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Fetal Foot Measurement

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121. Patient Dignity (Formerly:Patient Modesty): Volume 97

the patient would be on equal footing to make their decision. What is fair for one should be fair for all involved. In fact, since exposing body parts don't matter, than doctors/nurses should have naked pictures so pictures could view what is under the coats and scrubs to make everyone on an equal level. Remember we are told as a patient, being naked w/ these people doesn't matter so let's see if that is true. JR At , said... Sometimes timing is everything. The very recent discussion we had about dignity (...) works in healthcare. The big question is what benefits are there for these kinds of polls. Polls can be used to measure attitudes or shape public opinion. Is it fair and ethical to say you can trust your nurse more than you can trust your family Doctor or your clergyman? PT At , said... I hope you all can take a few minutes to read this current article in “Public Discourse” with the following address: https://www.thepublicdiscourse.com/2019/04/51161/ arguing against the American Nurses Association

2019 Bioethics Discussion Blog

123. Evaluation and Treatment of Hypertriglyceridemia

at least every 5 yr (1/⊕⊕○○). 1.2. We recommend basing the diagnosis of hypertriglyceridemia on fasting triglyceride levels and not on nonfasting triglyceride levels (1/⊕⊕⊕○). 1.3. We recommend against the routine measurement of lipoprotein particle heterogeneity in patients with hypertriglyceridemia (1/⊕⊕○○). We suggest that measurement of apolipoprotein B (apoB) or lipoprotein(a) [Lp(a)] levels can be of value, whereas measurement of other apolipoprotein levels has little clinical value (2/⊕⊕○○). 2.0 (...) extensive investigation. Recommendation 1.1. Severe and very severe hypertriglyceridemia increase the risk for pancreatitis, whereas mild or moderate hypertriglyceridemia may be a risk factor for cardiovascular disease. Therefore, similar to the NCEP ATP III guideline committee's recommendations, we recommend screening adults for hypertriglyceridemia as part of a fasting lipid panel at least every 5 yr (1/⊕⊕○○). 1.1. Evidence Serum triglycerides are routinely measured under fasting conditions to obtain

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2012 The Endocrine Society

124. Heart Disease and Stroke Statistics?2012 Update

pressure (BP) measurements and interviews; and an estimate can be made for total CVD, including myocardial infarction (MI), AP, HF, stroke, and hypertension. A major emphasis of this Statistical Update is to present the latest estimates of the number of people in the United States who have specific conditions to provide a realistic estimate of burden. Most estimates based on NHANES prevalence rates are based on data collected from 2005 to 2008 (in most cases, these are the latest published figures (...) 66.4 72.9 86.1 BMI <25 kg/m 2 62.5 31.9 39.1 28.0 25.3 4–5 Diet goals met 0.0 0.3 0.3 0.1 0.5 Fruits and vegetables ≥4.5 cups/d 7.9 12.3 11.7 11.4 15.8 Fish ≥2 3.5-oz servings/wk (preferably oily fish) 9.2 18.3 16.8 19.7 19.4 Sodium <1500 mg/d 0.0 0.6 0.6 0.8 0.3 Sugar-sweetened beverages ≤450 kcal/wk 32.0 51.9 41.0 54.6 71.2 Whole grains (1.1 g fiber/10 g carbohydrates) ≥3 1-oz equivalents/d 3.2 7.3 7.0 7.1 8.4 Other dietary measures Nuts, legumes, seeds ≥4 servings/wk 8.7 21.7 19.6 22.5 24.7

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2012 American Heart Association

125. 2012 KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD

the kidney of pathologic-anatomic findings 27 Table 5. GFR categories in CKD 27 Table 6. Albuminuria categories in CKD 28 Table 7. Relationship among categories for albuminuria and proteinuria 31 Table 8. CGA staging of CKD: examples of nomenclature and comments 32 Table 9. Prognosis of CKD: Relationship of outcomes and strength of relationship to Cause (C), GFR (G), Albuminuria (A) and other measures 33 Table 10. Annual percentage change in GFR across diagnosis categories 35 Table 11. Sources of error (...) creatinine and IFCC traceable cystatin C assays 52 Table 17. PerformancecomparisonofcystatinC-basedestimatingequationsinNorthAmericanandEuropeanpopulations 54 Table 18. Strengths and limitations of GFR measurement methods and markers 55 Table 19. Factors affecting urinary ACR 59 Table 20. Decline in kidney function in various populations (longitudinal studies only) 64 Table 21. Decline in kidney function in CKD populations 65 Table 22. Studies evaluating rapid progression (general population studies only

2012 National Kidney Foundation

126. EANM Practice Guideline-SNMMI Procedure Standard for 18F-FDG Use in Inflammation and Infection

, on the basis of a cumulated reported accuracy (.85%) and expert opinion that major indications for 18 F-FDG PET/CT in infection and in?ammation are as follows: • Sarcoidosis (9–15). • Peripheral bone osteomyelitis (nonpostoperative, non– diabetic foot) (16–23). • Suspected spinal infection (spondylodiskitis or verte- bral osteomyelitis, nonpostoperative) (24–28). TABLE 1 Published Studies with More Than 10 Patients Before December 2011 Disease Considered papers Sensitivity Speci?city Accuracy References (...) Sarcoidosis 7 (173 patients) 93.5% (7 papers) Data not available 95.5% (1 papers) 9–15 Osteomyelitis 8 (287 patients) 94.6% (8 papers) 91.5% (8 papers) 94.5% (6 papers) 16–23 Spondylodiskitis 5 (136 patients) 100.0% (5 papers) 89.3% (5 papers) 91.0% (4 papers) 24–28 FUO 15 (758 patients) 90.6% (15 papers) 76.9% (15 papers) 86.4% (10 papers) 29–44 Vasculitides 12 (283 patients) 80.4% (12 papers) 89.3% (12 papers) 85.0% (3 papers) 45–56 Diabetic foot 5 (220 patients) 70.6% (5 papers) 84.4% (5 papers) 80.0

2012 Society of Nuclear Medicine and Molecular Imaging

127. CPG for Diabetes Mellitus Type 1

guidelines during hospitalization of patients with diabetes mellitus type 1 161 9.1.1. Surgical Patient 162 9.1.2. Critical patient 164 9.1.3. Stable patient 166 9.2. Preventive and treatment measures in the case of outpatient acute intercurrent diseases in patients with diabetes mellitus type 1 168 9.3. Psychological disorders in patients with diabetes mellitus type 1 173 9.3.1. Affective disorders 173 9.3.2. Anxiety disorders 175 9.3.3. Eating disorders 176 9.4. Risk of decompensation of diabetes (...) type 1 194 9.9 Clinical management of diabetes mellitus type 1 in patients with special needs 196 9.9.1. Immigrant Population 196 9.9.2. Patients with visual impairment 201 10. Acute complications 203 10.1. Hypoglycaemia 203 10.1.1. Symptoms of suspicion 204 10.1.2. Criteria for evaluating the severity 205 10.1.3. Performance measures in case of hypoglycaemia 206 It has been 5 years since the publication of this Clinical Practice Guideline and it is subject to updating. CLINICAL PRACTICE GUIDELINE

2012 GuiaSalud

128. Newborn blood spot screening

baby. Baby’s NHS number. Birth history form (Appendix 4). Blood spot card and glassine envelope (spare cards can be obtained from the Camelia Botnar newborn screening laboratory). Water for cleansing (the water should not be heated and the foot should not be submerged (Rationale 30). Non-sterile protective gloves and plastic apron. Automated incision device for use on newborns. Sharps box. Cotton wool/gauze or spot plaster. Comfort measures Ensure the baby is in a secure position for taking (...) (Rationale 12, 15) Repeat samples There are 2 types of repeat request: Avoidable repeats : where we could have done something differently Unavoidable repeats : where there was nothing we could do to prevent it We are only measured on our Avoidable repeat rate. Unavoidable repeat samples may be required from a few babies due to: Borderline thyroid stimulating hormone (TSH) results Inconclusive CF screening results The baby having received a blood transfusion within 3 days of the sample being taken

2012 Publication 1593

129. Use of Galactogogues in Initiating or Augmenting the Rate of Maternal Milk Secretion

as a last resort when other non-pharmacological measures have not resulted in an increase in milk volumes. However, some providers may inappropriately recommend galactogo- gues prior to emphasizing the primary means of increasing the overall rate of milk synthesis (i.e., frequent feeding and complete milk removal at regular intervals) or evaluating other medical factors that potentially may be involved. Pharmaceutical Galactogogues Currently available pharmaceutical galactogogues are all dopamine (...) breastfeeding routines. 22,23 Summary Despite widespread use of these pharmaceutical galacto- gogues, there are important reasons for reconsideration of this practice: Galactogogues do increase baseline serum prolactin, but there is no direct correlation between baseline prolactin levels and rates of milk synthesis or measured volumes of milk production. Previous studies up through 2006 have tended to show a pattern of increased milk production, but they have generally been of poor quality, 9,10

2011 Academy of Breastfeeding Medicine

130. HeartLight: Heart Rate Monitoring for Newborn Resuscitation

require 3 electrodes to be positioned which can delay resuscitation further. The usual site for transmission PO is the foot or hand. However, in newborn babies, and particularly those requiring resuscitation when the HR is low, blood flow is reduced so physiological mechanisms preserve brain and heart blood flow at the expense of other less important organs and limbs. As a consequence of this and the choice of wavelengths, it can be more difficult to obtain a reliable HR from POs on the limbs (...) recruited into HeartLight will be sought. Other: parental feedback Questionnaire Healthcare provider feedback Healthcare professionals caring for babies recruited into HeartLight will have their feedback on the device sought. Other: healthcare provider feedback Questionnaire Outcome Measures Go to Primary Outcome Measures : Heart Rate acquisition time in the first minute of life [ Time Frame: 1 hour ] Time to acquire heart rate from new optical hat sensor from birth should be within 1 minute of birth

2016 Clinical Trials

131. Validity of Newborn Clinical Assessment to Determine Gestational Age in Bangladesh. (PubMed)

physical/neuromuscular signs and measure anthropometrics. The distribution, agreement, and diagnostic accuracy of different clinical methods of GA assessment were determined compared with early ultrasound dating.In the live-born cohort (n = 1066), the mean ultrasound GA was 39.1 weeks (SD 2.0) and prevalence of preterm birth (<37 weeks) was 11.4%. Among assessed newborns (n = 710), the mean ultrasound GA was 39.3 weeks (SD 1.6) (8.3% preterm) and by Ballard scoring the mean GA was 38.9 weeks (SD 1.7 (...) ) (12.9% preterm). The average bias of the Ballard was -0.4 weeks; however, 95% limits of agreement were wide (-4.7 to 4.0 weeks) and the accuracy for identifying preterm infants was low (sensitivity 16%, specificity 87%). Simplified methods for GA assessment had poor diagnostic accuracy for identifying preterm births (community health worker prematurity scorecard [sensitivity/specificity: 70%/27%]; Capurro [5%/96%]; Eregie [75%/58%]; Bhagwat [18%/87%], foot length <75 mm [64%/35%]; birth weight <2500

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2016 Pediatrics

132. Umbilical Cord Prolapse

to hospital VII. Management: Temporizing measures to relieve cord pressure Adjust maternal position to reduce cord pressure Raise foot of the bed (Trendelenburg's Position) Sims' position Mother in left lateral decubitus position Genu-pectoral position Mother in knee-chest position Vaginal retrograde pressure applied to presenting part Hand in vagina elevates presenting part Mother should stop pushing with 0.25 mg SC Consider filling with 500-700 cc Saline Minimize handling of the cord Do not attempt (...) Prolapse Aka: Umbilical Cord Prolapse , Prolapsed Cord From Related Chapters II. Epidemiology Vertex presentation: 0.4% : 0.5% : 4-6% : 15-18% III. Pathophysiology Umbilical Cord Prolapses Frank cord presentation Cord prolapsed through Occult cord presentation Cord trapped alongside presenting part Follows Occurs when presenting part is ill fitting ling Fetal abnormality Fetal blood supply obstructed when cord out of Drop in of Prolapsed Cord Vasospasm of umbilical vessels Compression between pelvic

2018 FP Notebook

133. EANM/SNMMI Guideline for 18F-FDG Use in Inflammation and Infection

can conclude, on the basis of a cumulated reported accuracy (.85%) and expert opinion that major indications for 18 F-FDG PET/CT in infection and in?ammation are as follows: • Sarcoidosis (9–15). • Peripheral bone osteomyelitis (nonpostoperative, non– diabetic foot) (16–23). • Suspected spinal infection (spondylodiskitis or verte- bral osteomyelitis, nonpostoperative) (24–28). TABLE 1 Published Studies with More Than 10 Patients Before December 2011 Disease Considered papers Sensitivity Speci?city (...) Accuracy References Sarcoidosis 7 (173 patients) 93.5% (7 papers) Data not available 95.5% (1 papers) 9–15 Osteomyelitis 8 (287 patients) 94.6% (8 papers) 91.5% (8 papers) 94.5% (6 papers) 16–23 Spondylodiskitis 5 (136 patients) 100.0% (5 papers) 89.3% (5 papers) 91.0% (4 papers) 24–28 FUO 15 (758 patients) 90.6% (15 papers) 76.9% (15 papers) 86.4% (10 papers) 29–44 Vasculitides 12 (283 patients) 80.4% (12 papers) 89.3% (12 papers) 85.0% (3 papers) 45–56 Diabetic foot 5 (220 patients) 70.6% (5 papers

2013 European Association of Nuclear Medicine

134. Patient Modesty: Volume 84

that a single exam encounter produces psychiatric trauma. Here is the paper from The American Counseling Association: " ." Here are some excerpts: Menage (1993) studied 500 women who underwent obstetric and gynecological procedures, and found that 100 women described the procedure as being “terrifying” or “very distressing,” while 30 met the full criteria for PTSD (p. 221). Studies of patients in this setting have yielded alarming results ranging from 18.5% to 59%, with measures taken up to 9 years

2018 Bioethics Discussion Blog

135. Rapiacta (peramivir hydrate)

and adolescents, as a measure to prevent possible accidents, the following points should be explained to the patient/their family: after start of treatment with the drug, (1) abnormal behavior may occur and (2) the parent etc. should ensure that the child/adolescent is not left alone for at least 2 days when treated at home. Because there have also been reports of similar symptoms occurring in the setting of influenza encephalopathy etc., the above points should be explained.” 3 The drug product in vials (...) substance may form upon ************* in the current manufacturing process, Form 1 and Form 2 were able to be distinguished by any of infrared spectrum, water content, X-ray powder diffraction pattern, and photomicrograph. In manufacture, formed crystals are to be identified by ****** and furthermore, **** of ****** is to be measured to confirm that the obtained crystals are peramivir trihydrate. 2.A.(1).2) Manufacturing process The drug substance, “Peramivir Hydrate” is produced using

2010 Pharmaceuticals and Medical Devices Agency, Japan

136. Prevention and management of venous thromboembolism

3.3 Laboratory tests in assessment of thrombosis risk 9 4 methods of prophylaxis 10 4.1 General measures 10 4.2 Mechanical methods 10 4.3 Antiplatelet agents 11 4.4 Unfractionated and low molecular weight heparins 11 4.5 Heparinoids 12 4.6 Fondaparinux 12 4.7 Hirudins 13 4.8 Dextrans 13 4.9 Vitamin K antagonists 13 4.10 New oral agents 13 4.11 Combined mechanical and pharmacological prophylaxis 14 5 t hromboprophylaxis in surgical patients 15 5.1 General surgery 15 5.2 Laparoscopic surgery 17 5.3 (...) 14.2 Pulmonary embolism 54 15 a dverse effects of vte prophylaxis and treatment 56 15.1 Bleeding 56 15.2 Heparin induced thrombocytopenia 58 15.3 Reduced bone mineral density 59 15.4 Vitamin K antagonists, embryopathy and fetal haemorrhage 59 16 Provision of information 60 16.1 Checklist for provision of information 60 16.2 Sources of further information 61 16.3 Patient information leaflets 61 17 implementing the guideline 62 17.1 Resource implications of key recommendations 62 17.2 Auditing

2010 SIGN

137. Management of diabetes

Crescent Edinburgh EH12 9EB www.sign.ac.ukContents 1 Introduction 1 1.1 The need for a guideline 1 1.2 Remit of the guideline 1 1.3 Definitions 2 1.4 Statement of intent 3 2 Key recommendations 5 2.1 Lifestyle management 5 2.2 Psychosocial factors 5 2.3 Management of type 1 diabetes 6 2.4 Management of diabetes in pregnancy 7 2.5 Management of diabetic cardiovascular disease 7 2.6 Management of kidney disease in diabetes 7 2.7 Prevention of visual impairment 8 2.8 Management of diabetic foot disease 8 (...) with type 2 diabetes 39 7 Management of diabetes in pregnancy 56 7.1 Introduction 56 7.2 Contraception 56 7.3 Pre-pregnancy care 57 7.4 Nutritional management 59 7.5 Optimisation of glycaemic control 59 7.6 Complications during pregnancy 60 7.7 Fetal assessment 62 7.8 Gestational diabetes 63 7.9 Delivery 66 7.10 Infants of mothers with diabetes 66 7.11 Postnatal care 67 7.12 Follow up of women with GDM 68 7.13 Checklist for provision of information 68 8 Management of diabetic cardiovascular disease 70

2010 SIGN

138. When the antiabortion movement meets the antivaccine movement…

have been accused of cheating on their husbands. to post comments By Todd W. (not verified) on 31 Jul 2015 ) From that post: The earliest neural activity that can be associated with brain function has been measured was at 12 weeks of development. It however displays none of the characterisitics of actual brainwaves seen on a normal EEG. R. M. Bergstrom stimulated the fetal brain stem directly and recorded random bursts of electrical activity, which looked exactly like the bursts produced by fetal (...) , and a wide variety of other conditions and diseases when there is no credible evidence that they do and lots of evidence that they don't. One particularly pernicious myth, designed to appeal (if you can call it that) to religious fundamentalists, is the claim that vaccines are made using fetal parts. This particular claim reared its ugly head again in the context of a that hit the news last week. Before I get to the "sting" operation against Planned Parenthood, bear with me a moment while I discuss a bit

2015 Respectful Insolence

139. Addyi - Flibanserin

Health Drugs (AC) on June 18, 2010. Pivotal to the indication sought were two Phase 3 clinical trials conducted in North America, where efficacy was assessed by two pre-specified co-primary endpoints – satisfying sexual events (SSEs) and sexual desire (measured daily by an electronic diary, eDiary). Notably, both trials failed to show a statistically significant improvement relative to placebo in sexual desire. However, both trials demonstrated nominally statistically significant improvement vs (...) . placebo in sexual desire measured by another instrument – the Female Sexual Function Index desire domain (FSFI-desire). The Applicant stated that the results from the secondary FSFI-desire endpoint should be adequate to support approval. Most of the AC members did not agree with the Applicant’s proposal to alter the methodology of analysis post-hoc. The AC voted 10 to 1 that the Applicant had not provided sufficient evidence of efficacy. Safety concerns raised by the AC included central nervous system

2015 FDA - Drug Approval Package

140. Strensiq - asfotase alfa

on weight, with regard to patient compliance issues. In order to provide greater clarity regarding product administration, a dosing table has been included in the SmPC. Another point for clarification was raised with regard to this, concerning feasibility of accurate dose measurement. The Applicant has subsequently provided adequate reassurance with regard to the accuracy of dose measurement using widely available syringes for both proposed dosing regimens. Stability data indicate that the active (...) supplementation. This way PLP (the primary vitamin B6 coenzymic form) measurements would not be affected by dietary intake. The evaluation was carried out as a pilot to a planned study ALP-PT-26, which confirmed the previously submitted results. It has been shown that continuous treatment of Akp2-/- mice with asfotase alfa for the full duration of the study (47 days), partially improved the reduced grip strength in the forelimbs, completely prevented the increase in both plasma PLP and liver glycogen levels

2015 European Medicines Agency - EPARs

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