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McMurray Test

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261. KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease

Standardization (COGS) checklist for reporting clinical practice guidelines 322 FIGURES Figure 1. Receiver operating characteristic (ROC) curves, examining the utility of iron status tests to distinguish iron deficient from nondeficient study patients 293 Figure 2. Sensitivity and specificity of TSAT and serum ferritin and their combination (TSAT + ferritin) and bone marrow iron (BM iron) to identify correctly a positive erythropoietic response (Z1-g/dl [Z10-g/l] increase in Hb [DHb]) to intravenous iron (...) in 100 nondialysis patients with CKD (areas under the ROCs) 294 Figure 3. Lymphocytotoxic antibody reactivity against random donor test panel in relation to the number of blood transfusions 313 Figure 4. Algorithms for red cell transfusion use in CKD patients 315 Additional information in the form of supplementary materials can be found online at http://www.kdigo.org/clinical_practice_guidelines/anemia.php http://www.kidney-international.org contents & 2012 KDIGO Kidney International Supplements

2012 National Kidney Foundation

262. KDOQI US Commentary on the 2012 KDIGO Clinical Practice Guideline for Anemia in CKD (Full text)

Outcomes) clinical practice guideline for anemia in chronic kidney disease (CKD) was published in 2012. x 1 KDIGO Anemia Work Group. KDIGO Clinical Practice Guideline for Anemia in Chronic Kidney Disease. Kidney Int Suppl . 2012 ; 2 : 279–335 | | An international group of experts, led by John J.V. McMurray and Patrick S. Parfrey, with the assistance of an evidence review team from Tufts Medical Center in Boston, created comprehensive, evidence-based guidance for the treatment of anemia in CKD, tempered (...) those that the work group thought required comment or qualification are reproduced here. All material is reproduced with permission of KDIGO. Guideline Statements and Commentary Testing for Anemia Frequency of testing for anemia 1.1.1: For CKD patients without anemia (as defined … in Recommendation 1.2.1 for adults and Recommendation 1.2.2 for children), measure Hb concentration when clinically indicated and ( Not Graded ): • at least annually in patients with CKD 3 • at least twice per year

2012 National Kidney Foundation PubMed abstract

263. KDOQI US Commentary on the 2012 KDIGO Clinical Practice Guideline for Management of Blood Pressure in CKD

the drug classes of agents tested, to test drug combinations and add-on therapy ap- proaches, and to provide guidance for situations such as obesity, for which drug metabolism/distribution may be different. Certainly, the expanding numbers with diabetes and diabetic CKD would make this Box4.KDIGORecommendationsforBloodPressureManage- mentinCKDNDPatientsWithDiabetesMellitus 4.1: WerecommendthatadultswithdiabetesandCKDND withurinealbuminexcretion30mgper24hours(or equivalent*)whoseof

2012 National Kidney Foundation

264. 2012 KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD

demonstrating a positive reagent strip test for albuminuria/proteinuria or quantitative albuminuria/proteinuria test 57 Figure 17. GFR and albuminuria grid to reflect the risk of progression 63 Figure 18. Distributionoftheprobabilityofnonlinearitywiththreeexampletrajectoriesdemonstratingdifferentprobabilities of nonlinearity 69 Figure 19. Summary estimates for risks of all-cause mortality and cardiovascular mortality associated with levels of serum phosphorus, PTH, and calcium 86 Figure 20. Prevalence (...) International Supplements (2013) 3,5–14 summary of recommendation statements3.3:CKD METABOLIC BONE DISEASE INCLUDING LABORATORY ABNORMALITIES 3.3.1: We recommend measuring serum levels of calcium, phosphate, PTH, and alkaline phosphatase activity at least once in adults with GFRo45ml/min/1.73 m 2 (GFR categories G3b-G5) in order to determine baseline values and inform prediction equations if used. (1C) 3.3.2: We suggest not to perform bone mineral density testing routinely in those with eGFRo45ml/min/1.73 m

2012 National Kidney Foundation

265. ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease (SIHD)

or Statements 2571 1.6. Magnitude of the Problem 2571 1.7. Organization of the Guideline 2571 1.8. Vital Importance of Involvement by an Informed Patient: Recommendation 2572 2. Diagnosis of SIHD: Recommendations 2572 2.1. Clinical Evaluation of Patients With Chest Pain 2572 2.1.1. Clinical Evaluation in the Initial Diagnosis of SIHD in Patients With Chest Pain 2572 2.1.2. Electrocardiography 2572 2.1.2.1. RESTING ELECTROCARDIOGRAPHY TO ASSESS RISK 2572 2.1.3. Stress Testing and Advanced Imaging for Initial (...) Diagnosis in Patients With Suspected SIHD Who Require Noninvasive Testing 2572 2.1.3.1. ABLE TO EXERCISE 2572 2.1.3.2. UNABLE TO EXERCISE 2572 2.1.3.3. OTHER 2574 3. Risk Assessment: Recommendations 2574 3.1. Advanced Testing: Resting and Stress Noninvasive Testing 2574 3.1.1. Resting Imaging to Assess Cardiac Structure and Function 2574 3.1.2. Stress Testing and Advanced Imaging in Patients With Known SIHD Who Require Noninvasive Testing for Risk Assessment 2575 3.1.2.1. RISK ASSESSMENT IN PATIENTS

2012 Society for Cardiovascular Angiography and Interventions

266. Decision Making in Advanced Heart Failure

). ? Benefits and risks of noncardiac procedures should be reviewed in the context of competing risks for death and functional limitation attributable to heart failure (eg, hip replacement, repair of asymptomatic aortic aneurysm, or screening tests). ? Decisions for major cardiac and noncardiac interventions should include consideration of “what if” situations of unanticipated adversity. ? Referral to a palliative care team should be considered for assistance with difficult decision making, symptom man

2012 American Heart Association

267. Population Approaches to Improve Diet, Physical Activity, and Smoking Habits (Full text)

simultaneously. The Stanford Five-City Project tested a 5-year community-based program that incorporated behavior change theory (social learning theory, a communication-behavior change model), community organization principles, and social marketing methods. After 3 to 5 years of intervention, compared with controls, the intervention communities saw improvements in several cardiovascular risk factors, including lower blood cholesterol, blood pressure, resting heart rate, weight gain, and smoking prevalence (...) cardiovascular risk factors and behaviors simultaneously have been less successful, which suggests the importance of focused messages for the target audience. This is a major premise of social marketing, which uses a consumer orientation to behavior change: Incorporation of research from the target population, testing of different strategies and channels of delivery, and integration of marketing principles (eg, product, place, promotion) into the intervention. Media and education have also been prominently

2012 American Heart Association PubMed abstract

268. Management of Atrial Fibrillation

of Thromboembolism xiii6.1 Risk Stratification For Stroke 6.2 Strategies for Thromboembolic Prophylaxis 6.3 Antithrombotic Therapy 6.3.1 Anticoagulation With Vitamin K Antagonists 6.3.2 Optimal International Normalized Ratio 6.3.2.1 Point-of-care testing and self-monitoring of anticoagulation 6.3.3 Anticoagulation With Direct Thrombin Inhibitors 6.3.4 Investigational Agents 6.3.5 Antiplatelet Agent Aspirin 6.3.6 Aspirin And Clopidogrel Combination 6.4 Anticoagulation In Special Circumstances 6.4.1 Peri-operative (...) (e.g. AF terminates within 24 – 48 h). After the initial management of symptoms and complications, underlying causes of AF should be sought. A TTE is useful to detect ventricular, valvular, and atrial disease as well as rare congenital heart disease. Thyroid function tests, a full 7 Table 5 : EHRA score of AF-related symptoms AF = atrial fibrillation; EHRA = European Heart Rhythm Association. Table 5 : EHRA score of AF-related symptoms AF = atrial fibrillation; EHRA = European Heart Rhythm

2012 Ministry of Health, Malaysia

269. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction (Full text)

STEMI e397 10.1. Use of Noninvasive Testing for Ischemia Before Discharge: Recommendations e397 10.2. Assessment of LV Function: Recommendation e398 10.3. Assessment of Risk for SCD: Recommendation e398 11. Posthospitalization Plan of Care e399 11.1. Posthospitalization Plan of Care: Recommendations e399 11.1.1. The Plan of Care for Patients With STEMI e399 11.1.2. Smoking Cessation e399 11.1.3. Cardiac Rehabilitation e399 11.1.4. Systems of Care to Promote Care Coordination e399 12. Unresolved (...) in the subject under consideration are selected by the ACCF and AHA to examine subject-specific data and write guidelines in partnership with representatives from other medical organizations and specialty groups. Writing committees are asked to perform a formal literature review; weigh the strength of evidence for or against particular tests, treatments, or procedures; and include estimates of expected outcomes where such data exist. Patient-specific modifiers, comorbidities, and issues of patient preference

2012 American Heart Association PubMed abstract

270. Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation

and the prevention of stroke in patients with stroke or transient ischemic attack (TIA), 5 we review recent trials testing the safety and effi- cacy of a thrombin inhibitor (dabigatran) and 2 factor Xa inhibitors (rivaroxaban and apixaban) in preventing stroke in patients with AF, and we revise management recom- mendations. 4,5 Recommendations follow the AHA’s and the American College of Cardiology’s methods of classifying the level of certainty of the treatment effect and the class of evidence (Table 1 (...) ), RIETE (Registro Informatizado de la Enfermedad Tromboemb´ olica), and ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) scores have been developed A recommendation with Level of Evidence B or C does not imply that the recommendation is weak. Many important clinical questions addressed in the guidelines do not lend themselves to clinical trials. Although randomized trials are unavailable, there may be a very clear clinical consensus that a particular test or therapy is useful

2012 American Academy of Neurology

271. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease: Executive Summary

or Statements 2571 1.6. Magnitude of the Problem 2571 1.7. Organization of the Guideline 2571 1.8. Vital Importance of Involvement by an Informed Patient: Recommendation 2572 2. Diagnosis of SIHD: Recommendations 2572 2.1. Clinical Evaluation of Patients With Chest Pain 2572 2.1.1. Clinical Evaluation in the Initial Diagnosis of SIHD in Patients With Chest Pain 2572 2.1.2. Electrocardiography 2572 2.1.2.1. RESTING ELECTROCARDIOGRAPHY TO ASSESS RISK 2572 2.1.3. Stress Testing and Advanced Imaging for Initial (...) Diagnosis in Patients With Suspected SIHD Who Require Noninvasive Testing 2572 2.1.3.1. ABLE TO EXERCISE 2572 2.1.3.2. UNABLE TO EXERCISE 2572 2.1.3.3. OTHER 2574 3. Risk Assessment: Recommendations 2574 3.1. Advanced Testing: Resting and Stress Noninvasive Testing 2574 3.1.1. Resting Imaging to Assess Cardiac Structure and Function 2574 3.1.2. Stress Testing and Advanced Imaging in Patients With Known SIHD Who Require Noninvasive Testing for Risk Assessment 2575 3.1.2.1. RISK ASSESSMENT IN PATIENTS

2012 Society for Cardiovascular Angiography and Interventions

272. Management of bleeding in patients on antithrombotic agents

‐life and length of functional defect induced by the drug Assess the source of bleeding Request full blood count, prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen concentration, creatinine concentration If available, request a specific laboratory test to measure the antithrombotic effect of the drug Correct haemodynamic compromise with intravenous fluids and red cell transfusion Apply mechanical pressure, if possible Use endoscopic, radiological or surgical measures (...) of the anticoagulant activity of LMWH lasts approximately 4 h. The mechanism of action of LMWH and differences from UFH were recently reviewed (Gray et al , ). LMWH activity may be monitored with the anti‐Xa test. Although LMWH may also prolong the APTT, this test should not be used to assess the extent of drug effect. Protamine reverses approximately 60% of LMWH based on data from animal studies (Bang et al , ; Lindblad et al , ; Van Ryn‐McKenna et al , ) and healthy human volunteers (Holst et al , ). The largest

2012 British Committee for Standards in Haematology

273. Meniscal tear presentation, diagnosis and management

be significant quadriceps wasting. McMurray (Figure 1) and Apley tests (Figure 2) are often positive, although these are specific but not sensitive – specificity being 57–98% and 80–99%, and sensitivity being 10–66% and 16–58% respectively. 2,9 The most useful clinical test for meniscal injury is the Thessaly test, which is demonstrated in Figure 3 . Although rarely taught and poorly utilised, recent validation demonstrated a sensitivity of 90%, and specificity of 98% in detecting meniscal injury. 10 (...) do not rapidly improve. Figure 1. McMurray test: The patient lies supine on the bed with the hip and knee both flexed. With the foot as close to the hip as possible, the clinician holds the knee joint (with fingers along the joint line) with one hand, and the other hand rotates the tibia internally and externally while extending and flexing the knee. If the test is positive (suggesting a meniscal tear), the patient will feel pain and the clinician will feel and/or hear meniscal movement when

2012 Clinical Practice Guidelines Portal

274. A Case of Infrapatellar Fat Pad Ganglion of the Knee (Full text)

A Case of Infrapatellar Fat Pad Ganglion of the Knee A ganglion cyst can induce symptoms around the knee and should be considered as an intra-articular mass in differential diagnosis.A 22-year-old female presented with a persistent medial knee joint pain in her left knee for 2 years. There was soft tissue swelling on the anteromedial aspect of the infrapatellar region on her left knee. Lachman and McMurray tests were negative. MRI showed a multilobular cyst in the infrapatellar fat pad with T1

2017 The open orthopaedics journal PubMed abstract

275. Relationship between Clinical, MRI, and Arthroscopic Findings: A Guide to Correct Diagnosis of Meniscal Tears (Full text)

a careful examination, to bypass MRI and perform directly arthroscopy in suspected cases. Methods  A total of 80 patients with a history of knee trauma, preoperative RX, and MRI underwent arthroscopy over an 8-month period at our department. All patients had a clinical examination performed by an experienced knee surgeon. These examiners evaluated and recorded the results of three tests: medial and lateral joint line tenderness test, McMurray's test, and Apley's test. The injury was classified (...) as a meniscal tear if there were at least two positive tests. Finally, using the arthroscopic findings as the gold standard, sensibility, specificity, accuracy, positive and negative predictive values of clinical examination, and MRI were evaluated and compared. Results  Clinical examination performed by an experienced knee surgeon reported better sensitivity (91 vs. 85%), specificity (87 vs. 75%), accuracy (90 vs. 82%), positive predictive value (94 vs. 88%), and negative predictive value (81 vs. 71%) than

2017 Joints PubMed abstract

276. FA Clinical Outcome Measures

to Primary Outcome Measures : Friedreich Ataxia Rating Scale [ Time Frame: once every 1 year ] rating scale based on clinical neurologic examination Secondary Outcome Measures : 9-hole peg test [ Time Frame: once every 1 year ] timed test of fine motor skills performed as a set of four trials (two trials per hand), for patients with FA who are able to complete this testing timed 25 foot walk [ Time Frame: once every 1 year ] timed 25 foot walk is performed twice for patients with FA who are able (...) to complete this testing. Assistive devices such as canes, service dogs, walkers, or crutches are permitted. Vision assessment [ Time Frame: once every 1 year ] High and low contrast visual acuity tested on patients with FA who are able to perform this test. Glasses or contact lenses are permitted. Quality of Life Questionnaires [ Time Frame: once every 1 year ] a set of quality of life questionnaires is administered for study participants with Friedreich ataxia. Questionnaires include items

2017 Clinical Trials

277. Occupational Therapy for Adults Undergoing Total Hip Replacement

from both the literature (McMurray et al 2000, Drummond et al 2012), and from expert practitioners involved in the College of Occupational Therapists Specialist Section – Trauma and Orthopaedics, has, however, con?rmed that differences exist in practice across the UK in areas which include pre- operative assessment and education processes, use of hip precautions and equipment provision. The number of service users undergoing total hip replacement in the UK is high. This demand for orthopaedic

2012 Publication 1554

278. Colorectal Cancer Prevention (PDQ®): Health Professional Version

or surveillance could counterbalance long-term risks such as gastrointestinal ulceration and hemorrhagic stroke for the average-risk individual.[ ] Calcium supplements A randomized placebo-controlled trial tested the effect of calcium supplementation (3 g calcium carbonate daily [1,200 mg elemental calcium]) on the risk of recurrent adenoma.[ ] The primary endpoint was the proportion of patients (72% of whom were male) in whom at least one adenoma was detected following a first and/or second follow-up

2016 PDQ - NCI's Comprehensive Cancer Database

279. Genetics of Colorectal Cancer (PDQ®): Health Professional Version

% or greater on MMRpro and MMRpredict are recommended for genetic evaluation referral and testing. Associated Genes and Syndromes Hereditary CRC has two well-described forms: (1) polyposis (including and (AFAP), which are caused by pathogenic variants in the gene; and , which is caused by pathogenic variants in the MUTYH gene); and (2) (often referred to as hereditary nonpolyposis colorectal cancer), which is caused by germline pathogenic variants in DNA MMR genes ( , , , and ) and . Other CRC syndromes (...) that all individuals with newly diagnosed CRC are evaluated for Lynch syndrome through molecular diagnostic tumor testing assessing MMR deficiency. A is supported, in which all CRC cases are evaluated regardless of age at diagnosis or fulfillment of existing clinical criteria for Lynch syndrome. A more cost-effective approach has been reported whereby all patients aged 70 years or younger with CRC and older patients who meet the revised Bethesda guidelines are tested for Lynch syndrome. Tumor

2016 PDQ - NCI's Comprehensive Cancer Database

280. Heart Failure (Multi-Disciplinary Community Care) Clinics Field Evaluation

Analytic Plan and Study Definitions 25 Statistical Analyses 26 Institutional Review Board 26 Results 27 Baseline Characteristics of HF patients 27 Clinic Visits and Diagnostic Tests 27 Medication Use 27 Comparison of Early vs. Recent Cohorts 28 Target Doses of ACEi/ARB and ß-blockers 28 Predictors of ACEi/ARB and ß-blocker use 28 Discussion 30 Table 1: Baseline Characteristics 32 Table 2: Diagnostic Test Performed over 1 year of chart abstraction 33 Table 3: Medication ever prescribed 34 Table 4 (...) Parameter PERSONEL Mean number of Physicians 4.7 (1-8)* % cardiologist 80.6 % internists 22.6 % family physicians 9.7 % Heart failure training 80.6 Mean Number of Nurses 2.0 (1-6)* LOCATION % Academic 25.8 % Community Based 74.2 Mean Annual Total Visits 1020 (200-1479)* Mean Annual Total New Patients 139 (25-128)* % Access to Onsite Echocardiography 80.6 % Access to Onsite Nuclear Cardiology Testing 58.1 % Access to Onsite Angiography 38.7 % Access to Onsite Exercise Stress Testing 77.4 Mean Exam Rooms

2011 Health Quality Ontario

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