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141. Otitis Media with Effusion (OME)

AOM, most often between the ages of 6 months and 4 years. In the first year of life, >50% of children will experience OME, increasing to >60% by age 2 years. When children aged 5 to 6 years in primary school are screened for OME, about 1 in 8 are found to have fluid in one or both ears. The prevalence of OME in children with Down syndrome or cleft palate, however, is much higher, ranging from 60% to 85%. , Figure 3. Position of the eustachian tube (red) as it connects the middle ear space

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2016 American Academy of Otolaryngology - Head and Neck Surgery

142. Management of Concussion-mild Traumatic Brain Injury (mTBI)

and generally accepted as current best practice. The Work Group recognized primary care providers should consider, as appropriate during each encounter, the following physical findings, signs and symptoms (“red flags”) that may indicate a neurologic condition that requires urgent specialty consultation (e.g., consultation with neurology, neuro-surgical): • Progressively declining level of consciousness • Progressively declining neurological exam • Pupillary asymmetry • Seizures • Repeated vomiting

2016 VA/DoD Clinical Practice Guidelines

143. Diagnosis of Acute Gout: A Clinical Practice Guideline from the American College of Physicians

, redness observed over joints, painful or swollen first metatarsophalangeal joint, proven or suspected tophi, and the comorbid risk factor of hyperuricemia. Details on each algorithm are provided in the accompanying evidence review ( ). DECT Low-quality evidence from 3 observational studies ( ) showed that DECT had a sensitivity of 85% to 100% and specificity of 83% to 92% for predicting gout compared with assessment of synovial fluid MSU crystals or clinical algorithms. Ultrasonography Low-quality (...) gout is more frequent than generally admitted. As a consequence, this facinating paper is really usefull, especially fot the GP. A 60 year-long clinical experience allows me to state that in healthy individual, the nail pressure upon the helix brings about the Gastric Aspecific Reflex (in the stomach both fundus and body dilate, while antral-pyloric region contracts) after a Latency Time of 10 seconds precisely. On the contrary, in individual involved by gout constitution, this Latency Time lowers

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2016 American College of Physicians

145. A pathognomonic ECG you should recognize instantly

instantly. ----------------------------------------------------------- Comment by KEN GRAUER, MD ( 7/22/2018 ): ----------------------------------------------------------- I agree completely with Dr. Meyers that on seeing this ECG and being told that the patient presented to the ED with “generalized weakness” — that your reflexive response (ie, that should be made in no more than 2-3 seconds ) — should be, “What’s the serum K+?” That said — I’d add the following points: What is the serum Mg++ level? I (...) in the prior ECG in the inferior leads. This most probably reflects the benign variant of early repolarization — but I suspect it accounts for the fact that although inferior lead ST-T waves are flattened in the ED ECG ( RED border in Figure-1 ) — they are not as depressed as I might have expected with the exceedingly low serum K+ level of 2.3 mEq/L. I find it helpful to repeat the ECG of a patient with a new electrolyte disorder after treatment — in this case, just to be sure that the T wave inversion

2018 Dr Smith's ECG Blog

146. Guidelines for diagnosing and managing pediatric concussion

if the child/adolescent plays high-risk sports—not as a general rule. B On Presentation (what are the “red flags”?) Number Evidence 2.1 Assess and treat any physical, cognitive and neurological deficits. A/B 2.2 Determine the need for CT imaging. A 2.3 Consider admission or prolonged observation if the child/adolescent shows “red flag” symptoms. B 2.4 Treat acute headaches. C 2.5 Prescribe physical and cognitive rest. B/C 2.6 Discharge the child/adolescent for observation at home under certain conditions (...) children/adolescents who have sustained a head injury do not need imaging. For those who do, a CT scan is the most appropriate technology in the acute setting to identify skull fractures and important lesions, such as hemorrhage. Level of evidence: A. 2.3: Consider admission or prolonged observation if the child/adolescent shows “red flag” symptoms. When: On presentation, after negative results of imaging. Who: Health care professionals. • Example: Emergency Department and other hospital-based

2014 CPG Infobase

147. Colon mustard oil instillation induced cross-organ reflex sensitization on the pelvic-urethra reflex activity in rats. (PubMed)

, and phosphorylated NR2B (pNR2B) but not of total NR2B (tNR2B) in the spinal cord tissue. Both cross-organ reflex sensitization and increments in protein expression were reversed by intra-colonic pretreatments with ruthenium red (a non-selective transient receptor potential vanilloid, TRPV, antagonist), capsaizepine (a TRPV1-selective antagonist), lidocaine (a nerve conduction blocker) as well as by the intra-thecal pretreatment with APV (a NRMDR antagonist) Co-101244 (a NR2B-selective antagonist) and roscovitine (...) Colon mustard oil instillation induced cross-organ reflex sensitization on the pelvic-urethra reflex activity in rats. We investigated the participation of cyclin-dependent kinase-5 (Cdk5)-mediated N-methyl-D-aspartate receptor (NMDAR) NR2B subunit phosphorylation in cross-organ reflex sensitization caused by colon irritation. The external urethral sphincter electromyogram (EUSE) reflex activity evoked by the pelvic afferent nerve test stimulation (TS, 1 stimulation/30s) and protein expression

2009 Pain

148. Nasopharyngeal Cancer Treatment (Adult) (PDQ®): Patient Version

of the body to check general signs of health, including checking for signs of disease, such as swollen in the neck or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken. : A series of questions and tests to check the brain, , and function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic (...) of (the that carries ) in the red blood cells. The portion of the blood sample made up of red blood cells. Epstein-Barr virus (EBV) test : A to check for to the Epstein-Barr virus and markers of the Epstein-Barr virus. These are found in the blood of patients who have been infected with EBV. Hearing test : A procedure to check whether soft and loud sounds and low- and high-pitched sounds can be heard. Each ear is checked separately. Certain factors affect prognosis (chance of recovery) and treatment options

2018 PDQ - NCI's Comprehensive Cancer Database

149. Genetics of Skin Cancer (PDQ®): Health Professional Version

characteristics The high-risk consists of individuals with the following physical characteristics: Fair skin that sunburns easily. Lightly pigmented irides (blue and green eye color). Presence of freckles in sun-exposed skin. Poor ability to tan. Blond or red hair color. Specifically, people with more highly pigmented skin demonstrate lower incidence of BCC than do people with lighter pigmented skin. Individuals with Fitzpatrick type I or II skin were shown to have a twofold increased risk of BCC in a small (...) case-control study.[ ] (Refer to the section in the section of this summary for a more detailed discussion of skin phenotypes based upon pigmentation.) Blond or red hair color was associated with increased risk of BCC in two large cohorts: the Nurses’ Health Study and the Health Professionals’ Follow-Up Study.[ ] In women from the Nurses’ Health Study, there was an increased risk of BCC in women with red hair relative to those with light brown hair (adjusted relative risk [RR], 1.30; 95% confidence

2018 PDQ - NCI's Comprehensive Cancer Database

150. International Consolidated Venous Ulcer Guideline

. >1.985 mm as measured using high frequency ultrasound or other clinically documented technique. A (Choh et al., 2010; Vesic et al., 2008; Volikova et al., 2009; Xia et al., 2004), CVI= 0.667, Moderate SOR A.2.b.iii. Stasis dermatitis including tan or red-brown skin color (hemosiderin deposits) usually at medial ankle, or small erosions that may be open or crusted. A (Alguire et al., 1997; Burton, 1993; Pappas et al., 1997) CVI= 0.952, High SOR A.2.b.iv. Lipodermatosclerosis, (fibrosis of dermis (...) A.3.a.i. Recognize that venous ulcers can exist in the presence of mixed arterial/venous pathology. C3 (ASPS, 2007; Bonham et al., 2009; Falanga 1997; Kerstein 1996), CVI= 0.952, High SOR A.3.b. Confirm and localize venous insufficiency using color duplex scanning ultrasound, or other appropriate imaging such as light reflexive rheology, if feasible, in supine and standing positions to measure blood flow, venous refill time (see also A.3.d.) and venous reflux. A ( Kjaer et al., 2005; Lee et al

2015 Association for the Advancement of Wound Care

151. Late Effects of Treatment for Childhood Cancer (PDQ®): Patient Version

: and : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken. : A series of questions and tests to check the brain, spinal cord, and nerve function. The exam checks a person’s mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam (...) and the amount of glucose that is attached to is measured. A higher than normal amount of glucose attached to red blood cells can be a sign of diabetes mellitus. Fasting blood sugar test : A test in which a blood sample is checked to measure the amount of glucose in the blood. This test is done after the patient has had nothing to eat overnight. A higher than normal amount of glucose in the blood can be a sign of diabetes mellitus. Endocrine System Key Points for This Section Thyroid gland Thyroid late

2018 PDQ - NCI's Comprehensive Cancer Database

152. Primary CNS Lymphoma Treatment (PDQ®): Patient Version

status, coordination, ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam. : An exam that uses a special with a bright, narrow slit of light to check the outside and inside of the eye. (magnetic resonance imaging) : A procedure that uses a magnet, , and a computer to make a series of detailed pictures of areas inside the brain and spinal cord. A substance called is into the patient through a . The gadolinium collects (...) and type of . - The amount of (the protein that carries ) in the red blood cells. - The portion of the blood sample made up of red blood cells. Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white blood cells, and platelets are counted. The CBC is used to test for, diagnose, and monitor many different conditions. : A procedure in which a blood sample

2018 PDQ - NCI's Comprehensive Cancer Database

153. Langerhans Cell Histiocytosis Treatment (PDQ®): Patient Version

: Flaking of the scalp that may look like dandruff. Raised, red or brown, crusted rash in the area, , back, or chest, that may be itchy or painful. Bumps or on the scalp. Ulcers behind the ears, under the , or in the groin area. Fingernails that fall off or have discolored grooves that run the across the nail. Mouth Signs or symptoms of LCH that affects the mouth may include: Swollen . Sores on the roof of the mouth, inside the cheeks, or on the tongue or lips. Teeth that become uneven or fall out. Bone (...) , such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken. : A series of questions and tests to check the brain, , and function. The exam checks a person's mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam. : A procedure in which a sample of is drawn and checked for the following: - The amount

2018 PDQ - NCI's Comprehensive Cancer Database

154. Cancer Pain (PDQ®): Patient Version

parts of the ) caused by or targeted therapy. Skin pain, rash, or (redness, tingling, or burning in the palms of the hands and/or the soles of feet) caused by chemotherapy or targeted therapy. Pain in and muscles throughout the body caused by or therapy. of the jaw caused by bisphosphonates given for cancer that has spread to the bone. Pain caused by , including: Pain from . Pain from the position the patient stays in during radiation therapy. Mucositis. Inflammation of the in areas that were (...) : and : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of your health habits and past illnesses and treatments will also be taken. : A series of questions and tests to check the brain, , and function. The exam checks your mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam. Your

2018 PDQ - NCI's Comprehensive Cancer Database

155. Gastrointestinal Complications (PDQ®): Health Professional Version

anesthesia and pudendal blocks. Diet Inadequate fluid intake.* Altered bowel habits Repeatedly ignoring defecation reflex. Excessive use of laxatives and/or enemas. Prolonged immobility* and/or inadequate exercise Spinal cord injury or compression, fractures, fatigue, weakness, or inactivity (including bedrest). Intolerance with respiratory or cardiac problems. Bowel disorders Irritable colon, diverticulitis, or tumor.* Neuromuscular disorders (disruption of innervation leads to atony of the bowel (...) neuropathy caused by the vinca alkaloids, taxanes, and thalidomide. Other drugs such as opioid analgesics or anticholinergics (antidepressants and antihistamines) may lead to constipation by causing decreased sensitivity to the defecation reflexes and decreased gut motility. Since constipation is common with the use of opioids, a bowel regimen will be initiated at the time opioids are prescribed and continued for as long as the patient takes opioids. Opioids produce varying degrees of constipation

2018 PDQ - NCI's Comprehensive Cancer Database

156. Vestibular Assessment ? Eye movement Recordings

recordings BSA 2015 © BSA 2016 Page5 Appendix E. Positional and head-shaking tests 44 Recommended Procedure Vestibular Assessment – eye movement recordings BSA 2015 © BSA 2016 Page6 2. Abbreviations BPPV benign paroxysmal positional vertigo CRP corneo-retinal potential ENG 1 electro-nystagmography INO internuclear ophthalmoplegia OKN optokinetic nystagmus SN spontaneous nystagmus SPV slow phase velocity VF visual fixation VNG video-nystagmography VOR vestibular ocular reflex 3. Introduction 3.1 (...) -red camera. In the event that complete darkness is not achievable in the clinic room, the lighting should remain constant (dim) throughout the test. In the case of electro-nystagmography recordings this should minimise any changes in the corneo-retinal potential. Also in the case of ENG recordings, where it is not possible to obtain complete darkness it is suggested that un-illuminated Frenzel’s glasses can be used with eyes open in a darkened room to eliminate visual cues (Baloh et al, 1977

2016 British Society of Audiology

157. Newborn Nursing Care Pathway

history) Assess mother’s/ family/ supports understanding of newborn physiology and capacity to identify variances that may require further assessments Refer to: • Skin Norm and Normal Variations • Outer canthus aligned with upper ear • Dark or slate blue color • Blink reflex present • Edematous lids • Sclera clear • No tears • Pupils equal and reactive to light • May see subconjunctival hemorrhage • Administer eye prophylaxis (after completion of initial feeding or by 1 hour after birth) 20 promotes (...) Services BC Physiological Assessment 0 – 12 hours Period of Stability (POS) >12 – 24 hours >24 – 72 hours >72 hours – 7 days and beyond MOutH Assess: • Lips for colour • Tongue midline • Frenulum • Palate • Reflexes • Oral health and care Assess mother’s/ family/ supports understanding of newborn physiology and capacity to identify variances that may require further assessments Refer to: • Feeding Norm and Normal Variations • Mucosa moist smooth and pink • May have epithelial pearls • Tongue midline

2015 British Columbia Perinatal Health Program

160. Core Competencies for Management of Labour

to appropriately respond to the emotional needs of the woman 3. The RN will be able to describe and discuss: • Physiological vs. active management of the third stage of labour • Normal appearance and integrity of the placenta • Number of vessels in umbilical cord • Principles of cord blood sampling • Normal newborn transition • The benefits of early skin-to-skin contact • Normal newborn behavioural states and reflexes • Nursing actions that promote stabilization of the newborn • Newborn conditions that would (...) • Newborn thermoregulation including skin-to-skin care • Physical assessment at birth including newborn transition from intrauterine to extrauterine environ- ment – identification of variances • Behaviour states and reflexes - identification of variances • IM injections • Prophylactic eye care 27. Preparation for Emergency C/S birth 28. Neonatal ResuscitationCore Nursing Practice Competencies: Managing Labour 13 Perinatal Services BC Copyright © 2011 - PSBC GLOSSARY OF TERMS Active Phase – regular

2014 British Columbia Perinatal Health Program

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