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11981. Influenza Vaccination

Influenza Vaccination Influenza Vaccination. Flu vaccine; information and side-effects | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Influenza Vaccination Authored by , Reviewed by | Last edited 18 Sep 2018 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK (...) over 75 benefiting the most. The quadrivalent vaccine (QIV) should be given to 18- to 65-year-olds at increased clinical risk (including pregnant women). In light of an independent cost-effectiveness study into QIV undertaken by PHE and considered by JCVI, the Green Book was updated in October 2017 to provide the advice that QIV is the best option for 18-65 at-risk groups in the 2018/19 season. It is also used for the childhood programme. Method of administration Vaccines are normally given

2008 Mentor

11982. Meningococcal Vaccines

Meningococcal Vaccines Meningococcal Vaccines. About Meningococcal Vaccines | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Meningococcal Vaccination Authored by , Reviewed by | Last edited 20 Aug 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European (...) -18) through general practice using a call and recall system. And older first-time university entrants up to the age of 25 years, directly replacing the MenC vaccine as part of the "freshers" programme. From September 2015 adding MenACWY vaccine to the routine adolescent schools programme (school year 9 or 10 - those aged 13-15), as a direct replacement for the MenC vaccination. From January 2016, a catch-up campaign for 2015/16 year 11 students (those aged 15-16). Available vaccines All available

2008 Mentor

11983. Needlestick Injury

follow-up of both care worker and donor. The care worker in particular will require early involvement by the occupational health service. They may need specific advice on having to take sick leave if medication is required and the possible requirement for psychological support. Prevention of avoidable exposure in an occupational setting This is of prime importance. The HPA (now part of Public Health England) advises the following: [ ] General measures Wash hands before and after contact with each (...) Needlestick Injury Needlestick Injury. Understanding needlestick injuries | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Needlestick Injury Authored by , Reviewed by | Last edited 24 Jun 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European

2008 Mentor

11984. Myelodysplastic syndromes (MDS)

Myelodysplastic syndromes (MDS) Myelodysplastic Syndromes. MDS information and Treatment | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Myelodysplastic Syndromes Authored by , Reviewed by | Last edited 26 Feb 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK (...) haematopoietic cell transplantation is the only currently available modality that is curative in a large proportion of patients. [ ] In lower-risk MDS, the risk of AML progression is smaller and survival longer than in higher-risk MDS, with about one half of elderly patients dying from causes other than the consequences of MDS or AML. In lower-risk MDS, the main priority is generally the treatment of cytopaenias, mainly of anaemia and improving quality of life. Anaemia often eventually requires repeated red

2008 Mentor

11985. Multiple Pregnancy

days and 13 weeks 6 days: The fetal positions should be noted. The risk per pregnancy in monochorionic pregnancies and for each baby in dichorionic and trichorionic pregnancies should be calculated. Women whose risk of Down's syndrome exceeds 1:150 should be offered a referral to a fetal medicine specialist in a tertiary-level fetal medicine centre. Twin pregnancies should use the 'combined test' and consider second-trimester serum screening if the woman books too late for first-trimester screening (...) , more general cognitive delay or motor problems, behavioural problems and difficulty in parent-child interactions all appear to be more common in multiple birth children. [ ] There are more likely to be feeding issues when trying to breast-feed two babies rather than one. Also, the non-medical financial, social and emotional consequences of caring for twins or higher-order multiples need to be considered. Prevention Clearly, the outcomes of multiple pregnancies (particularly higher-order multiples

2008 Mentor

11986. Maternal Mortality

Maternal Mortality Maternal Mortality. Definition and causes of maternal mortality | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Maternal Mortality Authored by , Reviewed by | Last edited 19 May 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European (...) Guidelines. You may find one of our more useful. In this article In This Article Maternal Mortality In this article Defined as death of either a pregnant woman or death of a woman within 42 days of delivery, miscarriage, termination or ectopic pregnancy providing the death is associated with pregnancy or its treatment. [ ] In the UK, maternal mortality rates can be calculated in two ways: Through official death certification to the Registrars General (the Office for National Statistics and its

2008 Mentor

11987. Malaria Full Text available with Trip Pro

be aware that this is not a guarantee against infection . Other behavioural modifications, such as avoiding outdoor activity after sunset, wearing long-sleeved shirts and trousers, using ITNs and insect repellant, must also be recognised as important. Encouraging migrant travellers visiting family and friends to take prophylactic medication should be a priority - any immunity to malaria accrued by growing up in a malarious country is rapidly lost on emigration and second-generation family members (...) Malaria Malaria. Professional reference for Malaria. | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Malaria Authored by , Reviewed by | Last edited 22 Feb 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may find the article

2008 Mentor

11988. Neonatal Examination

Neonatal Examination Neonatal Examination. Examining Neonates and screening | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Neonatal Examination Authored by , Reviewed by | Last edited 13 Sep 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European (...) , chest, abdomen, spine and limbs to exclude major abnormalities. A strong cry and a widespread pink blush over the face and body are good signs that all is well. Some children may be born with . Ambiguous genitalia is a medical emergency and requires urgent assessment by a paediatrician. If you have sufficient clinical experience, an orogastric tube should be passed when the neonate's mother has suffered polyhydramnios. This excludes oesophageal atresia. The Apgar score gives a reproducible

2008 Mentor

11989. Travel Advice

for a remote trip The following is a fairly comprehensive first aid kit for two people travelling together to a remote environment. It is based on advice given in 'Pocket First Aid and Wilderness Medicine', a book written by two well-established expedition doctors with experience of looking after travellers in remote locations (listed in Further reading, which can be recommended as a comprehensive pocket information source for travellers, whether medical or not). Some doctors may feel uncomfortable (...) health history) by their own doctor. It also means that the drugs are available when needed, as it is unlikely that a passing travelling doctor will carry spare drugs with which to supply others. Recommended reference book Pocket First Aid and Wilderness Medicine. This is an excellent handbook covering what to do as a layperson in most medical situations the traveller might encounter [ ] . Equipment Thermometer (or 'FeverScan'®). Tweezers (pointed-end). Scissors. Sewing needle. Safety pins x 2. 10 ml

2008 Mentor

11990. Stillbirth and Neonatal Death

Stillbirth and Neonatal Death Stillbirth and Neonatal Death Information Page | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Stillbirth and Neonatal Death Authored by , Reviewed by | Last edited 16 Apr 2014 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK (...) to fall over a period of two decades, and perinatal mortality rates have fallen by a third since 1982. It is felt that improvements in general healthcare, midwifery and neonatal intensive care are bringing about the gradual decline in deaths. Worldwide figures are higher. A recent WHO survey gives the stillbirth rate (although note the variable definition affects numbers) as 17.7 across 29 countries, and the early neonatal death rate as 8.4. [ ] Risk factors Fetal growth restriction: The biggest risk

2008 Mentor

11991. Tackling Foundation Years (House Jobs)

medical graduates with core clinical skills that are necessary to deal with acutely unwell patients. [ ] Starting right Typically, the two foundation years consist of 6 four-month posts. These usually consist of medical and surgical specialities and other recognised specialities - for example, haematology, anaesthetics, and general practice. When applying for foundation year posts, consider the factors that are most important to you; for example, location, family commitments, and previous jobs you (...) , spare supplies for the ward round, etc). Indulge in life outside medicine and switch off from work. Getting on with other professionals - for example, nurses and physiotherapists, can make a great difference. Sleep deprivation leads to more mistakes being made. Junior doctors undergoing sleep deprivation have lowered general confidence in their decision-making abilities, suggesting that despite the lack of sleep doctors can still appreciate their deficiencies. Night shifts are often viewed

2008 Mentor

11992. Sudden Death

Sudden Death Death (Recognition and Certification) Information. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Death (Recognition and Certification) Authored by , Reviewed by | Last edited 13 Nov 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK (...) and European Guidelines. You may find one of our more useful. In this article In This Article Death (Recognition and Certification) In this article Recognition of death It is vital when certifying death, to ensure that death has indeed occurred. In the modern world of advanced intensive care techniques and potential for organ donation, this can be a challenge. In the UK at present, there is no legal definition of death and there is no international consensus, although it is generally taken to mean

2008 Mentor

11993. Thyroid Function Tests

impairment. [ ] Hypothyroid pregnancies Increased fetal loss and IQ deficits in infants are associated with mothers who had undiagnosed or undertreated hypothyroidism during pregnancy. Thyroxine requirements are also likely to change during pregnancy. It is important that specialist medical-obstetric teams manage such pregnancies. The thyroid status of pregnant hypothyroid patients should be checked: Prior to conception (where possible). At diagnosis of pregnancy. At antenatal booking. At least once (...) Thyroid Function Tests Thyroid Function Tests. About TFTs endocrine test. | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Thyroid Function Tests Authored by , Reviewed by | Last edited 23 Dec 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European

2008 Mentor

11994. Depression in Pregnancy

Depression in Pregnancy Depression in Pregnancy | Causes and Treatment | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Depression in Pregnancy Authored by , Reviewed by | Last edited 11 Mar 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European (...) distress. Relationships are often under pressure - domestic violence increases during pregnancy. Pregnancy-related sex steroids increase activation of the hypothalamic-pituitary-adrenal axis (the cortisol stress system) which is associated with depression. Some investigators have suggested that high levels of cortisol may affect fetal growth and development and be associated with altered temperament and behaviour. [ ] Many women stop antidepressant medication due to concerns about potential harm

2008 Mentor

11995. Delay In Walking

Delay In Walking Delay In Walking. Delay In child Walking. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Delay In Walking Authored by , Reviewed by | Last edited 23 Apr 2014 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You (...) of developmental delay. Most of the answers should be in the "red book", the personal health record of the child. Were there any problems in pregnancy? Antepartum haemorrhage or hypertension in pregnancy may be relevant. Was the child a full-term normal delivery? Prematurity and problems suggesting possible intrapartum asphyxia should be noted. Relatively few cases of cerebral palsy are due to intrapartum asphyxia. [ ] As babies of earlier gestation are surviving they may be contributing to the cases

2008 Mentor

11996. Dental and Periodontal Diseases Full Text available with Trip Pro

Dental and Periodontal Diseases Some Dental and Periodontal Diseases General Information | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Some Dental and Periodontal Diseases Authored by , Reviewed by | Last edited 3 Jul 2014 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research (...) evidence, UK and European Guidelines. You may find the article more useful, or one of our other . In this article In This Article Some Dental and Periodontal Diseases In this article Background This is a broad topic and does not form part of the routine training of medical staff, so it is usually best dealt with by a dental general practitioner. However, current NHS dentistry provision is increasingly patchy, so such problems are presenting to medical primary care and emergency departments more

2008 Mentor

11997. Death (Recognition and Certification)

it is generally taken to mean the irreversible loss of capacity for consciousness combined with the irreversible loss of capacity to breathe. [ ] Guidance on the diagnosis and confirmation of death was issued in 2008 from the Academy of Medical Royal Colleges. The guidance is mainly concerned with confirmation of death in hospital and in circumstances where the diagnosis of death may be more difficult (patients on ventilators, for example). Guidance on the diagnosis and confirmation of death from the Academy (...) Death (Recognition and Certification) Death (Recognition and Certification) Information. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Death (Recognition and Certification) Authored by , Reviewed by | Last edited 13 Nov 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based

2008 Mentor

11998. Data Security and Caldicott Guardianship

and based on research evidence, UK and European Guidelines. You may find one of our more useful. In this article In This Article Data Security and Caldicott Guardianship In this article Protection of confidentiality of patient information and enabling safe and appropriate information sharing has long been one of the principles of good medical practice laid down by the General Medical Council (GMC). [ ] The Caldicott Report in 1997 reviewed use of patient-identifiable information and, subsequently (...) responsibilities (CSSRs). This includes flows of information to and from partner agencies, sharing through the NHS Care Records Service (NHS CRS) and related IT systems, disclosure to research interests and disclosure to the police. Individual general medical and dental practices, pharmacists and opticians do not need to appoint a Caldicott Guardian but do need to have an Information Governance lead who should be a lead clinician or high-level manager, with the knowledge and authority to provide the same role

2008 Mentor

11999. Dog Bites

Dog Bites Human and Animal Bites. Read about Animal Bites | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Human and Animal Bites Authored by , Reviewed by | Last edited 16 Jun 2014 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may (...) find the article more useful, or one of our other . In this article In This Article Human and Animal Bites In this article Epidemiology [ ] Substantially more dog bites occur than cat bites. It has been estimated that dog bites account for 60-90% of bites, cat bites for 5-20% and human bites for 4-23%. One study reported that of an estimated 740 people per 100,000 annually bitten by dogs, only a small proportion seek medical attention. 2.6 in 100,000 require hospital admission. Half of all children

2008 Mentor

12000. Dose Adjustment For Normal Eating and Exercise (DAFNE)

Dose Adjustment For Normal Eating and Exercise (DAFNE) Diabetes Education and Self-management Programmes. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Diabetes Education and Self-management Programmes Authored by , Reviewed by | Last edited 2 Dec 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written (...) . Reducing the need for - and potentially better targeting of - medication and other items such as blood testing strips. Diabetes education must be flexible enough to suit the needs of the individual - eg, cultural, linguistic, cognitive and literacy needs. There are several different programmes available across the UK: For people with type 1 diabetes The Dose Adjustment for Normal Eating (DAFNE) Programme [ ] . The X-PERT Insulin Programme is suitable for people with type 1 diabetes who feel they cannot

2008 Mentor

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