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Tongue Carcinoma

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1501. British guideline on the management of asthma

patients with a diagnosis of asthma, although there is less evidence available for people at either age extreme. The guideline does not cover patients whose primary diagnosis is not asthma, for example those with chronic obstructive pulmonary disease (COPD) or cystic fibrosis, but patients with these conditions can also have asthma. Under these circumstances many of the principles set out in this guideline will apply to the management of their asthma symptoms. 1.2.2 Target users of the guideline (...) to withdraw the treatment. 3 | Diagnosis24 British guideline on the management of asthma Table 4: Clinical clues to alternative diagnoses in wheezy children Clinical clue Possible diagnosis Perinatal and family history Symptoms present from birth or perinatal lung problem Cystic fibrosis; chronic lung disease of prematurity; ciliary dyskinesia; developmental lung anomaly Family history of unusual chest disease Cystic fibrosis; neuromuscular disorder Severe upper respiratory tract disease Defect of host

2019 SIGN

1502. Evidence Brief - Barriers and Facilitators to Use of Medications for Opioid Use Disorder

and the general community despite evidence of their effectiveness and guidelines from the Veterans Affairs/Department of Defense (DoD), Centers for Disease Control & Prevention (CDC), and the Key Findings · We did not identify VHA studies on barriers or facilitators to use of medications for opioid use disorder (OUD) published since 2014. This review focuses on 16 studies that have the most VHA applicability. Most of these studies discussed buprenorphine/naloxone, but not extended-release naltrexone. · The 4 (...) , and it is therefore thought to have a lower risk of overdose. 5 Evidence Brief: Barriers and Facilitators to Use of Medications for OUD Evidence Synthesis Program 5 Buprenorphine used for OUD treatment is a higher dose than buprenorphine formulations approved to treat chronic pain and is typically co-formulated with naloxone, which helps deter misuse by causing opioid withdrawal if the medication is crushed and injected or snorted instead of being used under the tongue as prescribed. Buprenorphine is also

2019 Veterans Affairs Evidence-based Synthesis Program Reports

1503. Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines: January to June 2019

with radiotherapy with or without concurrent systemic therapy, FDG PET/CT is an improvement over MRI in detecting residual disease [31]. Likewise, FDG PET/CT is highly sensitive (92.3%) for the diagnosis and highly accurate (90.4%) for the preoperative staging of tongue squamous cell carcinoma [32]. Hematologic Cancer Five studies met the inclusion criteria [33-37]. Two phase II trials examined the interim PET response-adapted strategy in patients with advanced stage Hodgkin lymphoma [33,34]. In the GOELAMS LH (...) 3724 patients; 4754 scans (22 tumour types) FDG PET/CT, 68 Ga- PSMA-11 PET/CT, 68 Ga- DOTA- TATE PET/CT, 11 C- Choline, 18 F-FET PET/CT, 11 C- Methionin e PET/CT Not specified Pre- and post- questionnaire NA NA PET/CT resulted in a change in management in 37.1% (1763/4754) of examinations (1456—non- treatment to treatment, 307—treatment to non- treatment). Caspersen et al, 2019 [71] Retrospective 93 patients (suspected serious disease or occult cancer) FDG PET/CT NA Biopsy, follow- up Malignancy

2019 Cancer Care Ontario

1504. HIV infection and AIDS: HIV diagnosis in people with symptoms

loss of vision but is treatable and prognosis improves with earlier diagnosis. Symptoms include floaters (due to inflammatory cells in the vitreous), reduced vision, flashing lights, and scotomas. Multiple granular white dots with retinal haemorrhages may be noted on fundoscopy. Cancers HIV infection is associated with an increased risk of malignancies many of which are associated with advanced HIV disease such as Kaposi's sarcoma, non-Hodgkin's lymphoma, and invasive cervical cancer. Lymphoma (...) as vesicles, then ulcerate and crust. See the CKS topic on for further information. Gastrointestinal conditions HIV infection may cause: Oesophageal candidiasis Symptoms include retrosternal pain or dysphagia, and oral candidiasis is also likely to be present. Diarrhoea This is very common and is usually due to virulent organisms or opportunistic infections. Bacteria, protozoa (such as Cryptosporidium species which indicates advanced HIV disease when persistent), Mycobacteria, viruses, cancers

2020 NICE Clinical Knowledge Summaries

1505. Evidence Map - Aromatherapy and Essential Oils

intercourse, avoiding intimacy Sleep, critical care/ICU 34 --- Sleep Sleep quality Sleep, various populations 35 Samples included mostly healthy volunteers, and some patients with insomnia or ischemic heart disease Sleep Sleep quality Stress, healthy adults 36 --- Psychological Stress Stress, nurses 37 --- Psychological Work-related stress Symptom relief, burn patients 20 --- Psychological Anxiety Physical Pain Sleep Sleep quality Symptom relief, cancer 21 Samples included patients with various forms (...) Anxiety Anxiety, various populations 19 Samples included patients with clinical anxiety, other health conditions or settings (eg, cancer, perioperative, ICU, colonoscopy), or healthy volunteers Psychological Anxiety Complications, hemodialysis 24 --- Psychological Anxiety; depression; stress Physical Fatigue, pruritis Global QOL Sleep Sleep quality Depressive symptoms, various populations 22 Only 1 of 8 eligible studies targeted patients with depression or anxiety. The others enrolled healthy

2019 Veterans Affairs Evidence-based Synthesis Program Reports

1506. Palliative care - oral: Scenario: Prevention

[ ]. There is evidence that treatment with oral antifungal drugs that are completely or partially absorbed from the gastrointestinal tract is effective in preventing oral candidiasis in people with cancer receiving chemotherapy and/or radiotherapy. There is no evidence on the effect of prevention of oral candidiasis on general well-being or that effective prophylaxis is associated with a reduction in systemic disease. Little evidence is available on drug toxicity and development of microbial drug resistance (...) with fluoride is often better tolerated. Rinse the mouth after each meal and at night with warm water or 0.9% sodium chloride solution (ready made or made up). Irrigation with warm water or 0.9% sodium chloride solution helps to remove oral debris and is soothing and nontraumatic. Sodium chloride solution can be made for each rinse by dissolving half a 5 mL teaspoon of salt in 225 mL water. If the tongue is heavily furred (especially if causing distress), brush with a soft toothbrush twice a day and use

2020 NICE Clinical Knowledge Summaries

1507. Clinical Guidance Summary for Pediatric Patients with MIS-C Associated with SARS-CoV-2 and Hyperinflammation in COVID-19

reflects currently available evidence coupled with expert opinion but is meant to be modified as additional data become available. The recommendations provided in this document do not replace the importance of clinical judgment tailored to the unique circumstances of an individual patient. Methods The multidisciplinary Task Force was composed of 9 pediatric rheumatologists, 2 adult rheumatologists, 2 pediatric cardiologists, 2 pediatric infectious disease specialists, and 1 pediatric critical care (...) with COVID-19 present with mild symptoms and have excellent outcomes. MIS-C remains a rare complication of SARS-CoV-2 infections (H). • MIS-C is temporally associated with SARS-CoV-2 infections. Therefore, the prevalence of the virus in a given geographic location, which may change over time, should inform management decisions (M). Diagnostic evaluation of MIS-C: • A child under investigation for MIS-C should also be evaluated for other infectious and non-infectious (e.g., malignancy) etiologies that may

2020 American College of Rheumatology

1508. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19

Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19 Last updated September 25, 2020 and posted online at Please check website for most updated version of these guidelines. Version 3.3.0 Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19 Authors Adarsh Bhimraj 1 , Rebecca L. Morgan 2 , Amy Hirsch Shumaker 3 , Valery Lavergne 4 , Lindsey Baden 5 (...) , Vincent Chi-Chung Cheng 6 , Kathryn M. Edwards 7 , Rajesh Gandhi 8 , Jason Gallagher 9 , William J. Muller 10 , John C. O’Horo 11 , Shmuel Shoham 12 , M. Hassan Murad 13 , Reem A. Mustafa 14 , Shahnaz Sultan 15 , Yngve Falck-Ytter 3 Affiliations 1 Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio 2 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario 3 VA Northeast Ohio Healthcare System, Case Western Reserve University School

2020 Infectious Diseases Society of America

1509. Endovascular Aortic Repair of Aneurysms Involving the Renal-Mesenteric Arteries (FEVAR) Full Text available with Trip Pro

Valiant Thoracic Stent Graft. J Vasc Surg. 2017; 66 : 335-342 ) In patients with complex aortic aneurysms that do not fit the basic anatomical requirements consistent with the Instructions for Use (IFU) of available devices , a variety of innovative techniques have been described to expand the indications of EVAR and TEVAR.( Ouriel K. Fowl R.J. Davies M.G. Forbes T.L. Gambhir R.P. Ricci M.A. et al. Disease-specific guidelines for reporting adverse events for peripheral vascular medical devices. J Vasc (...) function). This should be conditioned by the surgeon’s experience and the endovascular environment and resources available. The extent of aneurysmal disease and a comprehensive clinical risk assessment should be integral components of reports addressing complex aortic aneurysms to allow for a meaningful comparison between reports evaluating various and diverse techniques. In general, most patients with complex aortic aneurysms undergo a comprehensive pre-operative medical evaluation that is guided

2020 Society for Vascular Surgery

1510. Nutrition screening and use of oral nutrition support for adults in the acute care setting

temperature spikes - Wet voice quality - Tongue fasciculation (may be indicative of motor neurone disease) - Xerostomia - Heartburn - Change in eating habits - for example, eating slowly or avoiding social occasions - Frequent throat clearing - Recurrent chest infections - Atypical chest pain6 | Nutrition screening and use of oral nutrition support for adults in the acute care setting | National Clinical Guideline Recommendation 12 Healthcare professionals should recognise that people with acute (...) Screening Tool (MUST) had a positive risk score for malnutrition, with 74% in the high risk category. Malnutrition risk was common in all age groups and diagnostic categories with no significant difference between men and women when adjusted for age. However, risk increased with age, and prevalence was higher in those with gastrointestinal disease (48%), respiratory disease (38%) and neurological disease (32%). It was also higher in patients with cancer than those without (44% versus 34%) and in those

2020 National Clinical Guidelines (Ireland)

1511. Diarrhoea - adult's assessment: Scenario: Acute diarrhoea (less than 4 weeks)

a rectal examination to assess for rectal tenderness, stool consistency, and for blood, mucus, and possible malignancy. If acute causes have been excluded and the person has features suggestive of an early presentation of a , see . Clinical features of dehydration Mild dehydration Lassitude. Anorexia, nausea. Light-headedness. Postural hypotension. Usually no signs. Moderate dehydration Apathy/tiredness. Dizziness. Nausea/headache. Muscle cramps. Pinched face. Dry tongue or sunken eyes. Reduced skin (...) , which is often present in inflammatory bowel disease, irritable bowel syndrome, and ischaemic colitis. History of recent radiation treatment to the pelvis. Factors increasing the risk of immunosuppression (for example, human immunodeficiency virus infection, long term steroid use, or chemotherapy). Any surgery or medical conditions (for example, endocrine disease) accounting for the diarrhoea. Diet and use of alcohol or substances such as sorbitol. Assess for complications of diarrhoea

2020 NICE Clinical Knowledge Summaries

1512. Psychosis and schizophrenia: Adverse effects

be relieved by reducing the dose of the antipsychotic. Tardive dyskinesia — late-onset movement disorder that can occur with prolonged use of antipsychotics. It is characterized by rhythmical, involuntary movements, usually lip-smacking and tongue rotating, although it can affect the limbs and trunk. It may be persistent and can sometimes worsen on treatment withdrawal. The drug should be discontinued on appearance of early signs. Weight gain — common with all antipsychotics, but more frequent with second (...) levels at least annually. People taking antipsychotics who experience palpitations or any other symptoms that suggest cardiac disease should undergo electrocardiography. Stroke risk — olanzapine and risperidone are associated with an increased risk of stroke in elderly people with dementia. The Committee on Safety of Medicines has advised [ ] that: For acute psychotic conditions in elderly people with dementia, risperidone should be limited to short-term use under specialist advice. Olanzapine

2020 NICE Clinical Knowledge Summaries

1513. Guideline on the management of patients with giant cell arteritis Full Text available with Trip Pro

ischaemia such as visual loss or diplopia and no immediate access to phlebotomy. What evaluations should be performed soon after starting treatment for GCA? 5. Patients treated for GCA should be evaluated for features of the disease relevant to the prognosis, such as clinical and laboratory features of a marked inflammatory response at diagnosis, ischaemic manifestations such as transient visual loss or jaw/tongue claudication and signs or symptoms indicating involvement of the aorta and its proximal (...) claudication [ ]. Visual loss or stroke may occur in GCA, attributed to vascular occlusion; most GCA-associated visual loss occurs prior to glucocorticoid treatment or shortly after treatment initiation, underlining the importance of immediate treatment if the disease is strongly suspected [ , ]. The reported proportion of patients with visual loss in GCA varies depending on the GCA case-finding method and method of ascertainment of visual loss; for example, in a UK study recruiting from a rheumatology

2020 British Society for Rheumatology

1514. Guidance for Return to Practice for Otolaryngology-Head and Neck Surgery: Part Two

medically Skull base malignancy Salivary cancer • Salivary duct carcinoma • High-grade mucoepidermoid carcinoma • Adenoid cystic carcinomaCarcinoma ex pleomorphic adenoma • Acinic cell carcinomaAdenocarcinoma • Other aggressive, high-grade salivary histology Skin cancer • Melanoma > 1 mm thickness • Merkel cell carcinoma • Advanced-stage, high risk squamous cell carcinoma • Basal cell carcinoma in critical area (i.e., orbit) Time Sensitive – Consider Postpone > 30 days Low-risk DTC lower volume (...) without metastasis Low-grade salivary carcinoma Slower growing BCC 5 Routine – Consider Postpone 30 – 90 days; Reassess after pandemic appears to be resolving Thyroid • Goiter without airway/respiratory compromise • Routine benign thyroid nodules and thyroiditis • Revision DTC with low volume, stable or slow rate of progression Parathyroid • HPT with calcium < 12 mg/dL, without active cardiac, renal, or neuromuscular manifestations Benign salivary lesions and tumors Skin cancer • Melanoma = 1mm

2020 American Academy of Otolaryngology - Head and Neck Surgery

1515. Covid-19: Clinical guide to surgical prioritisation during the coronavirus pandemic

of obstructed renal tract Malignant tumour or Lymph node biopsy Peritoneal Dialysis Catheter Insertion Resection of Posterior Urethral Valves Pyloromyotomy Paediatric Orthopaedic surgery Slipped Upper Femoral Epiphysis MDT Directed Suspected bone or soft tissue malignant tumours Fractures - Displaced articular/ peri- articular/ Forearm/Femoral Exposed metalwork Please note Any delay in treatment, especially of cancers, trauma and life threatening conditions, may lead to adverse outcomes. Other Specialist (...) /otherwise unhealed. Removal of prosthesis - unresponsive to conservative Rx. Burns- reconstruction for severe eyelid closure problems/ microstomia/joint and neck contracture MDT Directed Major soft tissue tumour resection (all sites) MDT Directed Skin cancer resection - All sites. Melanoma/ Poorly di?erentiated cancers/nodal disease/compromise of vital structures, including the eye, nose and ear. Urology MDT directed testicular cancer surgery - non- metastatic. MDT directed penile cancer surgery

2020 NHS England

1516. Tocilizumab use in paediatric and adolescent rheumatology Information for health professionals

that this risk is real, although it has also been suggested that the autoimmune disease itself is associated with a small increase in the rate of malignancy (as occurs in adults). It is important that doctors discuss with the families the risk and benefit profile associated with the use of these drugs (PRINTO 2016). Blood monitoring and follow-up schedule: The paediatric and adolescent rheumatology clinical affairs committee acknowledges that the monitoring schedule listed in this document differs from (...) (NSAIDs) and systemic corticosteroids and methotrexate. § Polyarticular course juvenile idiopathic arthritis (pcJIA): by either IV infusion or S/C injection for treating juvenile idiopathic polyarthritis (rheumatoid factor positive or negative, and extended oligoarthritis) in patients two years and older whose disease has responded inadequately to methotrexate (this is defined as 15mg/m2 given subcutaneously once-weekly for at least three months). N.B. Tocilizumab is recommended only if the companies

2020 British Society for Rheumatology

1517. Treatment of Patients with Schizophrenia

, and physical conditions, such as cardiovascular, respiratory, and infectious diseases and malignancies, particularly lung cancer (American Psychiatric Association 2013a; Hayes et al. 2017; Heilä et al. 2005; Hjorthøj et al. 2017; Laursen et al. 2014; Lee et al. 2018; Oakley et al. 2018; Olfson et al. 2015; Tanskanen et al. 2018; Walker et al. 2015). Increases in morbidity and mortality related to physical health in individuals with schizophrenia are likely associated with factors such as obesity, diabetes (...) of Disease IPS Individual placement and support LAI Long-acting injectable MD Mean difference NICE National Institute for Health and Care Excellence NMS Neuroleptic malignant syndrome NNH Number needed to harm NNT Number needed to treat NQF National Quality Forum OR Odds ratio PANSS-6 Positive and Negative Syndrome Scale, 6 item version 11 PANSS-30 Positive and Negative Syndrome Scale, 30 item version PORT Schizophrenia Patient Outcomes Research Team PROMIS Patient-Reported Outcomes Measurement

2020 American Psychiatric Association

1518. Nosebleed (Epistaxis) Full Text available with Trip Pro

, as the guideline development group (GDG) felt that very young, otherwise healthy children rarely required evaluation for nosebleeds. The group also recognized that literature informing treatment of nosebleeds in infants and toddlers was scant. Additionally, while bleeding from the nose may occur secondary to a variety of systemic diseases and head and neck disorders, this guideline does not apply to patients who have a diagnosed bleeding disorder, tumors of the nose or nasopharynx, vascular malformations (...) , crusting from nasal inflammation, or nasal foreign bodies. Persistent or recurrent nasal bleeding in adolescent males, particularly unilateral nosebleed in the presence of nasal obstruction, could suggest the diagnosis of juvenile nasopharyngeal angiofibroma, an uncommon histologically benign but locally invasive vascular tumor. A recent study of emergency department databases in 4 states showed that children who presented with epistaxis had a mean age of 7.5 years and 57.4% were male. Procedures

2020 American Academy of Otolaryngology - Head and Neck Surgery

1519. Guidelines on Chronic Coronary Syndromes Full Text available with Trip Pro

8.1.2 Valvular heart disease (including planned transcatheter aortic valve implantation) 44 8.1.3 After heart transplantation 44 8.2 Non-cardiovascular comorbidities 45 8.2.1 Cancer 45 8.2.2 Diabetes mellitus 45 8.2.3 Chronic kidney disease 46 8.2.4 Elderly 46 8.3 Sex 46 8.4 Patients with refractory angina 47 9. Key messages 48 10. Gaps in the evidence 49 10.1 Diagnosis and assessment 49 10.2 Assessment of risk 49 10.3 Lifestyle management 49 10.4 Pharmacological management 49 10.5 Revascularization (...) Recommendations for investigations in patients with suspected vasospastic angina 42 Recommendations for screening for coronary artery disease in asymptomatic subjects 43 Recommendations for hypertension treatment in chronic coronary syndromes 44 Recommendations for valvular disease in chronic coronary syndromes 44 Recommendations for active cancer in chronic coronary syndromes 45 Recommendations for diabetes mellitus in chronic coronary syndromes 45 Recommendations for chronic kidney disease in chronic

2019 European Society of Cardiology

1520. Guideline: Perinatal care of the extremely preterm baby

Oral (directly onto tongue) 0.25 mL (optimal dose uncertain) 78 Paracetamol 75 Oral 15 mg/kg every 6–8 hours Rectal Morphine 75 Oral 80–200 microgram/kg every 4 hours IV injection 50 microgram/kg every 4–6 hours Titrate dose as required SC injection IV infusion 10 microgram/kg/hour Fentanyl 75 Intranasal (via atomiser) 79 1.5 microgram/kg SC injection 1 microgram/kg every 2–4 hours IV injection IV infusion 1 microgram/kg/hour Titrate dose as required Midazolam 79 Intranasal 0.2–0.3 mg/kg Buccal IV

2020 Queensland Health

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