3 PRIMARY PREVENTION Primary prevention is defined as prevention targeted towards the general population. There is indirect evidence that sun avoidance and other sun-protective measures (for example clothing, hats (...) found in sunscreens may be carcinogenic. 7,8 Case-control studies and clinical trials have shown no reduction or increase in melanoma incidence with broad-spectrum sunscreen use. Little is known about the potential long-term effects of sunscreen use. 7,8 Given these potentially adverse effects of sunscreens in relation to risk of melanoma, physical protection measures should be regarded as more important than sunscreen use. 7,8 There may be theoretical risks associated with sun avoidance, 9

2017 SIGN

118. 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

119. Standards for obstetrical ultrasound assessments

? ? ? ? ? ? ? ? 17 APPENDIX 4 – CONTACT INFORMATION AND FDS REFERRAL CRITERIA ? ? ? ? 19 APPENDIX 5 – PGSP MINIMUM REPORTING STANDARDS FOR NUCHAL TRANSLUCENCY ULTRASOUND MEASUREMENTS ? ? ? ? ? ? ? ? ? ? ? ? 20 APPENDIX 6 – CROWN RUMP LENGTH (CRL) CHART ? ? ? ? ? ? ? ? ? ? ? ? ? ? 22 APPENDIX 7 – INTERGROWTH 21ST FETAL GROWTH STANDARDS REVIEW ? ? 23 APPENDIX 8 – AMNIOTIC FLUID VOLUME ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 24 APPENDIX 9 – SOGC – 1ST TRIMESTER DATING ULTRASOUND ? ? ? ? ? ? ? ? ? 27 APPENDIX 10 (...) are identified, the ultrasound examination must be expanded appropriately and all abnormal findings documented, measured (if appropriate) and reported? ? ? When significant fetal growth and/or fluid volume abnormalities and/or structural malformations are identified, recommendations given in the final report should include a referral to, or consultation with, the Fetal Diagnostic Service (FDS), the Provincial Medical Genetics Program, or other specialists? Appendix 4 ? ? When a fetal soft marker(s

2016 CPG Infobase

120. Guidelines for the Management of Genital Herpes in New Zealand

– Management of Recurrent Episodes of Genital Herpes 18 GENITAL HERPES IN PREGNANCY 18 Maternal Fetal Transmission 19 Use of Antivirals in Pregnancy and Breastfeeding 19 Mode of Delivery 21 Special Situations in Pregnancy 21 Prevention of HSV in the Neonate 21 Summary of Clinical Management of First Episode Genital Herpes in Pregnancy 22 Treatment algorithm – Management of Women with Suspected Genital Herpes in Pregnancy 23 First Episode Genital Herpes: First and Second Trimester Acquisition 23 First (...) Episode Genital Herpes: Third Trimester Acquisition 23 Management of Pregnant Women with Recurrent Genital Herpes 24 Treatment algorithm – Management of Women with History of Genital Gerpes Prior to Pregnancy and Women with First Clinical Episode Greater than 6 Weeks Prior to Delivery 25 NEONATAL HSV INFECTION 25 Transmission to the Fetus and Newborn 26 Disease Classification 26 Table 2: Classification of Neonatal HSV Infection46 27 Management of Neonatal HSV Infection 29 Guidelines for Talking

2017 New Zealand Sexual Health Society

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