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2861. Clinical Oncology Society of Australia position statement on exercise in cancer care

of standard practice in cancer care and to be viewed as an adjunct therapy that helps counteract the adverse effects of cancer and its treatment; all members of the multidisciplinary cancer team to promote physical activity and recommend that people with cancer adhere to exercise guidelines; and best practice cancer care to include referral to an accredited exercise physiologist or physiotherapist with experience in cancer care. Changes in management as a result of the guideline: COSA encourages all (...) to counteract the adverse physical and psychological effects of cancer and its treatment. This article summarises the position of the Clinical Oncology Society of Australia (COSA) on the role of exercise in cancer care, taking into account the strengths and limitations of the evidence base. It provides guidance for all health professionals involved in the care of people with cancer about integrating exercise into routine cancer care. Main recommendations: COSA calls for: exercise to be embedded as part

2018 MJA Clinical Guidelines

2862. Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

modification, and is recommended in addition to lifestyle intervention, not as a substitute. Low dose therapy is recommended initially, with subsequent titration to reduce the mild and self-limiting gastrointestinal side effects. Anti-androgens in PCOS have limited evidence and are only recommended for hirsutism when at least 6 months of COCPs with cosmetic therapy have failed. Bariatric surgery can improve clinical features; however, registry studies demonstrate concerns around pregnancy outcomes (...) and should only be considered in PCOS after lifestyle therapy fails. Assessment and treatment of infertility (Algorithm 5) Algorithm 5 ( ) outlines recommendations on pre-conception care and infertility management. While infertility assessment and management require specialist care, optimisation of psychological health, lifestyle intervention and provision of evidence-based resources to inform women on infertility treatment recommendations are well placed in primary care. The key change recommended

2018 MJA Clinical Guidelines

2863. Integrated care for older people (?ICOPE)? implementation framework: guidance for systems and services

-solving and cognitive behavioural therapy to address caregivers’ needs. 22 er caregivers spport and training Supporting the physical and mental well-being of caregivers and supporting their skills-based care competencies is essential to supporting the care of older people. Caregivers often form a critical component of the unpaid workforce. The mode of training and support for caregivers will differ by setting and should be flexible to suit local needs, capacity and available resources. Services should (...) that enables well-being in older age. ii Intrinsic capacity is a person’s total physical and mental reserves. iii Functional ability comprises the health-related attributes that enable people to be and to do what they value.4 Integrated care for older people (ICOPE) implementation framework: guidance for systems and services FIGURE 1. A public health framework for healthy ageing and the opportunities for public health High and stable capacity HEALTH SERVICES: LONG-TERM CARE: ENVIRONMENTS: Declining

2019 World Health Organisation Guidelines

2864. BTS/SIGN British Guideline on the Management of Asthma

Predicting future risk of asthma attacks 32 4.4 Physiological measures 36 4.5 Other approaches 37 5 Supported self management 38 5.1 Effectiveness of supported self management 38 5.2 Components of a self-management programme 38 5.3 Self management in specific patient groups 42 5.4 Adherence and concordance 45 5.5 Implementation in practice 48 6 Non-pharmacological management 50 6.1 Primary prevention 50 6.2 Secondary prevention 557 Pharmacological management 62 7.1 Intermittent reliever therapy 63 7.2 (...) Regular preventer therapy 63 7.3 Initial add-on therapy 70 7.4 Additional controller therapies 72 7.5 Specialist therapies 73 7.6 Deceasing treatment 82 7.7 Specific management issues 82 8 Inhaler devices 85 8.1 Technique and training 85 8.2 ß 2 agonist delivery 85 8.3 Inhaled corticosteroids for stable asthma 86 8.4 Prescribing devices 86 8.5 Use and care of spacers 87 8.6 Environmental impact of metered-dose inhalers 87 9 Management of acute asthma 89 9.1 Lessons from asthma deaths and near-fatal

2019 British Thoracic Society

2865. Transjugular Intrahepatic Portosystemic Stent-Shunt (TIPSS) in the management of portal hypertension

recommend TIPSS (where there is good evidence to support its use) is performed in the following clinical situations: a. Acute variceal bleeding unresponsive to other treatments such as endoscopy (camera examination of the gullet) with banding of varices and drug therapy (so called standard of care). Patients who have very severe liver disease are unlikely to benefit since they will not tolerate the physical insult of a TIPSS procedure. b. In a non-emergency situation to prevent further re-bleeding from (...) gastro-oesophageal variceal bleeding refractory to endoscopic and drug therapy, covered TIPSS is recommended (strong recommendation, moderate quality evidence). Salvage TIPSS is not recommended where the Child-Pugh score is >13 (strong recommendation, low quality of evidence) In patients who have Child’s C disease (C9-13) or MELD = 19, and bleeding from oesophageal varices or GOV1 and GOV2 gastric varices and are hemodynamically stable, early or pre- emptive TIPSS can be considered within 72h

2019 British Society of Gastroenterology

2866. Guidelines for the management of hereditary colorectal cancer

of recommendation: strong) o We recommend screening for H. pylori in patients with LS and subsequent eradication therapy if indicated. (GRADE of evidence: low; Strength of recommendation: strong) Lynch-Like Syndrome (LLS) o We recommend that deficient MMR tumours without hypermethylation/BRAF mutation and without a germline pathogenic variant in MMR genes should undergo somatic tumour testing with a CRC gene panel. (GRADE of evidence: low; Strength of recommendation: strong) o We recommend that if double

2019 British Society of Gastroenterology

2867. Baseline Staging Imaging for Distant Metastasis in Women with Stage I, II, and III Breast Cancer

-57 days after mastectomy or breast- conserving surgery) and before systemic therapy 19 (25) I 38 (49) II 18 (23) III Histopathology, clinical and follow- up data, imaging follow-up including FDG-PET/CT Postoperative distant metastases that were previously undetected Gunalp et al., 2012 [13] RET 336 Preoperative: 141 Pre-op 47 (28-78) Physical examination, mammography, breast and axilla FDG-PET/CT Pre-op 19 (14) I 51 (36) IIA Histopathology or patient follow-up. For bone foci, MRI was performed (...) of disease recurrence, the association of distant metastasis and biomarker profile in early-stage breast cancer has not been adequately studied in prospective studies of staging investigation. The benefit and risks of the routine use of biomarker profiles to assess for distant metastasis is still unclear and, thus, its use to guide decisions on imaging staging for clinical early-stage breast cancer is not recommended regardless of whether the patient is going for neoadjuvant therapy. Guideline 1-14

2019 Cancer Care Ontario

2868. Quality indicators for pulmonary rehabilitation programs in Canada: A CTS expert working group report

University, Halifax, Nova Scotia, Canada; b Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada; c Centre for Heart Lung Innovation, University of British Columbia, Vancouver, British Columbia, Canada; d Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; e Division of Respirology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; f Division of Pulmonary Medicine, Department of Medicine (...) of physical therapy, respir- ology and exercise physiology. Working group members had research and clinical expertise in pulmonary rehabilitation as well as experience in QI development. Quality indicators were developed using a process based on the Modified RAND Appropriateness Method. 14,15 This consisted of a systematic review of the literature to identify potential QI, followed by a Delphi exercise to select the final QI. Systematic review of the literature We used the following question to guide our

2019 Canadian Thoracic Society

2869. Metastatic Breast Cancer Summary

. For patients with metastatic breast cancer at diagnosis in Australia, 5-year relative survival is low at 32%, compared with over 95% for patients with early breast cancer. While many patients with metastatic breast cancer are living longer, current treatments for metastatic breast cancer are generally not curative. The main treatment goals for metastatic breast cancer are to effectively manage symptoms and optimise quality of life, as well as to prolong survival. There can be emotional, physical (...) NOT APPROPRIATE to use chemotherapy in preference to endocrine therapy (with or without a CDK inhibitor) as initial treatment for patients with metastatic breast cancer that is hormone receptor- positive and HER2 negative, unless there is visceral crisis. 9 NOT APPROPRIATE to routinely use extensive locoregional therapy in metastatic breast cancer patients with minimal symptoms attributable to the primary tumour. APPROPRIATE to communicate effectively and sensitively in a culturally safe environment

2019 Cancer Australia

2870. 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 (...) . Final recommendations were approved by the ASCRS Clinical Guidelines Commit- tee and ASCRS Executive Committee. In general, each AS- CRS Clinical Practice Guideline is updated every 3 to 5 years. INITIAL EVALUATION 1. A disease-specific history and physical examination should be performed, emphasizing symptoms, risk factors, and pres- ence of secondary infection. Grade of Recommendation: Strong recommendation based on low-quality evidence, 1C. The diagnosis of pilonidal disease is most often

2019 American Society of Colon and Rectal Surgeons

2871. Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease

with radiation therapy can also have a direct effect on bone in the treated field which leads to bone atrophy. It can also indirectly effect bone through vascular changes. Insufficiency fractures are a common complication after radiation therapy and generally affect bones that are under the most physiologic stress —for example, pelvic or rib fractures with pelvic or chest irradiation, respectively. A variety of physical, metabolic, and psychosocial changes in patients with cancer, such as malnourishment due (...) . RECOMMENDATIONS Patients with nonmetastatic cancer may be at risk for osteoporotic fractures due to baseline risks or due to the added risks that are associated with their cancer therapy. Clinicians are advised to assess fracture risk using established tools. For those patients with substantial risk of osteoporotic fracture, the clinician should obtain a bone mineral density test. The bone health of all patients may benefit from optimizing nutrition, exercise, and lifestyle. When a pharmacologic agent

2019 American Society of Clinical Oncology Guidelines

2872. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America

antibiotic therapy, and subsequent management decisions. Although some recommendations remain unchanged from the 2007 guideline, the availability of results from new therapeutic trials and epidemiological investigations led to revised recommendations for empiric treatment strategies and additional management decisions. Conclusions: The panel formulated and provided the rationale for recommendations on selected diagnostic and treatment strategies for adult patients with community-acquired pneumonia (...) : In the Inpatient Setting, Should Patients with Suspected Aspiration Pneumonia Receive Additional Anaerobic Coverage beyond Standard Empiric Treatment for CAP? Question 11: In the Inpatient Setting, Should Adults with CAP and Risk Factors for MRSA or P. aeruginosa Be Treated with Extended-Spectrum Antibiotic Therapy Instead of Standard CAP Regimens? Question 12: In the Inpatient Setting, Should Adults with CAP Be Treated with Corticosteroids? Question 13: In Adults with CAP Who Test Positive for Influenza

2019 American Thoracic Society

2873. Policy Prevention of Sports-related Orofacial Injuries

as this will prevent or reduce injury by better absorbing and dis- tributing the force of impact. 65 The practitioner also should consider the patient’s vertical dimension of occlusion, personal comfort, and breathing ability. 63 By providing cushioning between the maxilla and mandible, mouthguards also may reduce the incidence or severity of condylar displacement injuries as well as the potential for concussions. 55,66 Due to the continual shifting of teeth in orthodontic therapy, the exfoliation of primary teeth (...) of injuries in the young athlete. Sports Med 2003;33(1):75-81. 6. Knapik JJ, Marshall SW, Lee RB, et al. Mouthguards in sport activities: History, physical properties and injury prevention effectiveness. Sports Med 2007;37(2):117-4. 7. Gassner R, Tuli T, Hachl O, Moreira R, Ulmer H. Cra- niomaxillofacial trauma in children: A review of 3,385 cases with 6,060 injuries in 10 years. J Oral Maxillofac Surg 2004;62(4):399-407. 8. Black AM, Patton DA, Eliason PH, Emery CA. Prevention of sport-related facial

2018 American Academy of Pediatric Dentistry

2874. Acne clinical guideline

the guideline was prepared. The results of future studies may require revisions to the recommendations in this guideline to reflect new data. Scope This guideline addresses the management of adolescent and adult patients who present with acne vulgaris (AV). This document will discuss various acne treatments, including topical therapies, systemic agents, and physical modalities, including lasers and photodynamic therapy. In addition, grading/classification system, microbiology and endocrinology testing (...) agents • Spironolactone • Antiandrogens • Oral corticosteroids What is the effectiveness and what are the potential side effects of isotretinoin in the treatment of adult acne and acne vulgaris in adolescents to adults? What is the effectiveness and potential side effects of physical modalities for the treatment of acne vulgaris in adolescents to adults, including: • Intralesional steroids • Chemical peels • Comedo removal • Lasers and photodynamic therapy What is the effectiveness and what

2016 American Academy of Dermatology

2875. Clinical practice guidelines for dementia in Australia

occupational therapy interventions which should include: environmental assessment and modification to aid independent functioning; prescription of assistive technology; and tailored intervention to promote independence in activities of daily living.* People with dementia who develop behavioural and psychological symptoms should be offered a comprehensive assessment at an early opportunity by a professional skilled in symptom assessment and management. This should involve their carer(s) and families (...) as appropriate and include; analysis of the behaviours, assessment of physical and mental health, pain or discomfort, side effects of medication, the influence of religious and spiritual beliefs and cultural norms, physical environmental and interpersonal factors, an assessment of carer(s) health and communication style, understanding the behaviour as a form of communication.* People with Alzheimer’s disease, vascular dementia or mixed dementias with mild-to-moderate behavioural and psychological symptoms

2016 MJA Clinical Guidelines

2876. Immunoglobulin infusions: intravenous and subcutaneous

Immunoglobulin infusions: intravenous and subcutaneous Immunoglobulin infusions: intravenous and subcutaneous | Great Ormond Street Hospital Google Tag Manager Navigation Search Search You are here Immunoglobulin infusions: intravenous and subcutaneous Immunoglobulin infusions: intravenous and subcutaneous ) ( ). In addition, it can be used as supportive therapy for secondary immunodeficiency where extrinisic factors such as chemotherapy cause damage to the immune system, eg following stem cell (...) prescription. For indications that are not included in the 'Red' or 'Blue' categories in the National Guidelines, approval will need to be sought from the GOSH Immunoglobulin Advisory Panel. Immunoglobulin is a human blood product and must not be administered unless it is prescribed on the child / young person's electronic prescription chart as per hospital policy ( ) ( ). Calculate the dose ( ): replacement therapy: 400–600mg/kg/3 weeks (divide dose by 3 for weekly SCIg dose) modulation: 1–2g/kg

2017 Publication 1593

2877. Peripheral venous cannulation of children

guideline ( ). Any training should acknowledge that the physical act of inserting a cannula into the child’s vein is only a part of this procedure. Training should incorporate the sequence of events and psychological considerations ( )( ). Once the essential skills have been taught, the trainee must have opportunities to practise cannulation as soon and as frequently as possible ( )( ). The newly trained HCP should continue to make themselves aware of developments in practice, research and available (...) of restrictive physical intervention and therapeutic holding that will be required for the individual child ( ; )( ). The age of the child and their possible competence to assent or consent to the procedure must also be considered. Cannulation – procedure There should be adequate lighting of the environment and the room warm enough to encourage vasodilation. Position the child on a chair, on a treatment couch or on their parent’s lap as appropriate. Whenever possible, allow the child the freedom to select

2017 Publication 1593

2878. The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline

in Australia awaiting visa outcomes. People from refugee-like backgrounds are likely to have experienced disruption of basic services, poverty, food insecurity, poor living conditions and prolonged uncertainty; they may have experienced significant human rights violations, trauma or torture. These circumstances place them at increased risk of complex physical and mental health conditions. They face numerous barriers to accessing health care after arrival in Australia, such as language, financial stress (...) eosinophil count and stool sample if abnormal. Refer pregnant women or children < 15 kg for specialist management. Intestinal parasites: Check full blood examination for eosinophilia. If pre-departure albendazole therapy is documented: if there are no eosinophilia and no symptoms, no investigation or treatment is required; and if there is eosinophilia, perform stool microscopy for ova, cysts and parasites, followed by directed treatment. If no documented pre-departure albendazole therapy, depending

2017 MJA Clinical Guidelines

2879. The Diagnosis and Acute Management of Childhood Stroke, Clinical Guideline

7 PRIMARY PAEDIATRIC STROKE CENTRE CARE 21 8 MODIFIABLE FACTORS AND ACUTE STABILISATION 23 8.1 Blood Pressure 23 8.2 Glucose 25 8.3 Temperature 25 8.4 Oxygen supplementation 26 8.5 Hydration 27 8.6 Seizures 27 9 REPERFUSION THERAPIES 29 9.1 Intravenous tissue plasminogen activator 29 9.2 Endovascular therapy 32 10 ANTI-THROMBOTIC THERAPY 34 10.1 Anticoagulation and antiplatelet therapy 34 10.2 Steroid therapy 35 11 INTRACRANIAL PRESSURE AND DECOMPRESSIVE CRANIECTOMY FOR ACUTE ARTERIAL STROKE 36 (...) . Recommendations for the use of stroke recognition tools 10 Table 8. Recommendations for physical examinations in children with suspected or confirmed stroke 10 Table 9. Recommendations to reduce time to diagnosis 11 Table 10. Neuroimaging recommendations for diagnosing arterial ischaemic stroke 13 Table 11. Neuroimaging recommendations for diagnosing haemorrhagic stroke 13 Table 12. Risk factors for initial and recurrent stroke 15 Table 13. Initial laboratory investigations for suspected or confirmed

2017 Stroke Foundation - Australia

2880. Endocrine Society of Australia position statement on male hypogonadism (part 2): treatment and therapeutic considerations

/mja16.00448 Published online: 5 September 2016 Topics Related Articles Abstract Introduction: Part 1 of this position statement dealt with the assessment of male hypogonadism, including the indications for testosterone therapy. This article, Part 2, focuses on treatment and therapeutic considerations for male hypogonadism and identifies key questions for future research. Main recommendations: Key points and recommendations are: Excess cardiovascular events have been reported in some but not all studies (...) of older men without pathological hypogonadism who were given testosterone treatment. Additional studies are needed to clarify whether testosterone therapy influences cardiovascular risk. Testosterone is the native hormone that should be replaced in men being treated for pathological hypogonadism. Convenient and cost-effective treatment modalities include depot intramuscular injection and transdermal administration (gel, cream or liquid formulations). Monitoring of testosterone therapy is recommended

2016 MJA Clinical Guidelines


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