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Neutropenic Fever Clinical Decision Rule

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1. Neutropenic Fever Clinical Decision Rule

Neutropenic Fever Clinical Decision Rule Neutropenic Fever Clinical Decision Rule Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Neutropenic Fever Clinical Decision Rule Neutropenic Fever Clinical Decision Rule Aka: Neutropenic Fever Clinical Decision Rule , Multinational Association for Supportive Care in Cancer Risk Index , MASCC Risk Index II. Indications Assess risk in III. Contraindications Children under age 16 years (have different rules for risk stratification) IV. Criteria symptom severity (choose one) No symptoms or Mild symptoms: 5 points Moderate symptoms: 3 points not present: 5 points not present: 4 points Solid tumor

2018 FP Notebook

2. Neutropenic Fever Clinical Decision Rule

Neutropenic Fever Clinical Decision Rule Neutropenic Fever Clinical Decision Rule Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Neutropenic Fever Clinical Decision Rule Neutropenic Fever Clinical Decision Rule Aka: Neutropenic Fever Clinical Decision Rule , Multinational Association for Supportive Care in Cancer Risk Index , MASCC Risk Index II. Indications Assess risk in III. Contraindications Children under age 16 years (have different rules for risk stratification) IV. Criteria symptom severity (choose one) No symptoms or Mild symptoms: 5 points Moderate symptoms: 3 points not present: 5 points not present: 4 points Solid tumor

2015 FP Notebook

3. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy Full Text available with Trip Pro

, ASCO released a guideline on antimicrobial prophylaxis for FN, as well as recommendations for identifying patients with fever and neutropenia who may be treated as outpatients. The Infectious Diseases Society of America (IDSA) “Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer” was released in 2011. For outpatient identification, validated tools such as the Multinational Association of Support Care in Cancer (MASCC) score or Talcott’s rules, as well (...) identification of candidate patients for outpatient treatment. (¶)See Recommendation 3.1 regarding evaluation of patients for hospital admission. CISNE, Clinical Index of Stable Febrile Neutropenia; MASCC, Multinational Association for Supportive Care in Cancer. Guideline Questions What is the recommended initial diagnostic approach for patients with fever who are seeking emergency medical care within 6 weeks of receiving chemotherapy? Which patients with FN are at low risk of medical complications

2018 Infectious Diseases Society of America

4. Guideline for the management of fever and neutropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update.

in Children and Young People with Febrile Neutropenia This update review was conducted in accordance with "Systematic reviews: Centre for Reviews and Dissemination's (CRD's) guidance for undertaking reviews in health care" and registered on the PROSPERO Registry of systematic reviews: CRD42011001685. It sought studies which aimed to derive or validate a clinical decision rules (CDR) in children or young people (aged 0–18 years) presenting with febrile neutropenia (FN). Both prospective and retrospective (...) this, 89 articles were identified for detailed examination, of which 4 articles were eligible for inclusion in this review and 21 further studies were incorporated into a separate systematic review of clinical decision rules. See Figure 1 in the systematic review for a flow chart detailing the study selection process. Strategies for Empiric Management of Pediatric Fever and Neutropenia in Patients With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: a Systematic Review of Randomized

2017 National Guideline Clearinghouse (partial archive)

5. Australian consensus guidelines for the management of neutropenic fever in adult cancer patients

for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patients. J Clin Oncol. 2000; 18: 3038–51. 13 Talcott JA, Siegel RD, Finberg R, Goldman L. Risk assessment in cancer patients with fever and neutropenia: a prospective, two-center validation of a prediction rule. J Clin Oncol. 1992; 10: 316–22. 14 Lingaratnam S, Slavin MA, Mileshkin L, Burbury K, Solomon B, Koczwara B etal. An Australian survey of clinical practices in management (...) % of patients with solid tumours or lymphomas and in more than 80% of patients with haematological malignancies. 1,2 At least half of all neutropenic patients who become febrile have an established or occult infec- tion. 3 Mortality rates for critically ill patients have been reported at 10–20% with rates for patients with gram- negative bacteraemia as high as 40%. 4 These statistics demonstrate the clinical imperative to manage neutro- penic fever promptly and effectively in order to optimize patients

2011 Clinical Practice Guidelines Portal

6. Neutropenic sepsis: prevention and management in people with cancer

by the Joint Standing Committee on Medicines (a joint committee of the Royal College of Paediatrics and Child Health and the Neonatal and Paediatric Pharmacists Group) for further information. [2] Examples of risk scoring systems include The Multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients (Journal of Clinical Oncology 2000; 18: 3038–51]) and the modified Alexander rule for children (aged under 18 (...) the Multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients (Journal of Clinical Oncology 2000; 18: 3038–51) and the modified Alexander rule for children (aged under 18) (European Journal of Cancer 2009; 45: 2843–9). Neutropenic sepsis: prevention and management in people with cancer (CG151) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

7. Neutropenic sepsis

opinion in a review article notes that the incidence of clinically documented infection in people with febrile neutropenia is only 20–30% [ ]. An additional review article notes that people who are immunosuppressed and/or have neutropenia often lack an obvious source of infection [ ]. Expert opinion in a review article notes that if a child undergoing anticancer treatment is unwell, sepsis should be considered early, even if they do not have a fever [ ]. When to suspect neutropenic sepsis (...) , according to the National Institute for Health and Care Excellence (NICE) [ ]. The definition of neutropenia using absolute neutrophil count varies in the literature [ ; ; ; ]. The risk of clinically significant infection and sepsis increases as the neutrophil count decreases to less than 0.5 x 10 9 /L [ ; ]. Febrile neutropenia is the most common complication of anticancer treatment, and describes the presence of fever in a person with neutropenia [ ] . The exact definition of febrile neutropenia

2019 NICE Clinical Knowledge Summaries

8. A systematic review of risk prediction rules in febrile neutropenic episodes in children and young people undergoing treatment for malignant disease (Protocol for a systematic review)

or young people (aged 0 – 18y) who are receiving treatment for cancer or leukaemia (including extra-cranial and intra-cranial tumours) presenting with febrile neutropenia. Studies with adults which report data for patients <18y will be included if outcome data are reported separately. Predictor variables: Clinical decision rules (CDR) using clinical and haematological or biochemical variables used to predict outcome for the particular episode of febrile neutropenia (e.g. age, sex, type of cancer, type (...) A systematic review of risk prediction rules in febrile neutropenic episodes in children and young people undergoing treatment for malignant disease (Protocol for a systematic review) A systematic review of risk prediction rules in febrile neutropenic episodes in children and young people undergoing treatment for malignant disease (Protocol for a systematic review) A systematic review of risk prediction rules in febrile neutropenic episodes in children and young people undergoing treatment

2009 Health Technology Assessment (HTA) Database.

9. Fever Without Source or Unknown Origin-Child

MB, Bachur RG. Clinical predictors of occult pneumonia in the febrile child. Acad Emerg Med. 2007;14(3):243-249. 50. Leventhal JM. Clinical predictors of pneumonia as a guide to ordering chest roentgenograms. Clin Pediatr (Phila). 1982;21(12):730-734. 51. Bleeker SE, Derksen-Lubsen G, Grobbee DE, Donders AR, Moons KG, Moll HA. Validating and updating a prediction rule for serious bacterial infection in patients with fever without source. Acta Paediatr. 2007;96(1):100-104. 52. Mahabee-Gittens EM (...) neutropenia in children with cancer. Adv Exp Med Biol. 2009;634:185-204. 61. Korones DN, Hussong MR, Gullace MA. Routine chest radiography of children with cancer hospitalized for fever and neutropenia: is it really necessary? Cancer. 1997;80(6):1160-1164. 62. Phillips B, Wade R, Westwood M, Riley R, Sutton AJ. Systematic review and meta-analysis of the value of clinical features to exclude radiographic pneumonia in febrile neutropenic episodes in children and young people. J Paediatr Child Health

2015 American College of Radiology

10. International Guideline for the Management of Fever and Neutropenia in Children with Cancer and/or Undergoing Hematopoietic Stem Cell Transplantation

risk factors in febrile, neutropenic children and adolescents. Pediatr Hematol Oncol 13:217-29, 1996 21. Klaassen RJ, Goodman TR, Pham B, et al: "Low-risk" prediction rule for pediatric oncology patients presenting with fever and neutropenia. J Clin Oncol 18:1012-9, 2000 22. Lucas KG, Brown AE, Armstrong D, et al: The identification of febrile, neutropenic children with neoplastic disease at low risk for bacteremia and complications of sepsis. Cancer 77:791-8, 1996 23. Macher E, Dubos F, Garnier N (...) chest radiography in children with cancer hospitalized for fever and neutropenia. Cancer 68:940-3, 1991 55. Phillips R, Wade R, Riley R, et al: Systematic review and meta-analysis of the value of clinical features to exclude radiographic pneumonia in febrile neutropenic episodes in children and young people. J Paediatr Child Health, 2011 56. Furno P, Bucaneve G, Del Favero A: Monotherapy or aminoglycoside-containing combinations for empirical antibiotic treatment of febrile neutropenic patients

2012 SickKids Supportive Care Guidelines

11. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer Full Text available with Trip Pro

of the infection risks, diagnostic methods, and antimicrobial therapies required for management of febrile patients through the neutropenic period. Accordingly, algorithmic approaches to fever and neutropenia, infection prophylaxis, diagnosis, and treatment have been established during the past 40 years, guided and modified by clinical evidence and experience over time. The Infectious Diseases Society of America Fever and Neutropenia Guideline aims to provide a rational summation of these evolving algorithms (...) contain new sections on the management of indwelling CVCs and environmental precautions for neutropenic patients. The following 12 clinical questions are addressed in the guideline: I. What is the role of risk assessment and what distinguishes high-risk and low-risk patients with fever and neutropenia? II. What cultures should be collected and what specific tests should be performed during the initial assessment? III. In febrile patients with neutropenia, what empirical antibiotic therapy

2010 Infectious Diseases Society of America

12. Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock Full Text available with Trip Pro

utilization variables, and/or cellular variables. However, after review of the literature, the committee continues to choose to define septic shock by clinical, hemodynamic, and oxygen utilization variables only. Ideally, septic shock should be diagnosed by clinical signs, which include hypothermia or hyperthermia, altered mental status, and peripheral vasodilation (warm shock) or vasoconstriction with capillary refill greater than 2 seconds (cold shock) before hypotension occurs. Threshold heart rates (...) Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock American College of Critical Care Medicine Clinical Practice... : Critical Care Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer Register for a free account Registered users can

2017 Society of Critical Care Medicine

13. Pediatrics, Fever (Treatment)

. [ , , ] Temperature elevation may not be the only sign of sepsis in neonates and infants. Other potential signs and symptoms of sepsis unique to infancy should also be assessed. History taking is an important part of clinical decision making. The clinician should ask the patient's parents or caretakers about the following items when they bring in a febrile or ill-appearing child: Immunization history, such as recent vaccination or a history of inadequate immunizations History of exposure to sick contacts (...) -appearing children with unremarkable histories and physical examinations may be discharged home without laboratory testing or presumptive use of antibiotics. An LP should be considered for those who are irritable, lethargic, inconsolable, or toxic appearing. During summer months, children with fever and no other signs may have an enterovirus infection. Some studies report the incidence as high as 50% in febrile children in the ED. Enteroviral infection is a clinical diagnosis for the emergency physician

2014 eMedicine Emergency Medicine

14. Pediatrics, Fever (Diagnosis)

. [ , , ] Temperature elevation may not be the only sign of sepsis in neonates and infants. Other potential signs and symptoms of sepsis unique to infancy should also be assessed. History taking is an important part of clinical decision making. The clinician should ask the patient's parents or caretakers about the following items when they bring in a febrile or ill-appearing child: Immunization history, such as recent vaccination or a history of inadequate immunizations History of exposure to sick contacts (...) -appearing children with unremarkable histories and physical examinations may be discharged home without laboratory testing or presumptive use of antibiotics. An LP should be considered for those who are irritable, lethargic, inconsolable, or toxic appearing. During summer months, children with fever and no other signs may have an enterovirus infection. Some studies report the incidence as high as 50% in febrile children in the ED. Enteroviral infection is a clinical diagnosis for the emergency physician

2014 eMedicine Emergency Medicine

15. Pediatrics, Fever (Follow-up)

. [ , , ] Temperature elevation may not be the only sign of sepsis in neonates and infants. Other potential signs and symptoms of sepsis unique to infancy should also be assessed. History taking is an important part of clinical decision making. The clinician should ask the patient's parents or caretakers about the following items when they bring in a febrile or ill-appearing child: Immunization history, such as recent vaccination or a history of inadequate immunizations History of exposure to sick contacts (...) -appearing children with unremarkable histories and physical examinations may be discharged home without laboratory testing or presumptive use of antibiotics. An LP should be considered for those who are irritable, lethargic, inconsolable, or toxic appearing. During summer months, children with fever and no other signs may have an enterovirus infection. Some studies report the incidence as high as 50% in febrile children in the ED. Enteroviral infection is a clinical diagnosis for the emergency physician

2014 eMedicine Emergency Medicine

16. Pediatrics, Fever (Overview)

. [ , , ] Temperature elevation may not be the only sign of sepsis in neonates and infants. Other potential signs and symptoms of sepsis unique to infancy should also be assessed. History taking is an important part of clinical decision making. The clinician should ask the patient's parents or caretakers about the following items when they bring in a febrile or ill-appearing child: Immunization history, such as recent vaccination or a history of inadequate immunizations History of exposure to sick contacts (...) -appearing children with unremarkable histories and physical examinations may be discharged home without laboratory testing or presumptive use of antibiotics. An LP should be considered for those who are irritable, lethargic, inconsolable, or toxic appearing. During summer months, children with fever and no other signs may have an enterovirus infection. Some studies report the incidence as high as 50% in febrile children in the ED. Enteroviral infection is a clinical diagnosis for the emergency physician

2014 eMedicine Emergency Medicine

17. KDIGO Clinical Practice Guideline for Acute Kidney Injury

Supplements (2012) 2,ivNotice Kidney International Supplements (2012) 2, 1; doi:10.1038/kisup.2012.1 SECTION I: USE OF THE CLINICAL PRACTICE GUIDELINE This Clinical Practice Guideline document is based upon the best information available as of February 2011. It is designed to provide information and assist decision-making. It is not intended to de?ne a standard of care, and should not be construed as one, nor should it be interpreted as prescribing an exclusive course of management. Variations in practice (...) and the strength of the recommendation. Thus, there were 22 (36.1%) recommendations graded ‘1’ and 39 (63.9%) graded ‘2.’ There were 9 (14.8%) recommendations graded ‘1A,’10(16.4%)were‘1B,’3(4.9%)were‘1C,’and0(0%)were ‘1D.’ There were 2 (3.3%) graded ‘2A,’ 10 (16.4%) were ‘2B,’ 20 (32.8%) were ‘2C,’ and 7 (11.5%) were ‘2D.’ There were 26 (29.9%) statements that were not graded. Some argue that recommendations should not be made when evidence is weak. However, clinicians still need to make clinical decisions

2012 National Kidney Foundation

18. A systematic review of risk prediction rules in febrile neutropenic episodes in children and young people undergoing treatment for malignant disease

A systematic review of risk prediction rules in febrile neutropenic episodes in children and young people undergoing treatment for malignant disease Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith (...) therapy or contamination 6. Not about analgesics used in the clinic Full text-screening: As above, with the addition of: 7. No relevant outcome measure reported ">Prioritise the exclusion criteria Example: Two reviewers will independently extract data from each article. We first try to extract numerical data from tables, text or figures. If these are not reported, we will extract data from graphs using digital ruler software. In case data are not reported or unclear, we will attempt to contact authors

2011 PROSPERO

19. Clostridioides difficile Infection in Adults and Children

for a terminal clean and the discontinuation of precautions. These are determined on a case-by-case basis with IPE and the clinical team. 19 UMHS C. difficile Infection in Adults and Children MM/YYYY Isolation practices for readmission. When patients with a history of CDI are readmitted, they do not need to be placed in CP-D unless they are readmitted with diarrhea. Patients with a history of CDI that are readmitted with diarrhea should be managed in CP-D until CDI has been ruled out. Visitor/family (...) Clostridioides difficile Infection in Adults and Children Quality Department Guidelines for Clinical Care 1 UMHS C. difficile Infection in Adults and Children 12/2019 Clostridioides difficile Infection Guideline Team Team Leads Tejal N Gandhi MD Infectious Diseases Krishna Rao, MD Infectious Diseases Team Members Gregory Eschenauer, PharmD Pharmacy John Y Kao, MD Gastroenterology Lena M Napolitano, MD Surgery F Jacob Seagull, PhD Leaning Heath Sciences David M Somand, MD Emergency Medicine

2020 University of Michigan Health System

20. Istradefylline (Nourianz) - Parkinson's disease

8.4.3. Electrocardiograms (ECGs) 58 8.4.4. QT 59 8.4.5. Immunogenicity 59 8.5. Analysis of Submission-Specific Safety Issues 59 8.5.1. Impulse Control Disorder 59 8.5.2. Dizziness, Hypotension, Orthostatic Hypotension 61 8.5.3. Falls 62 8.5.4. Effects on Ability to Drive 62 8.5.5. Cardiac Safety 63 8.5.6. Suicide 64 8.5.7. Neutropenia and Neutropenic Sepsis 66 8.5.8. Drug-Drug interactions 67 8.6. Safety Analyses by Demographic Subgroups 67 CDER Clinical Review Template Version date: September 6 (...) Istradefylline (Nourianz) - Parkinson's disease CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 022075Orig1s000 CLINICAL REVIEW(S) (b) (4) Clinical Review Natalie Branagan, MD NDA 022075 Nourianz/istradefylline CLINICAL REVIEW Application Type NDA Application Number(s) 022075 Priority or Standard Class 2 Resubmission Submit Date(s) February 27, 2019 Received Date(s) February 27, 2019 PDUFA Goal Date August 27, 2019 Division/Office DNP Reviewer Name(s) Natalie Branagan, MD Review

2019 FDA - Drug Approval Package

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