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Pelvic Relaxation

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162. 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

163. 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

165. Primary postpartum haemorrhage

, colour, cerebral perfusion) o Hypovolemic shock disproportionate to the revealed blood loss o Feelings of pelvic or rectal pressure o Urinary retention · Act promptly to: o Resuscitate as required [refer to 3.3 Resuscitation] o Perform vaginal/rectal examination to determine site and extent o Consider transfer to operating theatre (OT) for clot evacuation, primary repair and/or tamponade of blood vessels · Refer to Queensland Clinical Guideline: Perineal care 38 Refer to online version, destroy

2019 Queensland Health

166. Gynaecological Cancers: a Handbook for Aboriginal and Torres Strait Islander Health Workers and Health Practitioners

in the cervix • Stage II: cancer has spread to the vagina or other tissue next to the cervix • Stage III: cancer has spread to tissue on the side of the pelvis (pelvic sidewall) • Stage IV: cancer has spread to the bladder or rectum, or beyond the pelvis to the lung, liver or bones. i31 CERVICAL CANCER Treatments for cervical cancer The aims of treatment for cervical cancer are to: • remove the cancer • destroy the cancer cells and slow growth of the cancer and/or • manage the symptoms of cervical cancer (...) the effects of treatment on fertility and menopause, go to Chapter 7. Types of surgery for cervical cancer include: • trachelectomy: removal of the cervix only • hysterectomy: removal of the womb and cervix (Figure 4.1). Depending on the size and type of the cancer, the surgeon may also remove: - a small part of the upper vagina - ligaments supporting the cervix - lymph nodes in the pelvis (pelvic lymphadenectomy). • lymph node dissection (pelvic lymphadenectomy): removal of some lymph nodes in the pelvis

2018 Cancer Australia

169. Treatment for Acute Pain: An Evidence Map

several classes. Pain relieving analgesics include opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen. These are often used in combination. Based on putative pain mechanisms, providers may also manage acute pain with muscle relaxants, antidepressants, alpha-2 agonists, GABA analogues, corticosteroids, NMDA receptor antagonists, local anesthetics, cannabinoids, among others. 23, 24 Topical agents such as capsaicin and lidocaine are also used. 23 Many medications for pain

2019 Effective Health Care Program (AHRQ)

171. Urological Trauma

., et al. Diagnosis and management of ureteric injury: an evidence-based analysis. BJU Int, 2004. 94: 277. 121. Chou, M.T., et al. Prophylactic ureteral catheterization in gynecologic surgery: a 12-year randomized trial in a community hospital. Int Urogynecol J Pelvic Floor Dysfunct, 2009. 20: 689. 122. Delacroix, S.E., Jr., et al. Urinary tract injures: recognition and management. Clin Colon Rectal Surg, 2010. 23: 104. 123. Visco, A.G., et al. Cost-effectiveness of universal cystoscopy to identify (...) Kidney Autotransplantation: A Minimally Invasive Way to Salvage Kidneys. Eur Urol Focus, 2018. 4: 198. 152. Zhao, L.C., et al. Robotic Ureteral Reconstruction Using Buccal Mucosa Grafts: A Multi-institutional Experience. Eur Urol, 2017. 153. Pereira, B.M., et al. Bladder injuries after external trauma: 20 years experience report in a population-based cross-sectional view. World J Urol, 2013. 31: 913. 154. Figler, B.D., et al. Multi-disciplinary update on pelvic fracture associated bladder

2019 European Association of Urology

172. Neuro-urology

bladder diary in women with urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct, 2008. 19: 955. 61. Henze, T. Managing specific symptoms in people with multiple sclerosis. Int MS J, 2005. 12: 60. 62. Liu, C.W., et al. The relationship between bladder management and health-related quality of life in patients with spinal cord injury in the UK. Spinal Cord, 2010. 48: 319. 63. Khalaf, K.M., et al. The impact of lower urinary tract symptoms on health-related quality of life among patients (...) augmentation cystoplasty: A transitional urologist’s viewpoint. J Pediatr Urol, 2017. 97. Yang, C.C., et al. Bladder management in women with neurologic disabilities. Phys Med Rehabil Clin N Am, 2001. 12: 91. 98. Podnar, S., et al. Protocol for clinical neurophysiologic examination of the pelvic floor. Neurourol Urodyn, 2001. 20: 669. 99. Harrison, S., et al. Urinary incontinence in neurological disease: assessment and management. NICE Clinical Guideline 2012. [CG148]. 100. Liu, N., et al. Autonomic

2019 European Association of Urology

173. Male Sexual Dysfunction

. Erectile dysfunction in the cardiovascular patient. Eur Heart J, 2013. 34: 2034. 50. Seftel, A.D., et al. Coexisting lower urinary tract symptoms and erectile dysfunction: a systematic review of epidemiological data. Int J Clin Pract, 2013. 67: 32. 51. Rosen, R., et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol, 2003. 44: 637. 52. Zhang, Y., et al. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome (...) 2 and 4 years after radical prostatectomy. J Urol, 2009. 181: 731. 79. Incrocci, L., et al. Pelvic radiotherapy and sexual function in men and women. J Sex Med, 2013. 10 Suppl 1: 53. 80. Morgia, G., et al. Association between long-term erectile dysfunction and biochemical recurrence after permanent seed I(125) implant brachytherapy for prostate cancer. A longitudinal study of a single-institution. Aging Male, 2016. 19: 15. 81. Stember, D.S., et al. The concept of erectile function preservation

2019 European Association of Urology

175. 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

2019 European Association of Urology

176. 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

2019 European Association of Urology

177. Guidance For: Prone Positioning in Adult Critical Care

before start of procedure Minimum of 5 people plus 1 for chest drains Yes No All team members aware of role Yes No Appropriate ventilator settings Yes No Cardiovascular stability Yes No Adequate sedation (ie. RASS -5) Yes No Adequate muscle relaxation – consider need for bolus Yes No Pillows positioned correctly – chest, pelvis, knees Yes No Team members familiar with procedure Yes No Appendix 1. LocSSIP PROCEDURE SAFETY CHECKLIST: Prone Ventilation in Critical Care PaO2/FiO2 Ratio Grade Laryngoscopy (...) or BiVAD support Relative: • Multiple Trauma e.g. Pelvic or Chest fractures, Pelvic fixation device • Severe facial fractures • Head injury/Raised intracranial pressure • Frequent seizures • Raised intraocular pressure • Recent tracheostomy <24hrs • CVS instability despite resuscitation with fluids and inotropes • Previously poor tolerance of prone position • Morbid obesity • Pregnancy 2 nd /3 rd trimester c. Equipment • Low air loss mattress/kinetic therapy bed or local equivalent • Airway trolley

2019 Faculty of Intensive Care Medicine

178. 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

179. BSPGHAN Motility Working Group consensus statement- Anorectal manometry in children with defecation disorders Full Text available with Trip Pro

is secondary to constipation, but in approximately 20% it is associated with conditions such as non‐retentive fecal incontinence (NFI). Pelvic floor dyssynergia, which describes poor coordination between pelvic floor muscles and abdominal wall muscles during defecation, can also lead to FI and will require different management strategies. In children with FI secondary to CC, the majority will have functional constipation but up to 5% are affected by other medical conditions that lead to delayed transit (...) parameters can be obtained (Table ). It is, however, recognized that is certain circumstances (eg, significant child distress or anxiety, learning difficulties, or in infants with suspected Hirschsprung's disease) ARM can be done under sedation. If sedation is needed, muscle relaxants should be avoided and clarity given to the parents and recipient healthcare professionals with regard to the limited information obtained (essentially limited to resting pressure of the anal sphincter and RAIR

2020 British Society of Paediatric Gastroenterology Hepatology and Nutrition

180. Erectile Dysfunction

and psychological systems. Biopsychosocial stimulation causes the local release of nitric oxide via the parasympathetic system increasing formation of cyclo-guanosine monophosphate (cGMP) which causes relaxation of the cavernosal smooth muscle. This compresses the small veins in the penis preventing venous return and erection occurs. Various mechanisms can interfere with this pathway and reduce of 3’5’-cGMP concentration below the level necessary for an erection. The Sexual Health Inventory for Men (SHIM) can (...) of libido (annual risk 5 per 1000 patients) but are not generally associated with erectile dysfunction No medical assessment or prior diagnosis of erectile dysfunction History of trauma to genital area, pelvis or spine since medical assessment Non-response after an adequate trial of PDE-5 inhibitors Contraindications to PDE-5 inhibitors If the safety of sexual activity is a concern, for example: Unstable heart disease (e.g., angina) Recent myocardial infarction Poorly compensated heart failure Unstable

2018 medSask

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