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181. Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (Full Version)

, premalignant conditions like Bowen’s disease and erythroplasia of Queyrat, priapism, urethral stricture, and psoralen and ultraviolet A (PUVA) therapy. 126-128 Therefore, MC for preventing penile cancer is possibly one of the sev- eral preventive interventions, which still does not account for a host of risk factors. 127-129 The International Consultation on Urologic Disease 2009 consensus publication on penile cancer prevention advocated smoking cessation as a Grade C recommendation, while male HPV

2018 Canadian Urological Association

182. Blast crisis

focal neurological signs priapism confusion or stupor history of chronic myelogenous leukaemia (CML) exposure to ionising radiation exposure to alkylating chemotherapeutic agents Diagnostic investigations FBC and differential peripheral blood smear bone marrow aspiration and biopsy karyotype fluorescent in situ hybridisation quantitative PCR serum leukocyte alkaline phosphatase serum vitamin B12 T315I gene mutation test Treatment algorithm ACUTE ONGOING Contributors Authors Professor of Medicine

2017 BMJ Best Practice

183. Traumatic brain injury

of limbs, priapism, spinal shock) • Other o SaO 2 , Blood gases o Labs, including clotting o Results of full secondary survey (needs senior orthopaedic surgeon/general surgeon to review) and presence of other injuries o Trauma imaging (including abdominal assessment- FAST scan +/or CT), particularly CT scans and cervical spine imaging. 2. Initial management • Stabilisation of airway and cervical spine, breathing and circulation (ABC) is the priority for all patients before attention to other injuries

2018 Children's Acute Transport Service

185. Male Sexual Dysfunction

among older adults in the United States. N Engl J Med, 2007. 357: 762. 2. Rosenberg, M.T., et al. Identification and diagnosis of premature ejaculation. Int J Clin Pract, 2007. 61: 903. 3. Tekgül, S., et al. European Association of Urology guidelines on Paediatric Urology. Edn. presented at the EAU Annual Congress London, 2017. 4. Montague, D.K., et al. American Urological Association guideline on the management of priapism. J Urol, 2003. 170: 1318. 5. Eland, I.A., et al. Incidence of priapism (...) in the general population. Urology, 2001. 57: 970. 6. Kulmala, R.V., et al. Priapism, its incidence and seasonal distribution in Finland. Scand J Urol Nephrol, 1995. 29: 93. 7. Furtado, P.S., et al. The prevalence of priapism in children and adolescents with sickle cell disease in Brazil. Int J Hematol, 2012. 95: 648. 8. Adeyoju, A.B., et al. Priapism in sickle-cell disease; incidence, risk factors and complications - an international multicentre study. BJU Int, 2002. 90: 898. 9. Emond, A.M., et al. Priapism

2018 European Association of Urology

187. CRACKCast E143 – Diving Injuries and Dysbarism

marmorata – patchy cyanotic marbling of the skin (trunk and torso) – may first show up as pruritus, then erythema, then mottling. This is due to venous stasis. Lymphatic obstruction presents with edema. Spinal cord at high risk – lumbar region: ● Limb weakness/paralysis ● Paresthesias – distal to proximal migration ● Numbness ● Low back/abdominal pain ● Bladder symptoms, fecal incontinence, priapism ● Patchy symptoms Cerebral symptoms: ● Headache, blurred vision, diplopia, dysarthria, fatigue, behaviour

2018 CandiEM

188. Guidelines for the use of hydroxycarbamide in children and adults with sickle cell disease Full Text available with Trip Pro

, ), significant improved aerobic exercise tolerance and physical fitness (Wali & Moheeb, ). These cardiovascular benefits may be due to the associated increase in haemoglobin. Priapism Case reports suggest some benefit of hydroxycarbamide to prevent recurrent ischaemic priapism (Al Jam'a & Dabbous, ; Saad et al , ) through its mechanism of enhancing NO bioavailability, but there is no evidence to support its role in acute episodes (Uzoma et al , ). Avascular necrosis (AVN) A prospective non‐randomised study (...) prevent priapism (2D) In children and adults with SS/Sβ 0 and symptomatic chronic anaemia that interferes with daily activities or quality of life, recommend treatment with hydroxycarbamide (1C) Use in other genotypes Hydroxycarbamide has been less well investigated in SCD phenotypes other than SS/Sβ 0 thalassaemia genotypes. Although there are no completed randomised clinical trials of hydroxycarbamide use in patients with sickle cell/HbC (SC) disease, cohort studies suggest a beneficial role

2018 British Committee for Standards in Haematology

190. CRACKCast E174 – Genitourinary and Renal Tract Disorders

CRACKCast E174 – Genitourinary and Renal Tract Disorders CRACKCast E174 – Genitourinary and Renal Tract Disorders - CanadiEM CRACKCast E174 – Genitourinary and Renal Tract Disorders In , , by Adam Thomas May 3, 2018 This episode of CRACKCast covers Rosen’s Chapter 173, Genitourinary and Renal Tract Disorders. Torsion, phimosis, UTIs, stones, and priapism are some of the high-yield topics covered here. Shownotes: Core Questions [1] List a DDx for priapism and describe treatment . Priapism

2018 CandiEM

191. Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents

additional outcomes to consideration for this review: chemical leukoderma and priapism. Inclusion and Exclusion Criteria We specified our inclusion and exclusion criteria based on the PICOTS (Populations, Interventions, Comparators, Outcomes, Timing, Settings) identified in topic refinement. Table 1 specifies inclusion and exclusion criteria. Table 1. Inclusion and exclusion criteria PICOTS Element Inclusion Criteria Exclusion Criteria Populations KQ 1: Individuals birth through 17 years of age without

2018 Effective Health Care Program (AHRQ)

192. Diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion

with lifestyle modi?cations, substituting alternative medications in place of those that can exacerbate ED, and moving on to PDE5i in patients who have organic causes of ED such as spinal cord injuries, radical pelvic surgery, severe atherosclerosis, or those who fail lifestyle therapy or desire rapid improvement in their ED. Typically,thesemenmaybestartedonaPDE5itrial,with appropriate counseling about risk of priapism (de?ned as an erection lasting longer than 4 hours). Contraindications for PDE5i use (...) include use of nitrates and inadequate cardiac reserve for sexual activity requiring clearance by a cardiolo- gist.Further,thesemedicationsshouldbeusedwithcautionin menonanalphablocker astheycancauseanunsafedropin bloodpressure.SideeffectsofPDE5iagentsincludeheadache, facial?ushing,muscleaches,nasalcongestion,abluetingein vision, dizziness, dyspepsia, and priapism. Typical doses of PDE5iaresildena?l50–100mg,tadala?l5–20mg,vardena?l 10–20 mg, and avana?l50–200 mg. All of these drugs are expensive, $10

2018 Society for Assisted Reproductive Technology

195. Tadalafil - Pulmonary Hypertension

of 80.00-125.00%. EMA/803097/2016 Page 24/26 2.4.6. Conclusions on clinical aspects A summary of the literature with regard to clinical data of tadalafil and two bioequivalence studies were provided to demonstrate that the active substance does not differ significantly in properties with regards to safety and efficacy of the reference product and was accepted by the CHMP. 2.5. Risk management plan Safety concerns Summary of safety concerns Important identified risks • Priapism (MedDRA PT: Priapism (...) Safety concern Routine risk minimisation measures Additional risk minimisation measures Important identified risks: Priapism Sections 4.4 and 4.8 of the SPC contain adequate information on this safety concern. Sections 2 and 4 of PL advise patients on this safety concern. None Important identified risks: Hypotension/Increased Hypotensive Effect Sections 4.3, 4.4, 4.5 and 4.8 of the SPC contain adequate information on this safety concern. Sections 2 and 4 of PL advise patients on this safety concern

2017 European Medicines Agency - EPARs

196. Tadalafil Lilly

, which have been assessed and authorised (including all post-marketing procedures). Assessment report EMA/CHMP/23344/2017 Page 9/13 2.5. Risk management plan Safety concerns Summary of Safety Concerns Important Identified Risks All Indications: • Hypotension/Increased Hypotensive Effect • Priapism Important Potential Risks All Indications: • Nonarteritic anterior ischemic optic neuropathy (NAION) • Sudden hearing loss PAH Indication: • Increased Uterine Bleeding Important Missing Information (...) . • The package leaflet under Possible Side Effects (Section 4) includes low blood pressure None Priapism • Specific label text in the SmPC under Special Warnings and Precautions (Section 4.4) states that patients who experience erections lasting 4 hours or more should be instructed to seek immediate medical assistance. • Priapism and Prolonged erections are listed in the SmPC as undesirable effects under Section 4.8. • The package leaflet instructs patients to inform the doctor immediately if the erection

2017 European Medicines Agency - EPARs

197. Spinal injury: assessment and initial management

if the person: has any significant distracting injuries is under the influence of drugs or alcohol is confused or uncooperative has a reduced level of consciousness has any spinal pain has any hand or foot weakness (motor assessment) has altered or absent sensation in the hands or feet (sensory assessment) has priapism (unconscious or exposed male) has a history of past spinal problems, including previous spinal surgery or conditions that predispose to instability of the spine. 1.1.4 Carry out full in-line (...) or absent sensation in the hands or feet priapism in an unconscious or exposed male. 1.9.2 If possible, record information on whether the assessments show that the person's condition is improving or deteriorating. 1.9.3 Record pre-alert information using a structured system and include all of the following: the patient's age and sex time of incident mechanism of injury injuries suspected signs, including vital signs and Glasgow Coma Scale treatment so far estimated time of arrival at emergency

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

198. Testosterone Replacement Guidelines

Advantages Disadvantages Intramuscular - Cheap - Known efficacy - Lots of experience of use - Long-acting - Easy dose titration - Licensed in UK - Can monitor compliance - Fluctuating drug levels resulting in fluctuating symptoms (mood and libido – which may be an issue in boys with learning difficulties) - Local problems with injections (pain, inflammation, sterile abscess) - Attending to healthcare services - Priapism potentially if excess administered - Potential paroxysms of coughing and dyspnoea

2019 British Society for Paediatric Endocrinology and Diabetes

200. CRACKCast E106 – Spinal Cord

they are mediated by the spinal levels; examples would be: DTR’s Autonomic dysfunction: Neurogenic shock Priapism If you have a bulbocavernosus reflex = spinal shock is over; if you don’t have a BC reflex the spinal injury has likely led to spinal shock. “Spinal shock refers to the loss of muscle tone and reflexes with complete cord syndrome during the acute phase of injury. Spinal shock typically lasts less than 24 hours but has been reported occasionally to last days to weeks. A marker of spinal shock is loss

2017 CandiEM

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