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161. National Clinical Guideline on Adult type 1 diabetes mellitus

- evident that safe, effective care and treatment are important in ensuring that patients get the best outcomes from their care. The Department of Health is of the view that supporting evidence-based practice, through the clinical effectiveness framework, is a critical element of the health service to deliver safe and high quality care. The National Clinical Effectiveness Committee (NCEC) is a Ministerial committee set up in 2010 as a key recommendation of the report of the Commission on Patient Safety (...) and Quality Assurance (2008). The establishment of the Commission was prompted by an increasing awareness of patient safety issues in general and high profile health service system failures at home and abroad. The NCEC on behalf of the Department of Health has embarked on a quality assured National Clinical Guideline development process linked to service delivery priorities. Furthermore, implementing National Clinical Guidelines sets a standard nationally, to enable healthcare professionals to deliver

2018 HIQA Guidelines

162. Regorafenib (Stivarga) indicated as monotherapy for the treatment of adult patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib treatment

- ment, incorrect statistical analysis). For each domain, assessors were expected to judge the risk of bias (‘low risk’, ‘high risk’, or ‘un- clear’) on the basis of the information retrieved from the paper and from the CSR. The results of the risk of bias assessment at both study and outcome level are presented in Table A8 and Table A9 in Appendix 1. The external validity of the included trial was assessed using the EUnetHTA guideline on applica- bility of evidence in the context of a relative (...) by the addition of one fluorine atom. Although regorafenib is a targeted therapy, there is no relevant predictive biomarker identified. Pharmacodynamics/Kinetics Absorption: a high-fat meal increased the mean area under the curve (AUC) of the drug by 48% compared with the fasted state and decreased the mean AUC of the active metabolites M-2 (N- oxide) by 20% and M-5 (N-oxide and N-desmethyl) by 51%. A low-fat meal increased the mean AUC of regorafenib by 36%, M-2 by 40%, and M-5 by 23%, compared

2018 EUnetHTA

163. 2018 IDSA Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy

for effective monitoring for vascular access complications and antimicrobial adverse events (weak recommendation, low-quality evidence) . III. Can persons who inject drugs (PWID) be treated with OPAT at home? No recommendation can be made about whether PWID may be treated with OPAT at home (no recommendation, low-quality evidence) . Decisions should be made on a case-by-case basis. IV. Should elderly patients be allowed to be treated with OPAT at home? Elderly patients should be allowed to be treated (...) OPAT have laboratory test monitoring while on therapy? If so, which tests should be done and how often? Serial laboratory testing should be monitored in patients receiving OPAT (strong recommendation, high-quality evidence) . Data are insufficient to make evidence-based recommendations about specific tests and specific frequencies of monitoring for individual antimicrobials used in OPAT. XV. For patients receiving vancomycin as part of OPAT, should vancomycin serum levels be measured regularly

2018 Infectious Diseases Society of America

164. Mercaptamine (Cystadrops) - cystinosis

-Danlos syndrome FAS full analysis set GC gas chromatography GEE generalised estimating equation HDPE High Density Polyethylene HPLC High performance liquid chromatography HRT Heidelberg retina tomograph HRT/RTM Rostock cornea module of the Heidelberg retina tomograph ICH International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use ICP-MS Inductively coupled plasma mass spectrometry IOP intraocular pressure IR infrared IVCM in-vivo confocal (...) with a known active substance, No. 726/2004 (Mandatory Scope) Annex 4: Orphan designated medicinal product. 2.2. Quality aspects 2.2.1. Introduction The finished product is presented as an eye drops solution containing 5.5 mg/ml of mercaptamine hydrochloride, equivalent to 3.8 mg/ml mercaptamine, as active substance. Other ingredients are: benzalkonium chloride solution (BAK), carmellose sodium (CMC), citric acid monohydrate, disodium edetate, hydrochloric acid, sodium hydroxide and water for injections

2017 European Medicines Agency - EPARs

165. RCTs of cholesterol lowering agents of different classes were cancelled in succession

with higher LDL cholesterol level may live longer. A systematic review which was published in June 2016 revealed that people aged 60 years and older with higher LDL cholesterol lived longer almost without exception (abstract on p10). It was the article which was read most frequently for five months following the month of the publication on the BMJ Open Journal. It shows that the public has high interest in this issue. On the other hand, scholars insisting on the "cholesterol=devil" hypothesis (...) counterattack fiercely against this article. The prime example is the joint guideline by the European Society of Cardiology and European Atherosclerosis Society (ESC/EAS). Editorial C M ED HECK -The Informed Prescriber Translated from the Editorial in Med Check-TIP (in Japanese) Jan 017 ; 17 (69) The guideline recommend that in people at very high cardiovascular risk, LDL-cholesterol should be lowered to <1.8 mmol/L (70 mg/dL), or in people whose baseline cholesterol level is between 1.8 and 3.5 mmol/L (70

2017 Med Check - The Informed Prescriber

166. Local Endometrial Trauma (Endometrial Scratch): A Treatment Strategy to Improve Implantation Rates

) in the rates of implantation, clinical pregnancy and live births (27.7%, 66.7% and 48.9%, respectively) compared with control subjects who did not have an endometrial biopsy (14.2%, 30.3% and 22.5%, respectively). Similarly, a further prospective nonrandomised study 6 identified a favourable influence of local injury to the endometrium in intracytoplasmic sperm injection patients with high-order implantation failure. Two systematic reviews and meta-analyses 7,8 have shown a beneficial effect of local (...) , Strassburger D, Bern O, Ron-El R, Friedler S. Favorable influence of local injury to the endometrium in intracytoplasmic sperm injection patients with high-order implantation failure. Fertil Steril 2007;87: 198–201. 7. El-Toukhy T, Sunkara S, Khalaf Y . Local endometrial injury and IVF outcome: a systematic review and meta-analysis. Reprod Biomed Online 2012;25:345–54. 8. Potdar N, Gelbaya T, Nardo LG. Endometrial injury to overcome recurrent embryo implantation failure: a system atic review and meta

2017 Royal College of Obstetricians and Gynaecologists

167. Implantation of a corneal graft-keratoprosthesis for severe corneal opacity in wet blinking eyes

Recommendations 1.1 Current evidence on the efficacy of implantation of a corneal graft–keratoprosthesis for severe corneal opacity in wet blinking eyes is adequate in the short to medium term. Although the evidence on safety shows a high incidence of significant adverse effects, there are few options for patients © NICE 2018. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 1 of 10with severe corneal opacity if standard corneal grafts (...) adhesion problems (retinal detachment with or without choroidal detachment or retinoschisis) were reported in 27% (11/41) of eyes in the case series of 37 patients at a mean follow-up of 22 months. Six patients needed surgery: 5 had vitrectomy and 1 had trans-scleral cyclophotocoagulation. 5.4 Glaucoma or increased intraocular pressure was reported in 81% (34/42) of eyes (in 5 eyes of people with, and 29 eyes of people without, Stevens–Johnson syndrome) in the case series of 40 patients at a mean

2015 National Institute for Health and Clinical Excellence - Interventional Procedures

168. Low back pain and radicular pain: development of a clinical pathway

LIST OF ABBREVIATIONS 7 ? SCIENTIFIC REPORT 12 1 INTRODUCTION 12 1.1 BACKGROUND: A FREQUENT PROBLEM WITH HIGH SOCIETAL IMPACT 12 1.2 STUDY OBJECTIVES AND RESEARCH QUESTIONS 13 1.3 DEFINITION OF CONCEPTS 13 1.3.1 Definition of low back and radicular pain 13 1.3.2 Definition of clinical pathway 14 1.4 STUDY PROCESS 14 2 A SYSTEMATIC REVIEW OF LITERATURE 15 2.1 RESEARCH OBJECTIVE 15 2.2 METHODS 15 2.3 RESULTS 16 2.4 LIMITATIONS 22 3 INTERNATIONAL COMPARISON OF PATHWAYS 22 3.1 RESEARCH OBJECTIVE 22 3.2 (...) WIV – ISP Wetenschappelijk Instituut Volksgezondheid – Institut Scientifique de Santé Publique wk(s) Week(s) WVV Wetenschappelijke Vereniging voor Verzekeringsgeneeskunde WVVK Wetenschappelijke vereniging van Vlaamse kinesitherapeuten yrs Years ZNA Ziekenhuis Netwerk Antwerpen ZOL Ziekenhuis Oost-Limburg 12 Low back pain and radicular pain: development of a clinical pathway KCE Report 295 ? SCIENTIFIC REPORT 1 INTRODUCTION 1.1 Background: a frequent problem with high societal impact Low back pain

2017 Belgian Health Care Knowledge Centre

169. Prescribing patterns of dependence forming medicines

medication supply from iGen and Braeburn and also discussions with various companies about medications potentially applicable in the treatment of addictions and related problems. This includes exploration of the potential for - and consideration of research trials of - improved medications with less abuse liability, longer duration of action (e.g. implant or depot formulations) and also novel non-injectable emergency medications. JS works with the charity Action on Addiction, and also with the Pilgrim (...) or by whether patients live in high or low deprivation neighbourhoods. Characteristics of patients by average prescribing period Some types of DFM tend to be prescribed on average for longer periods in more deprived neighbourhoods. • While local area-level deprivation was not significantly associated with whether or not DFM prescribing periods exceeded 30 days, it was associated with the mean average length of prescriptions. Mean average length is affected by the overall distribution in prescribing periods

2017 Public Health Research Consortium

170. Proposals for a further expansion of day surgery in Belgium

of selected procedures and related day-care and inpatient stays (2011-2013) 91 Table 22 – Top-10 day-surgery procedures (2011-2013) 94 Table 23 – Lens extraction with insertion of an intraocular lens prosthesis, 2011-2013 96 6 Proposals for a further expansion of day surgery in Belgium KCE Report 282 Table 24 – Elective surgical procedures with high national day-care rates and outliers, 2011-2013 97 Table 25 – Excision of an epididymal cyst, 2011-2013 97 Table 26 – Elective surgical procedures (...) , though at varying rates. 2 As a matter of fact, day surgery represents an innovative tool for the health sector reform in Europe by contributing to several common objectives: improving quality of care, controlling cost, and enhancing efficiency and possibly equity. 3 In order to promote the worldwide development of high quality day surgery the International Association for Ambulatory Surgery (IAAS) was founded (in 1995); the Belgian Association of Ambulatory Surgery (BAAS) was one of its founding

2017 Belgian Health Care Knowledge Centre

171. Management of Anal Fissures

or to lateral internal sphincterotomy decreases postoperative pain and allows for primary wound healing. Grade of Recommendation: Weak rec- ommendation based on low-quality evidence, 2C. flap techniques for fissure coverage have the advantage of primary wound healing, faster pain relief, and poten- tially providing better functional results. small, noncom- parative studies have evaluated the outcomes of patients undergoing anocutaneous flap coverage with either botu- linum toxin injection or lis. a combined (...) Management of Anal Fissures Copyright © The American Society of Colon & Rectal Surgeons, Inc. Unauthorized reproduction of this article is prohibited. 7 Diseases of the Colon & ReCtum Volume 60: 1 (2017) t he a merican s ociety of Colon and Rectal surgeons is dedicated to ensuring high-quality patient care by advancing the science, prevention, and manage- ment of disorders and diseases of the colon, rectum, and anus. t he Clinical Practice Guidelines Committee is com- posed of society members

2017 American Society of Colon and Rectal Surgeons

172. Clinical Practice Guideline on the Management of Osteoarthritis of the Hip

from a single “High” quality study for recommending for or against the intervention. b) Limited strength evidence supports that obese patients with symptomatic osteoarthritis of the hip, when compared to non-obese patients, have increased incidence of postoperative dislocation, superficial wound infection, and blood loss after total hip arthroplasty. Strength of Recommendation: Limited Evidence Description: Evidence from two or more “Low” strength studies with consistent findings or evidence from (...) ” strength studies with consistent findings, or evidence from a single “High” quality study for recommending for or against the intervention. 6 INTRAARTICULAR INJECTABLES a) Strong evidence supports the use of intraarticular corticosteroids to improve function and reduce pain in the short-term for patients with symptomatic osteoarthritis of the hip. Strength of Recommendation: Strong Evidence Description: Evidence from two or more “High” strength studies with consistent findings for recommending

2017 American Academy of Orthopaedic Surgeons

173. The Diagnosis and Acute Management of Childhood Stroke, Clinical Guideline

risk of in- hospital death if the child experienced high blood pressure (141). However, in this study, the method and timing of measurements were not controlled, and due to diagnostic delays, some measures may have been taken up to five days post stroke. In contrast, Grelli et al respectively analysed 98 children diagnosed with arterial ischaemic stroke and concluded that hypertension was not associated with infarct size, poor clinical outcome or mortality (142). This cohort was notably different (...) -65 80-100/40-65 SBP, systolic blood pressure; DBP, diastolic blood pressure; * blood pressure ranging from 5th - 95th percentile of height. The 90th percentile blood pressure is 1.28 standard deviations over the mean. Adapted from the fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents (135) and the guidelines for basic paediatric neurological observation (146).Australian Childhood Stroke Advisory Committee 25 8.2 Glucose Both hyper

2017 Stroke Foundation - Australia

174. Complex regional pain syndrome in adults. UK guidelines for diagnosis, referral and management in primary and secondary care 2018 (2nd edition)

, the Vascular Society, the Association of British Neurologists and the British Society of Clinical Neurophysiology. Patients with complex regional pain syndrome (CRPS) and their relatives contributed to the development process. Published with:ii © Royal College of Physicians 2018 The Royal College of Physicians The Royal College of Physicians (RCP) plays a leading role in the delivery of high-quality patient care by setting standards of medical practice and promoting clinical excellence. The RCP provides (...) is disproportionate to any inciting event B) The patient has at least one sign in two or more of the categories C) The patient reports at least one symptom in three or more of the categories D) No other diagnosis can better explain the signs and symptoms ? ? ? ? Category Sign (you can see or feel a problem) Symptom (the patient reports a problem) 1 ‘Sensory’ Allodynia (to light touch and/or temperature sensation and/or deep somatic pressure and/or hyperalgesia (to pinprick) ? Hyperesthesia does also qualify

2018 British Society of Rehabilitation Medicine

175. BTS guideline for oxygen use in adults in healthcare and emergency settings.

failure , aim at an oxygen saturation of 94% to 98% (or 88% to 92% if the patient is at risk of hypercapnic respiratory failure) ( grade D ). Continuous positive airway pressure (CPAP) with entrained oxygen or high-flow humidified nasal oxygen to maintain saturation 94% to 98% (or 88% to 92% if at risk of hypercapnia) should be considered as an adjunctive treatment to improve gas exchange in patients with cardiogenic pulmonary oedema who are not responding to standard treatment (or non-invasive (...) pressure ventilation) who do not have an alert card, it is recommended that low-concentration oxygen treatment should be started using a 24% Venturi mask at 2-3 L/min (or a 28% Venturi mask at 4 L/min or nasal cannulae at 1-2 L/min if a 24% mask is not available) with an initial target saturation of 88% to 92% pending urgent blood gas results. These patients should be treated as a high priority by emergency services and the oxygen concentration should be reduced if the saturation exceeds 92

2017 National Guideline Clearinghouse (partial archive)

176. Cataracts in adults: management.

injection into the Internet Archive (or other archive sites). To use ArchiveBot, drop by #archivebot on EFNet. To interact with ArchiveBot, you issue commands by typing it into the channel. Note you will need channel operator permissions in order to issue archiving jobs. The dashboard shows the sites being downloaded currently. There is a dashboard running for the archivebot process at . ArchiveBot's source code can be found at . TIMESTAMPS Search Sign In Username or Email * Password * Remember Me Don't (...) of different intraocular lenses (see "Before Cataract Surgery," below) Types of anaesthesia The person's individual risk of complications during or after surgery (for example, the risk of postoperative retinal detachment in people with high myopia; also see "Risk Stratification," below) What to do and what to expect on the day of cataract surgery What to do and what to expect after cataract surgery What support might be needed after surgery Medicines after surgery (for example, eye drops) and medicines

2017 National Guideline Clearinghouse (partial archive)

177. Complex regional pain syndrome/reflex sympathetic dystrophy medical treatment guideline.

at, and it grabs all content under that URL, records it in a WARC, and then uploads that WARC to ArchiveTeam servers for eventual injection into the Internet Archive (or other archive sites). To use ArchiveBot, drop by #archivebot on EFNet. To interact with ArchiveBot, you issue commands by typing it into the channel. Note you will need channel operator permissions in order to issue archiving jobs. The dashboard shows the sites being downloaded currently. There is a dashboard running for the archivebot process (...) or be caused or exacerbated by opioid and hypnotic use. Refer to the Division's for more information on behavioral modifications to address sleep disturbances. Education/Informed/Shared Decision Making Evidence Statements Regarding Education/Informed Decision Making Some Evidence Information provided only by video is not sufficient education (Design: Prospective randomized controlled trial ). See the original guideline document for time to produce effect and frequency. Injections—Therapeutic For post

2017 National Guideline Clearinghouse (partial archive)

178. Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery: Systematic Review Update

orthopedic surgeries, such as total knee replacement (TKR), total hip replacement (THR), and hip fracture (HFx) surgery, carry a high risk for venous thromboembolism (VTE)—deep vein thrombosis (DVT) and pulmonary embolism (PE). Methods. Updating a 2012 review, we compare interventions to prevent VTE after TKR, THR, and HFx surgery. We searched four databases and other sources through June 3, 2016, for randomized controlled trials (RCTs) and large nonrandomized comparative studies (NRCSs) reporting (...) postoperative VTE, major bleeding, and other adverse events. We conducted pairwise meta-analyses, Bayesian network meta-analyses, and strength of evidence (SoE) synthesis. Results. Overall, 127 RCTs and 15 NRCSs met criteria. For THR: low molecular weight heparin (LMWH) has lower risk than unfractionated heparin (UFH) of various VTE outcomes (moderate to high SoE) and major bleeding (moderate SoE). LMWH and aspirin have similar risks of total PE, symptomatic DVT, and major bleeding (low SoE). LMWH has less

2017 Effective Health Care Program (AHRQ)

179. Interventions Targeting Sensory Challenges in Children with Autism Spectrum Disorder - An Update

high risk of bias [ROB]). Populations, intervention approaches, and outcomes assessed varied across studies. Relative to usual care or other interventions, sensory integration–based approaches improved measures related to sensory and motor skills in the short term (3 RCTs with high, moderate, and low ROB and 1 high ROB retrospective cohort study). Environmental enrichment improved nonverbal cognitive skills in treated children compared with standard care in two small RCTs (low and moderate ROB (...) ). Four small RCTs (2 moderate and 2 high ROB) of auditory integration–based approaches reported mixed results. Studies of music therapy (4 RCTs—1 low, 2 moderate, and 1 high ROB—and 1 high ROB nonrandomized trial) used different protocols and addressed different outcomes, precluding synthesis. Massage improved ASD symptom severity and sensory challenges versus a waitlist control condition (7 studies, 5 with likely overlapping participants, 3 moderate and 4 high ROB). Additional RCTs (moderate

2017 Effective Health Care Program (AHRQ)

180. Islet Cell Replacement Therapy for Insulin-Dependent Diabetes

and cancer, as well as the potential for the immunosuppressive drugs to negatively affect islet function. 4,7 Because of these risks, ViaCyte plans to use the PEC-Direct product only in people with high-risk type 1 diabetes, defined as those who experience: impaired awareness of low blood sugar levels (hypoglycemia unawareness) extreme fluctuations of blood sugar (glycemic lability) and/or frequent and severe incidences of low blood sugar (hypoglycemic episodes). 3 The PEC-Encap (VC-01) Product ViaCyte’s (...) at the University of Alberta Hospital in Edmonton. 9,16 Neither the PEC-Direct nor the PEC-Encap products are expected to be available outside of clinical trials for several years. 3,17,18 Cost The cost of the PEC-Direct and PEC-Encap products is not yet known. Who Might Benefit? ViaCyte’s PEC-Direct product is intended only for patients living with high-risk type 1 diabetes (also called “brittle” or “labile” diabetes). 3,19 Between 10% and 15% of the approximately 350,000 Canadians living with type 1 diabetes

2017 CADTH - Issues in Emerging Health Technologies

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