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Perception Exam

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141. Erectile Dysfunction

the topic of sexual concerns with a physician, it is critical that the physician initiate the inquiry. 46, 47 When the man’s presenting concern is ED, a comprehensive evaluation and targeted physical exam should be performed. Detailed assessment of sexual American Urological Association (AUA) Erectile Dysfunction Copyright © 2018 American Urological Association Education and Research, Inc.® 9 concerns may be difficult in a clinical setting when the presenting complaint is not ED; however, basic inquiry (...) , the partner’s views on sexuality, and the partner’s personal health/sexual issues, are useful to support a man in the evaluation of ED and to select an appropriate management strategy. Physical exam. Vital signs including pulse and resting blood pressure should be assessed. Obesity is a key indicator of ED risk. 49 Consideration should be given to the assessment of waist circumference. 50 BMI is an alternative but has less specificity for central adiposity, which is a more robust indicator of underlying CVD

2018 American Urological Association

142. CRACKCast E186 – Substance Abuse

with the finding Think: Vitals – all of them! Head to toe exam, specifically: Mental status Skin Pupils Needle track marks See Table 140.1 in Rosens 9 th Edition Chapter 140 for: Physical Examination findings of substance abuse, the agents predominantly involved, and the proposed mechanism. Wisecracks [1] What is the CRAFFT to screen for substance abuse among adolescents? This is a huge problem! With massive amounts of morbidity and mortality. By the time adolescents become adults in the United States, almost (...) effects. A variety of adverse effects have been reported from cathinone derivatives, including tachycardia, hypertension, agitation, hyponatremia, hallucinations, paranoia, and suicide. Acute pharmacologic effects of alcohol and/or drug use in adolescents include changes in: Mood Perception Cognition Psychomotor performance. Substance intoxication may lead to: Blackouts Aggressive behavior Unplanned sexual behavior Other behaviors associated with poor judgement. Substance use and/or SUDs

2018 CandiEM

143. Ablative techniques for the treatment of localised prostate cancer

, urinary dysfunction and general health perception. Compared to whole-gland therapy, focal cryotherapy was associated with higher rates of urinary continence and statistically equivalent rates of recurrence-free survival at 60 months. A cost-effectiveness study found that cryotherapy was unlikely to be cost-effective compared with other PCa treatments. IRE (3 case series studies 3-5 ): Between 25 and 62 per cent of patients were positive for PCa at follow-up, although the authors noted that most had (...) cancer and at least a 10-year life expectancy. 11 Watchful waiting and active surveillance with regular PSA testing and digital rectal exams are also possible strategies, particularly for men older than 75 years and for those with significant comorbidities. 14 Hormone therapy may be used as a neoadjuvant therapy (a treatment given prior to the primary therapy) for up to six months before radiotherapy. This aims to shrink the tumour before treatment, particularly for men with medium- or high-risk

2018 COAG Health Council - Horizon Scanning Technology Briefs

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

, this may be much higher in the elderly (> 65 years), where the ?gure is likely to be 50% or higher. 16 The quality of perception of itch may be sex depen- dent. 17 The management of pruritus requires a detailed history and examination coupled with appropriate investigations, directed from the initial clinical assessment. A major aim of these guidelines is to evaluate screening investigations in generalized pruritus without cutaneous signs and their value in the absence of clinical evidence of systemic (...) Pruritus is a common symptom in patients with various hepa- tobiliary disorders, including cholestasis of pregnancy. 138–140 The skin in hepatic pruritus is often generally hyperpigmented and excoriated. 141 The hands and feet are often the worst- affected areas. 139 Pruritus in association with fatigue at presen- tation may be a marker for more aggressive disease, for exam- ple primary biliary cholangitis. 142 There is a poor correlation between pruritus and bile acid levels, suggesting that other

2018 British Association of Dermatologists

145. Hoarseness (Dysphonia)

of the need to search for an underlying etiology; identify patients who may benefit from treatment; discourage the perception of dysphonia as a trivial condition that does not warrant attention Risks, harms, costs : Potential anxiety related to diagnosis; time expended in diagnosis, documentation, and discussion Benefits-harm assessment : Preponderance of benefits over harm Value judgments : The group believes that this is a critical component to caring for patients with altered voice (...) is often recognized by perception of abnormal cry. Suspicion should prompt otolaryngology consultation. Premature infants and neonates are also at risk for iatrogenic injury to their vocal folds due to prolonged intubation. When infants do present with dysphonia, underlying etiologies should be considered—such as birth trauma, surgery (eg, patent ductus arteriosus correction) or intubation, and intracranial process (eg, Arnold-Chiari malformation or posterior fossa mass, congenital laryngeal anomaly

2018 American Academy of Otolaryngology - Head and Neck Surgery

146. COPD Disease Education in Pulmonary Rehabilitation: A Workshop Report

processes has not received the samedegreeofattentionwithinthecontextof PR, with limited research concerning the educationalneedsofpatientswithCOPD.To illustrate this, in the recent ATS/European Respiratory Society document on PR, 760 citations were noted, but fewer than 20 were related to education (2). Health education is anticipated to impact ?ve possible patient domains: 1)knowledge; 2) perception of bene?t; 3) health beliefs; 4) health behaviors; and 5) health outcomes. Two studies have examined (...) the impact of education on knowledge acquisition, and demonstrated that education in PR does improve health knowledge (31, 35). Relationships between knowledge and any of the other aforementioneddomainshavenotyetbeen examined for patients with COPD, and therefore the impact of this improved knowledge after PR on health is not yet understood. Patient perceptions of the lived experience of education in PR have demonstratedapositiveimpact.Asystematic review of ?ve qualitative papers concludes

2018 American Thoracic Society

148. End-of-Life Care for People Experiencing Homelessness

care and end-of-life care. Patient Assessment and Evaluation 1. Focus primarily on assessing the social, emotional, mental, and environmental needs that affect the delivery of care for the terminally ill patient experiencing homelessness. 2. Focus the initial physical exam on the patient’s area of concern or areas most likely to be affected given the diagnosis or chief complaint. Perform serial focused exams as tolerated (if needed). Attempt to evaluate the stage of the patient’s condition. Look (...) ill patient experiencing homelessness. 2. Focus the initial physical exam on the patient’s area of concern or areas most likely to be affected given the diagnosis or chief complaint. Perform serial focused exams as tolerated (if needed). Attempt to evaluate the stage of the patient’s condition. Look for evidence of occult alcoholism or addiction. 3. Practice trauma-informed care during the physical examination and in all patient encounters, recognizing that individuals who are homeless are likely

2018 National Health Care for the Homeless Council

149. Heavy Episodic Drinking Among Post-secondary Students: Influencing Factors and Implications (Report at a Glance)

. The study, Heavy Episodic Drinking among Post-secondary Students: Influencing Factors and Implications, examined student perceptions and attitudes, expectations, reasons and consequences influencing heavy episodic drinking. The study also explored three high- risk drinking issues: alcohol-induced blackouts, pre-drinking and drinking to cope. The findings from the report continue to demonstrate the extreme nature of heavy episodic drinking and the risks posed to students. In response, this study suggests (...) perceptions and attitudes towards alcohol, expectations about excessive drinking, reasons for excessive drinking, positive and negative consequences experienced from drinking, and student suggestions for addressing the issue. General Findings ? The majority of students did not recognize what constituted heavy episodic drinking, did not see it as an issue in the post-secondary context, and considered drinking a part of the post- secondary experience. ? Most students stated that the average student could

2018 Canadian Centre on Substance Abuse

150. Early Detection of Prostate Cancer

Early Detection of Prostate Cancer Prostate Cancer: Early Detection Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning For Medical Students Exams/LLL (...) /Certifications Exam Prep Research Research Funding AUA Funding Research Education & Events Online Research Education Courses Research Resources Biorepositories and Other Resources Research Publications Research Career Opportunities Advocacy Scholar & Fellowship Programs Comment Letters & Resources International International Opportunities Annual Meeting Membership Collaborations Academic Exchanges Giving Back Practice Resources Coding and Reimbursement Practice Managers' Network (PMN) Patient Safety

2018 American Urological Association

153. Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients

study. The authors con- cluded that oral fluid screening is comparable to urine screening for detecting illicit drug use in a pain management population. In a follow-up study from the same group(12), the authors exam- ined paired oral fluid and urine specimens from a chronic pain population (n=133). Upon screening of both specimens for each patient, they found 21.3% of specimens positive in both matrices and 63.7% negative in both matrices, for an overall agreement rate of 85%. Of the 15

2018 American Academy of Pain Medicine

154. Continuous glucose monitoring (CGM real-time) and flash glucose monitoring (FGM) as personal, standalone systems in patients with diabetes mellitus treated with insulin

and consistent management approach. They should cover these basic principles of diabetes management [16]: • Interventions to promote and support healthy lifestyles, including healthy diet, physical activity, avoidance of tobacco use, and harmful use of alcohol. • Medication for blood glucose control – insulin or oral hypo-glycaemic agents as required. • Medication to control cardiovascular disease risk. • Regular exams for early detection of complications: comprehensive eye examination, measurement of urine (...) . Human factors, such as patient perceptions and behavioural self-regula- tion, are central to adherence to prescribed regimens, as well as to adoption and utilization of dia- betes technology, and they will continue to be crucial as diabetes management evolves [115]. Pa-Continuous (real-time) and flash glucose monitoring as personal, standalone systems in patients with DM treated with insulin Version 1.4, 27 July 2018 EUnetHTA Joint Action 3 WP4 92 tients who do not understand or practice the basics

2018 EUnetHTA

155. Low Back Pain, Adult Acute and Subacute

Low Back Pain, Adult Acute and Subacute Health Care Guideline: Adult Acute and Subacute Low Back Pain www.icsi.org Copyright © 2017 by Institute for Clinical Systems Improvement 1 Diagnosis Algorithm Text in blue in this algorithm indicates a linked corresponding annotation. Adult patient present with acute or subacute low back pain History and exam: • Pain characteristics • Sensory and strength changes • Prior treatment and response yes Complete assessment tools for pain and function (...) functional limitations (e.g., work status and difficulty caring for oneself). The higher the score, the more perceived disability the patient has. Using this test helps the examiner understand the patient's perception of how back pain is affecting his or her life. This tool has at least four versions/ formats in English and more in other languages (Fairbank, 2000). Roland-Morris Disability Questionnaire is another tool available for the assessment of low back pain disability. A substantial number

2018 Institute for Clinical Systems Improvement

156. Paediatric Urology

TIP hypospadias repair. J Pediatr Urol, 2013. 9: 990. 224. Cambareri, G.M., et al. Hypospadias repair with onlay preputial graft: a 25-year experience with long-term follow-up. BJU Int, 2016. 118: 451. 225. Castagnetti, M., et al. Primary severe hypospadias: comparison of reoperation rates and parental perception of urinary symptoms and cosmetic outcomes among 4 repairs. J Urol, 2013. 189: 1508. 226. Kocvara, R., et al. Inlay-onlay flap urethroplasty for hypospadias and urethral stricture repair (...) study of an objective scoring system for evaluating cosmetic appearance in hypospadias patients. J Pediatr Urol, 2013. 9: 1006. 257. Weber, D.M., et al. The Penile Perception Score: an instrument enabling evaluation by surgeons and patient self-assessment after hypospadias repair. J Urol, 2013. 189: 189. 258. Haid, B., et al. Penile appearance after hypospadias correction from a parent’s point of view: Comparison of the hypospadias objective penile evaluation score and parents penile perception

2018 European Association of Urology

157. Updated treatment recommendations for Early Colon Cancer

of the associated Log Book are now available ESMO Examination 2019 ESMO Examination – Results will be communicated via email to each participant early December. Recertification & CME If you’ve already sat the ESMO exam, then take a look at our CME opportunities Women for Oncology Advancing the careers of female oncologists to become the leaders of tomorrow Leaders Generation Programme An exciting, intensive course designed for the future leaders in our profession and our society. Apply by 7 January 2019 (...) ]. The length of oxaliplatin-based adjuvant treatment for stage III colon cancer based on the IDEA data may be tailored to 3 months for CAPOX (T1-3 N1 disease) [II, B], 6 months for CAPOX (T4 or N2 disease) [I, A] or 6 months for FOLFOX (T4 or N2 disease) [I, A], also taking into consideration pathological risk characteristics, patient comorbidity and risk perception. (See Figure 1). For patients not fit for oxaliplatin, either capecitabine or LV5FU2 (de Gramont) infusion are acceptable adjuvant regimens

2019 European Society for Medical Oncology

158. Low back pain and radicular pain: development of a clinical pathway

OBJECTIVE 46 5.2 METHODS 46 5.3 RESULTS 47 5.3.1 Characteristics of the Belgian pathway initiatives 47 5.3.2 Key interventions and building elements 56 5.4 LIMITATIONS 59 6 HEALTHCARE PROVIDERS PERCEPTION - NOMINAL GROUPS 60 KCE Report 295 Low back pain and radicular pain: development of a clinical pathway 3 6.1 RESEARCH OBJECTIVE 60 6.2 METHODS 60 6.3 RESULTS 60 6.3.1 First contact and Triage 63 6.3.2 Diagnostic 64 6.3.3 Treatment 64 6.3.4 Return to work 66 6.4 LIMITATIONS 66 7 PATIENTS PERCEPTION (...) with the healthcare system is not so early 81 8.1.2 A large heterogeneity of professionals can be involved in the first contact 81 4 Low back pain and radicular pain: development of a clinical pathway KCE Report 295 8.1.3 The search for a solution is a trial and error process 81 8.1.4 Professionals and patients have not the same perception of ‘the trajectories’ heterogeneity 82 8.2 FINDING 2: DIAGNOSTIC AND CAUSE ARE UNCERTAIN 82 8.2.1 Rarely there are underlying severe pathologies 82 8.2.2 Radicular pain should

2017 Belgian Health Care Knowledge Centre

159. Recommendations on routine screening pelvic examination

/about-us/competing-interests. correspondence Dr Marcello Tonelli; e-mail info@canadiantaskforce.ca references 1. Society of Obstetricians and Gynaecologists of Canada. My first pelvic exam. Ottawa, ON: Society of Obstetricians and Gynaecologists of Canada. Available from: http:// sogc.org/publications/my-first-pelvic-exam. Accessed 2015 May 5. 2. Bloomfield H, Olson A, Cantor A, Greer N, MacDonald R, Rutks I, et al. Screening pel- vic examinations in asymptomatic average risk adult women. Veterans (...) for a clinical practice guideline from the American College of Physicians. Ann Intern Med 2014;161(1):46-53. 18. Golomb D. Attitudes toward pelvic examinations in two primary care settings. R I Med J 1983;66(7):281-4. 19. Harper C, Balistreri E, Boggess J, Leon K, Darney P. Provision of hormonal contra- ceptives without a mandatory pelvic examination: the first stop demonstration proj- ect. Fam Plann Perspect 2001;33(1):13-8. 20. Bourne PA, Charles CA, Francis CG, South-Bourne N, Peters R. Perception

2016 CPG Infobase

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