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Pelvic Relaxation

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141. Menopause

, usually for carcinogenic illness (pelvic radiation or chemotherapy). 1. The menopauseMENOPAUSE 6 One of the questions most commonly asked by women in their late forties is: “Is it the change? Can I have a blood test?” In practice, it is rarely useful to perform blood tests as hormone levels fluctuate widely over a very short time span, making the results confusing and unreliable. Blood tests (for FSH) are usually only indicated when a premature menopause is suspected in a younger woman, or to rule out (...) and caffeine and avoiding or modifying a known trigger may help; wearing natural fabrics that can ‘breathe’ and using lightweight cotton bedding may also help • exercise can help general wellbeing and mood as well as improving stamina and fitness • relaxation or stress reduction techniques will improve coping strategies • cognitive behavioral therapies, including counseling may help to deal with life events that are causing anxiety • vaginal symptoms may be relieved by regular use of vaginal moisturisers

2018 Royal College of Nursing

143. Peramivir (Alpivab) - Influenza, Human

study: renal tubular and pelvic mineralization, tubular dilatation, epithelial renal hyperplasia) and juvenile rats (drug-related minor renal cortical tubular changes), species that do not generate acyl glucuronide. The applicant has discussed this topic further, with a requirement for Assessment report EMA/CHMP/148367/2018 Page 23/108 updating sections 4.8 and 5.3 focus on the potential for renal toxicity and the possible clinical relevance. As renal necrosis has been seen in rabbits, reports

2018 European Medicines Agency - EPARs

144. Antenatal and Postnatal Analgesia Full Text available with Trip Pro

Antenatal analgesia Many women experience pain during pregnancy including headache, lower back pain and pelvic pain. Prior to giving advice regarding analgesic options pain should be investigated as appropriate to exclude serious causes. Non‐pharmacological interventions should be considered first line; for example, adequate rest, hot and cold compresses, massage, acupuncture, physiotherapy, relaxation and exercise. Some women find aromatherapy soothing and very useful as an aid to relaxation, so it can

2018 Royal College of Obstetricians and Gynaecologists

145. Management of symptomatic hypermobility in children and young people

can be useful such as having a stool to rest their feet on in front of the toilet to help optimize the position of the pelvis and enable effective bowel opening ? Onward referral for medical management of significant bowel symptoms may be required ? Onward referral for medical management of significant urological symptoms may be required 4 Cardiovascular autonomic dysfunction – patients with symptomatic hypermobility may describe symptoms of autonomic dysfunction, which affects heart rate, blood (...) , into which the young person and family/carers put their own collection of activities and interventions which can be used to reduce the pain experience, can be a useful adjunct. These can include items to encourage distraction, positive coping statements, relaxation scripts or apps, sleep hygiene, mindfulness, aromatherapy oils, exercises, comforting objects. These may be real or a virtual box that has been created by the young person and family/carers (https://www.swft.nhs.uk/application/files/7714/6012

2019 British Society for Rheumatology

146. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: an AUA/SUFU Guideline

about OAB, the benefits versus risks/burdens of the available treatment alternatives and the fact that acceptable symptom control may require trials of multiple therapeutic options before it is achieved. Clinical Principle Treatment: First-Line Treatments: Behavioral Therapies 6. Clinicians should offer behavioral therapies (e.g., bladder training, bladder control strategies, pelvic floor muscle training, fluid management) as first line Approved by the AUA Board of Directors April 2019 Authors (...) ’ disclosure of potential conflicts of interest and author/staff contributions appear at the end of the article. © 2019 by the American Urological Association American Urological Association (AUA)/ Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Guideline DIAGNOSIS AND TREATMENT OF OVERACTIVE BLADDER (Non-Neurogenic) IN ADULTS: AUA/SUFU GUIDELINE E. Ann Gormley, Deborah J. Lightner, Kathryn L. Burgio, Toby C. Chai, J. Quentin Clemens, Daniel J. Culkin, Anurag Kumar Das

2019 American Urological Association

148. WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights

of caesarean sections, among others). Low- to moderate-certainty evidence REC 1b: Nurse-led applied 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). REC 1c: Psychosocial couple-based prevention programme (content includes emotional self-management, conflict management, problem solving, communication and mutual support strategies that foster (...) Executive summary TABLE 1 (continued) RECOMMENDATION (REC) a STRENGTH OF RECOMMENDATION, CERTAINTY OF EVIDENCE Interventions for leg cramps REC 5: Magnesium, calcium or non-pharmacological treatment options can be used for the relief of leg cramps in pregnancy, based on a woman’s preferences and available options. Not specified Interventions for low back and pelvic pain REC 6: Regular exercise throughout pregnancy is recommended to prevent low back and pelvic pain. There are a number of different

2019 World Health Organisation Guidelines

150. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults

: Behavioral Therapies 6. Clinicians should offer behavioral therapies (e.g., bladder training, bladder control strategies, pelvic floor muscle training, fluid management) as first line therapy to all patients with OAB. Standard (Evidence Strength Grade B) 7. Behavioral therapies may be combined with pharmacologic management. Recommendation (Evidence Strength Grade C) Second-Line Treatments: Pharmacologic Management 8. Clinicians should offer oral anti-muscarinics or oral β 3 -adrenoceptor agonists (...) and discussed all submitted comments and revised the draft as needed. Once finalized, the guideline was submitted for approval to the PGC. Then it was submitted to the AUA Board of Directors (BOD) for final approval. Funding of the panel was provided by the AUA and the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU), although panel members received no remuneration for their work. AUA's amendment process provides for the amendment of existing evidence-based guideline

2019 American Urological Association

151. Management of Infertility

and who wish to become pregnant? o KQ 3a. Does the optimal treatment strategy vary by patient characteristics such as age, ovarian reserve, race, BMI, presence of other potential causes of female infertility, or presence of male factor infertility? • KQ 4. What are the comparative safety and effectiveness of available treatment strategies for women with tubal or peritoneal factors (e.g., pelvic adhesions) who are infertile and who wish to become pregnant? o KQ 4a. Does the optimal treatment strategy

2019 Effective Health Care Program (AHRQ)

152. Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia Full Text available with Trip Pro

reduction of LUTS. This effect may be potentiated by a reduction of the α-1 adrenergic receptor density in the embolized prostate, causing relaxation of smooth muscle ( x 19 Sun, F., Crisostomo, V., Baez-Diaz, C., and Sanchez, F.M. Prostatic artery embolization (PAE) for symptomatic benign prostatic hyperplasia (BPH): part 2, insights into the technical rationale. Cardiovasc Intervent Radiol . 2016 ; 39 : 161–169 ) (19) . The therapeutic effect of PAE was first described in a case report in 2000 ( x 20

2019 Society of Interventional Radiology

153. Pentosan polysulfate sodium (Elmiron) - bladder pain syndrome characterised by either glomerulations or Hunner’s lesions

be a patient disutility associated with use of bladder instillations relative to PPS although the level of this disutility is uncertain. ? The ICER versus BSC for patients who are considered inappropriate for bladder instillation is sensitive to the response rate assumed for placebo in the meta-analyses, the utility for BSC and an assumption that the efficacy of BSC wanes after one year (increases the ICER if this assumption is relaxed). However, BSC alone is not considered a major comparator to pentosan (...) , and after application of the appropriate SMC modifiers, the Committee accepted pentosan polysulfate sodium for use in NHSScotland. Other data were also assessed but remain confidential.* Additional information: guidelines and protocols The European Association of Urology (EAU) published guidelines on “Chronic Pelvic Pain” in March 2018. This recommends multimodal behavioural, physical and psychological techniques alongside oral or invasive treatments for bladder pain syndrome. It recommends: ? dietary

2019 Scottish Medicines Consortium

154. Management of Irritable Bowel Syndrome (IBS)

to improve IBS symptoms. GRADE: Conditional recommendation, moderate-quality evidence 29: We recommend offering constipation-predominant IBS patients linaclotide to improve IBS symptoms. GRADE: Strong recommendation, high-quality evidence STATEMENTS WITH NO RECOMMENDATIONS No recommendation A: The consensus group does not make a recommendation (neither for nor against) offering IBS patients relaxation techniques to improve IBS symptoms. No recommendation B: The consensus group does not make

2019 Canadian Association of Gastroenterology

156. Approaches to Limit Intervention During Labor and Birth

, but few have been studied extensively enough to determine clear or relative effectiveness. During the first stage of labor, water immersion has been found to lower pain scores without evidence of harm (8, 34). Intradermal sterile water injections, relaxation techniques, acupuncture, and massage may result in reduction in pain in many studies, but methodologies for rating pain and applying these techniques have been varied; therefore, exact tech- niques that are most effective have not been determined (...) phases: 1) the passive descent of the fetus through the maternal pelvis and 2) the active phase of maternal pushing. Stud- iesthat suggestan increasedrisk of adversematernal and neonatal outcomes with increasing second-stage dura- tion generally do not account for the duration of these passive and active phases (53, 54). Two meta-analyses of RCTs compared maternal and neonataloutcomesinwomenassignedtoimmediateversus delayed pushing have been published (49, 55). Both studies found that delaying

2019 American College of Obstetricians and Gynecologists

158. AIM Clinical Appropriateness Guidelines for Interventional Pain Management

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 ? Appropriate management of underlying (...) procedure. Studies have validated the efficacy of this intervention in chronic pain of facet origin. General Requirements 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

2019 AIM Specialty Health

159. Spine imaging

medications such as nerve membrane stabilizers or muscle relaxants o Physician-supervised therapeutic exercise program or physical therapy o Manual therapy or spinal manipulation o Alternative therapies such as acupuncture o Appropriate management of underlying or associated cognitive, behavioral or addiction disorders Clinical Indications The following section includes indications for which advanced imaging of the spine is considered medically necessary, along with prerequisite information and supporting (...) developed and validated criteria (ASAS cohort) for spondyloarthritis, as well as for their subsets, axial SpA and peripheral SpA. 17 While sacroiliitis is the most common MRI manifestation of axial spondyloarthropathy, bone marrow edema can be seen in the vertebra as well and characteristic patterns have been described. 18 Consensus among guidelines that radiography of the pelvis and/or spine is the preferred imaging modality for initial evaluation of SpA: ? The first-line imaging modality

2019 AIM Specialty Health

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