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Four Year Prognostic Index

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181. Management of Cardiovascular Diseases during Pregnancy

ratio ACS Acute coronary syndromes AF Atrial fibrillation AHF Acute heart failure AMI Acute myocardial infarction aPTT Activated partial thromboplastin time ARB Angiotensin receptor blocker ARNI Angiotensin receptor neprilysin inhibitor AS Aortic stenosis ASD Atrial septal defect ASI Aortic size index AT Atrial tachycardia AUC Area under the curve AV Atrioventricular BMI Body mass index BP Blood pressure BSA Body surface area CAD Coronary artery disease CARPREG CARdiac disease in PREGnancy CCB (...) issued in recent years by the European Society of Cardiology (ESC), as well as by other societies and organisations. Because of the impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines can be found on the ESC website ( ). ESC Guidelines represent the official position of the ESC on a given topic and are regularly updated. Members

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2018 European Society of Cardiology

182. ESC/EACTS Guidelines on Myocardial Revascularization

for revascularization. A patient-level and study-level meta-analysis of 9173 lesions demonstrated that with lesions with FFR <0.75, revascularization reduced the 1 year risk of major adverse cardiac events (MACE), including a reduction in the composite risk of death and MI. Thus, the FFR threshold of 0.75 is used to define more severe ischaemia that is of prognostic relevance. The presence of intermediate grade left main stem (LMS) disease is not infrequent and angiographic evaluation may be challenging. Assessment (...) by a Double Randomization of a Conventional Antiplatelet Strategy versus a Monitoring-guided Strategy for Drug-Eluting Stent Implantation and of Treatment Interruption versus Continuation One Year after Stenting ART Arterial Revascularization Trial AS Aortic stenosis ASE American Society of Echocardiography ATLANTIC Administration of Ticagrelor in the Cath Lab or in the Ambulance for New ST-Elevation Myocardial Infarction to Open the Coronary Artery ATLAS-ACS 2–TIMI 51 Anti-Xa Therapy to Lower

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2018 European Society of Cardiology

183. Recommendations for the Delivery of Psychosocial Oncology Services in Ontario

Provincial Psychosocial Oncology ProgramForeword | 3 Foreword As a psychiatrist and psychosocial professional who has worked for more than 20 years with patients and families affected by cancer, I have seen both the psychosocial impact of the disease as well as the tremendous improvements in quality of life offered by high- quality psychosocial oncology (PSO) services. While we have ample evidence demonstrating the benefits that PSO services can provide in managing the emotional, spiritual, functional (...) Regional Cancer Programs are encouraged to work collaboratively with stakeholders for provision of PSO services for a shared model of care. Patients be provided with the opportunity to be referred to the Regional Cancer Program where services are not available in the community.Executive Summary | 5 four SPECIALIZED PSO SERVICES FOR PATIENTS AND FAMILIES 4.1 Regional Cancer Programs ensure patients and families have access to individual, family and group PSO care from an inter-professional team

2018 Cancer Care Ontario

184. The management of primary mediastinal B?cell lymphoma: Good Practice Paper

and there is a female predominance (Swerdlow et al , ). Patients may present with compressive symptoms, including features of superior vena cava obstruction (SVCO) (Chim et al , ), or effusions (pericardial or pleural), the latter a poor prognostic factor (Aoki et al , ). The International Prognostic Index (IPI) score is usually low due to the young age of the patient, localised disease and lack of extranodal site involvement (Ceriani et al , ). Although extranodal disease is uncommon at diagnosis, it is more (...) CD274 (PD‐L1), and PDCDILG2 , encoding PDCDILG2 (PD‐L2) are located, has been well described in PMBCL (Green et al , ) and expression of CD274/PD‐L1 has been suggested as a possible prognostic biomarker (Bledsoe et al , ; Menter et al , ). Clinical presentation PMBCL characteristically presents with a bulky anterior mediastinal mass and, whilst it may invade local structures, disease is usually confined to the thoracic cavity. The age of presentation is typically in the third or fourth decade

2019 British Committee for Standards in Haematology

185. Radiation Therapy for the Whole-Breast (ASTRO)

or improved late toxicity with certain HF-WBI regimens as compared to CF-WBI. Four prospective randomized phase III clinical trials comparing HF-WBI to CF-WBI have reported 10-year outcomes data and serve as the evidentiary basis for this recommendation (Table 2). 3,4,8,19 The Ontario Clinical Oncology Group (OCOG) trial randomized patients to 4250 cGy in 16 fractions over 22 days versus 5000 cGy in 25 fractions over 35 days. 2,19 No tumor bed boost was delivered. Eligibility factors included breast (...) effects of HF-WBI compared to CF-WBI in either younger or older patients, and thus HF-WBI may be used regardless of age. • Recommendation strength: Conditional • Quality of evidence: Moderate • Consensus: 93% Narrative With the 10-year results of four major randomized trials showing no interaction of age with treatment arm for either cancer control or toxicity outcomes, women of all ages should be considered eligible for HF-WBI. Of 7095 patients on these trials, 1694 (24%) were 60 years. 8 Notably

2019 American Society for Radiation Oncology

186. Scoliosis ? Child

and with IV contrast Usually Not Appropriate O CT spine area of interest with IV contrast Usually Not Appropriate Varies CT spine area of interest without and with IV contrast Usually Not Appropriate Varies Tc-99m bone scan complete spine Usually Not Appropriate ?? ? ? Variant 2: Child (0 to 9 years of age). Early onset idiopathic scoliosis. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography complete spine Usually Appropriate ?? ? MRI complete spine without IV (...) contrast Usually Appropriate O MRI complete spine without and with IV contrast Usually Not Appropriate O CT spine area of interest with IV contrast Usually Not Appropriate Varies CT spine area of interest without and with IV contrast Usually Not Appropriate Varies CT spine area of interest without IV contrast Usually Not Appropriate Varies Tc-99m bone scan complete spine Usually Not Appropriate ?? ? ? Variant 3: Adolescent (10 to 18 years of age). Adolescent idiopathic scoliosis. No risk factors

2019 American College of Radiology

187. Management of Acute Compartment Syndrome

associated with acute compartment syndrome (ACS) but in an austere, remote environment, evidence based guidelines for the rapid treatment and comprehensive management of ACS is vital. In a sample of 17,166 casualties observed in a 10-year period of high casualties (2001-2010), Kragh et al reported 3,313 fasciotomies for an overall fasciotomy rate of 19%. Male combat casualties were 1.7-fold more likely to undergo fasciotomies vs. their female counterparts. As females are not traditionally involved (...) fractures without compartment syndrome (Schmidt 2011, Crespo 2015). Multiple factors contribute to patient outcomes and treatment costs after trauma; compartment syndrome contributes to worse patient-reported and functional outcomes, including negative effects on quality-of-life that remain more than a year after injury [Giannoudis 2002]. The significant medicolegal aspects surrounding compartment syndrome diagnosis and treatment also contribute to the burden of this condition on patients, providers

2019 American Academy of Orthopaedic Surgeons

188. SCAI clinical expert consensus statement on the classification of cardiogenic shock

. , Although hemodynamic definitions of CS may vary, the National Cardiovascular Data Registry defines CS as systolic blood pressure ≤ 90 and cardiac index <2.2 L/min/m 2 and/or the requirement for parenteral inotropic or vasopressor agents or mechanical support to maintain BP and CI above these levels. Although classic “cold, wet” CS is associated with low CI and high SVR and PCWP, there are four different common hemodynamic types of CS which are difficult to determine without invasive hemodynamic (...) intervention may later develop CS and the overall 30‐day mortality for patients with CS in association with MI is approximately 40–50%. Unfortunately, this incidence has not changed in the past 20 years since the publication of the landmark SHOCK (SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK) trial. - The SHOCK trial was conducted when the only percutaneous form of cardiopulmonary support was the intra‐aortic balloon pump (IABP). Since then, multiple devices (e.g., left

2019 Society for Cardiovascular Angiography and Interventions

189. AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm

-glucosidase inhibitor; apo B = apolipoprotein B; ARB = angiotensin II receptor blocker; ASCVD = atherosclerotic cardiovascular disease; BAS = bile acid sequestrant; BMI = body mass index; BP = blood pressure; CCB = calcium channel blocker; CGM = continuous glucose monitoring; CHD = coronary heart disease; CKD = chronic kidney disease; DKA = diabetic ketoacidosis; DPP4 = dipeptidyl peptidase 4; eGFR = estimated glomerular filtration rate; EPA = eicosapentaenoic acid; ER = extended release; FDA = Food (...) be individualized based on numerous factors, such as age, life expectancy, comorbid conditions, duration of diabetes, risk of hypoglycemia or adverse consequences from hypoglycemia, patient motivation, and adherence. Glycemic control targets include fasting and postprandial glucose as determined by self-monitoring of blood glucose (SMBG). In recent years, continuous glucose monitoring (CGM) has become more available for people with T2D and has added a considerable degree of clarity for the patient's

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2019 American Association of Clinical Endocrinologists

190. Treatment of Multiple Myeloma

with relapsed or refractory disease. INTRODUCTION Section: The purpose of this guideline is to provide evidence-based recommendations for the treatment of newly diagnosed and relapsed multiple myeloma. The treatment of multiple myeloma has changed significantly in the last 5 years. Since 2015, four new drugs have been approved, thus providing more options and adding to the complexity of treatment options ( ). Numerous large phase III trials have been performed in both the newly diagnosed and relapse (...) . The estimated number of deaths as a result of multiple myeloma in 2018 was 12,770, representing 2.1% of all cancer deaths. Despite significant advances and improvements in overall survival (OS), multiple myeloma remains incurable, and additional treatments are needed. The median survival is just over 5 years, and most patients receive four or more different lines of therapy throughout their disease course. In 2015, there were an estimated 124,733 people living with myeloma, and this number continues to rise

2019 American Society of Clinical Oncology Guidelines

191. Management of Cancer-associated Anemia with Erythropoiesis-Stimulating Agents

and RCTs are provided in the Data Supplement. For biosimilars, both of the included meta-analyses , and one of the two RCTs , involved patients with CKD. The only RCT in patients with cancer had a high likelihood of bias based on inadequate sample size, lack of an intent-to-treat analysis, and industry funding and authorship. The quality of the four included cohort studies of biosimilars - in patients with cancer was not formally assessed. RECOMMENDATIONS Section: CLINICAL QUESTION 1 To reduce the need (...) published studies, but one RCT in the updated literature review restricted to patients with metastatic breast cancer and one meta-analysis developed a decision model that incorporated intent of treatment. The 2013 Agency for Healthcare Research and Quality meta-analyses by Grant et al developed decision models for patients treated with curative or noncurative intent. The models suggest that ESAs increase quality-adjusted life-years but decrease life-years in both the curative and noncurative setting

2019 American Society of Clinical Oncology Guidelines

192. ACR–ASNR–ASSR–SPR Practice Parameter for the Performance of Computed Tomography (CT) of the Spine

the prognostic value of four imaging modalities in clearing the cervical spine for children with severe traumatic injuries. Childs Nerv Syst. 2012;28(5):699-705. 36. Cullen A, Terris M, Ford R. Spinal clearance in unconscious children following traumatic brain injury. Paediatr Anaesth. 2014;24(7):711-716. 37. Egloff AM, Kadom N, Vezina G, Bulas D. Pediatric cervical spine trauma imaging: a practical approach. Pediatr Radiol. 2009;39(5):447-456. 38. Gargas J, Yaszay B, Kruk P, Bastrom T, Shellington D, Khanna (...) in and is considered a primary imaging evaluation of acute spine trauma in adults. CT can be used for evaluating vertebral compression/insufficiency fractures in both acute and chronic clinical situations [1-14] 2. Given that the vast majority of cervical spine injuries in young children (especially those <3 years old) are of soft tissue rather than bone and considering the special vulnerability of this patient population to radiation, it should be recognized that the use of CT in this population may be of limited

2019 American Society of Neuroradiology

193. Developing a Value Framework for Genetic Diagnosis: Part I A Systematic Review of Outcomes Hierarchies and Measurement Approaches

PROs Patient-reported outcomes QA Quality assurance QALY Quality adjusted life year QI Quality improvement QOF UK Quality Outcomes Framework QOL Quality of life QSR Qualitative Systematic Review RW “real world”, as in “RW data” SER Systematic evidence review TEP Technical Expert Panel UK NHS UK National Health Service US United States ACMG Value Review, March 16, 2012 Page 5 EXECUTIVE SUMMARY Introduction This qualitative systematic review was commissioned by the American College of Medical (...) makers faced with rising costs of health care noted that: “..their concern was best embodied in the word value”, as Congress looked for ways to obtain more “..value for the public dollars spent on health care”. Legislation was introduced that year to promote value in health care by increasing funding for assessment of outcomes of health care practices. 1 The goals were to improve quality and address increasing costs through systematic development of evidence-based “physician- generated practice

2019 American College of Medical Genetics and Genomics

194. Global Vascular Guidelines for patients with chronic limb-threatening ischemia

, British Society for Endovascular Therapy, British Society of Interventional Radiology, Circulation Foundation, College of Podiatry, Society of Interventional Radiology, Society for Vascular Nursing, the Society for Vascular Technology of Great Britain and Ireland, and the Vascular Society of Great Britain and Ireland DOI: | | ---- Fig 2.1 Prevalence of peripheral artery disease (PAD; ankle-brachial index [ABI] <0.9) by age and sex in high-income countries ( HICs ) and in low- and middle-income (...) countries ( LMICs ). x 1 Fowkes, F.G., Rudan, D., Rudan, I., Aboyans, V., Denenberg, J.O., McDermott, M.M. et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet . 2013 ; 382 : 1329–1340 ---- | ---- Fig 2.2 Odds ratios ( ORs ) for peripheral artery disease (PAD) in high-income countries ( HICs ) and low- and middle-income countries ( LMICs ). BMI, Body mass index; CRP, C-reactive protein; CVD

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2019 Society for Vascular Surgery

195. Daratumumab (Darzalex) - multiple myeloma

was administered subcutaneously on days 1, 4, 8, and 11 of cycles 1 to 8, and dexamethasone 20mg was administered orally or intravenously on days 1, 2, 4, 5, 8, 9, 11, and 12. The dose of dexamethasone could be reduced to 20mg once weekly for patients who were older than 75 years of age, had poorly controlled diabetes, had a body-mass index (BMI) of <18.5, or for patients who had previous unacceptable adverse effects associated with glucocorticoid therapy. Treatment continued until the patient withdrew consent (...) administered as an intravenous infusion according to the following dosing schedule: Weeks Schedule Weeks 1 to 9 weekly (total of 9 doses) Weeks 10 to 24 every three weeks (total of 5 doses) Week 25 onwards until disease progression every four weeks For dose and schedule of medicinal products administered with daratumumab see the corresponding Summary of Product Characteristics (SPC). Following dilution the daratumumab infusion should be intravenously administered at the initial infusion rate detailed

2019 Scottish Medicines Consortium

196. Paediatric Urology

surgery may improve the fertility index in undescended testes: a prospective randomized trial. J Urol, 2005. 173: 974. 72. Cortes, D., et al. Hormonal treatment may harm the germ cells in 1 to 3-year-old boys with cryptorchidism. J Urol, 2000. 163: 1290. 73. Ritzen, E.M. Undescended testes: a consensus on management. Eur J Endocrinol, 2008. 159 Suppl 1: S87. 74. Kollin, C., et al. Surgical treatment of unilaterally undescended testes: testicular growth after randomization to orchiopexy at age 9 months (...) . Incidence of balanitis xerotica obliterans in boys younger than 10 years presenting with phimosis. Urol Int, 2013. 90: 439. 11. Celis, S., et al. Balanitis xerotica obliterans in children and adolescents: a literature review and clinical series. J Pediatr Urol, 2014. 10: 34. 12. Oster, J. Further fate of the foreskin. Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child, 1968. 43: 200. 13. Palmer, L.S., et al., Management of abnormalities of the external

2019 European Association of Urology

197. Male Sexual Dysfunction

of general male health status? The case for the International Index of Erectile Function-Erectile Function domain. J Sex Med, 2012. 9: 2708. 31. Dong, J.Y., et al. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol, 2011. 58: 1378. 32. Gandaglia, G., et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Eur Urol, 2014. 65: 968. 33. Gupta, B.P., et al. The effect of lifestyle modification (...) and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med, 2011. 171: 1797. 34. Braun, M., et al. Epidemiology of erectile dysfunction: results of the ‘Cologne Male Survey’. Int J Impot Res, 2000. 12: 305. 35. Johannes, C.B., et al. Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. J Urol, 2000. 163: 460. 36. Schouten, B.W., et al. Incidence rates of erectile dysfunction

2019 European Association of Urology

198. Penile Cancer

treated penile cancer? J Clin Pathol, 2014. 67: 268. 66. Wang, J.Y., et al. Prognostic significance of the degree of extranodal extension in patients with penile carcinoma. Asian J Androl, 2014. 16: 437. 67. Chaux, A., et al. The prognostic index: a useful pathologic guide for prediction of nodal metastases and survival in penile squamous cell carcinoma. Am J Surg Pathol, 2009. 33: 1049. 68. Velazquez, E.F., et al. Positive resection margins in partial penectomies: sites of involvement and proposal (...) in Asymptomatic Men and Patients with Phimosis. J Urol, 2016. 195: 1784. 25. Archier, E., et al. Carcinogenic risks of psoralen UV-A therapy and narrowband UV-B therapy in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol, 2012. 26 Suppl 3: 22. 26. Stern, R.S. The risk of squamous cell and basal cell cancer associated with psoralen and ultraviolet A therapy: a 30-year prospective study. J Am Acad Dermatol, 2012. 66: 553. 27. Daling, J.R., et al. Cigarette smoking

2019 European Association of Urology

199. Management of Non-neurogenic Male LUTS

. Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia. PROSCAR long-term efficacy and safety study. J Urol, 2000. 163: 13. 59. Roehrborn, C.G., et al. Serum prostate-specific antigen and prostate volume predict long-term changes in symptoms and flow rate: results of a four-year, randomized trial comparing finasteride versus placebo. PLESS Study Group. Urology, 1999. 54: 662. 60. Djavan, B., et al. Longitudinal study of men with mild (...) symptoms of bladder outlet obstruction treated with watchful waiting for four years. Urology, 2004. 64: 1144. 61. McConnell, J.D., et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med, 2003. 349: 2387. 62. Roehrborn, C.G. Alfuzosin 10 mg once daily prevents overall clinical progression of benign prostatic hyperplasia but not acute urinary retention: results of a 2-year placebo-controlled study. BJU Int

2019 European Association of Urology

200. Chronic Pelvic Pain

guidelines on chronic pelvic pain. Eur Urol, 2010. 57: 35. 5. Engeler, D.S., et al. The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development. Eur Urol, 2013. 64: 431. 6. McMahon, S.B., et al. Visceral pain. Br J Anaesth, 1995. 75: 132. 7. Shoskes, D.A., et al. Clinical phenotyping of patients with chronic prostatitis/chronic pelvic pain syndrome and correlation with symptom severity. Urology, 2009. 73: 538. 8. Magri (...) stimulus in women with irritable bowel syndrome. J Neurosci, 2008. 28: 349. 36. Naliboff, B.D., et al. Clinical and Psychosocial Predictors of Urological Chronic Pelvic Pain Symptom Change in 1 Year: A Prospective Study from the MAPP Research Network. J Urol, 2017. 198: 848. 37. Bajaj, P., et al. Endometriosis is associated with central sensitization: a psychophysical controlled study. J Pain, 2003. 4: 372. 38. Berkley, K.J., et al. Don't dismiss dysmenorrhea! Pain, 2011. 152: 1940. 39. Zondervan, K.T

2019 European Association of Urology

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