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High Pressure Injection Wound

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101. Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults Full Text available with Trip Pro

of AV access creation or placement until AV access abandonment or permanent loss of the AV access (synonym: cumulative AV access survival; secondary assisted patency). Surveillance Overarching term referring to both clinical monitoring and technical surveillance of an AV access; it includes haemodialysis parameters such as pump speed, dialyser inlet and transmembrane pressure and indices of dialysis adequacy ( K t / V urea); sequential measurements with trend analysis of intra-access flow, dynamic (...) or static dialyser outlet pressure, AV access recirculation or AV access duplex ultrasound assessment. Technical surveillance Assessment of an AV access at regular intervals using a specialized apparatus; distinct from clinical monitoring. AV access Overarching term referring to both AV fistulas and AV grafts. AV access thrombosis Blood clot obstructing the AV access; indicates loss of anatomic, haemodynamic and clinical patency. AV fistula Surgically created autogenous vascular access used for chronic

2019 European Renal Best Practice

102. British Association of Dermatologists guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in children and young people Full Text available with Trip Pro

Supporting Information). Additional references relevant to the topic were also isolated from citations in reviewed literature. Evidence from the included studies was graded according to the GRADE system (high, moderate, low or very low quality). Recommendations are based on evidence drawn from systematic reviews of the literature pertaining to the clinical questions identified; tables Linking the Evidence To the Recommendations (LETR) (Appendix B; see Supporting Information), the summary of findings (...) recommendations and ratings were agreed upon unanimously by the core members of the GDG and patient representatives. For further information on the wording used for recommendations and strength of recommendation ratings see Section 2. The GDG is aware of the lack of high‐quality evidence for these recommendations, therefore strong recommendations with an asterisk (*) are based on available evidence and/or consensus within the GDG and specialist experience. Most of the recommendations are derived from

2019 British Association of Dermatologists

103. Compression therapy after invasive treatment of superficial veins of the lower extremities

of high stiffness around the leg, even when their individual components are elastic. This stiffness of elastic textiles results in an increase of sub-bandage pressure when patients stand up or when they walk. x 5 Kalodiki, E. Use of intermittent pneumatic compression in the treatment of venous ulcers. Future Cardio . 2007 ; 3 : 185–191 | | | Examples are “multilayer bandages” like Profore (Smith & Nephew, Memphis, Tenn), Comprifore (Jobst, Charlotte, NC), and Coban 2 (3M, St. Paul, Minn) as a “two (...) is that it provides even higher sub-bandage pressures in the upright body position and when the patient is walking, whereas the pressure is tolerably low during rest. x 7 Moffatt, C. Variability of pressure provided by sustained compression. Int Wound J . 2008 ; 5 : 259–265 | | | The effects of the intermittent pressure peaks during walking are comparable to those of intermittent pneumatic compression pumps, for which there is more evidence concerning hemodynamic efficacy published than for bandages. x 5 Kalodiki

2019 American Venous Forum

104. ACR–ASNR Practice Parameter for the Performance of Computed Tomography (CT) of the Brain

of Neuroradiology (ASNR), and the Society for Pediatric Radiology (SPR). Computed tomography (CT) is a technology that produces cross-sectional images of the body using x-rays. Computed tomography (CT) is utilized extensively in imaging of the brain. This practice parameter outlines the principles for performing high-quality CT imaging of the brain in pediatric and adult patients. There should be an effort to minimize radiation exposure, particularly in children. An alternate modality should be considered when (...) evaluation following surgical treatment of tumor, intracranial hemorrhage, or hemorrhagic lesions [30] 7. Treated or untreated vascular lesions [31,32] 8. Mental status change [33] 9. Increased intracranial pressure [3,4] 10. Headache [34,35] 11. Acute neurologic deficits [36] 12. Suspected intracranial infection [37-43] 13. Suspected hydrocephalus [44-46] 14. Certain congenital skull and brain lesions (such as, but not limited to, craniosynostosis, macrocephaly, and microcephaly) [6,47,48] 15

2019 American Society of Neuroradiology

105. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

to children. Abbreviations: AAP — American Academy of Pediatrics AAPD — American Academy of Pediatric Dentistry ASA — American Society of Anesthesiologists BIS — bispectral index CPAP — continuous positive airway pressure ECG — electrocardiography EEG — electroencephalogram/electroencephalography EMS — emergency medical services LMA — laryngeal mask airway MRI — magnetic resonance imaging OSA — obstructive sleep apnea PALS — pediatric advanced life support Introduction The number of diagnostic and minor (...) patients both during and after sedation for a procedure. The monitoring and care outlined may be exceeded at any time on the basis of the judgment of the responsible practitioner. Although intended to encourage high-quality patient care, adherence to the recommendations in this document cannot guarantee a specific patient outcome. However, structured sedation protocols designed to incorporate these safety principles have been widely implemented and shown to reduce morbidity. These practice

2019 American Academy of Pediatrics

106. Treatment of Diabetes in Older Adults Full Text available with Trip Pro

65 to 85 years with diabetes, we recommend a target blood pressure of 140/90 mm Hg to decrease the risk of cardiovascular disease outcomes, stroke, and progressive chronic kidney disease. (1|⊕⊕⊕O) Technical remark: Patients in certain high-risk groups could be considered for lower blood pressure targets (130/80 mm Hg), such as those with previous stroke or progressing chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 m 2 and/or albuminuria). If lower blood pressure (...) targets are selected, careful monitoring of such patients is needed to avoid orthostatic hypotension. Patients with high disease complexity (group 3, poor health, ) could be considered for higher blood pressure targets (145 to 160/90 mm Hg). Choosing a blood pressure target involves shared decision-making between the clinician and patient, with full discussion of the benefits and risks of each target. 5.2 In patients aged 65 years and older with diabetes and hypertension, we recommend

2019 The Endocrine Society

107. What is the evidence on the role of the arts in improving health and well-being? A scoping review

differences in society and the environment that can shape health) have been developed across higher- and lower-income countries, including in Canada (Quebec), Finland, Lithuania and Latin American countries. These have had a shared focus on using the arts to promote social inclusion, skills development, capacity-building and health promotion (84). For example, among children specifically identified as at risk (e.g. living in areas characterized by high levels of economic deprivation, substandard housing

2019 WHO Health Evidence Network

108. Sepsis Management

of incidence vary, but consensus points to approximately 300 cases per 100,000 population per annum. (1) As comparators, myocardial infarction affects 208 patients per 100,000 per year (2) and stroke 223. (3) Mortality from sepsis is currently as high as mortality from acute myocardial infarction was in the 1960s. (4) According to the Centers for Disease Control and Prevention, sepsis affects more than 800,000 Americans annually and is the ninth leading cause of disease-related deaths. The Agency (...) in the 8 th Edition of the ICD-10-AM/ACHI/ACS. The diagnostic criteria in this guideline are applied after 30mls/kg isotonic fluid has been administered to reverse any 1 Australian Modification of ICD-10 incorporating the Australian Classification of Health Interventions and the Australian Coding Standards Sepsis impact 110 | Sepsis Management | A National Clinical Guideline hypovolaemia and are persistent systolic blood pressure 4 mmol/l. (18) The sources of sepsis are very consistent

2019 National Clinical Guidelines (Ireland)

109. Guideline regarding treatment of haemorrhoids

Injection sclerotherapy (SCL) 25 6.4 Evidence in the literature 25 6.4.1 Rubber Band Ligation (RBL) versus Infrared Coagulation (IRC)versus Sclerotherapy (SCL) 25 6.4.2 RBL versus DG-HAL versus SH versus Haemorrhoidectomy 29 6.5 Complications 31 6.5.1 Rubber Band Ligation (RBL) 31 6.5.2 Infrared Coagulation (IRC) 32 6.5.3 Sclerotherapy (SCL) 32 6.6 Relative effectiveness and ranking of the three options 32 6.7 Conclusions 33 6.8 GRADE 33 6.9 Recommendations for outpatient procedures 37 7 Surgical (...) be avoided (expert opinion, upgraded by guideline development group). ? The use of laxatives could be considered for symptom relief and to reduce bleeding (low level of evidence). ? Phlebotonics could contribute to symptom reduction (low level of evidence). 7 ? NSAIDs and non-opioids analgesics could be prescribed for pain (expert opinion). 1.3 Outpatient procedures ? Choice of the outpatient procedure (i.e. rubber band ligation, injection sclerotherapy and infrared coagulation) should be informed

2019 Palliative Care Evidence Review Service (PaCERS)

110. Clinical Practice Guideline for the Management of Infantile Hemangiomas

who are at high risk require treatment with propranolol, it is advisable to use the lowest effective dose, slowly titrate the dose, and administer the drug 3 times daily (to minimize abrupt changes in blood pressure); comanagement with a pediatric neurologist is recommended. , , , Other patients who may require lower propranolol doses include those with progressive IH ulceration while receiving therapy and those who experience adverse effects (such as sleep disturbances). Key Action Statement 3C (...) , bronchospasm, bronchiolitis, and cold-induced wheezing), and a decrease in heart rate or blood pressure. Rates of clinically important harms (hypoglycemia, hypotension, bradycardia, and bronchospasm) varied widely across the studies, and the authors assigned a moderate SOE for the association of propranolol with both clinically important and minor harms (with high study limitations). Overall, harms did not cause treatment discontinuation. Our additional review yielded 8 reports that met inclusion criteria

2019 American Academy of Pediatrics

111. Primary postpartum haemorrhage

and maternal comfort o Repair ensuring bleeding at the apex of the laceration is secured o Refer to Queensland Clinical Guideline: Perineal Care 38 for repair principles Condition compromised · Treat shock [refer to Section 3.3 Resuscitation] o Apply pressure on the wound or bimanual compression o Assess analgesia requirements · Urgently transfer to OT for repair under anaesthetic o GA usually more appropriate when hemodynamically unstable Suboptimal wound visualisation · Transfer to OT · Maximise lighting (...) · Transfer to OT or to higher level facility as relevant · Refer to MHP flowchart Monitor: · Vital signs – assess for shock · Fundal tone · Vaginal blood loss · Haemoglobin Transfer as required to: · Postnatal area · Intensive care/high dependency · Higher level facility Postnatal care: · Provide psychological support: · Treat anaemia · Administer VTE prophylaxis o Monitor for DVT/PE · Follow-up and self-care advice Bleeding controlled? Coagulopathy may influence surgical decisions · Consider future

2019 Queensland Health

112. Adult and Pediatric Antibiotic Prophylaxis during Vascular and IR Procedures: A Society of Interventional Radiology Practice Parameter Update Endorsed by the Cardiovascular and Interventional Radological Society of Europe and the Canadian Association for

site/wound infections incurred during surgery, the in- fectious complications in IR are most likely the result of bacterial inocu- lation into the bloodstream. Common mechanisms include (i) contamination of a needle, catheter, or wire by contact with a nonsterile surface or residual skin ?ora during vascular access (8);(ii) traversal of small vessels located along the trajectory of a needle creating channels of communication for bacteria to enter the bloodstream (9);(iii) intravasation (...) to aseptic technique, and an emphasis on hand hygiene (8,11). PROCEDURE CLASSIFICATION Although the pathogenesis behind infectious complications in IR is differentthaninsurgery,IRprocedureshaveinthepastbeencategorizedby usingde?nitionsestablishedbytheNationalAcademyofSciences/National Research Council surgical wound classi?cation originally de?ned in 1964 (12). More recent studies have found that the de?nitions used in this classi?cation schemeto describeinfectiousadverseevents,includingsepsis

2019 Society of Interventional Radiology

113. Penetrating Trauma-Lower Abdomen and Pelvis.

with a traumatic rupture of the prostatomembranous urethra, with an average of 3.1 associated injuries per patient [4,6]. The degree of bladder distension with urine determines its shape and, to some degree, the injury it may sustain. Even relatively minor trauma can rupture the fully distended bladder [7]; the empty bladder is seldom injured, except by crushing or penetrating wounds. Gross hematuria indicates urologic trauma. The presence of gross blood at the urethral meatus strongly suggests urethral injury (...) and Stone [11], 90% of 103 patients with a pelvic fracture did not have a bladder rupture; therefore, the authors concluded that cystography may be safely reserved for patients with pelvic fractures who are considered to be at high risk for such an injury. They limited cystography in pelvic fracture to patients with significant pubic arch involvement, gross hematuria, and/or hemodynamic instability. Bladder Injury The Consensus Panel of the Société Internationale D’Urologie has classified bladder injury

2019 American College of Radiology

114. Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and Evaluation of Devices: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

for lower-extremity PAD define CLI as the presence of ischemic rest pain, nonhealing wound/ulcer, or gangrene for >2 weeks with associated evidence of hypoperfusion as measured by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oximetry (TcP o 2 ), or skin perfusion pressure (SPP). Because timely revascularization for CLI is a Class I indication in the AHA/ACC guidelines, accurate perfusion assessment is critically important. The goal (...) of an ideal perfusion assessment test for CLI, unlike claudication, is to identify whether adequate blood is supplying the extremity to prompt timely wound healing and reduce major and minor amputations. Accurate noninvasive limb perfusion assessment will likely allow timely diagnosis but also reduce unnecessary invasive procedures in patients with adequate blood flow or among those with venous, neuropathic, or pressure ulcers. The ABI The ABI is calculated by dividing the higher of the posterior tibial

2019 American Heart Association

115. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures

index; BPD = biliopancreatic diversion; BPD/DS = biliopancreatic diversion with duodenal switch; CI = confidence interval; CPAP = continuous positive airway pressure; CPG = clinical practice guideline; CRP = C-reactive protein; CVD = cardiovascular disease; DBCD = dysglycemia-based chronic disease; DS = duodenal switch; DVT = deep venous thrombosis; DXA = dual- energy X-ray absorptiometry; EL = evidence level; EN = enteral nutrition; ERABS = enhanced recovery after bariatric surgery; ESG (...) . (2019*). Patients with a body mass index (BMI) =35 kg/m 2 and one or more severe obesity-related complications remediable by weight loss, including type-2 diabetes (T2D), high risk for T2D (insulin resistance, prediabetes, and/or metabolic syndrome), poorly controlled hypertension, nonalcoholic fatty liver disease/nonalcoholic steatohepatitis, obstructive sleep apnea, osteoarthritis of the knee or hip, and urinary stress incontinence, should be considered for a bariatric procedure (Grade C; BEL 3

2019 American Association of Clinical Endocrinologists

116. Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

ventricle results in increased venous pressure at rest and at exercise, with a greater dependency on the skeletal and respiratory muscle pumps for preload augmentation during exercise. In addition, lack of pulsatility and marked attenuation of the normal high-pressure high-flow pulmonary arterial circulation during exercise occur. Consequently, there is less recruitment of collapsible pulmonary vessels, especially at low exercise levels. This results in diminished ventricular preload, with decreased (...) collateral flow, suboptimal mixing of inferior and superior caval flow streams, endothelial dysfunction, absence of pulsatility, and absence of episodic high flow and high pressure, as is normally seen during exercise, all required for exercise-associated vessel recruitment and vasodilation. In combination, these factors contribute to a burden of pulmonary vascular trauma, resulting in an elevated and increasing pulmonary vascular resistance, which can itself contribute to Fontan circulatory failure

2019 American Heart Association

117. Treatment for Acute Pain: An Evidence Map

A. Nelson, M.Sc. Shellina Scheiner, PharmD, B.C.G.P. Mary L. Forte, Ph.D., D.C. Mary Butler, Ph.D., M.B.A. Sanket Nagarkar, D.D.S., M.P.H. Jayati Saha, Ph.D. Timothy J. Wilt, M.D., M.P.H. AHRQ Publication No. 19(20)-EHC022-EF Oct ober 2019 ii Key Messages Purpose of review The purpose of this evidence map is to provide a high-level overview of the current guidelines and systematic reviews on pharmacologic and nonpharmacologic treatments for acute pain. We map the evidence for several acute pain (...) treated in select settings (emergency departments; inpatient and outpatient surgical facilities; primary and specialty care clinics; and dental clinics and dental surgery centers)? a. How is acute pain for these conditions assessed and monitored? b. Which individual characteristics modify perceptions of pain severity, treatment options, and treatment response? 2. Which of these priority acute pain conditions have recent, high-quality guidelines that address acute pain treatments? 3. Which

2019 Effective Health Care Program (AHRQ)

118. Paediatric Urology

., et al. Correction of congenital penile curvature using modified tunical plication with absorbable sutures: the long-term outcome and patient satisfaction. Eur Urol, 2007. 52: 261. 271. Sasso, F., et al. Penile curvature: an update for management from 20 years experience in a high volume centre. Urologia, 2016. 83: 130. 272. Gittes, R.F., et al. Injection technique to induce penile erection. Urology, 1974. 4: 473. 273. Schultheiss, D., et al. Congenital and acquired penile deviation treated (...) therapy with LHRH and HCG in cryptorchid infants. Eur J Pediatr, 1993. 152 Suppl 2: S31. 66. Forest, M.G., et al. Effects of human chorionic gonadotropin, androgens, adrenocorticotropin hormone, dexamethasone and hyperprolactinemia on plasma sex steroid-binding protein. Ann N Y Acad Sci, 1988. 538: 214. 67. Aycan, Z., et al. Evaluation of low-dose hCG treatment for cryptorchidism. Turk J Pediatr, 2006. 48: 228. 68. Hesse, V., et al. Three injections of human chorionic gonadotropin are as effective

2019 European Association of Urology

119. Urological Trauma

Physician, 2001. 63: 1567. 261. Selikowitz, S.M. Penetrating high-velocity genitourinary injuries. Part I. Statistics mechanisms, and renal wounds. Urology, 1977. 9: 371. 262. Hudak, S.J., et al. Operative management of wartime genitourinary injuries at Balad Air Force Theater Hospital, 2005 to 2008. J Urol, 2009. 182: 180. 263. Cass, A.S., et al. Bilateral testicular injury from external trauma. J Urol, 1988. 140: 1435. 264. Michielsen, D., et al. Burns to the genitalia and the perineum. J Urol, 1998 (...) expectant (conservative) management of renal trauma--a systematic review. J Trauma, 2005. 59: 493. 29. Sujenthiran, A., et al. Is Nonoperative Management the Best First-line Option for High-grade Renal trauma? A Systematic Review. Eur Urol Focus, 2017. 30. Mingoli, A., et al. Operative and nonoperative management for renal trauma: comparison of outcomes. A systematic review and meta-analysis. Ther Clin Risk Manag, 2017. 13: 1127. 31. Bjurlin, M.A., et al. Comparison of nonoperative management

2019 European Association of Urology

120. Renal Transplantation

uncontrolled donors after cardiac death. Transplant Proc, 2008. 40: 1023. 45. Jochmans, I., et al. Hypothermic machine perfusion of kidneys retrieved from standard and high-risk donors. Transpl Int, 2015. 28: 665. 46. Treckmann, J., et al. Machine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death. Transpl Int, 2011. 24: 548. 47. Gill, J., et al. Pulsatile perfusion reduces the risk of delayed graft function in deceased donor kidney transplants (...) , irrespective of donor type and cold ischemic time. Transplantation, 2014. 97: 668. 48. Matsuno, N., et al. Machine perfusion preservation for kidney grafts with a high creatinine from uncontrolled donation after cardiac death. Transplant Proc, 2010. 42: 155. 49. Jochmans, I., et al. Graft quality assessment in kidney transplantation: not an exact science yet! Curr Opin Organ Transplant, 2011. 16: 174. 50. Thuillier, R., et al. Benefits of active oxygenation during hypothermic machine perfusion of kidneys

2019 European Association of Urology

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