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141. Prosthetic and Amputee Rehabilitation - Standards and Guidelines (3rd Edition)

. Extensive use was also made of pre-existing reviews especially previously published guidelines and standards and their supportive evidence. The working party decided not to label each standard with a formal level of evidence tag because of the recognised problems of these levels of evidence for standards in rehabilitation. 1.17 This report cannot be directive and it is not within the remit of the report to designate the status of any provider unit. However, it is hoped that the recommendations

2018 British Society of Rehabilitation Medicine

142. Commissioning guide for rectal bleeding

haemorrhoids should be given advice about topical treatment, oral fluid intake, high fibre diet and fibre supplementation. 12 Consideration should be given to referral to a specialist community or secondary care provider of colorectal services if symptoms persist/alter or are particularly troublesome. An acute anal fissure is a tear in the skin of the anal canal, and may be treated with dietary advice and a bulking agent. Topical glyceryl trinitrate (GTN) 0.4% ointment should be considered for chronic (...) each dosage form, and prices can vary on a month to month basis and should be regularly checked. Anal fissures with an atypical appearance or a clinical appearance of chronicity such as scarring or tags suggests referral to secondary care may be needed as topical treatments are unlikely to be effective. Low risk patients with rectal bleeding who are concerned about colorectal malignancy should be Commissioning guide 2017 Rectal Bleeding 9 considered for direct access (direct to test) flexible

2018 Association of Coloproctology of Great Britain and Ireland

143. CRACKCast E098 – Sexually Transmitted Infections

ulcers Genital herpes Primary syphilis Chancroid Lymphogranuloma venereum (rare) Granuloma inguinale (rare) Neoplasm/Trauma Genital discharge Gonorrhea Chlamydia Nongonococcal urethritis (NGU) Pelvic inflammatory disease (PID) Trichomoniasis Bacterial vaginosis Epithelial cell lesions Genital warts Secondary syphilis Molluscum contagiosum Neoplasm Nevi Skin tags Ectoparasites Pubic lice Scabies Body/Head lice Mites (chiggers) Ticks Question 2) List the differential diagnosis of painful and painless (...) symptoms of itching, burning, and paresthesias common prior to development and skin and mucosal lesions. Duration Generally lasts 2-4 weeks if untreated before spontaneous resolve. Generally shorter duration than primary with decreasing frequency and severity over time. Question 4) List 4 techniques for the diagnosis of herpes and how it is managed? Clinical: History of similar lesions in same distribution supports clinical diagnosis though insensitive and nonspecific. PCR diagnostic test of choice

2017 CandiEM

144. BSR guideline Management of Adults with Primary Sjögren's Syndrome Full Text available with Trip Pro

[ ]. In general the use of topical steroids should be limited to patients under supervision by an ophthalmologist. For longer term use ciclosporin-containing eye drops have been shown to reduce subjective symptoms and improve objective signs of inflammation in patients with both primary and secondary SS [ ]. Ciclosporin 0.1% (Ikervis®) is licensed and NICE approved as a possible treatment for people with dry eye disease that has not improved despite treatment with artificial tears (NICE TAG 369 December 2015

2017 British Society for Rheumatology

145. CRACKCast E095 – Large Intestine

* Clinical features (differences are underlined!) ● Abdo pain ● Tenesmus ● Bloody diarrhea (4-6 or more stools per day) ● Weight loss ● Rectal bleeding ● Pallor / fatigue ● Abdo pain ● Tenesmus ● Bloody diarrhea (4-6 or more stools per day) ● Nausea / vomiting ● Nocturnal diarrhea ● Fissures ● Anorectal abscesses ● Ulcerated hemorrhoids ● Strictures ● Growth and pubertal delay in children ● Weight loss ● Rectal bleeding ● Pallor / fatigue ● Peri-anal skin tags ● Dry mucous membranes 9) List 4 categories (...) Management: Cecal: surgery (open vs laparoscopic) Sigmoid: endoscopic reduction versus surgery 4) List 3 Perianal complications and 6 Extra-intestinal manifestations of Crohn’s disease. Perianal: Anal Fissures Skin tags Perianal Fistula Anorectal Abscess Anal Stenosis Ulcerated Hemorrhoids Elevated risk for adenocarcinoma in fistula tract and recurrent stenosis Extra-intestinal MSK (Arthritis, ankylosing spondylitis, isolated joint, Hypertrophic osteoarthropathy – Clubbing, periostitis) Miscellaneous

2017 CandiEM

146. CRACKCast E096 – Anorectal Disorders

! Managed Medically using the WASH approach. ● Warm water sitz ● Analgesia ● Stool softeners ● High fiber diet See below Usually can be managed supportively as well. (they will ulcerate and ooze dark blood in a few days). But, if within 72 hrs of onset of symptoms, they can have the clot EXCISED. Be sure to warn patients that excision will lead to evacuation of the clot, but also rebleeding, swelling and the formation of a skin tag. People that are bad candidates for this: kids, pregnant women (...) common in the midnight summer… Causes: Focal Dermatitis Feces on the perianal skin fecal irritation Usually associated with obesity, deep perineal clefts, hair, hemorrhoids, skin tags, fistulae, Poor hygiene – tight non-breathable clothing Systemic causes: Tea, coffee, beer, spicy foods, citrus fruits, IV hydrocortisone, colchicine, tetracyclines. Contact dermatitis from topical anesthetics (lidocaine), topical corticosteroids, perfumed soap Systemic diseases Derm: Psorasis Lichen sclerosus Non

2017 CandiEM

148. Early pregnancy loss

to MFM for follow-up— direct injection of potassium chloride may be indicated Advice for women • Refer to Section 1.2 for information/advice requirements • Provide information about usual cytotoxic precautions post treatment with methotrexate • Avoid: o Sun exposure (to limit skin inflammation) o Foods and vitamins containing folate/folic acid • Advise: o Pelvic examination and sexual intercourse carry risk of rupture in acute phase of resolution o Common side effects of methotrexate include: nausea (...) • Offer options to include extended family (e.g. photographs of family groups, relatives/siblings) Mementos • Suggestions to support memory creation include: o Apply for an EPL recognition certificate from the Department of Births, Deaths, Marriages and Divorces 94 o Create a keepsake box to keep sentimental items in o Collect mementos such as USS photos, initial positive pregnancy test, hospital identification tags, cot card, sympathy cards, toys or clothes that had been purchased for the baby o Name

2017 Queensland Health

149. Diagnosis, Assessment and Management of Constipation in Advanced Cancer: ESMO Clinical Practice Guidelines

Perineal inspection Digitalrectal examination Distension Abdominal masses Liver enlargement Tenderness Increased/decreased bowel sounds Skin tags Fissures Prolapse Anal warts Perianal ulceration Inner haemorrhoids Sphincter tone Tenderness Obstruction/stenosis Impacted faeces Complete absence of stool Tumour masses Blood Clinical Practice Guidelines Annals of Oncology iv116 | Larkin et al. Volume 29 | Supplement 4 | October 2018 Downloaded from https://academic.oup.com/annonc/article-abstract/29 (...) ] Liquid paraf?n A mineral oil that softens and lubricates the stools. Aspiration may cause lipoid pneumonia [93], anal seepage, skin excoriation and a foreign body reaction if there is a break in the anorectal mucosa. Less effective than PEG OIC, opioid-induced constipation; PEG, polyethylene glycol. Table 7. Enemas: contraindications for use Neutropaenia or thrombocytopaenia Paralytic ileus or intestinal obstruction Recent colorectal or gynaecological surgery Recent anal or rectal trauma Severe

2018 European Society for Medical Oncology

150. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

“chunk” includes a table of related recommendations, a brief synopsis, recommendation-specific supportive text, and when appropriate, flow diagrams or additional tables. References are provided within the modular chunk itself to facilitate quick review. Additionally, this format will facilitate seamless updating of guidelines with focused updates as new evidence is published, as well as content tagging for rapid electronic retrieval of related recommendations on a topic of interest. This evolved

2017 American Heart Association

151. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Gui Full Text available with Trip Pro

. This format also will facilitate seamless updating of guidelines with focused updates as new evidence is published, and content tagging for rapid electronic retrieval of related recommendations on a topic of interest. This evolved format was instituted when this guideline was near completion; therefore the current document represents a transitional formatting that best suits the text as written. Future guidelines will fully implement this format, including provisions for limiting the amount of text

2017 American Heart Association

152. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary Full Text available with Trip Pro

of related recommendations, a brief synopsis, recommendation-specific supportive text, and when appropriate, flow diagrams or additional tables. References are provided within the modular chunk itself to facilitate quick review. Additionally, this format will facilitate seamless updating of guidelines with focused updates as new evidence is published, as well as content tagging for rapid electronic retrieval of related recommendations on a topic of interest. This evolved approach format was instituted

2017 American Heart Association

154. Guidelines for Diagnostic Imaging During Pregnancy and Lactation

) to no MRI (n=1,418,451), there were 19 stillbirths or deaths versus 9,844 in the unexposed cohort (adjusted relative risk [RR], 1.68; 95% CI, 0.97–2.90). The risk also was not significantly higher for congenital anomalies, neoplasm, or vision or hearing loss. However, comparing gadolinium MRI (n=397) with no MRI (n=1,418,451), the outcome of any rheumatologic, inflammatory, or infiltrative skin condition occurred in 123 versus 384,180 births (adjusted hazard ratio, 1.36; 95% CI, 1.09–1.69). Stillbirths (...) and neonatal deaths also occurred more frequently among 7 gadolinium MRI-exposed versus 9,844 MRI unexposed pregnancies (adjusted RR, 3.70; 95% CI, 1.55–8.85). Limitations of the study assessing the effect of gadolinium during pregnancy include using a control group who did not undergo MRI (rather than patients who underwent MRI without gadolinium) and the rarity of detecting rheumatologic, inflammatory, or infiltrative skin conditions ( ). Given these findings, as well as ongoing theoretical concerns

2017 American College of Obstetricians and Gynecologists

155. NASPGHAN Capsule Endoscopy Clinical Report

the procedure, further laboratory or radiologic testing, undergoing SB enteroscopy, CTE, MRE, or exploratory laparoscopy (51). Finally the risks of CE should be disclosed to the family. These may include capsule retention, aspiration, skin or mucosal irritation, vomiting, pain, sore throat, missed lesion, repeat study, or equipment malfunction. If a capsule delivery device is used, then the risks of standard endoscopy are also present (52). Per one of the capsule manufac- turers, hypertension, respiratory (...) (1) Pain; (2) nausea; (3) vomiting; (4) obstruction-capsule retention (2.3%); (5) need for surgical or endoscopic removal; (6) bruising; (7) bleeding; (8) mucosal/skin irritation; (9) aspiration; (10) risks associated with EGD; (11) missed lesion; (12) incomplete Study; (13) need for repeat study; (14) equipment malfunction More thorough investigation of small bowel mucosa for lesion of interest (1) Not doing procedure; (2) surgical evaluation; (3). MR/CT enterography; (4) small bowel enteroscopy

2017 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

156. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Hea Full Text available with Trip Pro

diagrams or additional tables. References are provided within the modular chunk itself to facilitate quick review. This format also will facilitate seamless updating of guidelines with focused updates as new evidence is published, and content tagging for rapid electronic retrieval of related recommendations on a topic of interest. This evolved format was instituted when this guideline was near completion; therefore, the current document represents a transitional formatting that best suits the text

2017 American Heart Association

157. The UK guidelines for management and surveillance of Tuberous Sclerosis Complex Full Text available with Trip Pro

is available should be considered for treatment with an mTOR inhibitor. Those likely to benefit from an mTOR inhibitor according to current evidence are those with progressive deterioration in lung function and those with chylous complications. Skin Skin involvement is common in TSC. Lesions such as facial angiofibromatosis, hypomelanotic macules, shagreen patches, forehead fibrous plaques, skin tags and periungual fibromas are observed in individuals with TSC. Facial angiofibromas can affect approximately (...) or TSC2 lead to over-activation of the mTOR pathway and relatively uncontrolled cell growth that causes growth of benign tumours (hamartomas) in various organs, such as the brain, kidneys, skin, heart, lungs and bones. The management of TSC has varied dependent on treating physician, local and national policies and funding. There are no current UK guidelines. We conducted a Delphi consensus process to reach agreement amongst UK experts on the management of patients with TSC. The Delphi process

2018 Tuberous Sclerosis Association

158. HTA of smoking cessation interventions

with nicotine replacement therapy (NRT) are mild and temporary in nature. Commonly reported side effects include mild skin sensitivity (patch), hiccoughs and gastrointestinal disturbance (gum), local irritation of mouth, nose and throat (inhaler, spray and sublingual tablets). Chest pain and heart palpitations are the only potentially clinically significant serious adverse events to emerge from clinical trials. NRT does not appear to be associated with an increase in serious cardiovascular adverse events

2017 Health Information and Quality Authority

159. European Society of Endocrinology Clinical practice guidelines for the care of girls and women with Turner syndrome

European Society of Endocrinology Clinical practice guidelines for the care of girls and women with Turner syndrome Clinical practice guidelines for the care of girls and women with Turner syndrome: proceedings from the 2016 Cincinnati International Turner Syndrome Meeting in: European Journal of Endocrinology Volume 177 Issue 3 Year 2017 This site uses cookies, tags, and tracking settings to store information that help give you the very best browsing experience. If you don't change your (...) (⨁⨁◯◯). R 6.7. We recommend that, while peripheral edema mostly resolves by 2 years of age without therapy, any serious compromise of fingernails, toenails or extremity skin at any age be assessed and treated by a professional edema therapist (⨁◯◯◯). R 6.8. We recommend dental/orthodontic evaluation at diagnosis if no previous dental/orthodontic care was established. Future management and follow-up should be based on the standard of dental/orthodontic care, individual clinical findings and patient needs

2017 European Society of Endocrinology

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