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Murphy Sign

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101. The Primary Care Management of Headache

as an efficient method to explore ideas and perspectives of a group of individuals and collect qualitative data on a thoughtfully predetermined set of questions. Therefore, as part of the effort to develop this CPG, VA and DoD Leadership, along with the Headache CPG Work Group, held a patient focus group on January 16, 2019, at the Audie L. Murphy Memorial VA Hospital in San Antonio, TX. The aim of the focus group was to further understand the perspectives of patients who are receiving treatment for headache

2020 VA/DoD Clinical Practice Guidelines

102. The Non-Surgical Management of Hip & Knee Osteoarthritis (OA)

and collect qualitative data on a thoughtfully predetermined set of questions. Therefore, as part of the effort to update this CPG, VA and DoD Leadership held a patient focus group on April 17, 2019, at the Audie L. Murphy Memorial VA Hospital in San Antonio, TX. The focus group aimed to further understand the perspectives of patients with OA who are covered and/or receiving their care through the VA and/or DoD healthcare systems. The focus group comprised a convenience sample of four participants; two (...) Medical Command Corinne Devlin, MSN, RN, FNP-BC Christina D. Smith, RN, BSN The Lewin Group Clifford Goodman, PhD Erika Beam, MS Christine Jones, MS, MPH, PMP Ben Agatston, JD, MPH Rebecca Ierardo, MPP Andrea Dressel, BS ECRI Jim Reston, PhD, MPH Amy Tsou, MD, MSc Joann Fontanarosa, PhD Angela Motter, PhD Amber Moran, MA Kelley Tipton, MPH Stacey Uhl, MS Nancy Sullivan, BA Sigma Health Consulting Frances M. Murphy, MD, MPH Anjali Jain Research & Consulting Anjali Jain, MD Duty First Consulting Rachel

2020 VA/DoD Clinical Practice Guidelines

103. Stratification of clinical risk in pregnancy

Service User (until June 2019) Dr Peter McKenna Clinical Director, NWIHP Dr Léan McMahon Quality Assurance, NWIHP Dr Niamh Murphy Specialist Registrar Obstetrics and Gynaecology Dr John Murphy Lead, Clinical Programme for Neonatology Dr Cathal O’Keeffe Head of Clinical Risk, State Claims Agency (June 2018 - March 2019) Ms Margaret Philbin Former Director of Midwifery, Rotunda Hospital Ms Caroline Plascott CGDG Coordinator (until January 2019) Dr Karen Power CGDG Project Manager (until December 2019 (...) and the Childbirth GDG. Dr Karen Power and Prof Michael Turner wrote and prepared the final document and submitted the guideline for NCEC quality assurance. The time and effort for the external review, carried out by Ms Shona Hamilton and Dr Patrick O’Brien, is gratefully acknowledged. Signed by the Chair, Professor Michael Turner November 2019National Clinical Guidelines Providing standardised clinical care to patients in healthcare is challenging. This is due to a number of factors, among them variations

2020 National Clinical Guidelines (Ireland)

104. Practice Parameter for the Assessment and Treatment of Psychiatric Disorders in Children and Adolescents With Intellectual Disability (Intellectual Developmental Disorder)

. Some children display signs of ID/IDD later in their development, when academic demands exceed their capacities. Despite minimal literature on, or measures available for, systematic screening inlaterchildhoodandadolescence,primarycareandmental health professionals should consider referring children and adolescents who have academic performance or behavioral challenges for standardized testing of intellectual functioning. Diagnostic Evaluation A positive screen for intellectual or developmental (...) consideration of an electroencephalogram (EEG) if seizures or paroxysmal events are suspected, and brain magnetic resonance imaging (MRI) if there are his- torical ?ndings (ie, intrapartum asphyxia), physical ?ndings (cerebral palsy, microcephaly, macrocephaly, abnormalities of cranial contour), or abnormal neurologic ?ndings (focal motor ?ndings, pyramidal signs, extrapyramidal signs, epilepsy). The American College of Medical Genetics, 34 the ISCAC, 28 AAN, 29 and AAP 31 recommend a chromo- somal

2020 American Academy of Child and Adolescent Psychiatry

106. Diagnosis of Hypersensitivity Pneumonitis in Adults. An Official ATS/JRS/ALAT Clinical Practice Guideline Full Text available with Trip Pro

directions. Conclusions: The guideline committee developed a systematic approach to the diagnosis of HP. The approach should be reevaluated as new evidence accumulates. Keywords : ; ; ; ; ... Show All Contents Section: Summary of Recommendations Introduction How to Use These Guidelines Methods Definition Clinical Manifestations Subtypes of HP Symptoms and Signs Natural History and Prognosis Epidemiology Pathogenesis Inciting Agents Immunological Dysregulation Genetic/Host Susceptibility Radiological (...) associated with the clinical course and other outcomes ( , ). Symptoms and Signs Common symptoms and signs of both nonfibrotic and fibrotic HP include dyspnea, cough, and midinspiratory squeaks (or chirping rales or squawks) ( ). Less frequently, there may be constitutional symptoms such as weight loss, flu-like symptoms (chills, low-grade fever, and malaise), chest tightness, and wheezing, as well as physical examination findings of rales and cyanosis ( ). Onset may be acute (developing over days

2020 American Thoracic Society

107. British Association of Dermatologists guidelines for biologic therapy for psoriasis 2020: a rapid update Full Text available with Trip Pro

the options for alternative treatment strategies the impact of cancer progression/recurrence. Biologic therapy and infections R38 (↑↑) Assess people with psoriasis prior to, and during treatment with, biologic therapy with respect to: risk factors for infection (e.g. comorbidities, cotherapy, lifestyle and travel) known infections (past or current) signs or symptoms suggestive of infection. Biologic therapy and chronic viral infections – hepatitis B, hepatitis C and HIV R39 (↑↑) Test for hepatitis B (...) or signs suggestive of TB, new exposure to TB or prolonged residence in a high‐incidence setting should prompt further clinical assessment and investigation, including a repeat IGRA. Be aware that active TB on TNF antagonist therapy is often disseminated and extrapulmonary; symptoms may include unexplained weight loss, night sweats, nonresolving cough, haemoptysis and lymphadenopathy. R49 (GPP) Inform people that they should seek medical advice if symptoms of TB develop during or after treatment

2020 British Association of Dermatologists

108. The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management

of Addiction Medicine. Unauthorized reproduction of this article is prohibited. The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management Guideline Committee Members (alpha order): Anika Alvanzo, MD, MS, DFASAM, FACP Kurt Kleinschmidt, MD, FASAM Julie A. Kmiec, DO, FASAM George Kolodner, MD, DLFAPA, FASAM Gerald E. Marti, MD, PhD William F. Murphy, DO, MS, DFASAM Carlos F. Tirado, MD, FASAM Corey Waller, MD, MS, DFASAM, FACEP Lewis S. Nelson, MD, FASAM, FACEP, FACMT (Chair) Clinical Champions (...) patients with or at risk for alcohol use disorder and alcohol withdrawal. Recommendation I.2: For patients known to be using alcohol recently, regularly, and heavily, assess their risk of developing alcohol withdrawal even in the absence of signs and symptoms (see II. Initial Assessment for risk factors and risk assessment scale). RecommendationI.3: For patients who have signs and symptoms suggestive of alcohol withdrawal, assess the quan- tity, frequency, and time of day when alcohol was last consumed

2020 Publication 4891078

109. Creating Built Environments That Expand Active Transportation and Active Living Across the United States: A Policy Statement From the American Heart Association

. Infrastructure such as dedicated bus lanes, bus stop curb extensions, and signal priority at intersections can reduce delays. Accurate real-time service and wait-time information through signs or mobile phone applications can improve efficiency and appeal for riders. Traffic Safety/Vision Zero Monitoring the incidence and locations of crashes, injuries, and fatalities during active transport is needed to develop the appropriate infrastructure, education, and safety measures to support active transportation

2020 American Heart Association

110. Hyperosmolar hyperglycaemic state

-ketotic hyperglycaemic hyperosmolar syndrome (NKHS), is characterised by profound hyperglycaemia (glucose >33.3 mmol/L [>600 mg/dL]), hyperosmolality (effective serum osmolality ≥320 mmol/kg [≥320 mOsm/kg]), and volume depletion in the absence of significant ketoacidosis (pH >7.3 and HCO3 >15 mmol/L [>15 mEq/L]), and is a serious complication of diabetes. HHS may be the first presentation of type 2 diabetes. Kitabchi AE, Umpierrez GE, Murphy MB, et al. Management of hyperglycemic crises in patients (...) . Kitabchi AE, Umpierrez GE, Murphy MB, et al. Management of hyperglycemic crises in patients with diabetes. Diabetes Care. 2001 Jan;24(1):131-53. http://care.diabetesjournals.org/content/24/1/131.long http://www.ncbi.nlm.nih.gov/pubmed/11194218?tool=bestpractice.com Wolfsdorf JI, Allgrove J, Craig ME, et al; International Society for Pediatric and Adolescent Diabetes. ISPAD clinical practice consensus guidelines 2014. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2014 Sep

2018 BMJ Best Practice

111. Whipple's disease

clade with a genome rich in the nucleotides guanine and cytosine (G-C). Raoult D, Ogata H, Audic S, et al. Tropheryma whipplei twist: a human pathogenic Actinobacteria with a reduced genome. Genome Res. 2003 Aug;13(8):1800-9. http://genome.cshlp.org/content/13/8/1800.long http://www.ncbi.nlm.nih.gov/pubmed/12902375?tool=bestpractice.com Bentley SD, Maiwald M, Murphy LD, et al. Sequencing and analysis of the genome of the Whipple's disease bacterium Tropheryma whipplei. Lancet. 2003 Feb 22;361(9358 (...) apathy anxiety, depression, hypomania, psychosis, change in personality myoclonic signs seizures nystagmus brisk reflexes, extensor plantar responses, weakness predominating in arm extensors and leg flexors, hypertonia amenorrhoea, polydipsia, hyperphagia, decreased libido ataxia headaches oculomasticatory and oculofacioskeletal myorhythmias hemiparesis cranial nerve involvement extrapyramidal movement disorder peripheral neuropathies age >50 years male sex genetic factors Diagnostic investigations

2018 BMJ Best Practice

112. Cholecystitis

Cholecystitis Cholecystitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cholecystitis Last reviewed: February 2019 Last updated: March 2018 Summary Major complication of cholelithiasis (i.e., gallstones); symptomatic gallstones are common before developing cholecystitis. RUQ pain lasting more than 3 to 6 hours and fever are common. RUQ tenderness, a distended RUQ mass, and positive Murphy's sign are key (...) RUQ pain positive Murphy's sign abdominal mass right shoulder pain anorexia nausea fever vomiting jaundice gallstones physical inactivity low fibre intake severe illness trauma severe burns total parenteral nutrition (TPN) diabetes ceftriaxone ciclosporin hepatic arterial embolisation infections Diagnostic investigations FBC C-reactive protein LFTs RUQ ultrasound scan cholescintigraphy (hepatobiliary iminodiacetic acid [HIDA] scan) abdominal CT abdominal MRI abdominal x-ray Treatment algorithm

2018 BMJ Best Practice

113. Assessment of delirium

of how hospital care is failing older persons and a window to improve quality of hospital care. Am J Med. 1999 May;106(5):565-73. http://www.ncbi.nlm.nih.gov/pubmed/10335730?tool=bestpractice.com Kiely DK, Bergmann MA, Murphy KM, et al. Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity. J Gerontol A Biol Sci Med Sci. 2003 May;58(5):441-5. http://www.ncbi.nlm.nih.gov/pubmed/12730254?tool=bestpractice.com Murray AM, Levkoff SE, Wetle T, et al. Acute delirium (...) ://www.ncbi.nlm.nih.gov/pubmed/22325705?tool=bestpractice.com These include: Hyperactive delirium - a condition where a patient might have heightened arousal, with restlessness, agitation, hallucinations, and inappropriate behaviour Hypoactive delirium - a condition where a patient might display lethargy, reduced motor activity, incoherent speech, and lack of interest Mixed delirium - a combination of hyperactive and hypoactive signs and symptoms. The term sub-syndromal delirium has also been used to define partially

2018 BMJ Best Practice

114. Hyperosmolar hyperglycaemic state

-ketotic hyperglycaemic hyperosmolar syndrome (NKHS), is characterised by profound hyperglycaemia (glucose >33.3 mmol/L [>600 mg/dL]), hyperosmolality (effective serum osmolality ≥320 mmol/kg [≥320 mOsm/kg]), and volume depletion in the absence of significant ketoacidosis (pH >7.3 and HCO3 >15 mmol/L [>15 mEq/L]), and is a serious complication of diabetes. HHS may be the first presentation of type 2 diabetes. Kitabchi AE, Umpierrez GE, Murphy MB, et al. Management of hyperglycemic crises in patients (...) . Kitabchi AE, Umpierrez GE, Murphy MB, et al. Management of hyperglycemic crises in patients with diabetes. Diabetes Care. 2001 Jan;24(1):131-53. http://care.diabetesjournals.org/content/24/1/131.long http://www.ncbi.nlm.nih.gov/pubmed/11194218?tool=bestpractice.com Wolfsdorf JI, Allgrove J, Craig ME, et al; International Society for Pediatric and Adolescent Diabetes. ISPAD clinical practice consensus guidelines 2014. Diabetic ketoacidosis and hyperglycemic hyperosmolar state. Pediatr Diabetes. 2014 Sep

2018 BMJ Best Practice

115. Management of epithelial ovarian cancer

Management of epithelial ovarian cancer SIGN 135 • Management of epithelial ovarian cancer A national clinical guideline November 2013 • Revised 2018 EvidenceKEY TO EVIDENCE STATEMENTS AND GRADES OF RECOMMENDATIONS LEVELS OF EVIDENCE 1 ++ High quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias 1 + Well conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias 1 - Meta-analyses, systematic reviews, or RCTs with a high risk of bias 2 ++ High (...) studies rated as 2 + GOOD PRACTICE POINTS ? Recommended best practice based on the clinical experience of the guideline development group NHS Evidence has accredited the process used by Scottish Intercollegiate Guidelines Network to produce guidelines. Accreditation is applicable to guidance produced using the processes described in SIGN 50: a guideline developer’s handbook, 2008 edition (www.sign.ac.uk/guidelines/fulltext/50/index.html). More information on accreditation can be viewed

2018 SIGN

116. Pharmacological management of migraine

Pharmacological management of migraine SIGN 155 • Pharmacological management of migraine A national clinical guideline February 2018 Evidence www.healthcareimprovementscotland.org Edinburgh Office | Gyle Square |1 South Gyle Crescent | Edinburgh | EH12 9EB Telephone 0131 623 4300 Fax 0131 623 4299 Glasgow Office | Delta House | 50 West Nile Street | Glasgow | G1 2NP Telephone 0141 225 6999 Fax 0141 248 3776 The Healthcare Environment Inspectorate, the Scottish Health Council, the Scottish (...) Health Technologies Group, the Scottish Intercollegiate Guidelines Network (SIGN) and the Scottish Medicines Consortium are key components of our organisation. KEY TO EVIDENCE STATEMENTS AND RECOMMENDATIONS LEVELS OF EVIDENCE 1 ++ High-quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias 1 + Well-conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias 1 - Meta-analyses, systematic reviews, or RCTs with a high risk of bias 2 ++ High-quality

2018 SIGN

117. Management of stable angina

the following individuals who contributed during the early stages of guideline development. Mr Stephen Heller-Murphy Programme Manager, SIGN Mr Robert Jeffrey Consultant Cardiothoracic Surgeon, retired Mrs Margaret Moncrieff Lay representative, South Lanarkshire 11.3 THE STEERING GROUP Professor Sir Lewis Ritchie, OBE, (Chair) Mackenzie Professor and Head of Department, Department of General Practice and Primary Care, University of Aberdeen Mrs Corinne Booth Senior Health Economist, Healthcare Improvement (...) Management of stable angina SIGN 151 • Management of stable angina A national clinical guideline April 2018 www.healthcareimprovementscotland.org Edinburgh Office | Gyle Square |1 South Gyle Crescent | Edinburgh | EH12 9EB Telephone 0131 623 4300 Fax 0131 623 4299 Glasgow Office | Delta House | 50 West Nile Street | Glasgow | G1 2NP Telephone 0141 225 6999 Fax 0141 248 3776 The Healthcare Environment Inspectorate, the Scottish Health Council, the Scottish Health Technologies Group, the Scottish

2018 SIGN

118. Cardiac arrhythmias in coronary heart disease

Cardiac arrhythmias in coronary heart disease SIGN 152 • Cardiac arrhythmias in coronary heart disease A national clinical guideline September 2018 www.healthcareimprovementscotland.org Edinburgh Office | Gyle Square |1 South Gyle Crescent | Edinburgh | EH12 9EB Telephone 0131 623 4300 Fax 0131 623 4299 Glasgow Office | Delta House | 50 West Nile Street | Glasgow | G1 2NP Telephone 0141 225 6999 Fax 0141 248 3776 The Healthcare Environment Inspectorate, the Scottish Health Council, the Scottish (...) Health Technologies Group, the Scottish Intercollegiate Guidelines Network (SIGN) and the Scottish Medicines Consortium are key components of our organisation. EvidenceKEY TO EVIDENCE STATEMENTS AND RECOMMENDATIONS LEVELS OF EVIDENCE 1 ++ High-quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias 1 + Well-conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias 1 - Meta-analyses, systematic reviews, or RCTs with a high risk of bias 2 ++ High

2018 SIGN

120. Violence: Primary Prevention Interventions to Reduce Perpetration of Intimate Partner Violence and Sexual Violence Among Youth

the perpetration of intimate partner violence and sexual violence. Intervention Primary prevention programs for youth ages 12 to 24 years aim to prevent or reduce perpetration of intimate partner and sexual violence and promote healthier relationships between peers and partners. Interventions in this review provide information about warning signs for, or consequences of, intimate partner and sexual violence. They may also include one or more of the following strategies: Teach healthy relationship skills

2018 Community Preventive Services Task Force

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