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161. Guidelines on autopsy practice: Third trimester antepartum and intrapartum stillbirth

, in conjunction with HTA. 8 CEff 150617 6 V1 Draft · The pathologist performing the autopsy must see the completed consent form, either as a physical copy or electronically, before commencing the autopsy. Any limitations on the scope of the autopsy must be complied with. · Any concerns regarding the validity of the consent should be resolved before commencing the autopsy. [Level of evidence D.] 6 Clinical information relevant to the autopsy (Best obtained using structured request form, see Appendix (...) unless the pathologist has seen a physical copy of the consent form and it is correctly completed). · Autopsy report: standards: 100% of autopsy reports must include all of the sections detailed in section 15 (above). standards: in 100% of autopsy reports the information documented is satisfactory, good or excellent. standards: in 100% of autopsy reports the clinicopathological summary is clear and concise and, when appropriate, contains the information detailed above. CEff 150617 12 V1 Draft 17

2017 Royal College of Pathologists

162. Guidelines on autopsy practice: Fetal autopsy (2nd trimester fetal loss and termination of pregnancy for congenital anomaly)

of the HTA s Code of Practice: Code A: Guiding Principles and the Fundamental Principle of Consent. 7 · The autopsy consent form should be compliant with the model Consent form for perinatal post mortem developed by SANDS, the stillbirth and neonatal death charity, in consultation with the HTA. 8 · The pathologist performing the autopsy must see the completed consent form, either as a physical copy or electronically, before commencing the autopsy. Any limitations on the scope of the autopsy must (...) : standards: supporting documentation was submitted with the body in 95% of cases. (NB it is recommended that an autopsy should not be commenced in the absence of clinical information) standards: 95% of submitted information is satisfactory, good or excellent standards: a correctly completed autopsy consent form, meeting national requirements is submitted with 95% of cases. (NB an autopsy must not be commenced unless the pathologist has seen a physical copy of the consent form and it is correctly

2017 Royal College of Pathologists

163. Guidelines on the management of abnormal liver blood tests

is estimated at just under 10%. 40 Primary sclerosing cholangitis-inflamma- tory bowel disease is associated with increased complications relating to liver disease, as well as increased colorectal cancer risk. 41 Periodic monitoring of liver blood tests is therefore common practice, with a low clinical threshold for investiga- tion of cholestatic liver blood tests by MRI. In the absence of currently approved medical therapy ongoing efforts clinically table 2 Liver aetiology table for patients with non (...) -invasive assessment, such as Fibrosis-4 (FIB-4) 49 or NAFLD Fibrosis Score (NFS), 50 is undertaken to identify patients with advanced fibrosis (Table 3). Patients with a low FIB-4 ( 65 years) or low NFS ( 65 years) can be managed in primary care. 51 Presently, the mainstay of treatment for NAFLD is to reduce calorie intake and increase physical activity with the aim of inducing gradual and long-term weight loss (see figures 1 and 2). Those patients with indeterminate FIB-4 (1.3–3.25) or NFS scores

2017 British Society of Gastroenterology

164. Guidelines on autopsy practice: Autopsy in sickle cell disease and persons with sickle trait

information relevant to the autopsy · All the present relevant and past medical history details, particularly the clinical mode of death, recent operation records, drug and pain-relief therapy, current radiology. CEff 050417 8 V4 Final · Laboratory results such as blood cultures, recent haematology data (haemoglobin, WBC, platelets, reticulocyte count, clotting studies) and relevant biochemistry, must be gathered, including the specific sickle genotype. · Discussion with the sickle physicians is always (...) , Lee E, de la Fuente J. Hyperhaemolysis syndrome in sickle cell disease: case report (recurrent episode) and literature review. Transfusion 2008;48:1231 1238. 19 Biedrzycki O, Bevan, Lucas S. Fatal overdose due to prescription fentanyl patches in a patient with sickle cell/ -thalassaemia and acute chest syndrome. Am J Forensic Med Pathol 2009;30:188 190. 20 Kark JA, Posey DM, Schumacher HR, Ruehle CJ. Sickle cell trait as a risk factor for sudden death in physical training. N Engl J Med 1987;317

2017 Royal College of Pathologists

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

of Health. Accuracy of the triple test The INBS guide 28 includes details on the accuracy (sensitivity, specificity) of the triple test and each of its components which is based on information published pre-1995. 29 The Malaysian Breast Cancer guidelines, 10 referenced a small cross-sectional study (N=50), published in 2008, 30 regarding the accuracy of the triple test score (physical examination, mammography and fine needle aspirate cytology) in the diagnosis of a palpable breast lump on women above 35 (...) concerning physical examination, begin with mammography. US is useful if mammography is inconclusive or suspicious. University of Michigan 2013 19 Men – Diagnose and treat enlargement or pain. Breast mass is rare, but suspicious for cancer UK DoH 2010 12 History & clinical assessment to be performed (note testicles also to be examined) Imaging: “Mammography and/or ultrasound should be performed in men with unexplained or suspicious unilateral breast enlargement” Biopsy: “Needle core biopsy should

2017 Cancer Australia

166. Canadian guideline on HIV pre-exposure prophylaxis and nonoccupational postexposure prophylaxis

at baseline or during PrEP use. • PrEP may be considered in people with low bone mass or osteoporosis after the risks and benefits have been discussed with them. Sexually transmitted infections and viral hepatitis • Laboratory screening for sexually transmitted infections is suggested at baseline and at each quarterly follow-up visit, with appropriate therapy for any identified infections. • Hepatitis A, B and C serologies should be performed at baseline, with vaccination for hepatitis A and B (...) infection • If tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) PrEP is prescribed in a person with chronic hepatitis B infection, appropriate monitoring for hepatitis B virus should be performed in accordance with hepatitis B treatment guidelines, if necessary in consultation with a qualified practitioner with experience in treating the virus. • When considering PrEP discontinuation, the need for ongoing therapy for hepatitis B virus should be assessed. If PrEP is discontinued and no other therapy

2017 CPG Infobase

167. Frailty in Older Adults - Early Identification and Management

patient fitness for physical activity (fall risk, cardiac risk, etc.). Consider referral to a community exercise program. A program that includes balance, strength, flexibility and endurance training is recommended. Direct patient to physical activity services offered by or 8-1-1. Consider referral to physical therapist or occupational therapist. Activity level Exercise program Fatigue and energy level Endurance and strength Basic Activities of Daily Living Consider referral for occupational therapy (...) with the patient and/or family/caregivers/representatives, and with other key care providers. Initiate advance care planning discussions for patients with frailty or vulnerable to frailty. Definition Frailty is broadly seen as a state of increased vulnerability and functional impairment caused by cumulative declines across multiple systems. 1–4 Frailty has multiple causes and contributors 5 and may be physical, psychological, social, or a combination of these. Frailty may include loss of muscle mass

2017 Clinical Practice Guidelines and Protocols in British Columbia

168. Ileoanal Pouch Report

Primary ileoanal pouch surgery Patient demographics and disease profile 32 Diagnosis 32 Age and gender 32 Age and diagnosis 34 Extent of disease 35 Time from diagnosis to surgery 36 ASA grade 37 Comorbidity 38 Use of biological therapy 395 Technical factors 40 Pouch design 40 Surgical approach 41 Planes of rectal dissection 42 Stapling in pouch construction and ileoanal anastomoses 43 Use of a defunctioning ileostomy 44 Complications 45 Revisional ileoanal pouch surgery Patient demographics (...) improvements in medical management of colitis. • Unsurprisingly the use of biological therapy in treatment of ulcerative colitis before patients undergo pouch surgery has increased exponentially since 2007. In 2016-17, around 30% of patients received biological therapy before undergoing pouch surgery.7 • Laparoscopic surgery has become more frequent in the last decade with about one-half of pouch procedures reported in the Registry being carried out with a laparoscopic or laparoscopically assisted approach

2017 Association of Coloproctology of Great Britain and Ireland

169. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock

throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. Methods: The panel consisted of five sections: hemodynamics, infection , adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup (...) therapy); he participates in the UK National Institute for Clinical and Healthcare Excellence Sepsis Guideline Development Group; he has served as an expert witness, disclosing that he is approached from time to time regarding expert witness testimony for ICU cases, which may involve patients who have sepsis and the testimony relates to generally accepted current standards of care, and formal guidance, as it currently pertains within the UK. Dr. Bellingan received funding from Faron (research

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2016 European Respiratory Society

170. Influencing best practice in breast cancer

treatment-focused genetic testing. Oncology Nurses f orum. 2012;39(2):E101-11. Meiser b, Tucker K, f riedlander M, et al. genetic counselling and testing for inherited gene mutations in newly diagnosed patients with breast cancer: a review of the existing literature and a proposed research agenda. breast Cancer Research. 2008;10(6):216. Trainer AH, Lewis CR, Tucker K, et al. The role of bRCA mutation testing in determining breast cancer therapy. Nature Reviews Clinical Oncology. 2010;7(12):708-17. 1 (...) pRACTICE IN bREAST CANCER pAg E 8 Appropriate to consider and discuss fertility and family planning with premenopausal women before they undergo breast cancer treatment. CoNTExT A substantial proportion of women in Australia are diagnosed with breast cancer prior to menopause. In 2016, it is estimated that there will be 5,035 new cases (32%) of breast cancer in women aged 20-54 years. Some treatments for breast cancer, including chemotherapy and hormone therapy, may induce premature menopause and lead

2016 Cancer Australia

171. Vascular Access for Haemodialysis

-Red Therapy in Dialysis Arterio-Venous Fistula Maturation and Survival: Systematic Review and Meta-Analysis. PLoS ONE 9(8): e104931. doi:10.1371/journal.pone.010493. 13.Campos RR, Chula DC, Perreto S, et al. Accuracy of physical examination and intra- access pressure in the detection of stenosis in haemodialysis arteriovenous fistula. Semin Dial 2008;21:269-273. 14. Coentrao B Faria B Pestana M Physical examination of dysfunctional arteriovenous ?stulae by non-interventionists: a skill worth (...) provide safe and effective therapy by enabling the removal and return of blood via an extracorporeal circuit. Vascular access should be easy to use, reliable and have minimal risk to the individual receiving haemodialysis. However, the provision of good quality access, whilst it is a fundamental aspect of the treatment of haemodialysis patients, remains difficult to achieve. Native access, in particular arteriovenous fistulae, requires prior planning and has a high primary failure rate. Arteriovenous

2015 Renal Association

172. WHO recommendations on maternal health

14 Augmentation of labour 15 6. Prevention of postpartum haemorrhage 15 7. Postnatal care 16 8 . Health promotion for maternal and newborn health 19 Management of maternal conditions 22 9. Postpartum haemorrhage 22 10. Pre-eclampsia and eclampsia 23 11. Peripartum infections 24 12. HIV infection 24 13. Malaria 27 14. Tuberculosis 27iv Abbreviations AIDS acquired immunodeficiency syndrome ANC antenatal care ART antiretroviral therapy ARV antiretroviral AZT zidovudine CCT controlled cord traction (...) PREGNANCY EXPERIENCE Nutrition and nutritional supplements ¦ ¦ Counselling about healthy eating and keeping physically active during pregnancy is recommended for pregnant women to stay healthy and to prevent excessive weight gain during pregnancy. (Recommended). Source ¦ ¦ In undernourished populations, nutrition education on increasing daily energy and protein intake is recommended for pregnant women to reduce the risk of low-birth-weight neonates. (Context-specific recommendation). Source

2017 World Health Organisation Guidelines

173. ABCD position statement on standards of care for management of adults with type 1 diabetes

Wilmott Marc Atkin PratiK Choudhury 2 Contents Introduction 1. Diagnosis of type 1 diabetes 1.1 Criteria for diagnosis of diabetes 1.2 Differentiating between type 1 and type 2 diabetes 1.3 Immediate treatment 1.4 Autoimmune conditions associated with type 1 diabetes 2. Initial management 2.1 Education 2.2 Nutritional advice 2.3 Physical activity and exercise 3. Follow up consultations and ongoing support 3.1 Consultation process 3.2 Annual review 3.3 Psychological support 4. Treatment, targets (...) conditions o Failure to respond to oral therapy o Positive antibody test (anti-GAD), islet cell antibodies (ICA), insulinoma associated antibodies (IA-2) or zinc transporter( ZnT8) most commonly used) 6 o Insulin deficiency suggested by low serum C-peptide or urine C-peptide:creatinine ratio The presence of one or more of these clues may point to a diagnosis of type 1 diabetes but absence does not exclude it. Pancreatic autoantibodies Pancreatic autoantibodies (eg anti GAD65, IA-2) are present

2017 Association of British Clinical Diabetologists

174. WHO recommendations on child health

acquired immunodeficiency virus ART antiretroviral therapy ARV antiretroviral AZT zidovudine BCG Bacillus Calmette-Guérin SMC seasonal malaria chemoprevention CSOM chronic supporative otitis media DTP diphtheria-pertussis-tetanus E ethambutol EFZ efavirenz FTC emtricitabine GRADE Grading of Recommendations, Assessment, Development and Evaluation GRC Guidelines Review Committee INH isoniazid HIV human immunodeficiency virus IM intramuscular IPV inactivated polio vaccine MCV measles-containing vaccine (...) are more effective among people receiving antiretroviral therapy (ART) and those without immunosuppression, but they are safe and can be used with some efficacy in all groups. ( No strength, quality). Source 2. BREASTFEEDING Exclusive breastfeeding ¦ ¦ All babies should be exclusively breastfed from birth until 6 months of age. ¦ ¦ Mothers should be counselled and provided support for exclusive breastfeeding at each postnatal contact. ¦ ¦ Breastfeeding progress should be assessed at each postnatal

2017 World Health Organisation Guidelines

175. Hypertension management and renin-angiotensin-aldosterone system blockade in patients with diabetes, nephropathy and/or chronic kidney disease

than a quarter of patients who are on dialysis in the UK have diabetes. 2 Diabetic kidney disease is associated with high morbidity and mortality, which are predominantly related to cardiovascular complications and the progression of kidney disease that requires renal replacement therapy. Hypertension is a modifiable risk factor for cardiovascular complications and progression of CKD. 3 This guidance is for the variety of clinicians who manage patients with diabetic kidney disease, including GPs (...) diabetes 5 © Association of British Clinical Diabetologists 2017 Recommendations The following are recommendations for renin-angiotensin-aldosterone system (RAAS) blockade and hypertension management in patients with type 1 diabetes. 1 In patients with type 1 diabetes and normoalbuminuria, we suggest a threshold for blood pressure therapy of a persistent upright (sitting or standing) blood pressure that is greater than or equal to 140/80 mmHg (Grade 2D). In children and adolescents with type 1 diabetes

2017 Association of British Clinical Diabetologists

176. WHO recommendations on adolescent health

and physical activity Tobacco 8. Violence and injury prevention 9. Prevention of mental health problems and promotion of mental health 10. Nutrition Management of adolescent conditions 11. HIV testing and counselling for adolescents living with HIV 12. Antiretroviral Therapy 13. Treatment of skin and oral HIV-associated conditions in children and adults 14. Treatment of sexually transmitted infections 15. Treatment of malaria 16. Treatment of malnutrition 17. Violence and injuries 18. Mental disorders 36 (...) Contentsiv Abbreviations AIDS ANC ART ARV AZT BW CCT EFZ FTC G6PD GDG GRADE GRC HIV IM IV 3TC mg NTD NVP NNRTI NRTI PMTCT PPH TDF WHO acquired immunodeficiency syndrome antenatal care antiretroviral therapy antiretroviral zidovudine body weight controlled cord traction efavirenz emtricitabine glucose-6-phosphate dehydrogenase Guidelines Development Group Grading of Recommendations, Assessment, Development and Evaluation Guidelines Review Committee human immunodeficiency virus intramuscular intravenous

2017 World Health Organisation Guidelines

177. Association of British Clinical Diabetologists - Renal Association (ABCD-RA) Clinical Practice Guidelines for Management of Lipids in Adults with Diabetes Mellitus and Nephropathy and/or Chronic Kidney Disease

is associated with the need for major changes in lifestyle, dietary and fluid intake restrictions, hospital attendance and medication. This is a time when patients are vulnerable to various physical and psychological stresses, and the risk of cardiovascular events increases. During this period, it is appropriate to review medication regimens and this should include management of lipid lowering therapy in patients with DM CKD. For some patients with a large pill burden and substantial co-morbid disease (...) , and there was no information on albuminuric status to better define baseline risk. In a meta-analysis demonstrating the benefit of cholesterol-lowering therapy in 18,686 people with diabetes, only 1466 had type 1 diabetes, 26 their mean age was 55 years, 56% had established vascular disease, and there was a high evident incidence of hypertension (48%) and nephropathy (although mean serum creatinine was 101µmol/l). Consequently, the basis for intervention in different guidelines has been variably set depending on age

2017 Association of British Clinical Diabetologists

178. Clinical Guideline for Administration of Molecular Radiotherapy

The purpose of this guideline is to define quality standards for the administration of Molecular Radionuclide Therapy (MRT). This guideline should be used to help individual departments formulate their own local protocols and assist commissioners seeking to understand and establish quality and performance standards for Molecular Radionuclide Therapy services. Molecular radionuclide therapy is given by administering a radiopharmaceutical (a radiation source attached to a drug or chemical) which (...) Rhenium- colloid Pain relief from bony metastases Synovectomy 177 Lutetium 177 Lutetium-PRRT (Peptide Receptor Radionuclide Therapy Neuroendocrine tumours (NETs) (peptides – Dotatate, Dotanoc, Dotatide Purpose Background List of Molecular Radiotherapy Isotopes 4 177 Lutetium-PSMA (Prostate Specific Membrane Antigen) Prostate Cancer 32 Phosphorous 32 Phosphorous –Phosphate Polycythemia vera and related disorders 90 Yttrium 90 Yttrium - colloidal silicate/citrate Arthritic conditions 90 Yttrium

2017 British Nuclear Medicine Society

179. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities

zone: Contains the patient and his/her immediate surroundings. This typically includes all inanimate surfaces that are touched by or in direct physical contact with the patient, such as the bed rails, bedside table, bed linen, infusion tubing, bedpans, urinals and other medical equipment. It also contains surfaces frequently touched by health care workers during patient care, such as monitors, knobs and buttons, and other “high frequency” touch surfaces. This is according to the definition included (...) , it was recognized that occupational health issues associated with the use of some personal protective equipment (for example, latex gloves) should also be taken into consideration for health care workers. The panel recommends that patients colonized or infected with CRE-CRAB-CRPsA should be physically separated from non-colonized or non-infected patients using (a) single room isolation or (b) by cohorting patients with the same resistant pathogen. Strong recommendation, very low to low quality of evidence ñ

2017 World Health Organisation Guidelines

180. Evidence-based Clinical Practice Guideline for Deprescribing Cholinesterase Inhibitors and Memantine

controlled trials of discontinuation versus continuation of cholinesterase inhibitors .. 29 Other study types of discontinuation of cholinesterase inhibitors 32 Memantine 34 Evidence to recommendations summary 35 Benefits of Cholinesterase Inhibitors and Memantine 36 Cholinesterase inhibitors (donepezil, rivastigmine and galantamine) 36 Mild to severe Alzheimer’s disease 36 Non–Alzheimer’s disease dementia 38 Memantine and dual therapy 39 Summary of benefits 39 Harms of Cholinesterase Inhibitors (...) , insufficient monitoring and lack of appropriate discontinuation seem to be the main contributors to inappropriate use of ChEIs [40]. For example, in a study of nursing home residents in the United States (US), 16% of all residents with advanced dementia continued to be prescribed a ChEI [42]. Three separate studies in Australia, Canada and the US found that, in approximately half of all observed deaths of ChEI users, therapy was continued into the last week before death [24,28,43]. Prescription

2018 Clinical Practice Guidelines Portal


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