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101. British Association of Dermatologists guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in children and young people Full Text available with Trip Pro

and young people Survivorship/survival 9 Internal organ dysfunction and support – PELOD, modified SOFA or MODS score 8 No residual impairment Eyes – ocular surface disease, eyelid management, trichiasis, meibomian Skin – scarring, dyschromia, dyspigmentation Genital – phimosis, adhesion, meatal scarring 7 7 7 7 Quality of life and psychosocial well‐being – cDLQI and other measures, time to recovery, time to return to school/work 7 Duration of hospitalization 6 Ventilated days 6 Recurrence 6 Outcomes (...) hypersecretion, haemoptysis Symptoms indicating bowel involvement, i.e. diarrhoea, abdominal distension Date when the patient developed the first symptom or sign of the disorder, e.g. sore throat, rash, skin pain, sore eyes/mouth Previous or ongoing medical problems; specifically, history of previous drug reactions, recurrent herpes simplex virus (HSV) infections, chest infections, diagnosis and treatment for malignancy and/or stem cell transplant. Diagnosis and causality R2 (↑↑) Exclude* the differential

2019 British Association of Dermatologists

102. The economic evaluation of early intervention with Anti-Tumor Necrosis Factor-alpha treatments in pediatric Crohn's disease

None/asymptomatic tags=0 0 1 to 2 indolent fistula/scant drainage, no tenderness 7.5 Active fistula/drainage/tenderness/abscess 15 Presence of Extra-intestinal manifestations None (no extra-intestinal manifestations) 0 =1 extra-intestinal manifestations (such as fever =38.5°C for 3 days in past week, definite arthritis, uveitis, E. nodosum, P. gangrenosum) 10 Total Score: 0 to 125 • 40 classified as “moderate” • >57.5 classified as “severe” (A decrease of 17.5 points is taken as evidence

2019 SickKids Reports

103. Guideline regarding treatment of haemorrhoids

by the prolapsed tissue may cause itching of the perianal skin (image 2). 15 Images 2: (circular) prolapsed haemorrhoids The most commonly used classification of haemorrhoids was described by Goligher. In the Goligher classification, Grade I describes haemorrhoidal prolapse through the proctoscope, grade II describes haemorrhoidal prolapse during straining which reduces spontaneously, grade III describes haemorrhoidal prolapse occuring during straining and requires manual reduction back into the anal canal (...) fissures, the passage of stool may be accompanied by a small amount of bright rectal bleeding usually limited to the toilet paper or on the surface of stool. Some patients complain of itching or perianal skin irritation; o Inflammatory bowel diseases (i.e. Crohn’s and Colitis): (bloody) diarrhoea, abdominal pain and/or general malaise; o Sexually transmitted infections: intermittent rectal bleeding associated with the passage of mucus, mild diarrhoea with fewer than four small loose stools per day

2019 Palliative Care Evidence Review Service (PaCERS)

104. Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and Evaluation of Devices: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

for lower-extremity PAD define CLI as the presence of ischemic rest pain, nonhealing wound/ulcer, or gangrene for >2 weeks with associated evidence of hypoperfusion as measured by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oximetry (TcP o 2 ), or skin perfusion pressure (SPP). Because timely revascularization for CLI is a Class I indication in the AHA/ACC guidelines, accurate perfusion assessment is critically important. The goal (...) , % Specificity, % Limitations Reference Ankle-brachial index Surrogate Evaluate for PAD 69–79 83–99 Calcified arteries, poor predictor for wound healing 8, 11 TcP o 2 Surrogate Nonhealing wounds or gangrene 98 44 Time, open wounds, amputation 1, 37 Skin perfusion pressure Surrogate Below-ankle lesions 72 88 Reproducibility, pain, artifacts from motion, bony prominences, and veins 16 Phosphorescence biosensors Biomarker Monitor PAD progression and treatment response NA NA Limited efficacy data, relatively

2019 American Heart Association

105. Screening and Management of the Hyperandrogenic Adolescent

fat distribution, skin tags, and acanthosis nigricans. Examination of androgen- sensitive skin areas such as the face, chest, abdomen, and back provide an assessment of the degree of hirsutism and can be used to chart patient progress over time; Ferriman–Gallwey scoring can be done if desired. Modified Ferriman–Gallwey (Fig. 2) scoring evaluates nine areas of the body; a score greater than 8 is indicative of hirsutism (3). Grading systems for acne include quantity (mild, moderate, or severe (...) . c Monitoring serum androgens is not recommended. Introduction Although androgen excess can manifest in many ways, the most common and recognizable symptoms are hirsutism and acne. (Alopecia also may be a symptom.) Hirsutism affects 5–10% of reproductive-aged females and is defined as excessive terminal hair growth in a distribution typically seen in adult men (face, sternum, lower abdomen, back, and thighs) (1). Acne vulgaris is a multifactorial skin con

2019 American College of Obstetricians and Gynecologists

106. Canadian guideline on genetic screening for hereditary renal cell cancers

path- ways. 9 BHDS is manifest by a triad of dermatological find- ings: fibrofolliculomas, trichodiscomas and acrochordons (skin tags). Only fibrofolliculomas are specific for BHDS. These typically appear in the third to fourth decade of life. Pulmonary cysts and pneumothorax can develop in 20% of patients. Affected individuals are known to develop various types of RCC, including oncocytic, chromophobe and, less commonly, clear cell and papillary histologies. Metastatic potential is usually low (...) type 2 RCC Chromophobe RCC/oncocytic RCC Epithelial (various) or mesenchymal (angiomyo-lipoma) Clear cell RCC Gene VHL MET FH FLCN TSC1 TSC2 SDHB SDHC SDHD Germline testing Yes Yes Yes Yes Yes Yes Target organs Renal tumours CNS hemangioblastomas Retinal hemangiomas Adrenal pheochromocytoma/ paraganglioma Pancreatic neuroendocrine tumours Endolymphatic sac tumours Epididymal cystadenomas Broad-ligament tumours Renal only Skin leiomyomas Renal tumours Uterine leiomyomas Skin fibrofolliculomas

2018 Canadian Urological Association

107. Acanthosis nigricans

age >40 years child/young adult female gender acrochordons (skin tags) acral distribution pruritus mucosal or palmoplantar lesions weight loss obesity insulin resistance positive FHx of AN or genetic syndrome FHx of diabetes mellitus malignancy medication Diagnostic investigations fasting blood glucose fasting blood insulin abdominal CT skin biopsy Treatment algorithm ONGOING Contributors Authors Consultant Dermatopathologist Southern California Permanent Medical Group Sunset Medical Center Los (...) Acanthosis nigricans Acanthosis nigricans - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Acanthosis nigricans Last reviewed: February 2019 Last updated: December 2017 Summary A benign skin disease that often reflects underlying medical conditions. Most commonly associated with obesity and insulin resistance. Some cases are associated with underlying malignancy and, where no other association is identified

2017 BMJ Best Practice

108. Appropriate care at the end of life

, includes all different types of documents, and is not intended to analyse nor synthesize strength of evidence for interventions, the documents were not assessed on their methodological rigour. 2.2.6 Data extraction The included documents were first categorized and tagged in Endnote into (not mutually exclusive) categories: ? Definitions/descriptions ? Prevalence ? Determinants, causing/contributing factors ? Consequences ? Interventions Because of the textual character of the elements of relevance

2018 Belgian Health Care Knowledge Centre

109. Immunoglobulin infusions: intravenous and subcutaneous

Immunoglobulin infusions: intravenous and subcutaneous Immunoglobulin infusions: intravenous and subcutaneous | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Immunoglobulin infusions: intravenous and subcutaneous Immunoglobulin infusions: intravenous and subcutaneous ) ( ). In addition, it can be used as supportive therapy for secondary immunodeficiency where extrinisic factors such as chemotherapy cause damage to the immune system, eg following stem cell (...) in children under two. The thighs become more muscular as the child gets older ( ). The abdomen is preferred in older children/young people as the skin is more pliable and allows larger volumes to be infused ( ). Trial and error may be required until best site and infusion time is identified for a particular patient. Choice of site may change with weight gain/loss and dose adjustment. Remove the local anaesthetic cream (if used) five minutes before the needles are inserted ( ). Draw up the immunoglobulin

2017 Publication 1593

110. Specimen collection – microbiology and virology

Specimen collection – microbiology and virology Specimen collection – microbiology and virology | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Specimen collection – microbiology and virology Specimen collection – microbiology and virology Microbiological and virological laboratory testing has a key role in the management of children with infection. Accurate and rapid identification of significant microorganisms is vital for guiding optimal antimicrobial (...) acids found on the skin. For virology specimen, a viral transport medium should be used as many viruses do not survive well outside the body. This can be obtained from the Virology Laboratory, Level 4 Camelia Botnar Laboratories. It may be stored at room temperature on theward, but should only be used for viral investigation. The viral transport medium must not be used after the expiry date. Samples submitted for bacterial polymerase chain reaction (PCR) should NOT be in transport medium. Transport

2017 Publication 1593

111. Peripheral venous cannulation of children

Peripheral venous cannulation of children Peripheral venous cannulation of children | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Peripheral venous cannulation of children Peripheral venous cannulation of children ). Peripheral cannulation provides access for the purpose of intravenous hydration, feeding, and administration of medication and blood products. A cannula is a flexible tube containing a needle (stylet), which may be inserted (...) equipment protecting key-parts using ANTT (aseptic non-touch technique) on a clean tray that has been disinfected with a 70% isopropyl alcohol wipe (eg Sani-Cloth 70 ® ) Select the correct size and type of cannula for the child. Selection should be based upon the needs of the patient and the intended use and position of the cannula ( )( ). Prepare personal protective clothing, ie clean gloves and apron ( ). Gloves should be of a comfortable fit but tight to the skin, particularly at the fingertips

2017 Publication 1593

112. Epidermolysis bullosa (EB): management of the newborn infant with EB

Epidermolysis bullosa (EB): management of the newborn infant with EB Epidermolysis bullosa (EB): management of the newborn infant with EB | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Epidermolysis bullosa (EB): management of the newborn infant with EB Epidermolysis bullosa (EB): management of the newborn infant with EB ). Infants with EB are nursed in their local neonatal unit (there is no need to transfer to specialised centres) and managed (...) as outreach ( ). The Great Ormond Street Hospital (GOSH) EB Clinical Nurse Specialist team delivers an outreach service. These guidelines are intended to support practitioners looking after infants with EB and to improve the care and safety of this group of patients. Background There are four major types of EB, each with different clinical outcomes. The common factor is an extreme fragility of the skin and mucous membranes ( ). The type of EB is determined by analysis of a skin biopsy. Regardless of type

2017 Publication 1593

113. Topical NSAIDs versus Opioids for Acute Musculoskeletal Pain: A Review of the Clinical Effectiveness

-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the comparative clinical effectiveness of topical NSAIDs versus opioids for the treatment of acute musculoskeletal pain? Key Message Compared with placebo, topical NSAIDs were effective in reducing pain from acute musculoskeletal conditions, such as sprains, strains or sport injuries. Adverse events were rare and were usually related to skin reactions. No evidence regarding (...) the comparative clinical effectiveness of topical NSAIDs versus opioids could be identified. Tags anesthesia, administration, topical, anti-inflammatory agents, non-steroidal, musculoskeletal pain, musculoskeletal Files In Brief Published : June 28, 2017 Rapid Response Summary with Critical Appraisal Published : January 30, 2017 Related Content Follow us: © 2019 Canadian Agency for Drugs and Technologies in Health Get our newsletter:

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

114. Diagnosis, staging and treatment of patients with oesophageal or oesophago-gastric junction cancer

cancer (excluding non-melanoma skin cancer) (National Cancer Registry Ireland (NCRI), 2018b). Cancer is the second leading cause of death in Ireland after diseases of the circulatory system. Deaths from cancer averaged about 8,875 deaths per year during 2013-2015, representing about 30.7% of all deaths in 2016 (NCRI, 2018b). Oesophageal cancer was ranked the sixth most common cause of cancer deaths in Ireland 2013-2015, with an average of 387 deaths annually from 2013-2015 (NCRI, 2018b). Cancer (...) incidence data from the NCRI and population projections from the Central Statistics Office (CSO) have been combined by the NCRI to estimate the number of new cancer cases expected in five year bands from 2020-2045. The total number of new invasive cancer cases (including non-melanoma skin cancer) is projected to increase by 84% for females and 111% for males between 2015 and 2045, based only on changes in population size and age distribution (demography). The incidence of oesophageal cancer in Ireland

2018 Health Service Executive (Ireland) - Clinical Guidelines

115. Varicella zoster virus and pregnancy

Varicella zoster virus and pregnancy 1 Varicella zoster virus and pregnancy DSOG (Danish Society of Obstetrics and Gynecology) Approved on January 2018 by the participants at the yearly obstetric guideline meeting in DSOG Page 1-3: English summary Page 4-21: The entire guideline in Danish including references 1. How to diagnose maternal VZV infection Recommendations Grade The diagnosis of a varicella zoster virus (VZV) infection is generally based on the typical skin manifestations ? v (...) The diagnosis can be based on the detection of specific antibodies (IgM & IgG) ? v The diagnosis can be based on the use of PCR to detect VZV DNA in skin lesions ? v 2. What is the risk for the fetus when the mother is VZV-infected in pregnancy? Recommendations Grade The pregnant woman should be advised that the risk of spontaneous abortion is not increased in the case of first trimester VZV infection ? C The pregnant woman should be informed about the small risk for the unborn to develop fetal varicella

2018 Nordic Federation of Societies of Obstetrics and Gynecology

116. Guidelines for the Management of Genital, Anal and Throat HPV Infection in New Zealand

contagiosum). For many patients, the psychological impact of warts is significant. If the diagnosis is uncertain, it is useful to get a second opinion (either from a colleague or a specialist). The differential diagnosis of genital warts includes: • Normal anatomic variants in women such as vestibular papillae, prominent sebaceous glands (Fordyce spots) and skin tags (acrochordans). • Normal anatomic variants in men such as sebaceous glands (Tyson’s glands), pearly penile papules, skin tags, angiofibroma (...) acuminata). HPV infects the penis, scrotum, perineum, anal canal, perianal skin, vaginal introitus, vulva, cervix. • Squamous intraepithelial lesions (SILs) of the vagina, cervix, anus, penis. HPV infection has been clearly linked to nearly all SILs and cancers of the cervix and anus. HPV is also linked to a subset of penile, vulval and vaginal cancer. • Oropharyngeal cancer (see page 23). • Infection of respiratory mucosa also occurs, particularly but not exclusively in children. Subclinical HPV

2017 New Zealand Sexual Health Society

117. Management of Hemorrhoids

office-based procedures, those who have grade III or IV hemorrhoids, or patients with substantial concomitant skin tags. In a meta- analysis of 18 randomized prospective studies comparing hemorrhoidectomy with office-based procedures, hemor - rhoidectomy was the most effective treatment for patients with grade III hemorrhoids. However, it was associated with increased pain and the highest complication rates. 20 Either open or closed hemorrhoidectomy can be performed with a variety of surgical devices

2018 American Society of Colon and Rectal Surgeons

118. Natural Sheepskins for Prevention or Treatment of Pressure Ulcers: Clinical Effectiveness. Cost-Effectiveness, and Guidelines

are the evidence-based guidelines regarding the use of natural sheepskins for the treatment of pressure ulcers in adults with impaired mobility? Key Message Four systematic reviews and three evidence-based guidelines were identified regarding natural sheepskins for the prevention or treatment of pressure ulcers in adults with impaired mobility. Tags wounds and injuries, pressure ulcer, sheep, skin ulcer, wool, medical devices, Medical, lambswool, bedsore, bedsores, Dressing, dressings Files Rapid Response

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

119. Soaker Pads for Residents in Long Term Care: Clinical Evidence and Guidelines

Result type: Report Question What is the clinical evidence regarding disposable soaking pads and skin breakdown for residents in long term care facilities? What are the evidence-based guidelines regarding disposable soaking pads for residents in long term care facilities? Key Message One evidence-based guideline was identified regarding the use of soaker pads for residents in long term care. Tags geriatrics, kidney, absorbent pads, homes for the aged, housing for the elderly, incontinence pads (...) , nursing homes, pressure ulcer, urinary incontinence, bed sore, skin lesion, residential care, underpads Files Rapid Response Summary of Abstracts Published : November 14, 2017 Follow us: © 2019 Canadian Agency for Drugs and Technologies in Health Get our newsletter:

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

120. Linezolid for the Treatment of Infections: A Review of the Clinical and Cost-Effectiveness

Report Type: Peer-reviewed summary with critical appraisal Result type: Report Question What is the comparative clinical effectiveness of linezolid to vancomycin or daptomycin in the treatment of bacteremia, bone and joint infections, skin and soft tissue infections, and pneumonia caused by methicillin-resistant staphylococcus aureus (MRSA)? What is the comparative clinical effectiveness of linezolid to daptomycin in the treatment of bacteremia, bone and joint infection, infective endocarditis, intra (...) -abdominal infections, and skin and soft tissue infections caused by vancomycin-resistant enterococci (VRE)? What is the cost-effectiveness of using intravenous or oral linezolid compared to daptomycin for the treatment of methicillin-resistant staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE)? What is the comparative clinical effectiveness of oral versus intravenous linezolid for the treatment of infections? What is the cost-effectiveness of oral versus intravenous linezolid

2017 Canadian Agency for Drugs and Technologies in Health - Rapid Review

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