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181. Hydroxychloroquine and Chloroquine Retinopathy Screening

or renal insufficiency. Adequate screening may not be possible with retinal co-pathology. Chloroquine appears to be more retinotoxic than hydroxychloroquine and so we recommend identical baseline and screening tests, but that screening begins after one year of therapy for all patients on chloroquine. Screening may be best incorporated into the hospital eye service via virtual clinics. The results of screening should be communicated back to the prescribing doctor, patient and GP as normal, possible (...) and spectral domain optical coherence tomography. GPP If the baseline examination demonstrates macular pathology, a baseline Humphrey 10-2 visual field test may be undertaken. GPP 2.3 Screening Protocol: Screening Tests The following is a standardised protocol for all patients. Criteria Level of evidence In addition to oral communication, written information about hydroxychloroquine retinopathy and screening for hydroxychloroquine retinopathy should be given to all patients. GPP All patients should undergo

2018 Royal College of Ophthalmologists

182. Therapy for Stage IV Non–Small-Cell Lung Cancer Without Driver Alterations

. 4 © 2020 by American Society of Clinical Oncology Hanna et alinclusioninthesystematicreviewoftheevidencebasedon the following criteria: ? PatientswithstageIVNSCLCwithoutdriveralterations (some trials that also included patients with stage IIIB NSCLC were included if separate analyses were conducted). ? Fully published presentations of English-language reports of phase II or III RCTs, rigorously conducted (see the Data Supplement for ASCO method of quality assessment) systematic reviews, or meta (...) abstracts not subsequently published in peer-reviewed journals; (2) editorials, commentaries, let- ters,newsarticles,casereports,ornarrativereviews;or(3) published in a non-English language. Guideline recom- mendationswerecrafted,inpart,usingtheGuidelinesInto DecisionSupport(GLIDES)methodologyandaccompanying BRIDGE-Wiz software. 12 In addition, a guideline imple- mentability review was conducted. Based on the imple- mentabilityreview,revisionsweremadetothedrafttoclarify recommended actions for clinical

2020 Cancer Care Ontario

183. Perioperative

cohort studies on renal tests (creatinine and others) found a positive correla- tion between pathological renal function tests and the occurrence of complications in 11 studies of patients with known pre-existing renal disease (the remaining studies either did not provide data or there was no significant relationship). (Johansson, 2013) A 2015 study of 37,345 noncardiac surgery and 2,024 cardiac surgery patients found that patients with acute kidney injury had a fivefold higher mortality risk (...) should be educated on the signs and symptoms of surgical site infection. • Patients and families should be provided emergency contact numbers and instructions on whom to call. • Confirm that discharge instructions have been explained, and patients and family should verbalize understanding. Because patients may forget verbal instructions, written instructions should be provided. • When necessary, it should be verified that the patient will have care assistance for at least 24 hours. • Patient

2020 Institute for Clinical Systems Improvement

184. Therapy for Stage IV Non-Small Cell Lung Cancer without Driver Alterations

by using a systematic review (2015 to 2018) of phase II and phase III RCTs and clinical experience. Articles were selected for inclusion in the systematic review of the evidence based on the following criteria: Patients with stage IV NSCLC without driver alterations (some trials that also included patients with stage IIIB NSCLC were included if separate analyses were conducted). Fully published presentations of English-language reports of phase II or III RCTs, rigorously conducted (see the Data (...) (if reported). Articles were excluded from the systematic review if they were (1) meeting abstracts not subsequently published in peer-reviewed journals; (2) editorials, commentaries, letters, news articles, case reports, or narrative reviews; or (3) published in a non-English language. Guideline recommendations were crafted, in part, using the Guidelines Into Decision Support (GLIDES) methodology and accompanying BRIDGE-Wiz software. In addition, a guideline implementability review was conducted. Based

2020 American Society of Clinical Oncology Guidelines

185. Germline and Somatic Tumor Testing in Epithelial Ovarian Cancer

and/or somatic tumor testing. Articles were excluded from the systematic review if they were editorials, commentaries, letters, news articles, case reports, or narrative reviews or were published in a non-English language. The guideline recommendations were crafted, in part, using the Guidelines Into Decision Support (GLIDES) methodology and accompanying BRIDGE-Wiz software. In addition, a guideline implementability review was conducted. Based on the implementability review, revisions were made to the draft (...) and prostate cancers). - Of note, in one study of an immune checkpoint inhibitor in endometrial cancer, PCR missed 1 patient with a dMMR tumor who responded to immunotherapy. However, IHC is simple and cost effective and is widely available in most pathology laboratories, although it is important to underscore that IHC may miss dMMR tumors due to mutations that lead to loss of MMR function but retain antigenicity. , Clinical decision making should not be made based on a VUS. Physicians and patients should

2020 American Society of Clinical Oncology Guidelines

186. Estrogen and Progesterone Receptor Testing in Breast Cancer Guideline Update

American Society of Clinical Oncology, Alexandria, VA; 5 University of North Carolina, Chapel Hill, NC; 6 St Jude Medical Center, Fullerton, CA; 7 University of Michigan, Ann Arbor, MI; 8 University of Queensland, Brisbane, Queensland, Australia; 9 Pathology Queensland, Brisbane, Queensland, Australia; 10 MD Anderson Cancer Center, Houston, TX; 11 Gemini Group, Ann Arbor, MI; 12 Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA; 13 Y ale Cancer Center, New Haven, CT; 14 Saskatchewan (...) ., M.D., and L.M.M. were members of the Steering Group with the co-chairs. Author support information (if applicable) appears at the end of this article. This guideline was developed through a collaboration between the College of American Pathologists and the American Society of Clinical Oncology and has been published jointly by invitation and consent in both the Archives of Pathology & Laboratory Medicine and the Journal of Clinical Oncology.Ithas been edited in accordance with style standards

2020 College of American Pathologists

187. Estrogen and Progesterone Receptor Testing in Breast Cancer

, Queensland, Australia 9 Pathology Queensland, Brisbane, Queensland, Australia 10 MD Anderson Cancer Center, Houston, TX 11 Gemini Group, Ann Arbor, MI 12 Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 13 Yale Cancer Center, New Haven, CT 14 Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada 15 University of Saskatchewan, Saskatoon, Saskatchewan, Canada 16 Weill Cornell Medicine, New York, NY 17 IEO, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere (...) on interventions Articles were excluded from the systematic review if they were (1) meeting abstracts not subsequently published in peer-reviewed journals; (2) editorials, commentaries, letters, news articles, case reports, or narrative reviews; or (3) published in a non-English language. The Expert Panel met in person at ASCO headquarters to update the guideline. The updated ASCO/CAP guideline was circulated in draft form, reviewed, and approved by the Expert Panel. ASCO’s Clinical Practice Guidelines

2020 American Society of Clinical Oncology Guidelines

188. Sepsis Management

of 1.5% annually. (6) This is partly due to an aging population, increased numbers of invasive procedures and the increasing number of people living with co-morbidities and on long-term immunosuppressive therapies. Multiple studies have shown that programs aimed at early identification and treatment of patients with sepsis lead to reduced mortality, intensive care unit (ICU) admission, ICU length of stay and hospital length of stay. (7, 8) 1.1 Definitions Infection is defined as a pathological

2019 National Clinical Guidelines (Ireland)

189. Management of Pilonidal Disease

excision with flap reconstruction. This clinical practice guideline will focus on the evaluation and man- agement of pilonidal disease. METHODOLOGY PubMed was used to search MEDLINE for all of the entries included between November 1945 and November 2017 and limited to humans and English language. Search terms in- cluded the MEDLINE subject heading pilonidal sinus and the subheadings anatomy/histology, diagnosis, diagnostic im- aging, surgery, and therapy, which provided 1022 titles. The PubMed search (...) term pilonidal abscess, also with limitations to humans and English language, provided an additional 174 titles. One additional article was added after the initial search was completed. These 1197 titles (including Cochrane Sys- temic Database Reviews) were reviewed, duplicate references were resolved, and 1075 titles remained for initial review. Of these 1075 titles, 191 were excluded because of incorrect pub- Earn Continuing Medical Education credit online at cme.lww.com. Funding/Support: None

2020 American Society of Colon and Rectal Surgeons

190. Management of Chronic Kidney Disease

). Other markers may include evidence of pathologic abnormality (eg, detected by renal biopsy), structural abnormalities (eg, abnormalities on imaging studies), or serum electrolyte abnormalities (eg, renal tubular syndromes). In 2002, the Kidney Disease Outcomes Quality Improvement Initiative (KDIGO) Work Group on CKD provided a comprehensive definition and staging system of CKD in an effort to provide a common language among health care providers, patients and researchers, and hopefully improve (...) on Medline was performed. The major search terms were: “chronic kidney disease excluding end-stage renal disease”; time frame started with 1/1/07 unless a more recent review (above) addressed the topic; type of publication was guidelines, controlled trials (including meta-analyses), and cohort studies; population was human/adult; and language was English. Within these parameters individual searches were performed for the following topics: screening; assessment of renal function/staging; history

2020 University of Michigan Health System

191. Management of Appendiceal Neoplasms

incidence of appendiceal tu- mors was 0.12 cases per 1,000,000 people per year; how- ever, based on recent large database studies, the incidence may be as high as 0.97 per 100,000 population. 1–3 It is unclear whether this increase reflects an actual change in the disease occurrence or simply greater recognition and reporting. Although tumors of the appendix are rare, surgeons should be familiar with the implications of ap- pendiceal pathology, because almost 300,000 appendec- tomies are performed (...) , and Scopus medical databases. Pertinent inclusion criteria were English lan- guage article and adult human patients, and both current and archaic terminology for appendiceal neoplasms were included as follows: (appendiceal, appendix, appendicular) TABLE 1. Histologic classification of PMP Pathologic lesion Criteria Acellular mucin • Mucin within peritoneal cavity without neoplastic epithelial cells Low-grade mucinous carcinoma peritonei (DPAM) • Epithelial component typically scanty • Minimal cytological

2020 American Society of Colon and Rectal Surgeons

192. Clinical Practice Guideline on Preventing Venous Thromboembolic Disease in Patients Undergoing Elective Hip and Knee Arthroplasty

Relationship between Quality and Domain Scores for Interventions 21 Relationship between Applicability and Domain Scores for Interventions 21 Relationship between Domain Scores and Quality of Screening/Diagnostic Tests 22 Relationship between Domain Scores and Applicability for Studies of Prognostics 23 Relationship between Quality and Domain Scores for Studies of Prognostics 24 Relationship between Domain Scores and Applicability for Studies of Prognostics 24 4 AAOS guideline language 26 Quality

2011 American Academy of Orthopaedic Surgeons

193. The treatment of distal radius fractures

the Quality of Evidence and Defining the Strength of the Recommendations for a detailed description of the link between the evidence supporting the strength of a recommendation and the language used in the guideline. 1. We are unable to recommend for or against performing nerve decompression when nerve dysfunction persists after reduction. Strength of Recommendation: Inconclusive Description: Evidence from a single low quality study or conflicting findings that do not allow a recommendation for or against (...) with no ulnar fracture or ulnar base fracture 103 DASH score in patients with no ulnar fracture or ulnar tip fracture 103 Wrist pain at final follow-up in patients with no ulnar fracture or ulnar base fracture .. 104 Wrist pain at final follow-up in patients with no ulnar fracture or ulnar tip fracture 104 AAOS v1.0 12.05.09 xxii List of Tables MCII of outcomes 5 Descriptive terms for results with MCII 5 Strength of recommendation descriptions 9 AAOS guideline language 10 Summary table for Recommendation 3

2009 American Academy of Orthopaedic Surgeons

194. Clinical Practice Guideline on the Diagnosis and Treatment of Osteochondritis Dissecans

: Practitioners should feel little constraint in following a recommendation labeled as Inconclusive, exercise clinical judgment, and be alert for emerging evidence that clarifies or helps to determine the balance between benefits and potential harm. Patient preference should have a substantial influencing role. AAOS Clinical Practice Guidelines Unit iv v1.1_033111 3. In a patient with a known OCD lesion on x-ray, an MRI of the knee is an option to characterize the OCD lesion or when concomitant knee pathology (...) is suspected such as meniscal pathology, ACL injury, or articular cartilage injury. Strength of Recommendation: Limited Description: Evidence from two or more “Low” strength studies with consistent findings, or evidence from a single “Moderate” quality study recommending for or against the intervention or diagnostic. A Limited recommendation means the quality of the supporting evidence that exists is unconvincing, or that well- conducted studies show little clear advantage to one approach versus another

2010 American Academy of Orthopaedic Surgeons

195. Somatic Cancer Panel Reporting in Ontario

Care Ontario’s (CCO) Pathology and Laboratory Medicine Program (PLMP). The purpose of the working group was to establish a standardized approach to: ? Variant reporting for somatic cancers ? Determine which findings and associated quality metrics should be included in a report ? Report formatting, including layout and content Need for Standardization The standardization of pathology reporting has been shown to improve the overall quality of pathology reporting and benefit clinical management (...) of patients (1). Pathology reports are often the primary tool for test results to be communicated to health care providers, and can be an important resource for patients (2). As a result, it is crucial that these reports convey complex information in a comprehensive and concise way (3). Evidence has indicated that complex, lengthy and poorly formatted test reports can negatively impact patient management and disease prevention (2). Although some guidelines exist for reporting genes in the context

2019 Cancer Care Ontario

196. Baseline Staging Imaging for Distant Metastasis in Women with Stage I, II, and III Breast Cancer

professionals, policy makers, program planners, and institutions involved in the management of women with clinical and pathologically confirmed primary breast cancer. RECOMMENDATIONS Recommendation 1 Staging tests using conventional anatomic (chest X-ray, liver ultrasound, chest- abdomen-pelvis computed tomography [CT] scan) and/or metabolic imaging modalities (positron emission tomography [PET]/CT, PET/magnetic resonance [MR], bone scintigraphy) should not be ordered routinely for women newly diagnosed (...) OBJECTIVES To provide recommendations for the use of imaging tests to detect distant metastases in women with newly diagnosed breast cancer. TARGET POPULATION Women with newly diagnosed primary breast cancer (originated in the breast) who have no symptoms of distant metastasis. INTENDED USERS This guideline is intended for health care professionals, policy makers, program planners and institutions involved in the management of women with clinical and pathologically confirmed primary breast cancer

2019 Cancer Care Ontario

197. Diagnosis of chronic thromboembolic pulmonary hypertension: A Canadian Thoracic Society clinical practice guideline update

. The chosen inclusion and exclusion criteria were noted at the abstract and full text review stages. Study selection criteria Articles selected for inclusion in the systematic review of the evidence reported data on CTEPH diagnosis. Animal stud- ies, pathology or preclinical studies, clinical images, isolated hemodynamic reports, letters, editorials, duplicate publica- tions without original data, reviews, studies published in a language other than English and French, and studies of uniquely pediatric (...) was proposed by the entire group. The strength of the recommendation was based on consideration both of the GRADE quality of evidence, and the expert panel’s synthesis of clinical judg- ment. The recommendations were then vetted by the CTS Canadian Respiratory Guidelines Committee (CRGC) Chair to optimize the language of each recommendation to ensure implementability. The recommendation consensus process was completed by electronic survey using a six-point voting scale (Table 4), whereby it was defined

2019 Canadian Thoracic Society

198. Adjuvant Systemic Chemotherapy for Stage II and III Colon Cancer Following Complete Resection

death, with an estimated 3400 deaths in 2014. Colorectal cancer is the third most common cancer site when both sexes are combined, representing 12.1% of all new cancer cases, with approximately 8900 new cases per year [18]. In males, colorectal cancer is the second most common site, and, in females, colorectal cancer is the third most common site [18]. The prognosis of the newly diagnosed colon cancer patient is determined by the clinico-pathological stage of the disease. In stage II disease (...) . Secondary outcomes of interest were OS, treatment toxicity, and quality of life. Articles had to report data for one of these outcomes. If more than one study evaluated the same data set, only the most recent paper was selected for inclusion. 3. They were English-language publications. 4. The clinical trials were published after 1987. Buyse et al. [23] summarized the results of randomized trials of adjuvant therapy for colorectal cancer up to 1987. The results of this meta-analysis are reviewed

2019 Cancer Care Ontario

199. Movement Disorder and Neurodegenerative Diseases.

duration of almost 6 years [30]. Corticobasal degeneration initially presents with asymmetric limb clumsiness in patients between 50 to 70 years of age and progresses to include unilateral limb rigidity and dystonia (including the “alien limb phenomenon”), postural imbalance, and cortical features (including apraxia, cortical dementia, cortical sensory deficits, and impaired language production) [30]. PSP, also known as Steele-Richardson-Olszewski syndrome, is the most common atypical Parkinsonism

2019 American College of Radiology

200. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities Full Text available with Trip Pro

for reports published during January 1, 1980-December 31, 2017, capable of addressing all of the newly identified clinical questions ( Table I ). Searches were limited to publications in the English language. Medical subject heading terms used in various combinations in the literature search included “psoriasis,” “inflammatory bowel disease,” “Crohn's disease,” “ulcerative colitis,” “metabolic syndrome,” “diabetes,” “obesity,” “dyslipidemia,” “hypertension,” “nonalcoholic fatty liver disease (...) and radiological study of 180 patients. Br J Rheumatol . 1991 ; 30 : 245–250 Skin lesions preceded arthritis in 72.7% of cases; in 9.7% of cases, skin lesions preceded joint involvement by 1 year, in 15.6% by 5 years, and in 47.4% by >5 years. In 14.9% of arthritis patients, articular pathology presented before skin lesions ( Fig 2 ). x 19 Torre Alonso, J.C., Rodriguez Perez, A., Arribas Castrillo, J.M., Ballina Garcia, J., Riestra Noriega, J.L., and Lopez Larrea, C. Psoriatic arthritis (PA): a clinical

2019 American Academy of Dermatology

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