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101. Imaging Guidelines

) and/or extraperitoneal pelvis (pelvis radiograph). These radiographs allow the treating physician to expeditiously assess for, and immediately intervene in, life-threatening conditions such as cardiac tamponade, pneumothorax, or hemothorax. Perform a chest radiograph in all trauma patients with potential for thoracic injury and for evaluation of any tubes and lines placed during resuscitation. In the experienced provider’s hands, FAST may have sensitivities higher than a conventional chest radiograph (...) -threatening conditions; z Prioritize and expedite radiologic interpretation with immediate communication of life-threatening and emergent findings in a closed loop fashion to facilitate immediate treatment decision-making. The critical importance and ultimate impact of a real-time collaborative availability of the interpreting radiologist in severely injured patients cannot be overstated. Include injury descriptors needed to appropriately determine AAST organ injury scale (OIS) grading and trauma injury

2018 American College of Surgeons

102. European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas Full Text available with Trip Pro

AIP mutations among apparently sporadic populations ( ). Other genes implicated in pituitary tumour predisposition include GPR101 (XLAG), p27Kip1 (multiple endocrine neoplasia type 4 (MEN4)), PRKAR1A (Carney complex), GNAS (McCune–Albright syndrome), neurofibromatosis type 1, SDHx mutations and DICER1 syndrome ( ). However, currently little is known about the potential for more aggressive pituitary tumour behaviour under these conditions. 3. Therapeutic options 3.1 Role of surgery R 3.1.1 We (...) recommend that imaging (MRI in most instances) should be used for quantification of tumour dimensions, invasion and growth. R 2.1.3 We recommend full endocrine laboratory evaluation in patients with aggressive pituitary tumours. R 2.1.4 In patients with aggressive pituitary tumours, and either site-specific symptoms or discordant biochemical and radiological findings, we recommend screening for metastatic disease. 2.2 Potential predictors of aggressiveness in pituitary tumours R 2.2.1 We recommend

2018 European Society of Endocrinology

103. Methodological quality and synthesis of case series and case reports Full Text available with Trip Pro

of Recommendations, Assessment, Development and Evaluation (GRADE) approach clearly separates the certainty of evidence from the strength of recommendation. This separation allows decision-making based on lower levels of evidence. For example, despite low certainty evidence (derived from case series) regarding the association between aspirin and Reye’s syndrome in febrile children, a strong recommendation for using acetaminophen over aspirin is possible. GRADE literature also describes five paradigmatic (...) patient may allow narrative or quantitative synthesis. Narrative synthesis A systematic review of the cases with the rare syndrome of lipodystrophy was able to suggest core and supportive clinical features and narratively summarised data on available treatment approaches. Another systematic review of 172 cases of the infrequently encountered glycogenic hepatopathy was able to characterise for the first time patterns of liver enzymes and hepatic injury in this disease. Quantitative synthesis

2018 Evidence-Based Medicine

104. Policy on Acute Pediatric Dental Pain Management

are contraindicated for pediatric pain management in most situations because, if administered during a viral illness, the potential exists for a serious condition known as Reye syndrome. 13 Acetaminophen lacks anti-inflammatory properties but can be a non-opioid alternative when NSAIDs are contraindicated. 11 Acetaminophen is found as a single agent and also in combination with other drugs. Overdose of acetaminophen is a potential pediatric emergency, and the maximum daily dose should be observed, especially when (...) Policy on Acute Pediatric Dental Pain Management AMERICAN ACADEMY OF PEDIATRIC DENTISTRY ORAL HEALTH POLICIES 101 Purpose The American Academy of Pediatric Dentistry (AAPD) recognizes that children vary greatly in their cognitive and emotional development, medical conditions, and responses to pain and interventions. Infants, children, adolescents, and those with special health care needs can and do experience pain, and the majority of pain in the dental setting can be prevented or substantially

2017 American Academy of Pediatric Dentistry

105. CRACKCast E130 – Viruses

to this disease. Neurologic complications are rare but can include encephalitis, aseptic meningitis, transverse myelitis, and Reye syndrome (the association of aspirin use with Reye syndrome, a progressive encephalopathy). [7] Describe clinical presentations of CMV infections and treatment The spectrum of illness caused by CMV ranges from asymptomatic to severe disseminated disease in the immunocompromised patient. CMV is particularly harmful in pregnant patients, because it can lead to congenital infection (...) !! Other arboviral infections, other viral causes of encephalitis, bacterial meningitis, HSV encephalitis, leptospirosis, Lyme disease, and brain abscess. [12] List and describe viral hemorrhagic febrile illnesses: Dengue Chikungunya Yellow fever Ebola Marburg Lassa fever [1] Dengue Found all over the world: top consideration for FITRT SE asia, pacific, warm americas Mosquito transmitted Asymptomatic → dengue hemorrhagic fever → dengue shock syndrome Dengue fever is a self-limited illness characterized

2017 CandiEM

106. Prevention, Diagnosis & Management of infective endocarditis

emboli despite adequate antimicrobial therapy Semi-elective (after 2 weeks of antimicrobials) PVE and relapsing infection Elective (after 6 weeks of antimicrobials) Well-tolerated chronic severe valvular regurgitation with controlled infection SUMMARY OF THE CLINICAL PRACTICE GUIDELINES FOR THE PREVENTION, DIAGNOSIS AND MANAGEMENT OF INFECTIVE ENDOCARDITIS20 IE in specific conditions There are important considerations for IE in congenital heart disease (CHD), CIED and transcatheter valve implants (...) Enterococcus species 88 4.2.2.5 HACEK microorganisms 91 4.2.2.6 Candida 92 4.2.2.7 Non-HACEK Gram-negative microorganisms 93 4.2.2.8 Other microorganisms 94 4.2.3 Empirical therapy 95 4.2.4 Outpatient parenteral antimicrobial therapy for infective endocarditis 99 5.0 SURGICAL INTERVENTION 100 5.1 Indications 100 5.2 Timing of surgery 102 5.2.1 Preventing systemic embolism 103 5.3 Sur gery in specific conditions 104 5.3.1 Cerebral infarction or haemorrhage 104 5.3.2 Right-sided endocarditis 105 5.3.3

2017 Ministry of Health, Malaysia

107. HTA of smoking cessation interventions

. Smoking during pregnancy is harmful. It is associated with an increased risk of congenital anomalies, preterm birth, intrauterine fetal growth restriction, placental abruption, stillbirth, sudden infant death syndrome, respiratory infection, adverse cognitive and behavioural outcomes in infancy, and the development of chronic disease in adulthood. Evidence shows that smokers with mental health disorders smoke more heavily, are more nicotine dependent, and have smoked for longer than smokers who do (...) not have an underlying mental health disorder. The factors linking mental health conditions and cigarette smoking are varied and complex. Recent evidence suggests that quitting smoking may improve symptoms of mental illness. Irish data on the prevalence of smoking in pregnancy and in people with mental health disorders are limited. Evidence from the ‘Growing Up in Ireland’ (GUI) study reported that the prevalence of smoking in pregnant women in Ireland fell from 28% in 1998 to 18% in 2008

2017 Health Information and Quality Authority

108. Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia

cited above 7 and a 2010 Agency for Healthcare Research and Quality (AHRQ) systematic review. 12 Nonmodifiable risk factors for CATD include age, sex, race/ethnicity, and family history. Certain medical conditions are associated with an increased risk of developing MCI and CATD, including depression, cancer, cardiovascular disease, diabetes, delirium, thyroid disorders, chronic kidney disease, and loss of hearing and/or vision. Modifiable risk or protective factors may include diet, physical (...) Affairs Washington, DC Rod Corriveau, Ph.D. Program Director, Extramural Research Program National Institute of Neurological Disorders and Stroke Washington, DC Jonathan King, Ph.D. Program Director, Division of Behavioral and Social Research National Institute on Aging Washington, DC Lisa McGuire, Ph.D. Lead, Alzheimer’s Disease and Healthy Aging Program Centers for Disease Control & Prevention Atlanta, GA iv Claudia Moy, Ph.D. Program Director, Office of Clinical Research National Institute

2017 Effective Health Care Program (AHRQ)

109. Glasgow Coma Scale for Field Triage of Trauma: A Systematic Review

of health care in the United States. The National Highway Traffic Safety Administration (NHTSA) requested and provided funding for this report. The reports and assessments provide organizations with comprehensive, evidence-based information on common medical conditions and new health care technologies and strategies. They also identify research gaps in the selected scientific area, identify methodological and scientific weaknesses, suggest research needs, and move the field forward through an unbiased (...) Strategy 6 Study Selection 6 Population and Conditions of Interest 7 Interventions, Comparisons, and Study Designs 7 Outcomes 7 Timing and Setting 8 Data Abstraction and Data Management 8 Assessment of Methodological Risk of Bias of Individual Studies 8 Assessing Research Applicability 9 Data Synthesis and Rating the Body of Evidence 9 Grading the Body of Evidence for Each Key Question 10 External Review 11 Results 12 Results of Literature Search 12 Key Question 1. In patients with known or suspected

2017 Effective Health Care Program (AHRQ)

110. Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia

cited above 7 and a 2010 Agency for Healthcare Research and Quality (AHRQ) systematic review. 12 Nonmodifiable risk factors for CATD include age, sex, race/ethnicity, and family history. Certain medical conditions are associated with an increased risk of developing MCI and CATD, including depression, cancer, cardiovascular disease, diabetes, delirium, thyroid disorders, chronic kidney disease, and loss of hearing and/or vision. Modifiable risk or protective factors may include diet, physical (...) Affairs Washington, DC Rod Corriveau, Ph.D. Program Director, Extramural Research Program National Institute of Neurological Disorders and Stroke Washington, DC Jonathan King, Ph.D. Program Director, Division of Behavioral and Social Research National Institute on Aging Washington, DC Lisa McGuire, Ph.D. Lead, Alzheimer’s Disease and Healthy Aging Program Centers for Disease Control & Prevention Atlanta, GA iv Claudia Moy, Ph.D. Program Director, Office of Clinical Research National Institute

2017 Effective Health Care Program (AHRQ)

111. Kawasaki Disease (KD)

in the subacute phase of the syndrome about 1 to 4 wk after onset as the rash, fever, and other early acute clinical symptoms begin to subside. Diagnosis Clinical criteria Serial ECG and echocardiography Testing to rule out other disorders: CBC, ESR, C-reactive protein, antinuclear antibody (ANA), rheumatoid factor (RF), albumin, liver enzymes, throat and blood cultures, urinalysis, chest x-ray Diagnosis of Kawasaki disease is by clinical criteria (see Table: ). Similar symptoms can result from (...) by or in close consultation with an experienced pediatric cardiologist, pediatric infectious disease specialist, or pediatric rheumatologist. Because infants with atypical Kawasaki disease are at high risk of coronary artery aneurysms, treatment should not be delayed. Therapy is started as soon as possible, optimally within the first 10 days of illness, with a combination of high-dose IVIG (single dose of 2 g/kg given over 10 to 12 h) and oral high-dose aspirin 20 to 25 mg/kg po qid. The aspirin dose

2013 Merck Manual (19th Edition)

112. Summary of the Committee to Advise on Tropical Medicine and Travel (CATMAT) statement on travellers' diarrhea

on patient preferences. Prolonged use of BSS in children carries a risk of salicylate intoxication and bismuth encephalopathy, as well as a theoretical risk of Reye's syndrome . Use of BSS is permitted in the case of certain children aged 2 years and older, based on an individual assessment of risks and benefits. BSS use is not recommended in children younger than 2 years of age. Fluoroquinolones High-quality data showed fluoroquinolones to be effective in preventing TD in travellers compared to placebo (...) on Tropical Medicine and Travel (CATMAT) Statement on Travelers’ Diarrhea Libman M 1 , on behalf of CATMAT* Affiliation 1 Division of Infectious Disease, McGill University Health Centre, Montréal, QC Correspondence DOI https://doi.org/10.14745/ccdr.v41i11a03 Abstract Background: Most travellers' diarrhea (TD) infections occur during travel to low- and middle-income countries. Type of travel, duration of stay, age of traveller and presence of certain medical conditions are important factors to consider

2015 CPG Infobase

113. Summary of the National Advisory Committee on Immunization (NACI) statement on seasonal influenza vaccine for 2015-2016

and are associated with an increased risk of aspiration morbid obesity (BMI ≥40) children and adolescents (aged 6 months to 18 years) with the following conditions: neurologic or neurodevelopment conditions (including seizure disorders, febrile seizures and isolated developmental delay) undergoing treatment for long periods with acetylsalicylic acid, because of the potential increase of Reye's syndrome associated with influenza. People of any age who are residents of nursing homes and other chronic care (...) at high risk of influenza-related complications or hospitalization Adults, including pregnant women, and children with the following chronic health conditions: cardiac or pulmonary disorders (including bronchopulmonary dysplasia, cystic fibrosis and asthma) diabetes mellitus and other metabolic diseases cancer, immune compromising conditions (due to underlying disease, therapy or both) renal disease anemia or hemoglobinopathy conditions that compromise the management of respiratory secretions

2015 CPG Infobase

114. Regular exploratory examination of the need for DMP revision - a feasibility study using the example of the DMP "CHD"

angiotensin converting enzyme (Angiotensin-Konversionsenzym) ACS acute coronary syndrome (akutes Koronarsyndrom) AGREE Appraisal of Guidelines for Research & Evaluation AHA American Heart Association AK Antikörper AkdÄ Arzneimittelkommission der deutschen Ärzteschaft AP Angina Pectoris ARB Angiotensin-Rezeptorblocker ASS Acetylsalicylsäure AT1-Rezeptorblocker Angiotensin-1-Rezeptorblocker AWMF Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften BfArM Bundesinstitut für Arzneimittel (...) und Medizinprodukte BMS Bare-Metal Stent CABG coronary artery bypass graft (aortokoronare Bypassoperation) CONSORT Consolidated Standards of Reporting Trials CRP C-reaktives Protein DAPT dual antiplatelet therapy (duale Thrombozytenaggregationshemmung) DEGAM Deutsche Gesellschaft für Allgemein- und Familienmedizin DGK Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V. DMP Disease-Management-Programm DES Drug-Eluting-Stent ESC European Society of Cardiology G-BA Gemeinsamer

2015 Institute for Quality and Efficiency in Healthcare (IQWiG)

115. Pandemic influenza vaccine H5N1 MedImmune

/Non-Conformity of paediatric studies 85 2.10. Product information 85 2.10.1. User consultation 85 2.10.2. Labelling exemptions 85 2.10.3. Additional monitoring 85 2.10.4. Conditional Marketing Authorisation 86 Assessment report EMA/CHMP/323530/2016 Page 3/92 3. Benefit-Risk Balance 86 4. Recommendations 90 Assessment report EMA/CHMP/323530/2016 Page 4/92 List of abbreviations Abbreviation or Specialized Term Definition AE adverse event AFI any febrile illness AGM African Green Monkeys ALT alanine (...) influenza vaccine LAIV live attenuated influenza vaccine LRI lower respiratory illness MAA Marketing Authorisation Application MAARI medically attended acute respiratory illness MDCK Madin-Darby canine kidney Assessment report EMA/CHMP/323530/2016 Page 5/92 Abbreviation or Specialized Term Definition MDV master donor virus MMR measles, mumps, rubella trivalent vaccine MN microneutralization NA neuraminidase NAI neuraminidase inhibiting NIH National Institutes of Health NOCD new onset of chronic diseases

2016 European Medicines Agency - EPARs

116. Headaches in over 12s: diagnosis and management

-and- conditions#notice-of-rights). Page 19 of 30P Positiv ositive diagnosis e diagnosis A diagnosis based on the typical clinical picture that does not require any further investigations to exclude alternative explanations for a patient's symptoms. [7] For information on referral for suspected tumours of the brain or central nervous system see the NICE guideline on suspected cancer. [8] Because of an association with Reye's syndrome, preparations containing aspirin should not be offered to people aged under (...) ] [2012] Headaches in over 12s: diagnosis and management (CG150) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 14 of 301.3.6 Explain the risk of medication overuse headache to people who are using acute treatments for their headache disorder. [2012] [2012] T T ension-type headache ension-type headache Acute tr Acute treatment eatment 1.3.7 Consider aspirin [8] , paracetamol or an NSAID for the acute treatment

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

117. Immunizations - seasonal influenza

regular medication or follow up for ischaemic heart disease. Chronic kidney disease Including people with chronic kidney disease stage 3, 4 or 5, nephrotic syndrome, and renal transplantation. Chronic liver disease Including people with cirrhosis, biliary atresia, and chronic hepatitis. Chronic neurological disease Including people with stroke and transient ischaemic attack (TIA). People with co-morbidities that could be exacerbated by influenza, or who are at risk of serious illness from influenza (...) itself, depending on clinical judgement, for example, people with cerebral palsy, learning disabilities, Parkinson's disease, multiple sclerosis, motor neurone disease, or hereditary and degenerative diseases of the central nervous system or muscles, or severe neurological disability. Conditions where respiratory function may be compromised, such as people with polio syndrome. Diabetes mellitus Including people with type 1 diabetes; and type 2 diabetes that is diet-controlled, requires oral anti

2019 NICE Clinical Knowledge Summaries

118. Diarrhoea - prevention and advice for travellers

fever or severe abdominal pain. Neither loperamide nor bismuth subsalicylate (for example Pepto-Bismol ® ) are recommended for children to relieve diarrhoeal symptoms. Loperamide should not be used in children younger than 12 years of age because of concerns that it may cause intestinal obstruction. Bismuth subsalicylate must not be used in children younger than 16 years of age because of the possible association between salicylates and Reye's syndrome. Medical assistance must be sought if: Stools (...) between salicylates and Reye's syndrome [ ; ]. It is also not recommended for children by Public Health England in recommendations on antimicrobial prescribing for travellers diarrhoea [ ], and some experts also advise against its use in this group [ ; ]. When to seek medical assistance The recommendations on when to seek medical assistance are in line with guidance issued by the WHO [ ], the American College of Gastroenterology and an expert panel [ ; ], information published by NaTHNaC

2019 NICE Clinical Knowledge Summaries

119. Migraine

disorder. Background information Background information Definition What is it? Migraine is a common primary headache disorder. Primary headaches are headaches which are not associated with another underlying condition. Secondary headaches are headaches which occur as a result of underlying local or systemic pathology such as intracerebral haemorrhage, malignancy or infection. Migraine is characterized by: Attacks of moderate or severe headache (commonly, but not always unilateral, and often described (...) . Excessive caffeine intake. Obesity. Snoring and sleep disorders. Co-morbid conditions such as head injury, pain disorders, anxiety and depression. Major life events such as divorce, marriage, or loss of a job. [ ; ; ; ; ; ] Prevalence How common is it? Migraine is a common condition with a global prevalence of around 1 in 7 people. Migraine is two to three times more common in women than men: The lifetime prevalence has been reported as 33% in women and 13% in men — before puberty migraine frequency

2019 NICE Clinical Knowledge Summaries

120. Acute pain management: scientific evidence (3rd Edition)

and cultural groups 413 11.5 The patient with obstructive sleep apnoea 415 11.6 The patient with concurrent hepatic or renal disease 418 11.6.1 Patients with renal disease 418 11.6.2 Patients with hepatic disease 419 11.7 The opioid-tolerant patient 426 11.7.1 Definitions and clinical implications 426 11.7.2 Patient groups 427 11.7.3 Management of acute pain 427 11.8 The patient with an addiction disorder 431 11.8.1 Management of acute pain in pregnant patients with an addiction disorder .. 433 11.8.2 CNS (...) renal impairment is low (U) (Level I [Cochrane Review]). 5. Non-selectiv e NSAIDs do not increase the risk of reoperation for bleeding after tonsillectomy in paediatric patients (Q) (Level I [Cochrane Review]). 6. Coxibs do not appear to produce bronchospasm in individuals known to have aspirin- exacerbated respiratory disease (U) (Level I). 7. In general, aspirin increases bleeding after tonsillectomy (N) ( Level I). 8. Non-selectiv e NSAIDs given in addition to paracetamol improve analgesia

2015 National Health and Medical Research Council

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