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141. Patient Dignity (Formerly: Patient Modesty): Volume 92

there. Male patients were turned away despite the fact that they had an order from their physician. I have but one thing to say about all this WTF! PT At , JF said... PT, Maybe you should get on psyc meds. Before you become a serial killer, killing nursing hags. At , Anonymous said... JF Nope,no reason to. If the cigarettes don’t get them first, obesity, diabetes and heart disease will. PT At , said... First, let's keep this blog thread free of ad hominem remarks. We want to read the opinions of all (...) approach would be successful by itself. This was the first time that this garment was being used; and, I wasn't sure how well a novel approach would be accepted by hospital personnel. Possibly, I was the topic of discussions, protocol meetings or jokes. I don't know. Throughout the entire process I was not hostile nor belligerent. I tried to politely "nail everything down" before the operation day. Nevertheless, my son and I were ready to pull the iv and walk (hobble) in the event of a last minute

2018 Bioethics Discussion Blog

142. Clinical Guidelines & Integrated Care Pathways for the Oral Health Care of People with Learning Disabilities

recommendations B (Evidence levels IIa, IIb, III) Requires availability of well conducted clinical studies but no randomised clinical trials on the topic of recommendation C (evidence level IV) Requires evidence from expert committee reports or opinions and/or clinical experience of respected authorities. Indicates absence of directly applicable studies of good quality. Additional Clinical Considerations & References Where applicable each guideline consists of three broad sections. The first section (...) on integrated care. They target a wide audience and should be made available to all those individuals and groups concerned with the health and welfare of people with learning disabilities. Improvements in oral health care can be obtained by encouraging carers to regularly examine the mouth of the person they are caring for. Completing an oral check (assessment) will help to identify any changes in the mouth and can aid appropriate diagnosis and treatment if reported to the dentist at an early stage

2012 British Society for Disability and Oral Health

143. Chronic obstructive pulmonary disease

of symptoms. End-of-life issues should be discussed when appropriate and advance care planning offered. Have I got the right topic? Have I got the right topic? From age 35 years onwards. This CKS topic covers the diagnosis, management, and referral of people with chronic obstructive pulmonary disease (COPD). There are separate CKS topics on , , , , , , , , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary (...) on referral to other members of the multidisciplinary team are based on the National Institute for Health and Care Excellence (NICE) guideline Management of chronic obstructive pulmonary disease in adults in primary and secondary care (partial update) [ ; ]. Treatment What treatment should I offer a person with COPD? Inhaled treatments (FEV1 50% predicted or greater) Inhaled treatments (FEV1 50% predicted or greater) Inhaled bronchodilators are the first-line drugs for the treatment of chronic obstructive

2015 NICE Clinical Knowledge Summaries

144. Expedition medicine’s role in sports and exercise medicine training

Pre-expedition planning and training draw the strongest parallels to an SEM team physician 4 . These elements are as essential to a successful and safe expedition as to sporting event cover 5 . Similar responsibilities include: medical screening of participants, determining the necessary medical equipment to take, sourcing and transportation, advising on potential health issues, casualty evacuation planning, teaching first aid/preventative health developing nutritional strategies. Risk assessment (...) own experience to address the role of expedition medicine in sports and exercise medicine training. The rise of expedition medicine Expedition medicine has recently increased in prominence. This is in part due to the popularity of adventure travel/endurance events, the ease and affordability of international flights, and a plethora of fundraising treks and sustainable development projects. The growth in demand has been met by a degree of formalisation in expedition medicine training. Multiple

2015 British Journal of Sports Medicine Blog

145. Getting there Safely—Avoid Driving Disasters

situations. As you plan your summer travel, be informed and be prepared. Keeping an emergency kit in your car is the best way to prepare for any type of emergency on the road. Include items like a first aid kit, jumper cables, tools (like a roadside emergency kit), and maps in your emergency car kit. For a full list of items to include in your car kit visit, . Here are some tips on what to do when driving through severe weather and what to do if disaster occurs when you are on the road. Severe Rain (...) a lot of memories. I work in the insurance industry and have seen many accidents in that time. This blog is very informative because many of the most common accidents that happen on the road can definitely be avoided if people would follow these basic concepts. I drive constantly to various parts of California and to this date I do not have a set of jumper cables or a first aid kit in my car. From this information it makes me want to make sure that I have these tools before my next road trip. My

2015 CDC Public Health Matters

146. 11 Winter Weather Tips : As Told by Adorable Dogs

during the winter season. I know ice/snow can be really dangerous, and people, even pets, can get into accident and hurt themselves. These tips help prevent people from getting hurt, spending extra money and even going on a trip to the hospital. There was one time we went to Big Bear Mountain, California, and I was not wearing enough layers, so I got sick after a few days. However, my question was, what would be a good remedy or first aid for frostbites? Very informative and direct. I think the tip (...) on the heart. If you have heart disease or high blood pressure, follow your doctor’s advice about shoveling snow or performing other hard work in the cold. If you have to do heavy outdoor chores, dress warmly and work slowly. 4. Prepare your car for winter weather. No one wants to ride unprepared. Always have an emergency kit in your car with supplies you can use if your car breaks down. Prepare your car for winter by following CDC’s . 5. Heat your home safely. As these guys know, fire can be scary

2015 CDC Public Health Matters

147. Infertility

in the UK, and providing first contact or primary healthcare. How up-to-date is this topic? How up-to-date is this topic? Changes Changes August 2018 — minor update. Citation amended. April 2018 — reviewed. A literature search was conducted in February 2018 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials (RCTs) published since the last revision of this topic. No changes to clinical recommendations have been made, but the topic has been (...) is it? Infertility is defined as the period of time people have been trying to conceive without success after which formal investigation is justified and possible treatment implemented [ ]. Infertility has been defined as failure to conceive after frequent unprotected sexual intercourse for one or two years. However, NICE highlights that the diagnosis of infertility based on a failure to conceive within 1 year may exaggerate the risk of infertility, since up to half of women who do not conceive in the first year

2013 NICE Clinical Knowledge Summaries

148. Be Prepared to Stay Safe and Healthy in Winter

, and a bag of sand or cat litter (for traction); compass and maps; flashlight, battery-powered radio, and extra batteries; first-aid kit; and plastic bags (for sanitation). When planning travel, be aware of current and forecast weather conditions. Equip in advance for emergencies Be prepared for weather-related emergencies, including power outages. Stock food that needs no cooking or refrigeration and water stored in clean containers. Ensure that your cell phone is fully charged. When planning travel (...) , be aware of current and forecast weather conditions. Keep an up-to-date emergency kit, including: Battery-operated devices, such as a flashlight, a National Oceanic and Atmospheric Administration (NOAA) Weather Radio, and lamps; extra batteries; first-aid kit and extra medicine; baby items; and cat litter or sand for icy walkways. Protect your family from carbon monoxide. Keep grills, camp stoves, and generators out of the house, basement and garage. Locate generators at least 20 feet from the house

2015 CDC Your Health - Your Environment Blog

149. Congenital syphilis: No longer just of historical interest

L Moore MD; Joan L Robinson MD; Élisabeth Rousseau-Harsany MD (board representative); Lindy M Samson MD Consultant: Noni E MacDonald MD Liaisons: Upton D Allen MD, Canadian Pediatric AIDS Research Group; Charles PS Hui MD, CPS Liaison to Health Canada, Committee to Advise on Tropical Medicine and Travel; Nicole Le Saux MD, Immunization Program, ACTive; Larry Pickering MD, American Academy of Pediatrics; Marina I Salvadori MD, CPS Liaison to Health Canada, National Advisory Committee (...) tests; the reader should refer to other sources for details . The majority of infants with congenital syphilis are infected in utero after the fourth month of gestation , but infection can occur as early as nine weeks’ gestation or via contact with an active gen­ital lesion at the time of delivery. Syphilis serology should routinely be performed at the first prenatal visit, followed by appropriate maternal counselling and therapy, if reactive . Rescreening should occur at 28 to 32 weeks’ gestation

2009 Canadian Paediatric Society

150. Emergency Medical Equipment On Board German Airliners. (PubMed)

contacted and data of 13 airlines were available for analysis (two airlines did not participate). A first aid kit was available on all airlines. Seven airlines reported having a doctor's kit, and another four provided an "emergency medical kit." Four airlines provided an automated external defibrillator (AED)/electrocardiogram (ECG). While six airlines reported providing anesthesia drugs, a laryngoscope, and endotracheal tubes, another four airlines did not provide even a resuscitator bag. One airline (...) did not provide any material for cardiopulmonary resuscitation (CPR).Although the minimal material required according to European aviation regulations is provided by all airlines for medical emergencies, there are significant differences in the provision of additional material. The equipment on most airlines is not sufficient for the treatment of specific emergencies according to published medical guidelines (eg, for CPR or acute myocardial infarction).© 2014 International Society of Travel

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2014 Journal of Travel Medicine

151. Exercise Intensity and Immune Function in Multiple Sclerosis

. Usual walking aids may be used however personal assistance is not permitted. Change in exercise capacity [ Time Frame: Baseline, weeks 5, 10, 15 and follow up (week 20) ] Exercise capacity will be assessed by the six minute walk test (6MWT). Participants walk continuously, turning at a defined distance, until six minutes have passed. Total distance travelled is the measured outcome. Change in fatigue [ Time Frame: Baseline, weeks 5, 10, 15 and follow up (week 20) ] Self-reported fatigue (...) Function in Multiple Sclerosis The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. Identifier: NCT02264704 Recruitment Status : Unknown Verified October 2014 by Ryan Bell, University of the West of Scotland. Recruitment status was: Not yet recruiting First Posted : October 15, 2014 Last Update Posted : October 15, 2014

2014 Clinical Trials

152. Management of Participants With Low-level Persistent Viremia (ANRS 161 L-VIR)

Ghosn, MD, PhD APHP More Information Go to Layout table for additonal information Responsible Party: French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS) Identifier: Other Study ID Numbers: ANRS 161 L-Vir 2014‐001663‐13 ( EudraCT Number ) First Posted: September 25, 2014 Last Update Posted: October 12, 2015 Last Verified: October 2015 Keywords provided by French National Institute for Health (...) . Management of Participants With Low-level Persistent Viremia (ANRS 161 L-VIR) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. Identifier: NCT02247687 Recruitment Status : Terminated (Low recruitment of participants for the study) First Posted : September 25, 2014 Last Update Posted : October 12, 2015 Sponsor: French

2014 Clinical Trials

153. Cancer Genetics Risk Assessment and Counseling

cancer in women: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 160 (4): 271-81, 2014. Resta RG: Defining and redefining the scope and goals of genetic counseling. Am J Med Genet C Semin Med Genet 142C (4): 269-75, 2006. Baty BJ, Kinney AY, Ellis SM: Developing culturally sensitive cancer genetics communication aids for African Americans. Am J Med Genet 118A (2): 146-55, 2003. Jenkins JF, Lea DH: Nursing Care in the Genomic Era: A Case-Based Approach. Sudbury, Mass (...) , surgeries, biopsies, major illnesses, medications, and reproductive history (for women, this includes age at menarche, parity, age at first live birth, age at menopause, and history of exogenous hormone use). Screening practices and date of last screening exams, including imaging and/or physical examinations. Environmental exposures. Past and current alcohol intake and tobacco use. Diet, exercise, and complementary and alternative medicine practices may also be assessed. For consultands with a history

2012 PDQ - NCI's Comprehensive Cancer Database

154. Safety of Probiotics to Reduce Risk and Prevent or Treat Disease

studies overall explored the effect of intervention or participant characteristics on safety. To summarize, in the few studies that reported on the time of onset of gastrointestinal effects, most effects were observed in the first 3 days of treatment. The onset of infections tended to occur 1 week to several weeks after initiation of probiotics use; however, this information is primarily derived from case studies and was not systematically reported. In indirect comparisons across studies, we found (...) what the review set out to achieve and what questions may have to be addressed in future research. First, because little evidence currently suggests the kinds of potential harms that should be investigated in a review on the safety of probiotics, the safety outcomes considered for this review were explicitly not specified a priori; instead, all reported adverse events were included in the review. Theoretically, a selection of particular kinds of harms could be guided by the nature

2011 EvidenceUpdates

155. Amebiasis (Follow-up)

, and diloxanide furoate) are best suited for such therapy. [ , ] This recommendation is based on 2 arguments: first, that invasive disease may develop, and second, that shedding of E histolytica cysts in the environment is a public health concern. [ ] Asymptomatic E dispar infections should not be treated, but because this organism is a marker of fecal-oral contamination, educational efforts should be initiated. [ ] Metronidazole is the mainstay of therapy for invasive amebiasis. [ , , ] Tinidazole has been (...) agent (eg, paromomycin or diloxanide furoate) to prevent a relapse. [ ] Amebic liver abscess of up to 10 cm can be cured with metronidazole without drainage. [ ] Clinical defervescence should occur during the first 3-4 days of treatment. Failure of metronidazole therapy may be an indication for surgical intervention. Treatment with a luminal agent should also follow. [ ] Chloroquine has also been used for patients with hepatic amebiasis. Dehydroemetine (available from the Centers for Disease Control


156. Chondroblastoma (Follow-up)

, Nakashima Y, Iwasa Y, Nakao R, Yanagisawa A. Immunohistochemical analysis for Sox9 reveals the cartilaginous character of chondroblastoma and chondromyxoid fibroma of the bone. Hum Pathol . 2010 Feb. 41(2):208-13. . Daugaard S, Christensen LH, Høgdall E. Markers aiding the diagnosis of chondroid tumors: an immunohistochemical study including osteonectin, bcl-2, cox-2, actin, calponin, D2-40 (podoplanin), mdm-2, CD117 (c-kit), and YKL-40. APMIS . 2009 Jul. 117(7):518-25. . . Santiago FR, Del Mar (...) to surgery in the management of chondroblastoma and suggested that it should be considered as a first-line treatment. Previous Next: Complications In addition to recurrence, many complications can occur after treatment of chondroblastomas, including the following: Infection Development of degenerative joint changes Fracture through the lesion Failure of osteoarticular allografts, if used Premature physeal closure and subsequent limb-length discrepancy or angular deformity of the limb Malignant

2014 eMedicine Surgery

157. Common Pregnancy Complaints and Questions (Follow-up)

Common Pregnancy Complaints and Questions (Follow-up) Common Pregnancy Complaints and Questions: First Trimester, Second Trimester, Third Trimester Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjU5NzI0LW92ZXJ2aWV3 processing > Common Pregnancy Complaints and Questions Updated: May 31, 2016 Author: Fidelma B Rigby, MD; Chief Editor: Christine Isaacs, MD Share Email Print Feedback Close Sections Sections Common Pregnancy Complaints and Questions First Trimester What are the first symptoms of pregnancy? Missing a period is usually the first signal of a new pregnancy, although women with irregular periods may not initially recognize a missed period as pregnancy. During this time, many women experience


158. Cysticercosis (Diagnosis)

with seizures and their families should know proper seizure first-aid. Patients who have had seizures should know about possible driving restrictions, which, in the United States, vary from state to state. Patients who have received a VP shunt should be educated about the signs and symptoms of elevated ICP (possible shunt failure) and meningitis (secondary infection of indwelling hardware). For excellent patient education resources, please see eMedicineHealth's . Previous References Schantz PM, Moore AC (...) : Mossammat M Mansur, MD, MBBS; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD Share Email Print Feedback Close Sections Sections Cysticercosis Overview Background Cysticercosis (ie, infection caused by eggs of the pork tapeworm) is an increasingly common medical problem in the United States, especially in the Southwest and other areas where large populations migrated from endemic areas and among populations that often travel to these areas. Cysticercosis is caused by the metacestode, or larval


159. Dermatologic Diseases of the Male Genitalia: Nonmalignant (Diagnosis)

treatment suggests a premalignant or malignant lesion. Biopsy is necessary to rule out primary and secondary malignancies that involve the penis. One case report describes the presentation of acute promyelocytic leukemia as an ulcerating balanoposthitis. [ ] Plasma Cell Balanitis Plasma cell balanitis, also known as Zoon balanitis and balanitis circumscripta plasmacellularis (see ), was first described by Zoon in 1952. This variant of balanitis almost exclusively affects uncircumcised males (...) subsequent use. The overall response rate to the first treatment is approximately 90%. A particular crusted variant (hyperkeratotic or Norwegian scabies) exists, characterized by more keratotic lesions, is seen in patients with HIV or other immunocompromised states. This form is highly contagious, even to individuals who are not immunocompromised, because of the high total mite burden and may lead to localized epidemic outbreaks. Bacterial superinfection, usually by staphylococcal or streptococcal


160. Amebiasis (Diagnosis)

migrants from and travelers to endemic regions, men who have sex with men, and immunosuppressed or institutionalized individuals. E histolytica is transmitted via ingestion of the cystic form (infective stage) of the protozoa. Viable in the environment for weeks to months, cysts can be found in fecally contaminated soil, fertilizer, or water or on the contaminated hands of food handlers. Fecal-oral transmission can also occur in the setting of anal sexual practices or direct rectal inoculation through (...) scenarios may favor inpatient care. See , a Critical Images slideshow, to help make an accurate diagnosis. Next: Pathophysiology E histolytica is a pseudopod-forming, nonflagellated protozoal parasite that causes proteolysis and tissue lysis (hence the species name) and can induce host-cell apoptosis (see the image below). Humans and perhaps nonhuman primates are the only natural hosts. Life cycle of Entamoeba histolytica. Ingestion of E histolytica cysts (see the first image below) from the environment


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