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Speech Language Pathology

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241. Consent and confidentiality in genetic practice: Guidance on genetic testing and sharing genetic information

to confirm diagnosis 17 Clinical scenario 14 17 5.2.1 Destruction of medical records 18 5.3 The use of existing genetic information to facilitate accurate genetic testing 18 Clinical scenario 15 18 Clinical scenario 16 18 Clinical scenario 17 19 5.4 Retention and storage of pathology and genetic samples in laboratories 19 5.5 National or international disease or mutation registers 20 5.5.1 Cancer registries 20 5.6 Disclosure of information to others 20 5.6.1 Where the basis of consent for releasing (...) family pedigrees 28 Clinical scenario 22 29 A2.2 Fair processing and disclosure of results of genetic tests 29 A2.3 Payment for copy records 30 A3 Mental Capacity Act 2005 30 A3.1 Overview 30 A3.2 Scope of individuals and activities covered by the MCA 30 A3.3 Providing consent 30 Appendix B: Flowcharts 32 Fig 1 Consent for (new) samples 32 Fig 2 Sharing and disclosing genetic information 33 Fig 3 Consent for analysis of stored samples or pathological material 34 Appendix C: Suggested consent forms 35

2011 Royal College of Pathologists

242. Recommendations for the use of chromosome microarray in pregnancy

these studies indicated the utility of CMA and led to debate on its introduction into routine practice. An in silico targeted analysis approach, which targets known genes and regions, well established to be associated with known syndromes, some of which are associated with fetal pathology, has been reported 7 . This approach will minimise the detection of variants of uncertain significance, but will increase the risk of false negative results. The Joint Committee on Genomics in Medicine (JCGM) is a joint (...) equivocal findings. PeerJ 2014:Apr 22;2:e354. 8. Firth et al. Database of Chromosomal Imbalance and Phenotype in humans using Ensembl resources. Am J Hum Genet 2009;84:524–533. 9. Hillman et al. How does altering the resolution of chromosome microarray analysis in the prenatal setting affect the rates of pathological and uncertain findings? J Matern Fetal Neonatal Med 2014;27(7): 649–657. 10. Miller et al. Consensus statement: Chromosome microarray is a first tier clinical diagnostic test

2015 Royal College of Pathologists

243. Guidance on the reporting of thyroid cytology specimens

office with various stakeholder organisations. They have between them contributed to national guidance in this area, and to published papers, research and other professional organisations with an interest in the area of thyroid pathology. Date active January 2016 Date for review January 2021 Comments This document replaces the 1st edition of Guidance on the reporting of thyroid cytology specimens, published in 2009. In accordance with the College’s pre-publications policy, this document (...) of patients with potential thyroid pathology 5 3 Taking thyroid cytology samples 6 4 Preparation and staining of thyroid cytology samples 6 5 Thyroid cytology reporting 7 6 Thyroid cytology audit 10 7 Diagnostic accuracy 11 8 External quality assurance 12 9 Ancillary testing 12 10 Clinical action 12 11 References 13 12 Tables 18 Table 1: Equivalence of terminology of thyroid cytology classifications 18 Table 2: The Bethesda system (TBS) for reporting thyroid cytopathology (with RCPath Thy system

2016 Royal College of Pathologists

244. Guidance on the reporting of thyroid cytology specimens

office with various stakeholder organisations. They have between them contributed to national guidance in this area, and to published papers, research and other professional organisations with an interest in the area of thyroid pathology. Date active January 2016 Date for review January 2021 Comments This document replaces the 1st edition of Guidance on the reporting of thyroid cytology specimens, published in 2009. In accordance with the College’s pre-publications policy, this document (...) of patients with potential thyroid pathology 5 3 Taking thyroid cytology samples 6 4 Preparation and staining of thyroid cytology samples 6 5 Thyroid cytology reporting 7 6 Thyroid cytology audit 10 7 Diagnostic accuracy 11 8 External quality assurance 12 9 Ancillary testing 12 10 Clinical action 12 11 References 13 12 Tables 18 Table 1: Equivalence of terminology of thyroid cytology classifications 18 Table 2: The Bethesda system (TBS) for reporting thyroid cytopathology (with RCPath Thy system

2016 Royal College of Pathologists

245. Code of practice and performance standards for forensic pathologists dealing with suspicious deaths in Scotland

and responsibilities of the forensic pathologist 3 2 Professional standards in forensic pathology 4 2.1 Introduction 4 2.2 The code of practice 4 2.3 Mortuary facilities 5 2.4 Peer review 5 2.5 Assistance from other specialists 5 2.6 Keeping up to date 5 2.7 Departure from the standards 5 2.8 Record-keeping 5 3 Initial contact with the pathologist 6 3.1 Standard 6 3.2 Code of practice 6 4 The briefing 7 4.1 Standard 7 4.2 Code of practice 7 5 Scene of the discovery of the body 8 5.1 Standard 8 5.2 Code of practice (...) , that document having been developed and accepted by the Home Office Forensic Science Regulator in Forensic Pathology and The Royal College of Pathologists (hereinafter referred to as ‘the College’). It allows pathologists to demonstrate high standards of professional performance using valid and acceptable criteria. The general principles of performance standards for pathologists are applicable throughout the whole of the United Kingdom. In Scotland the investigations into sudden, unexpected, unexplained

2016 Royal College of Pathologists

246. Code of practice and performance standards for forensic pathologists in England, Wales and Northern Ireland (produced with the Home Office, Forensic Science Regulator and Department of Justice)

Code of practice and performance standards for forensic pathologists in England, Wales and Northern Ireland (produced with the Home Office, Forensic Science Regulator and Department of Justice) PUB 250918 1 V2 Final Code of practice and performance standards for forensic pathology in England, Wales and Northern Ireland Home Office, The Forensic Science Regulator, Department of Justice and The Royal College of Pathologists Unique document number G131 Document name Code of practice (...) and performance standards for forensic pathology in England, Wales and Northern Ireland Version number 2 Produced by Home Office, The Forensic Science Regulator, Department of Justice and The Royal College of Pathologists (see section 12 for full membership of author groups) Date active September 2018 Date for review September 2021 Comments This document supersedes the 2004 version and includes significant changes relating to the Human Tissue Act. An earlier version was circulated to forensic pathologists

2012 Royal College of Pathologists

247. Guideline for the management of adults with Systemic Lupus Erythematosus Full Text available with Trip Pro

cannot accurately predict renal biopsy findings. 2. Pathological assessment of kidney biopsy 98 The use of the International Society of Nephrology/Renal Pathology Society (ISN/RPS) 2003 classification system is recommended, with assessment not only of active and chronic glomerular and tubulointerstitial changes, but also of vascular lesions associated with aPLs/APS. Treatment of renal involvement 3. Indications and goals of immunosuppressive treatment in LN 98 3.1 Initiation of immunosuppressive (...) for first renal biopsy in SLE 97 Any sign of renal involvement—in particular, urinary findings such as reproducible proteinuria ≥0.5 g/24 h, especially with glomerular haematuria and/or cellular casts—should be an indication for renal biopsy. Renal biopsy is indispensable since, in most cases, clinical, serologic and laboratory tests cannot accurately predict renal biopsy findings. 2. Pathological assessment of kidney biopsy 98 The use of the International Society of Nephrology/Renal Pathology Society

2017 British Society for Rheumatology

249. Summary of the development process and methodology for the investigation of a new breast symptom GP card

without cancer as they go home without further waiting, knowing they do not have cancer. ? Generally, a same-day core biopsy reporting service is not practical. 9 Guideline Statement Expected turnaround time for pathology reporting of diagnostic needle core biopsy samples should be specified locally. ? Time is required during one-stop assessment for patients to raise questions and concerns (regardless of diagnostic outcome), and for these to be addressed promptly.” BC=breast cancer; DoH=Department (...) years old. The triple test components examined differ slightly between the two guides therefore while direct comparison cannot be made, it is noted that the sensitivity reported was similar to that reported in the INBS guide (100% versus >99.6% respectively), however specificity was higher (95.2% versus >62% respectively) and false positive rate was lower (3.3% versus 40 years. 1 ICSI guidelines note that pathologic discharge is more worrisome in patients > 50 years old. 17 NCCN guidelines recommend

2017 Cancer Australia

250. Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada

Professor Department of Medicine McMaster University Director, Canadian Collaborative Research Network Brampton, ON Stewart Harris MD MPH FCFP FACPM Professor, Schulich School of Medicine & Dentistry The University of Western Ontario London, ON Thomas Hawke PhD Associate Professor Department of Pathology & Molecular Medicine McMaster University Hamilton, ON Bernard Hurley MD FRCSC Assistant Professor of Ophthalmology, The University of Ottawa Vitreo-Retinal Surgeon, The University of Ottawa Eye

2018 Diabetes Canada

251. PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines

design was not a criterion for inclusion or exclusion. Pediatric studies were included in this report and will be included in subsequent reports. The decision to include them was made by the Committee based on the formation of a Pediatric PET Subcommittee that will explore and report on indications relating to PET in pediatric cancer. Inclusion Criteria for Primary Studies Articles were selected for inclusion in the systematic review of the evidence if they were fully published, English-language (...) . Used a suitable reference standard (pathological and clinical follow-up) when appropriate. 6. Included =12 patients for a prospective study/randomized controlled trial (RCT) or =50 patients (=25 patients for sarcoma) for a retrospective study with the disease of interest. Inclusion Criteria for Systematic Reviews 1. Reviewed the use of FDG PET/computed tomography (CT) in cancer, sarcoidosis, or epilepsy. 2. Contained evidence related to diagnostic accuracy; change in patient clinical management

2018 Cancer Care Ontario

252. Recommendations for the Delivery of Psychosocial Oncology Services in Ontario

insights from their diverse areas of expertise, including psychiatry, nursing, primary care, social work, spiritual care, nutrition, physiotherapy, speech language pathology and community care. Cancer Care Ontario’s Regional PSO Leads, PSO experts and Patient and Family Advisors from across the country were also consulted. This recommendation report provides a comprehensive overview and articulates the need for necessary PSO services across OntarioContents | 9 Contents Psychosocial Oncology Definition (...) a psychoeducation program or peer-support group (Level 2). Another 35 to 40 percent of patients will have moderate to severe distress requiring specialized PSO assessment and intervention (Level 3). A few, about 10 to 15 percent of patients, may need complex care from multiple PSO disciplines (Level 4); for example, a patient with head and neck cancer may need symptom management, rehabilitative care (nutrition, speech language pathology), as well as social, emotional and practical support from a variety of PSO

2018 Cancer Care Ontario

253. Guidelines for the investigation of chronic diarrhoea in adults

and American spelling) such as ((((‘diarrhoea-predominant irritable bowel syndrome’ OR ‘chronic diarrhoea’ OR ‘functional diarrhoea’ OR ‘loose stools’ OR ‘faecal urgency’ OR ‘faecal incontinence’ OR ‘stool frequency’) AND ((diarrhoea[Title/Abstract]) AND (investigation OR investigate OR diagnostic OR diagnosis) AND "2000’(Publication Date): ‘3000’(Publication Date)) AND English(Language)) NOT case reports (Publi- cation Type))). Additional terms related to the specific conditions mentioned in the text (eg (...) bacterial overgrowth is suspected, we recommend an empirical trial of antibiotics as there is insufficient evidence to recommend routine hydrogen or methane breath testing (Grade of evidence level 3, Strength of recommendation strong). surgical and structural disorders ? We recommend use of anorectal manometry and endoanal ultrasound only when other local pathology has been excluded and conservative measures exhausted (Grade of evidence level 3, Strength of recommendation strong). ? We recommend

2018 British Society of Gastroenterology

254. Neonatal seizures

: F17.23-1-V1-R22 Abbreviations: AED: Anti-epileptic drug(s); BP: Blood pressure; EEG: Electroencephalogram; EOGBSD: Early onset Group B Streptococcal disease; HIE: Hypoxic ischaemic encephalopathy; IV: Intravenous; QCG: Queensland Clinical Guidelines, >: Greater than Queensland Clinical Guideline: Neonatal seizures Refer to online version, destroy printed copies after use Page 4 of 32 Flow Chart: Investigations Guided by specific clinical features of baby or expert advice Pathology Blood • Lactate (...) • Commence continuous EEG monitoring if available • Record EEG if available Treat underlying cause(s) as indicated • Hypoglycaemia-Refer to QCG Newborn hypoglycaemia • Infection- Refer to QCG EOGBS • HIE-Refer to QCG HIE • Other Subsequent investigations as indicated Yes bo Acute symptomatic seizure Subsequent investigations Pathology Blood • BGL • Urea and electrolytes Ca, Mg, Na • FBC • Blood culture CSF • Microscopy and bacterial culture • Glucose • Protein Urine • Culture Imaging • Cranial USS

2019 Queensland Health

255. Normal birth

, Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Queensland Clinical Guideline: Normal birth Refer to online version, destroy printed copies after use Page 3 of 42 Flow Chart: Initial assessment Queensland Clinical Guidelines: Normal birth. Flowchart version: F17.25-1-V2-R22 Initial contact · Reason for presentation/contact · Preferences for labour and birth · Emotional and psychological needs Review history · Verbal · Pregnancy Health Record · Obstetric, gynaecological (...) to enable informed choice 31 and consent 24 o Respect the woman’s right to decline recommended care 2,31,40 o Provide a pathway for women declining recommended care · Provide emotional and physical support to the woman o Use supportive language to build confidence in the woman · Respect and implement birth plan 40,56 [refer to Table 4. Birth preparation] · Involve the woman in clinical handover 57 Professional culture · A culture which includes 58 : o Mutual trust o Clear and respected boundaries o

2017 Queensland Health

256. Early pregnancy loss

location, PV: per vaginam, QTC: Queensland Trophoblast Centre, RhD-Ig: RhD immunoglobulin, TVS: transvaginal scan, USS: ultrasound scan, >: greater than, 2 Current smoker (risk increases with amount/day) 1.7–3.9* – Smoking (past or ever) 1.5* 1.1 to 2.2 Intrauterine device use more than 2 years 2.9* 1.4 to 2.3 Age 40 or older (compared to 25–29 years) 2.9* 1.4 to 6.1 Sterilisation ? 9.3 4.9 to 18.0 Documented tubal pathology 3.7* 1.2 to 4.8 *adjusted for: previous pelvic infection, smoking, recruitment (...) evacuation and minimise risk of Asherman’s syndrome o Administer antibiotics *Refer to the Australian pharmacopeia for complete drug information Refer to online version, destroy printed copies after use Page 21 of 39 Queensland Clinical Guideline: Early pregnancy loss 6 Second trimester pregnancy loss Second trimester pregnancy loss represents one to two percent of recognised pregnancies. 54 A cause and effect relationship is difficult to establish and there may be multiple contributing pathologies

2017 Queensland Health

257. Delirium in Adult Cancer Patients: ESMO Clinical Practice Guidelines

of arousal, disorientation to environment (time, place) or self (person), reduced concentration, disor- ganised thought process, impaired immediate recall and recent memory, visuospatial dysfunction, language disturbance, incoherent speech Perceptual disturbance and delusions Examples of perceptual disturbances: hallucinations (usually visual or tactile), illusions, misinterpretations Delusions that tend to be transient in nature Psychomotor disturbance Hypoactive delirium: reduced psychomotor activity (...) with reduced movement, lethargic, decreased ?ow of speech Hyperactive delirium: increased psychomotor activity with agitation, restlessness, increased ?ow of speech, enhanced startle reaction Mixed delirium: unpredictable, ?uctuating features of both hypoactive and hyperactive delirium Sleep–wake cycle disturbance e.g. insomnia, distressing dreams and nightmares, reversal of sleep–wake cycle, nocturnal worsening of symptoms, excessive daytime somnolence Emotional disturbance e.g. anxiety, fear

2018 European Society for Medical Oncology

258. EANM-EAN recommendations for the use of brain 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in neurodegenerative cognitive impairment and dementia: Delphi consensus Full Text available with Trip Pro

where pathological confirmation was not available. In cases where pathology confirmation was available, no minimum sample size was set for study inclusion. Otherwise, a minimum sample size of 30 was set for frequent disorders, and lower thresholds for less frequent disorders. Effect size for sensitivity, specificity and accuracy was considered small with values between 50% and 70%, medium with values 71%–80% or large with values 81%–100%. These and other data were extracted and reported in the PICO (...) (in terms of increased accuracy, and versus pathology or biomarker‐based diagnosis or conversion at follow‐up) compared to standard clinical/neuropsychological assessment alone to detect AD (section ), FTD (section ) and prodromal DLB (section ) in patients with persistent MCI of uncertain origin. FDG‐PET to support the diagnosis of AD in MCI (PICO 1) Critical outcomes for PICO 1 were available in 13 of the examined papers . These papers found a very large range of values. Sensitivity ranged between 38

2018 European Academy of Neurology

259. Endoscopic eradication therapy for patients with Barrett's esophagus: associated dysplasia and intramucosal cancer

Although uncommon, EAC is a highly lethal cancer associated with a poor 5- year survival rate of 15% to 20% and an overall median sur- vival of 50% and signi?cant P value ( 1 expert GI pathologist Risk with pathology review by 1 pathologist Risk difference with pathology review performed by>1 expert GI pathologist Cumulative rate of disease progressionwhen expert>1 (or panel) of GI pathologists confirmed the diagnosis of LGD compared with those studies that did not was 15.7% (95% CI, 12.7%-19.3%) vs (...) . The panel recognized there were no direct data on the following patient-important outcomes: cancer-speci?c mortality and all-cause mortality. Additionally, panel mem- bers also discussed factors that supported a strategy of continued surveillance such as (1) unclear generalizability of above results as the safety and effectiveness have pre- dominantly been shown at expert centers, (2) lack of clear diagnostic pathologic criteria for LGD and signi?cant inter- observer variability among pathologists

2018 American Society for Gastrointestinal Endoscopy

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