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Uterine Inversion

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121. Developmental rheumatology in children. Scenario: Clumsy child

pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying foot (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

122. Developmental rheumatology in children. Scenario: Bow legs in children

pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying foot (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

123. Developmental rheumatology in children. Scenario: Tip-toe walking

pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying foot (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

124. Developmental rheumatology in children. Scenario: Curly toes in children

, if there is persistent pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

125. Developmental rheumatology in children. Scenario: Flat feet in children

pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying foot (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

126. Developmental rheumatology in children. Scenario: Growing pains

pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying foot (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

127. Developmental rheumatology in children

, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying foot pathology (for example arthritis (...) , and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community management The recommendation on when community management

2019 NICE Clinical Knowledge Summaries

128. Contraception - progestogen-only methods

guidance from the FSRH (FSRH, 2009) on Progestogen-only pills and Progestogen-only injectable contraception; advice on when to suspect uterine perforation following insertion of an intrauterine device or system has been updated; and the upper age limits on the prescriptions for combined oral contraceptive pills have been changed to 50 years. May 2008 — update to text to reflect new guidance from the FSRH (FSRH, 2008), on progestogen-only implants. April to September 2007 — converted from CKS guidance (...) -operative treatment of moderate to severe symptoms of uterine fibroids. The dose (5 mg daily) is lower than that used for emergency contraception (30 mg as a one-off dose). The manufacturers of Esmya® advise avoiding concomitant use of POPs as they may reduce the efficacy of ulipristal. Basis for recommendation Basis for recommendation These recommendations are based on the Faculty of Sexual and Reproductive Healthcare (FSRH) clinical guidelines, Progestogen-only pills [ ], Drug interactions

2019 NICE Clinical Knowledge Summaries

129. Developmental rheumatology in children. Scenario: Knock knees in children

, if there is persistent pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

130. Developmental rheumatology in children. Scenario: Hypermobility in children

, if there is persistent pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

131. Developmental rheumatology in children. Scenario: Delayed walking in children

, if there is persistent pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

132. Developmental rheumatology in children. Scenario: In-toeing gait in children

, if there is persistent pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

133. Pulmonary embolism

for PE, but might be useful in the differential diagnosis Chest X-ray features that may be present include atelectasis, pleural effusion, or elevation of a hemidiaphragm. ECG signs that may be present include sinus tachycardia, non-specific ST-segment and T-wave abnormalities, right axis deviation, incomplete or complete right bundle-branch block, and, less commonly, T-wave inversion in leads V1–V3, P pulmonale, or the classical S1, Q3, T3 (S wave in lead 1, Q wave in lead 3, and T-wave inversion (...) (for example intracranial, intraspinal, intraocular, retroperitoneal, intra-articular or pericardial, intra-uterine, or intramuscular with compartment syndrome). Causes a fall in haemoglobin level of 20 g/L (1.24 mmol/L) or more. Leads to transfusion of 2 or more units of whole blood or red blood cells. Septic endocarditis. For more detailed information on prescribing tinzaparin, including cautions, adverse effects, drug interactions, and monitoring requirements, see the British National Formulary

2019 NICE Clinical Knowledge Summaries

134. Developmental rheumatology in children. Scenario: Heel pain in children

pain and problems with footwear, although there is no gold standard approach to treatment. [ ] Flat feet Flat feet The prevalence of flat feet is inversely related to age [ ] — flat foot (pes planus) is common in infants and children (97% prevalence in children younger than 2 years of age) and has often resolved by adolescence. It is usually physiologic, that is flexible, painless, and of no functional consequence, but rarely it can become stiff, painful, or rigid. This may indicate underlying foot (...) fragility and complications such as stroke, aortic dissection, and bowel rupture). Family history of sudden early death from aortic aneurysmal dissection/rupture (suggestive of Marfan's syndrome), or spontaneous arterial rupture or uterine rupture in childbirth (suggestive of vascular type Ehlers-Danlos syndrome). Symptoms that do not improve with rest, and resting leads to 'gelling' or stiffness (indicative of an inflammatory condition). Basis for recommendation Basis for recommendation Community

2019 NICE Clinical Knowledge Summaries

135. Relationship between behavioral indices of pain during labor pain with pain intensity and duration of delivery (PubMed)

cervical dilatation of 3-5 centimeters until delivery, the Labor Pain Coping Behavior Observation Form (comprised of 6 sub-groups of facial expressions, verbal expressions, tone of voice, body movements, degree of relaxation, and respiratory function and severity and duration of pain) was completed during uterine contractions and every half an hour. Using the Inventory of Labor Information; vital signs, frequency of contractions, and duration of the first and second stages of labor were measured (...) . The findings also revealed that the duration of the active phase of the first stage of labor (p<0.001 and r=-0.453), the duration of the second stage of labor (p<0.012 and r=-0.146), and the severity of pain (p<0.001 and r=-0.450) were significantly and inversely correlated with behavioral indicators during labor pain; i.e. an increase in the mean score of behavioral indicators during labor pain could lead to a decline in the duration of stages of labor and severity of pain.It was concluded that behaviors

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2018 Electronic physician

136. Renal injury after uninephrectomy in male and female intrauterine growth-restricted aged rats. (PubMed)

Renal injury after uninephrectomy in male and female intrauterine growth-restricted aged rats. Epidemiological studies report an inverse association between birth weight and risk for kidney disease that may differ between males and females, but studies investigating this association are limited. This study tested the hypothesis that male intrauterine growth-restricted offspring in a model of low birth weight induced by placental insufficiency in the rat exhibit enhanced renal injury in response (...) to a persistent secondary renal insult while female growth-restricted offspring are protected. For this study, control offspring from sham-operated dams and growth-restricted offspring from reduced uterine perfusion dams underwent uninephrectomy or a sham procedure at 18 months of age. One month later, urinary markers of renal injury, renal function, and histological damage were measured. Results were analyzed using 2-way ANOVA. Male and female offspring were assessed separately. Proteinuria and urinary

2019 PLoS ONE

137. Use and outcomes of minimally invasive hysterectomy for women with nonendometrioid endometrial cancers

hysterectomy for women with uterine cancer and high-risk histologic subtypes.We used the National Cancer Database to identify women with stages I-III uterine cancer who underwent hysterectomy from 2010-2014. Women with serous carcinomas, clear cell carcinomas, and sarcomas were examined. Women who had laparoscopic or robotic-assisted hysterectomy were compared with those who underwent open abdominal hysterectomy. After a propensity score inverse probability of treatment weighted analysis, the effect (...) Use and outcomes of minimally invasive hysterectomy for women with nonendometrioid endometrial cancers Minimally invasive hysterectomy is now used routinely for women with uterine cancer. Most studies of minimally invasive surgery for endometrial cancer have focused on low-risk endometrioid tumors, with few reports of the safety of the procedure for women with higher risk histologic subtypes.The purpose of this study was to examine the use of and survival associated with minimally invasive

2018 EvidenceUpdates

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

, sometimes following along nerves. A tendency for superficial necrosis has resulted in the name rodent ulcer .[ ] Some debate remains about the origin of SCC; however, these cancers are likely derived from epidermal stem cells associated with the hair follicle.[ ] A variety of tissues, such as lung and uterine cervix, can give rise to SCC, and this cancer has somewhat differing behavior depending on its source. Even in cancer derived from the skin, SCC from different anatomic locations can have

2018 PDQ - NCI's Comprehensive Cancer Database

139. Genetics of Kidney Cancer (Renal Cell Cancer) (PDQ®): Health Professional Version

. Hormonal and/or pain management medications may be given to provide release from uterine leiomyoma-related pain. The leiomyomas may also be removed surgically. Both and are typically managed with partial nephrectomy once they reach 3 cm. is being studied as a potential targeted therapy in individuals with HPRC-associated RCC. generally need no intervention. BHD patients are also at increased risk of , which is managed as it would be in the general population. Introduction [ Note: Many of the medical (...) sporadic clear cell RCC, presumably due to somatic variants in the VHL gene.[ ] Dietary intake of vegetables and fruits has been inversely associated with RCC. Greater intake of red meat and milk products have been associated with increased RCC risk, although not consistently.[ ] References American Cancer Society: Cancer Facts and Figures 2019. Atlanta, Ga: American Cancer Society, 2019. . Last accessed January 23, 2019. DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice

2018 PDQ - NCI's Comprehensive Cancer Database

140. Breast Cancer Prevention (PDQ®): Health Professional Version

of breast-feeding.[ ] The RR of breast cancer decreased by 4.3% (95%, CI, 2.9%–5.8%; P < .0001) for every 12 months of breast-feeding in addition to a decrease of 7.0% (95% CI, 5.0%–9.0%; P < .0001) for each birth. Exercise Active exercise may reduce breast cancer risk, particularly in young parous women.[ ] Numerous observational studies on the relationship between the level of physical activity and breast cancer risk have shown an inverse relationship.[ ] The average RR reduction is 30% to 40 (...) in the tamoxifen group. Adverse events of uterine cancer, venous thrombolic events, and cataracts were more common in tamoxifen-treated women, and there was no difference in ischemic heart disease events, strokes, or fractures.[ ] Treatment-associated symptoms of dyspareunia, musculoskeletal problems, and weight gain occurred less frequently in tamoxifen-treated women, whereas vasomotor flushing, bladder control symptoms, gynecologic symptoms, and leg cramps occurred less frequently in those receiving

2018 PDQ - NCI's Comprehensive Cancer Database

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