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161. Improving outcomes for people with sarcoma

Development Group 4 Key recommendations 8 1. Background 10 Incidence of sarcomas in England and Wales 11 Bone sarcomas 13 Soft tissue sarcomas 17 References 22 2. Patient perspectives 25 Information 26 Support 27 Choice and decision-making 27 GP information 27 3. Improving diagnosis of bone and extremity soft tissue sarcoma 36 Extremity, trunk, and head and neck soft tissue sarcomas 36 Bone sarcomas 37 4. Improving pathology 47 5. Improving treatment: sarcoma multidisciplinary teams 53 6. Improving (...) pathology and cytogenetic facilities. • A soft tissue sarcoma MDT should meet minimum criteria (as defined in Chapter 5) and manage the care of at least 100 new patients with soft tissue sarcoma per year. If a sarcoma MDT manages the care of patients with both bone and soft tissue sarcoma, it needs to manage the care of at least 50 new patients with bone sarcoma per year and at least 100 new patients with soft tissue sarcoma per year. • All patients who are managed by a sarcoma MDT should be allocated

2006 National Institute for Health and Clinical Excellence - Clinical Guidelines

162. Spinal injury: assessment and initial management

or older and reported pain in the thoracic or lumbosacral spine dangerous mechanism of injury (fall from a height of greater than 3 metres, axial load to the head or base of the spine – for example falls landing on feet or buttocks, high-speed motor vehicle collision, rollover motor accident, lap belt restraint only, ejection from a motor vehicle, accident involving motorised recreational vehicles, bicycle collision, horse riding accidents) pre-existing spinal pathology, or known or at risk (...) to another centre, provide verbal and written information that includes: the reason for the transfer the location of the receiving centre and the patient's destination within the receiving centre. Provide information on the linked spinal cord injury centre (in the case of cord injury) or the unit the patient will be transferred to (in the case of column injury or other injuries needing more immediate attention) the name and contact details of the person who was responsible for the patient's care

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

164. Guidelines for the management of community-acquired pneumonia in adults

covering many disciplines, including pathology, immunology and surgery International Advisory Board N Ambrosino (Italy) J N Baraniuk (USA) P J Barnes (UK) C R W Beasley (New Zealand) J R Britton (UK) A S Buist (USA) E R Chilvers (UK) S-H Cho (Korea) S-E Dahlen (Sweden) G C Donaldson (UK) M W Elliott (UK) Y Fukuchi (Japan) D M Geddes (UK) P Goldstraw (UK) R Goldstein (Canada) C Griffiths (UK) J C Hogg (Canada) S T Holgate (UK) P Hopewell (USA) M Ichinose (Japan) A Kendrick (UK) T King (USA) A J Knox (UK (...) : – The diagnosis is in doubt and a chest radio- graph will help in a differential diagnosis and management of the acute illness. [D] – Progress following treatment for suspected CAP is not satisfactory at review. [D] – The patient is considered at risk of under- lying lung pathology such as lung cancer. [D] When should a chest radiograph be performed in hospital? 2. All patients admitted to hospital with suspected CAP should have a chest radiograph performed as soon as possible to confirm or refute

2009 British Infection Association

165. Management of suspected viral encephalitis in children Full Text available with Trip Pro

are specific to childhood, but fortunately it is relatively rare. However doctors who treat acutely ill children should be aware of how to manage a child with suspected encephalitis as some of the individual causes of encephalitis will respond to specific treatments and delays in the diagnosis in these children can be devastating. Strictly speaking, inflammation of the brain parenchyma is a pathological diagnosis, however due to the practical limitations of this, surrogate clinical markers of inflammation (...) are used ( Table 1 . Definitions). Table 1 Definitions. Encephalopathy • Clinical syndrome of altered mental status (manifesting as reduced consciousness or altered cognition, personality or behavior) • Has many causes including systemic infection, metabolic derangement, inherited metabolic encephalopathies, toxins, hypoxia, trauma, vasculitis, or central nervous system infection Encephalitis • Inflammation of the brain • Strictly a pathological diagnosis; but surrogate clinical markers often used

2012 British Infection Association

166. Standards for obstetrical ultrasound assessments

levels consistent with obtaining diagnostic information and limited to medically indicated procedures? Appendix 3 2.0 Abnormal or Unexpected Findings Since the first identification of a clinically significant finding is often not anticipated by the referring care provider and may require immediate attention and case management decisions, verbal communication with the referring care provider, in advance of the final written report, is strongly recommended. ? ? When abnormal or unexpected findings (...) ) ? ? clubfoot ? ? lung pathology such as CCAM or pulmonary sequestration ? ? microcephaly (HC less than 3%) ? ? fetal body masses ? ? neck, face, back, such as sacroccoccygeal teratomas ? ? neural tube defect (except anencephaly à to be referred to Medical Genetics) ? ? obstructive uropathy: ? ? hydronephrosis greater than 10mm ? ? bilateral hydroureters ? ? megacystis ? ? oligohydramnios detected before 26 weeks gestation ? ? polyhydramnios (if confirmed at BCWH) ? ? renal anomalies: ? ? dysplastic

2016 CPG Infobase

167. Breastfeeding Healthy Term Infants

of and fewer feedings per 24 hours; dental and orthodontic problems; accidents and injuries (choking); candidiasis; speech development; infant attachment; 38 and acute otitis media 80 • Used therapeutically at times to encourage suckling among preterm infants that are gavage fed; to repattern specific sucking disorders; and to soothe infants of mothers who suckle for short periods due to an overabundant maternal milk supply 38,81 Preparation for Hospital Discharge • Assess maternal and newborn physical (...) of Asian origin. 38 If noted in infants less than 24 hours old it is pathological and clinical evaluation should be immediate 38,39 Early breastfeeding jaundice 38,92 is a prolongation of normal physiologic jaundice 9,38 that is associated with infrequent and ineffective breastfeeding resulting in limited intake and a delay of meconium passage and increased reabsorption of bilirubin from the bowel 13,92,93 More recently it is known as “starvation jaundice” 38,94 and occurs when breastfeeding

2015 British Columbia Perinatal Health Program

169. Population and Public Health Prenatal Care Pathway

? ? ? Woman is unable to understand the warning signs that would require her to seek prompt medical care? ? ? Woman experiences barriers (such as lack of transportation, literacy, language/cultural barriers, conflicting family or work obligations etc?) that prohibit her from following through with recommended care by PHCP ?7 Population and Public Health Prenatal Care Pathway Intervention SR: Screening & Referral SR: Screen woman for her access to PHCP care; assess woman’s need for additional supports (...) during her pregnancy (e?g? Doulas, Nutritionists, Childbirth Educators etc?) with information about how to access them? Offer woman information about warning signs and when to contact a PHCP CB: Capacity Building CB: Assist a vulnerable woman and those needing help (due to low literacy levels or language barriers etc?) to find appropriate PHCP and to develop strategies to address barriers to attendance or following through

2014 British Columbia Perinatal Health Program

170. Newborn Screening

screening prenatally and reinforce after the baby’s birth. The “Parent Information Sheet” is available online in multiple languages, and hard-copies can be ordered. Furthermore, at the hospital bedside, families will be given a smaller version, perforated off of the actual blood spot card, as a reminder of the imminent spot card collection. ? ? Newborn screening is standard of care and is performed on all babies unless declined by the parent(s) / guardian. An “informed refusal” process is outlined (...) or 1. Introduction6 Perinatal Services BC A. World Health Organization (WHO) Position Statement & Current Practices The World Health Organization (1998) states that “newborn screening should be mandatory if early diagnosis and treatment will benefit the newborn.” 3 BC, other Canadian provinces and territories, and most other jurisdictions in the world do not require explicit verbal or written consent for newborn screening. It is considered standard of care and is performed on all babies unless

2018 British Columbia Perinatal Health Program

171. Young Practitioners' Guide to Periodontology

requiring diagnosis/management or rare/complex clinical pathology Drug-induced gingival overgrowth Cases requiring evaluation for periodontal surgery Key references Ainamo J, Nordblad A and Kallio P. (1984) Use of the CPITN in populations under 20 years of age. International Dental Journal 34: 285-291. British Society of Periodontology. Basic Periodontal Examination (BPE), revised March 2016 Clerehugh V . (2008 (...) -term stability of periodontal health. By providing information on other pathologies, such as periapical pathology, pulpal/furcation involvements and caries, radiographs also provide a guide to the overall prognosis of teeth. This guide does not aim to dictate the choice of radiographs as each patient will have their own unique clinical presentation but care should be taken to ensure that each exposure is clinically justified, of suitable quality to be useful and provide clear benefit to the patient

2012 British Society of Periodontology

172. Fetal Health Surveillance: Antepartum & Intrapartum Consensus Guideline

. 68,69 In a time when uteroplacental function is often evaluated by biophysical variables (e.g., biophysical profile) or vascular flow measurements (e.g., Doppler inter- rogation of uterine or fetal vessels), the contraction stress test is now being performed much less frequently. 69,70 The CST may still be used when the fetus is at risk for the consequences of uteroplacental pathology. This includes maternal conditions such as diabetes or hypertension and fetal conditions such as growth restriction (...) - ing tool in healthy pregnancies, as it has not been shown to be of value in this group. (I-A) 2. Umbilical artery Doppler should be available for assess- ment of the fetal placental circulation in pregnant women with suspected placental insufficiency. (I-A) Fetal umbilical artery Doppler assessment should be considered (1) at time of referral for suspected growth restriction, or (2) during follow-up for suspected placen- tal pathology. 3. Depending on other clinical factors, reduced, absent

2008 British Columbia Perinatal Health Program

173. Patellofemoral Pain

pathologies. C Clinicians may use the patellar tilt test with the presence of hypomobility to support the diagnosis of PFP . CLASSIFICATION F Given the absence of a previously established valid classi- fication system for PFP , the clinical practice guideline group proposes a classification consisting of 4 subcategories as - sociated with the International Classification of Functioning, Dis - ability and Health. The proposed classification system is based on published evidence. The subcategories are named

2019 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

174. Pediatric ICU Admission, Discharge, and Triage Practice Statement and Levels of Care Guidance

involved with the surgical needs of the patient while in the ICU and be involved in the therapeutic decisions. | Support Services. In addition to the direct patient care providers, additional support service personnel should have expertise in providing care to the patient and family. These services may include social workers, pharmacists, case managers, chaplains, palliative care, integrative care, occupational therapy (OT), physical therapy (PT), speech language pathology (SLP), child life specialists

2019 Society of Critical Care Medicine

176. Prevention of skin cancer

involved Representative German Society of Pathology (DGP) PD Dr. Christian Rose* German Society of Paediatric and Adolescent Medicine (DGKJ) Prof. Dr. Peter Höger German Society of Urology (DGU) Prof. Dr. Jürgen Gschwend German Working Party for the Assistance of Persons with Disabilities and Chronic Diseases and their Relatives (BAG Selbsthilfe) Christiane Regensburger Otorhinolaryngology, Oral and Maxillofacial Surgical Oncology Working Group (AHMO) Prof. Dr. Jochen A. Werner (retired), PD Dr

2014 German Guideline Program in Oncology

177. NeoMedQ: Neonatal medicines

of administration and dose forms • Limit verbal (face to face and telephone orders) to medical emergency situations 6 Standardisation 6 • When possible, establish one standard neonatal drug concentration for each injectable and oral medication used o Reduces risk of medication errors when transferring between one facility and another o Can stimulate demand for manufactures to offer commercially prepared standard solutions Storage of medicines • Store medicines as per specific requirements for each medication (...) Nurse 2 the calculation and Nurse 2 checks that it is correct o Together: Nurse 1 and 2 perform the calculation and confirm verbally Event reporting • Adhere to local protocols for adverse event reporting • Regularly review the types or medication errors to identify weaknesses in the system and patterns of errors Printed copies of monographs • Destroy printed Queensland Clinical Guideline neonatal medicine monographs immediately after use o The most current and therefore the only correct version

2019 Queensland Health

178. Kidney Biopsy information and education for patients and caregivers

Results Quality anatomy, pathology and diagnostic procedures. Venkataraman et al (2014)(15) 120 Survey, described within a Letter to the Editor Group 1: Result of diagnostic mammogram and need for biopsy given verbally Group 2: Specific printed brochure given after diagnostic mammogram in addition to verbal communication from radiologist. Anxiety ? The number of women reporting high anxiety scores increased from 76.6% (46/60) in Group 1 to 86.8% (52/60) in Group 2 (not statistically significant (...) undergoing a renal biopsy. SEARCH STRATEGY Databases searched: The search was carried out in Medline (1946 – Dec 2017), The Cochrane Library (Central) and the Cochrane Kidney and Transplant Register of Studies. Text words for renal biopsy were combined with MeSH terms and text words for health education and patient education. No language restrictions were placed on the search. The search strategy is provided in the Appendices. Date of search/es: December 2017 WHAT IS THE EVIDENCE? The search strategy

2020 KHA-CARI Guidelines

179. Kidney Pre-biopsy medication: Antiplatelet and anticoagulant agents

), The Cochrane Library (Central) and the Cochrane Kidney and Transplant Register of Studies, Embase (May2017). Text words for renal biopsy were combined with MeSH terms and text words for aspirin, clopidogrel and anti-platelet therapy. No language restrictions were placed on the search. The search strategy is provided in the Appendices. Date of search/es: May 2017 WHAT IS THE EVIDENCE? Coagulation profile in the setting of renal biopsy Mejia-Vilet et al.(15) performed a retrospective observational study (...) PT, Carbone A. Lack of increased bleeding after liver biopsy in patients with mild hemostatic abnormalities. American journal of clinical pathology. 1990;94(6):747-53. 21. Schiffer CA, Anderson KC, Bennett CL, et al. Platelet transfusion for patients with cancer: clinical practice guidelines of the American Society of Clinical Oncology. Journal of Clinical Oncology. 2001;19(5):1519-38. 22. Mackinnon B, Fraser E, Simpson K, et al. Is it necessary to stop antiplatelet agents before a native renal

2020 KHA-CARI Guidelines

180. Recommendations for good practice in Ultrasound: Oocyte retrieval Full Text available with Trip Pro

pathologies and cautions during OPU Complications and risks Future developments Training and competence Quality assurance and performance. Some general aspects of the OPU technique are outlined in . Prior to OPU Pelvic US – An US evaluation should be performed before starting an ART treatment: to decide the ovarian stimulation protocol; to determine whether there is any anatomical abnormality or a malposition of the ovaries ( ) and to assess ovarian placement and ovarian/follicular accessibility after (...) and take actions to prevent any possible associated complications. Patients should at least be asked about the use of medications—more specifically the use of blood thinning agents (aspirin and others), relevant previous surgeries and any relevant disease or deficit of coagulation factors. Information provision and informed consent – Recent or confirmation of (written) informed consent for treatment should be obtained according to local regulations. Verbal and written information should be provided

2020 European Society of Human Reproduction and Embryology


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