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3881. Child and Adolescent Asthma Guidelines

, the degree to which symptoms affect sleep and activity, and the need for reliever medication. • Poor asthma control is de? ned as regular symptoms occurring in a usual week that affect the patient’s quality of life, or according to the asthma symptom control measures below. • Poor control should trigger a review of adherence, inhaler technique and preventer therapy. • If poor control persists, then recon- sider the diagnosis. • If poor control persists despite above, then consider increasing the asthma (...) bronchodilator use (>1 canister per month) • History of sudden asthma attacks • Intensive care admission or intubation (ever) • Requirement for long-term oral steroids B. Comorbidity • Major psychosocial problems • Alcohol and drug abuse in family • Severe food allergy and anaphylaxis C. Other factors • Poor inhaler technique • Underuse or poor adherence to ICS treatment • Tobacco smoke exposure • Discontinuous medical care • Socioeconomic disadvantage • Financial hardship • Unhealthy housing • Maori

2020 Asthma and Respiratory Foundation NZ

3882. Managing Chronic Cough as a Symptom in Children and Management Algorithms: CHEST Guideline and Expert Panel Report

. 95,96,97 Use of cough medications and presentation 564 to doctors were less likely in children with higher educated mothers, as described in a prospective 565 cohort of children studied from birth. 98 Hutton and colleagues described that “parents who wanted 566 medicine at the initial visit reported more improvement at follow-up, regardless of whether the 567 child received drug, placebo, or no treatment”. 99 Physicians should be cognizant that “a parent 568 navigating the Internet for information (...) (Dr Chang); Division of Allergy and Immunology, Department of 9 Medicine, New Jersey Medical School, Pulmonary and Allergy Associates, Morristown, New 10 Jersey, USA (Dr Oppenheimer); Division of Pulmonary, Allergy, and Critical Care Medicine, 11 Department of Medicine, UMass Memorial Medical Center, Worcester, MA, USA (Dr Irwin) 12 13 Correspondence 14 Prof Anne Chang 15 Tel: 61 7 30681111; Email: 16 17 Number of words in text: xx 18 19 20 1 Conflict of Interests table 21

2020 American College of Chest Physicians

3883. The EAU – EANM – ESTRO – ESUR – SIOG Guidelines on Prostate Cancer

: Treatment of Relapsing, Metastatic, and Castration-Resistant Prostate Cancer. Eur Urol, 2017. 71: 630. 3. Guyatt, G.H., et al. What is "quality of evidence" and why is it important to clinicians? BMJ, 2008. 336: 995. 4. Guyatt, G.H., et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008. 336: 924. 5. Phillips B, et al. Oxford Centre for Evidence-based Medicine Levels of Evidence. Updated by Jeremy Howick March 2009. 1998. 6. Guyatt, G.H., et al (...) with Hormone Therapy. N Engl J Med, 2017. 377: 338. 36. YuPeng, L., et al. Cholesterol Levels in Blood and the Risk of Prostate Cancer: A Meta-analysis of 14 Prospective Studies. Cancer Epidemiol Biomarkers Prev, 2015. 24: 1086. 37. Vidal, A.C., et al. Obesity increases the risk for high-grade prostate cancer: results from the REDUCE study. Cancer Epidemiol Biomarkers Prev, 2014. 23: 2936. 38. Davies, N.M., et al. The effects of height and BMI on prostate cancer incidence and mortality: a Mendelian

2020 European Association of Nuclear Medicine

3884. Addressing therapeutic questions to help Canadian physicians optimize asthma management for their patients during the Covid-19 pandemic

potential risk of disease transmission. Physical distancing for asthma patients We suggest that all patients with asthma follow current local, national public and global health advisories with respect to the indications for physical distancing and isolation. Patients with mild- moderate asthma should work from home if feasible. Patients with severe asthma should also work from home if feasible, and if not feasible, should remain off work for medical reasons until such time as the WHO or local public (...) . Ducharme c , Dhenuka Radhakrishnan d , Delanya Podgers e , Clare Ramsey f , Tania Samanta g , Andréanne Côté h , Masoud Mahdavian i , M. Diane Lougheed j a Western University, London, Ontario, Canada; b Department of Pediatrics, British Columbia Children’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada; c Departments of Pediatrics and of Social and Preventive Medicine, Centre Hospitalier Universitaire Sainte- Justine, University of Montreal, Montreal, Quebec, Canada; d

2020 Canadian Thoracic Society

3885. Addressing therapeutic questions to help Canadian physicians optimize COPD management for their patients during the Covid-19 pandemic

Respiratory Research Centre, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; f Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; g School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada; h Department of Medicine, McMaster University, Hamilton, Ontario, Canada; i Division of Pulmonary Medicine, Department of Medicine, University of Alberta; j Department of Medicine, Heritage Medical Centre, Prince George, British Columbia, Canada; k Respiratory (...) the home, we suggest that all patients follow current local, national and global public health advisories with respect to the indications for physical distancing and isolation. Patients should wash their hands with soap and water frequently for 20 seconds or use alcohol-based hand sanitizer containing at least 60% alcohol. Consider having at least a 30-day supply of all medications on hand to reduce the need for leaving the home, or select delivery options at your pharmacy, or have trusted individuals

2020 Canadian Thoracic Society

3886. Gynecologic Care for Adolescents and Young Women With Eating Disorders

and affect psy- chologic and physical health, a multidisciplinary approach is imperative. c Although obstetrician–gynecologists are not expected to treat eating disorders, they should be familiar with the criteria that warrant immediate hospitalization for medical stabilization. c Weight restoration is the best treatment for low bone mineral density (BMD) caused by disor- dered eating. VOL. 131, NO. 6, JUNE 2018 OBSTETRICS & GYNECOLOGY e205c Further research is needed to define best practices, including (...) concern about body weight or shape 4. Not explained by medical or mental disorders Anorexia nervosa 1. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight defined as weight that is less than minimally normal or, for children and adolescents, less than that minimally expected 2. Intense fear of gaining weight or becoming fat, or persistent behavior

2018 American College of Obstetricians and Gynecologists

3887. Children and young people exposed prenatally to alcohol

for the assessment and diagnosis of children and young people affected by PAE. It includes evidence-based recommendations on measurement of alcohol consumption in pregnancy and consensus-based recommendations on: y identification of children at risk of FASD y criteria for diagnosis and use of FASD as a descriptor y medical assessment y physical examination y sentinel features y neurodevelopmental assessment y the multidisciplinary assessment team y special considerations in the neurodevelopmental assessment y (...) The need for guidance 1 1.2 Remit of the document 3 1.3 Definitions and terminology 3 1.4 Origin of this guidance 8 1.5 Statement of intent 9 2 Identification of children at risk of FASD 10 2.1 Maternal alcohol history 10 3 Identification and assessment of children and young people affected by prenatal alcohol exposure 15 3.1 Diagnostic criteria 15 3.2 Medical assessment 17 3.3 Sentinel facial features 18 3.4 Neurodevelopmental assessment 19 3.5 Special considerations in the assessment of infants

2019 SIGN

3888. British guideline on the management of asthma

in pregnancy 126 12.1 Natural history and management of stable asthma 126 12.2 Management of acute asthma in pregnancy 127 12.3 Drug therapy in pregnancy 128 12.4 Management during labour 131 12.5 Drug therapy for breastfeeding mothers 132 13 Occupational asthma 133 13.1 Incidence 133 13.2 At-risk populations 133 13.3 Diagnosis 133 13.4 Management of occupational asthma 136 14 Organisation and delivery of care 138 14.1 Care pathways 138 14.2 Educating clinicians 138 14.3 Asthma clinics 139 14.4 (...) and experience. 4 “Prescribing medicines outside the conditions of their marketing authorisation alters (and probably increases) the prescribers’ professional responsibility and potential liability.” 4 The General Medical Council (GMC) recommends that when prescribing a medicine ‘off label’, doctors should: • be satisfied that there is no suitably licensed medicine that will meet the patient’s need • be satisfied that there is sufficient evidence or experience of using the medicine to show its safety

2019 SIGN

3889. A guideline developer's handbook

in this context includes diagnostic tests, risk factors, risk exposure or treatments with medical devices or drugs) must be specified clearly and precisely. The only exception is in drug therapy where drug classes should be used in preference to specific agents unless there is a clear reason for focusing on a named agent. The decision on comparisons may include placebo/no treatment, and comparison with other therapies. It should be borne in mind that, where there is an existing treatment, comparison (...) criteria should be drawn up and saved as part of the record of the review. This will provide guidance at a later stage when studies are being selected for review. Inclusion criteria will include definition of the topic and may include such factors as duration of therapy, drug dosage, and frequency of treatment. Other factors include any geographic or language limits, the types of trials that will be accepted, and date range to be covered. Any equality groups that are expected to have specific needs

2019 SIGN

3890. Cardiac arrhythmias in coronary heart disease

choices available. It is advised, however, that significant departures from the national guideline or any local guidelines derived from it should be documented in the patient’s medical records at the time the relevant decision is taken. 1.3.1 INFLUENCE OF FINANCIAL AND OTHER INTERESTS It has been recognised that financial interests in, or close working relationships with, pharmaceutical companies may have an influence on the interpretation of evidence from clinical studies. It is not possible (...) for medicinal use in humans. Generally ‘off-label’ prescribing of medicines becomes necessary if the clinical need cannot be met by licensed medicines within the marketing authorisation. Such use should be supported by appropriate evidence and experience. 8 “Prescribing medicines outside the conditions of their marketing authorisation alters (and probably increases) the prescribers’ professional responsibility and potential liability. ” 8 The General Medical Council (GMC) recommends that when prescribing

2018 SIGN

3891. Evaluation of Abnormal Liver Chemistries

of concomitant steatosis or viral hepatitis ( 59 ). Drug and supplement-induced liver injury Prescribed and over-the-counter medications, as well as non- prescribed complimentary alternative medicines or dietary sup- plements, represent a common source for acute and chronic liver injury. Identifi cation of an off ending agent is challenging and requires a comprehensive query of the patient, his or her family, and careful review of available medical and pharmacy records and laboratory data ( 22 ). Nearly all (...) fails to elucidate a diagnosis, to stage a condition, or when multiple diagnoses are possible. Am J Gastroenterol 2017; 112:18–35; doi: 10.1038/ajg.2016.517; published online 20 December 2016 1 Division of Gastroenterology/Hepatology, Department of Medicine, Stanford University School of Medicine , Palo Alto , California , USA ; 2 Digestive Health Institute, University Hospitals Cleveland Medical Center and Division of Gastroenterology and Liver Disease, Department of Medicine, Case Western Reserve

2017 American College of Gastroenterology

3892. Management of Infants Born to Mothers with COVID-19

Management of Infants Born to Mothers with COVID-19 INITIAL GUIDANCE: Management of Infants Born to Mothers with COVID-19 Date of Document: April 2, 2020 Karen M. Puopolo, M.D. Ph.D., Mark L. Hudak, M.D., David W. Kimberlin, M.D., James Cummings, M.D. American Academy of Pediatrics Committee on Fetus and Newborn, Section on Neonatal Perinatal Medicine, and Committee on Infectious Diseases ABSTRACT COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, has led to an unprecedented (...) with COVID-19 disease requires either direct physical contact or close ( 60 years of age and those with comorbid conditions should not provide care if possible. • Infants with negative SARS-CoV-2 molecular testing should optimally be discharged to the care of a designated healthy (non-infected) caregiver. If the mother is in the same household, she should maintain a distance of at least 6 feet for as much of the time as possible, and when in closer proximity to the neonate should use a mask and hand

2020 American Academy of Pediatrics

3893. Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines July to December 2019

/adenocarcinoma with or without neoadjuvant therapy, FDG PET/CT displayed overall poor sensitivity but high specificity for assessing lymph node metastases across three studies [4-6]. Hamai et al. [4] examined FDG PET/CT before and after neoadjuvant chemoradiotherapy, Dellaportas et al. [5] evaluated FDG PET/CT pre- neoadjuvant chemotherapy, and Lopci et al. [6] looked at FDG PET/CT before surgery. The diagnostic performance of CT and endoscopic ultrasound (EUS) were also unsatisfactory. Similarly in early T (...) in gynecologic cancer. Head and Neck Cancer Current Indications for Head and Neck Cancer ? For the baseline staging of node positive (N1-N3) head and neck cancer where PET will impact radiation therapy (e.g., radiation volume or dose). ? To assess patients with N1-N3 metastatic squamous-cell carcinoma of the head and neck after chemoradiation (human papillomavirus [HPV] negative); or who have residual neck nodes equal to or greater than 1.5 cm on re-staging CT performed 10 to12 weeks post therapy (HPV

2020 Cancer Care Ontario

3894. EANM Practice Guideline/SNMMI Procedure Standard for Dopaminergic Imaging in Parkinsonian Syndromes 1.0 Full Text available with Trip Pro

be executed by qualified registered/certified Nuclear Medicine Technologists. Please refer to: Performance Responsibility and Guidelines for Nuclear Medicine Technologists 3.1 and for further details. In some jurisdictions there may be additional qualifications necessary for technologists to also operate CT and/or MR components. Physicist A certified Medical Physics Expert (MPE) is responsible for quality assurance of SPECT and PET systems that are in clinical use and also for identification of possible (...) in the research and practice of nuclear medicine. In addition to publishing journals, newsletters, and books, the SNMMI also sponsors international meetings and workshops designed to increase the competencies of nuclear medicine practitioners and to promote new advances in the science of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional nonprofit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence

2020 European Association of Nuclear Medicine

3895. EANM Dosimetry Committee series on standard operational procedures for internal dosimetry : Dosimetry for 131I-mIBG treatment of neuroendocrine tumours Full Text available with Trip Pro

specialised treatments with radiopharmaceuticals and patient-specific dosimetry. A clinical example is given to demonstrate the application of the absorbed dose calculations. Preamble The European Association of Nuclear Medicine (EANM) is a professional nonprofit medical association that facilitates communication worldwide among individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. This guideline is intended to assist practitioners in providing (...) appropriate nuclear medicine care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by medical professionals taking into account the unique circumstances of each case. Thus, there is no implication that an approach differing from the guidance, standing alone, is below the standard of care

2020 European Association of Nuclear Medicine

3896. Covid-19: Updated recommendations for resumption of sleep clinic and laboratory testing

Ersu b , Kristin L. Fraser c , Eleni Giannouli d , Patrick J. Hanly c , Tetyana Kendzerska e , Sherri Katz b , Brandy Lachmann f , Annie Lajoie g , Caroline Minville h , Debra Morrison i , Indra Narang j , Marcus Povitz c , Robert Skomro k , Kathy Spurr l a Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; b Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada; c Department of Medicine, University of Calgary, Calgary (...) , Alberta, Canada; d Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; e Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; f University of British Columbia Hospital, Vancouver, British Columbia, Canada; g Research Institute, McGill University Health Centre, Montréal, Québec, Canada; h Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université de Laval, Québec, Québec, Canada; i Division of Respirology

2020 Canadian Thoracic Society

3897. Canadian Thoracic Society recommendations regarding the use of face masks by the public during the SARS-CoV-2 (COVID-19) pandemic

Canadian Thoracic Society, Ottawa, ON, Canada; h St Michael’s Hospital Unity Health Toronto, Li Ka Shing Knowledge Institute, Department of Medicine, University of Toronto, Toronto, ON, Canada. Summary • We support the Public Health Agency of Canada’s recommendation of wearing a homemade non- medical face mask in the community for periods of time when it is not possible to consistently maintain a 2-metre physical distance from others. • We recommend that all patients with underlying lung disease follow (...) . The Public Health Agency of Canada has recommended the use of non-medical/facial coverings in the community when physical distancing from others is not possible. 1 This recommendation includes patients with any underlying lung disease. This new recommendation is primarily designed to help reduce the asymptomatic or pre-symptomatic spread of the virus. Asymptomatic and pre-symptomatic spread of the SARS-CoV-2 virus has been previously reported 2-5 and is believed to be an important mode of viral

2020 Canadian Thoracic Society

3898. Inhaled Salbutamol Shortage – Mitigation Strategy for COPD

to meet demand for the drug. A tier 3 shortage is a shortage with the greatest potential impact on the Canadian drug supply and healthcare systems by virtue of availability of alternate supplies, ingredients, or therapies.” 3) Restrictions have been put in place by wholesalers and distributors to limit the supply of salbutamol which means that most patients will receive only one salbutamol inhaler or a one month supply at a time . 4) It is possible that the surge in demand relates to individuals (...) supply and leave additional time to obtain your refills from the pharmacy. Consider having the pharmacy or a trusted person deliver the medications to you so you can continue to stay at home and practice physical distancing. There is a shortage of salbutamol inhalers in Canada, if you do not need it, do not attempt to refill your prescription. When refilling your inhaled medications, you should expect to receive only a 1-month supply. This is in response to inventory control measures put in place

2020 Canadian Thoracic Society

3899. Multiple sclerosis: Scenario: Managing the major symptoms and complications of multiple sclerosis

effect on MS-related fatigue. However, it is not effective in all people, and may have intolerable adverse effects. For information on prescribing amantadine, see . Consider a non-drug treatment. The following may be helpful and the one chosen may depend on local availability and the person's preference. Mindfulness-based training. Cognitive behavioural therapy. A fatigue management educational programme. Supervised exercise programmes involving moderate progressive resistance training and aerobic (...) available from randomized controlled trials for this recommendation but considered that there is experience of the use of amitriptyline for emotional lability and that a trial of this is worthwhile. Also, that amitriptyline is a drug commonly used for a number of different medical problems and therefore neurologists and other healthcare professionals have a lot of experience in using it and of the adverse effects that can occur. Managing cognitive problems The recommendations relating to cognitive

2018 NICE Clinical Knowledge Summaries

3900. Leg cramps: How should I assess someone with leg cramps to identify a cause?

nocturnal leg cramps are indicated by: Sudden intense calf, or foot pain (rarely thigh); most often at night (or when resting). Visible or palpable knotting or tightening of the muscle or abnormal posture. Duration of pain usually seconds to less than 10 minutes. Single muscle (or part of muscle) involvement. No abnormal findings on physical examination. Good response to passive and active stretching. Residual tenderness in the affected muscle. Sleep disruption. Perform a history and examination to help (...) leg pulses. History (or symptoms) of an underlying condition (for example thyroid disease). Medication (for example diuretics, statins, long-acting beta-2 agonists). Investigations are usually not needed, unless the cramp has atypical features or an underlying cause is suspected (for example blood tests for urea, electrolytes, calcium, thyroid function tests, fasting glucose, liver function tests, and creatinine kinase; vascular studies for claudication; imaging of the lumbar spine for nerve root

2018 NICE Clinical Knowledge Summaries


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