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Pelvic Relaxation

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182. Muscle-invasive and Metastatic Bladder Cancer

, and late gadolinium-enhanced imaging. Radiology, 1994. 193: 239. 103. Kim, J.K., et al. Bladder cancer: analysis of multi-detector row helical CT enhancement pattern and accuracy in tumor detection and perivesical staging. Radiology, 2004. 231: 725. 104. Yang, W.T., et al. Comparison of dynamic helical CT and dynamic MR imaging in the evaluation of pelvic lymph nodes in cervical carcinoma. AJR Am J Roentgenol, 2000. 175: 759. 105. Kim, S.H., et al. Uterine cervical carcinoma: evaluation of pelvic lymph (...) node metastasis with MR imaging. Radiology, 1994. 190: 807. 106. Kim, S.H., et al. Uterine cervical carcinoma: comparison of CT and MR findings. Radiology, 1990. 175: 45. 107. Oyen, R.H., et al. Lymph node staging of localized prostatic carcinoma with CT and CT-guided fine-needle aspiration biopsy: prospective study of 285 patients. Radiology, 1994. 190: 315. 108. Barentsz, J.O., et al. MR imaging of the male pelvis. Eur Radiol, 1999. 9: 1722. 109. Dorfman, R.E., et al. Upper abdominal lymph nodes

2018 European Association of Urology

183. Urinary Incontinence

, S.S., et al. Responsiveness of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire in women undergoing treatment for pelvic floor disorders. Int Urogynecol J, 2013. 24: 213. 16. Kim, J., et al. 1576 Is there a relationship between incontinence impact questionnaire 7 score after surgery for stress urinary incontinence and patient-perceived satisfaction and improvement? J Urol. 189: e647.J Urol. 189: e647. (13)03402-2/abstract 17. Tran, M.G., et al. Patient reported outcome (...) )/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Neurourol Urodyn, 2011. 30: 2. 21. Brown, J.S., et al. Measurement characteristics of a voiding diary for use by men and women with overactive bladder. Urology, 2003. 61: 802. 22. Nygaard, I., et al. Reproducibility of the seven-day voiding diary in women with stress urinary incontinence. Int

2018 European Association of Urology

184. Adult Urodynamics

and Reporting Patient Education Adult Urodynamics: AUA/SUFU Guideline (2012) Published 2012 This guideline developed by AUA in collaboration with the Society for Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction is intended to review the literature regarding the use of urodynamic testing in common lower urinary tract symptoms (LUTS) conditions. It presents the principles of application and technique to guide the clinician in the role of urodynamics in complex LUTS disorders. [pdf] [pdf (...) with reduction of the prolapse in women with high grade pelvic organ prolapse (POP) but without the symptom of SUI. Multi-channel urodynamics with prolapse reduction may be used to assess for occult stress incontinence and detrusor dysfunction in these women with associated LUTS. ( Option ; Evidence Strength : Grade C) Overactive Bladder (OAB), Urgency Urinary Incontinence (UUI), Mixed Incontinence 6. Clinicians may perform multi-channel filling cystometry when it is important to determine if altered

2018 American Urological Association

185. WHO recommendations: non-clinical interventions to reduce unnecessary caesarean sections

, Intervention, Comparator, Outcome PFMT Pelvic Floor Muscle T raining RCT Randomized Controlled T rial RD Risk Difference RR Risk Ratio TWG T echnical Working Group UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USAID United States Agency for International Development VBAC Vaginal Birth After Caesarean WHO World Health Organization8 WHO recommendations non-clinical interventions to reduce unnecessary caesarean sections Executive summary Introduction Caesarean section (...) relaxation training programme (content includes group discussion of anxiety and stress-related issues in pregnancy and purpose of applied relaxation, deep breathing techniques, among other relaxation techniques). ? ? Psychosocial couple-based prevention programme (content includes emotional self-management, conflict management, problem solving, communication and mutual support strategies that foster positive joint parenting of an infant). “Couple” in this recommendation includes couples, people

2018 World Health Organisation Guidelines

186. Nonsurgical Treatments for Urinary Incontinence in Women: A Systematic Review Update

interventions mostly aim to strengthen the pelvic floor and change behaviors that influence bladder function, whereas pharmacological interventions mostly address bladder and sphincter function. This report addresses a Contextual Question and four Key Questions. Key Question 1: What are the benefits and harms of nonpharmacological treatments of UI in women, and how do they compare with each other? Key Question 2: What are the benefits and harms of pharmacological treatments of UI in women, and how do (...) Abbreviations: AE = adverse events, Imp = improvement, MBSR = mindfulness-based stress reduction, PFMT = pelvic floor muscle therapy, QoL = quality of life, Sat = satisfaction, TENS = transcutaneous electrical nerve stimulation (including transvaginal, surface, and related electric stimulation used to treat UI), UI = urinary incontinence. * The categorization of different interventions was based on recommendations from The National Institute for Health and Care Excellence (NICE) and American Urological

2018 Effective Health Care Program (AHRQ)

188. WHO recommendations: intrapartum care for a positive childbirth experience

preferences. Recommended Opioid analgesia for pain relief 20. Parenteral opioids, such as fentanyl, diamorphine and pethidine, are recommended options for healthy pregnant women requesting pain relief during labour, depending on a woman’s preferences. Recommended Relaxation techniques for pain management 21. Relaxation techniques, including progressive muscle relaxation, breathing, music, mindfulness and other techniques, are recommended for healthy pregnant women requesting pain relief during labour

2018 World Health Organisation Guidelines

189. A letter to my younger self

to see a trauma patient with a reasonable mechanism – but because he is stable and pain-free, you’ll decide not to do the pelvic XRay. That’s a mistake. You’re going to miss his unstable pelvic fracture. Thankfully one of your colleagues will find it and the patient ends up being ok. But, know that this will eat at you for weeks. You’ll talk to friends and colleagues who will make you feel better, but honestly – nothing makes a mistake easy to swallow. You just have to learn from it, it’ll make you (...) and reputations tarnished by poor interactions with allied health professionals. When someone is being rude to a nurse, stand up for them. It isn’t until you’re more senior that you have the confidence to this, and you’ll regret not doing it in some situations, but remember that your allied health colleagues are advocating for patients, and don’t deserve any abuse, from anyone, ever. Take vacations Real ones. Where you completely step away from working / studying, and relax. You’ll come to realize when you’ve

2018 CandiEM

190. Padeliporfin (Tookad) - prostate cancer / Prostatic Neoplasms

of positive cores, prostate volume and disease status (unilateral or bilateral) in addition to treatment to provide an adjusted comparison of the 2 treatment groups with respect to probability of success/failure for co-primary endpoint A and the HR of progression for co-primary endpoint B. In the Cox model analysis, the proportional hazard assumption was checked graphically plotting the log(-log[survival]) and was to be relaxed if necessary. For co-primary endpoint B, subjects who withdrew from the study (...) radiotherapy (location -pelvis, bone, other), TURP, other non- radical therapy). Updates on the status of recruitment are expected to be given by the applicant post-authorisation. Assessment report EMA/644309/2017 Page 93/146 Criteria for retreatment of the same lobe were not presented but were presumed to be the same as for initial treatment. It is not known how many patients were considered eligible for or were offered retreatment. Very few patients actually underwent retreatment. The percentage necrosis

2017 European Medicines Agency - EPARs

191. Exam Series: Guide to the Back Exam

nerve root irritation. Sacroiliac Joint Pain : Position the patient in a supine figure-of-four position – Flex, Abduct, and Externally Rotate one hip – placing the foot on the opposite knee. Push down on the outstretched knee while stabilizing the opposite pelvis. Pain and decreased movement of the test leg suggests sacroiliac joint pain. Gaenslen’s: Allow the patient to hang one leg off of the bed while lying supine, then instruct them to bring the other knee to their chest. Pain in the buttock (...) and pelvis. Typically in young male patients <40. Pain should be >3 months in duration, improving with movement and worsening with rest. Limited chest expansion. Systemic manifestations include uveitis, pulmonary fibrosis, and renal amyloidosis. X-rays show a bamboo spine: squaring of the vertebral bodies. HLA-B27 positive and RF negative on serology. Degenerative disc disease Age related loss of disc height. Rare in children and older adults with fibrotic discs. Axial back pain with no lower limb

2018 CandiEM

192. Spine Surgery

Surgery 6 Definitions Conservative management should include a combination of strategies to reduce inflammation, alleviate pain, and improve function, including but not limited to the following: ? Prescription strength anti-inflammatory medications and analgesics ? Adjunctive medications such as nerve membrane stabilizers or muscle relaxants ? Physician-supervised therapeutic exercise program or physical therapy ? Manual therapy or spinal manipulation ? Alternative therapies such as acupuncture (...) segments (List separately in addition to code for primary procedure) 22846 Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure) 22847 Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure) 22848 Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure) 22849 Reinsertion of spinal

2018 AIM Specialty Health

193. CRACKCast E180 – Labor & Delivery

fetal neck extension is associated with cord injuries and worsening dystocia, this maneuver is useful to ensure a successful vaginal delivery. This maneuver should only be attempted once the fetal elbows and chin have entered the pelvic inlet to avoid inducing the Moro reflex, in which fetal head flexion results in the arms being suddenly extended. During this maneuver, the fetal pelvis should be supported to avoid abdominal injuries. A generous episiotomy may be necessary to facilitate the maneuver (...) don’t have the luxury of whisking off the patient to the OR Let’s kick it back to our obs/gyne block and think through the causative factors; or the three P’s The passage – narrow pelvic architecture The passenger – big head, or malpresentation The power problem – uterus isn’t pushing like it should Tired mom Mother is sedated too much Chorioamnionitis Electrolyte abnormality (Ks, Cas, Mg, Phos, Na) Usually the cause is multifactorial! 6) Describe the steps in a “normal” delivery (in the ER) Let’s

2018 CandiEM

194. British Association of Dermatologists? guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis

a computed tomography scan of the neck, chest, abdomen and pelvis. A number of cancer treatments, including radiotherapy, can lead to pruritus by a variety of mechanisms. 63–65 Treatment of the malignancy can often help to resolve pruritus. 63,65,74 Can- cer-drug-induced pruritus requires modi?cation or discontinua- tion of medications. 63,64 Biological therapies are now commonly used in oncology. A recent meta-analysis of 33 RCTs concluded that pruritus was a signi?cant side-effect of cancer treatment (...) as ‘psy- chogenic’. The French psychodermatology group proposed that psychogenic pruritus should be renamed ‘functional itch disorder’. Relevant diagnostic criteria are outlined in Table 4. 182 A nursing programme ‘Coping with Itch’ included educa- tion on how to avoid trigger factors, how to apply treatments, lifestyle interventions, patient support groups, relaxation tech- niques and changes to cognition and behaviour. 186 A con- trolled study found no signi?cant difference in the intensity of itch

2018 British Association of Dermatologists

195. FDG-PET/CT(A) Imaging in Large Vessel Vasculitis and Polymyalgia Rheumatica: Joint Procedural Recommendation of the EANM, SNMMI, PET Interest Group, and endorsed by ASNC

be avoided within 24 hours 7 before FDG administration. At the moment and after administration of FDG, patients should relax in an adequately temperature-controlled room (20-22°C (68-71.6 °F)) to minimize physiologic uptake in muscles and brown fat [29]. In some cases, FDG uptake in brown fat can be reduced by beta-blocking drugs, e.g. oral administration 20 mg propranolol one hour before FDG injection [30]. Prior to positioning on the table, patients are asked to void urine. Patients with fever (...) being positive for active LVV (evidence level II, grade B). • Typical FDG joint uptake patterns including scapular and pelvic girdles, interspinous regions of the cervical and lumbar vertebrae or the knees should be 12 Diagnostic accuracy of FDG-PET/CT(A) for LVV and PMR The diagnostic performance of FDG-PET for the detection of LVV is overall good; individual studies are summarized in Table 4, and meta-analyses are summarized in Table 5. A recent meta-analysis of eight studies including 170 LVV

2018 Society of Nuclear Medicine and Molecular Imaging

196. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm Full Text available with Trip Pro

mortality 33 Perioperative morbidity 33 Endoleak 34 Access site complications 34 Acute limb thrombosis 34 Postimplantation syndrome 34 Ischemic colitis 34 Role of elective EVAR in the high-risk and unfit patient 34 OSR 35 Indications 35 Surgical approach 35 Aortic clamping 35 Graft type and configuration 36 Maintenance of pelvic circulation 37 Management of associated intra-abdominal vascular disease 37 Management of associated intra-abdominal nonvascular disease 38 Perioperative outcomes of open AAA

2018 Society for Vascular Surgery

197. Early Pregnancy Loss

to prevent early pregnancy loss. Therapies that have historically been recommended, such as pelvic rest, vitamins, uterine relaxants, and administration ofb-hCG,havenotbeen proved to prevent early pregnancy loss (60–62). Like- wise, bed rest should not be recommended for the prevention of early pregnancy loss (63). A 2008 Co- chrane review found no effect of prophylactic proges- terone administration (oral, intramuscular, or vaginal) in the prevention of early pregnancy loss (64). For threatened early (...) in the vacuum aspiration group (23, 42). How- ever, rates of hemorrhage-related hospitalization with or without transfusion are similar between treatment approaches (0.5–1%) (23, 43). Pelvic infection also can occur after any type of early pregnancy loss treat- ment. One systematic review concluded that although infection rates appeared lower among those undergo- ing expectant management than among those undergo- ing surgical evacuation (RR, 0.29; 95% CI, 0.09– 0.97), the overall rates of infection were low

2018 American College of Obstetricians and Gynecologists

198. Erectile Dysfunction

should be counseled regarding post-operative expectations. (Clinical Principle) 20. Penile prosthetic surgery should not be performed in the presence of systemic, cutaneous, or urinary tract infection. (Clinical Principle) 21. For young men with ED and focal pelvic/penile arterial occlusion and without documented generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction may be considered. (Conditional Recommendation; Evidence Level: Grade C) 22. For men with ED (...) on this topic. DRE may also permit assessment of the bulbocavernous reflex, which provides information on neural integrity of the pelvis. Absence of the bulbocavernous reflex is not in itself diagnostic, however, as this reflex is absent in up to 30% of normal patients. 51 DRE should be considered for men with TD who may proceed with testosterone therapy. Selected laboratory tests . With the possible exception of serum testosterone, glucose/hemoglobin A1c, and in some cases serum lipids, no routine serum

2018 American Urological Association

199. Erectile Dysfunction

, or urinary tract infec- tion. (Clinical Principle) 21. For young men with ED and focal pelvic/penile arterial occlusion and without documented generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction may be considered. (Conditional Recom- mendation; Evidence Level: Grade C) 22. For men with ED, penile venous surgery is not recommended. (Moderate Recommendation; Evidence Level: Grade C) 23. For men with ED, low-intensity extracorporeal shock wave therapy (ESWT) should (...) Association (AUA) Erectile Dysfunction Copyright © 2018 American Urological Association Education and Research, Inc.® 10 discussion of BPH/LUTS, please see the AUA Guideline on this topic. DRE may also permit assessment of the bulbocavernous reflex, which provides information on neural integrity of the pelvis. Absence of the bulbocavernous reflex is not in itself diagnostic, however, as this reflex is absent in up to 30% of normal patients. 51 DRE should be considered for men with TD who may proceed

2018 American Urological Association

200. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review

or (for headache) biofeedback? Exercise was chosen as a common comparator for all conditions except headache as it is recommended in most guidelines for these conditions and a frequent comparator in the chronic pain literature. Interventions considered in the review include exercise (including aspects of physical therapy), mind-body practices (yoga, tai chi, qigong), psychological therapies (cognitive- behavioral therapy, biofeedback, relaxation techniques, acceptance and commitment therapy), multidisciplinary

2018 Effective Health Care Program (AHRQ)

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