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81. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Initial Management of Concussion/mTBI

provider’s (PCP’s) office, ruling out traumatic brain or spine injury that requires emergency intervention is the initial priority. Acutely following injury, it is essential that a management plan be initiated for each patient including: information regarding monitoring for potential acute complications requiring re-assessment, education regarding expected symptoms and course of recovery, and recommendations for healthcare follow-up post-injury. 1 Treatment should be individualized and based (...) the effectiveness of active rehabilitation such as psychoeducational, psychological and cognitive interventions. 9-12 The primary forms of treatment have traditionally included a recommendation for physical and cognitive rest until symptoms subside along with other interventions, such as education, coping techniques, support and reassurance, neurocognitive rehabilitation and antidepressants. 9,13 However, the most recent world Sport-Related Concussion consensus statement indicated that there is currently

2018 Ontario Neurotrauma Foundation

82. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Sport-Related Concussion/mTBI

concussion/mTBI may require onsite (on-field) medical assessments by emergency medical professionals for a more severe head injury, cervical or spine injury, or loss of consciousness. In cases in which a concussion/mTBI is suspected without a more severe head or spine injury, a player should be removed from the field of play and a sideline assessment can be performed. The Concussion in Sport Group has created a revised Sport Concussion Assessment Tool (SCAT5 and the Concussion Recognition Tool 5 (...) with licensed training in mTBI. Individualized medical and rehabilitative care will be provided for the athlete and medical clearance is required before the athlete can return-to-sport. 6 The Buffalo Concussion Treadmill Test (Appendix ) can be used to investigate exercise tolerance in people with persistent symptoms. Healthcare professionals should counsel amateur athletes with a history of multiple concussion/mTBIs and subjective persistent neurobehavioural impairments about the risk of further concussion

2018 Ontario Neurotrauma Foundation

83. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Vestibular (Balance/ Dizziness) & Vision Dysfunction

interventions can be considered. While historically, medications have been used to suppress vestibular symptoms, including nausea, current evidence does not support this approach. 9 A Cochrane review by Hillier and Hollohan (2007) identifies vestibular rehabilitation as an effective intervention for unilateral peripheral vestibular dysfunction 1 ; this has been supported by Gurley et al. 6 Weaker evidence also suggests vestibular rehabilitation may be helpful for central vestibular dysfunction. 10 (...) Vestibular rehabilitation is typically provided by a specialized a healthcare professional with specialized training and involves various movement-based regimens to bring on vestibular symptoms and desensitize the vestibular system, coordinate eye and head movements, and improve functional balance and mobility. However, for the specific treatment of BPPV, Hillier and Hollohan (2007) conclude that canalith or particle repositioning manoeuvres are more effective than vestibular rehabilitation techniques. 1

2018 Ontario Neurotrauma Foundation

84. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults

., stroke, multiple sclerosis, spinal cord injury), mobility deficits, medically complicated/uncontrolled diabetes, fecal motility disorders (fecal incontinence/constipation), chronic pelvic pain, history of recurrent urinary tract infections (UTIs), gross hematuria, prior pelvic/vaginal surgeries (incontinence/prolapse surgeries), pelvic cancer (bladder, colon, cervix, uterus, prostate) and pelvic radiation. The female patient with significant prolapse (i.e., prolapse beyond the introitus) also may

2019 American Urological Association

86. QTc Prolongation and Psychotropic Medications

Manual. Prepared by Margo C. Funk, M.D., M.A., 1 Scott R. Beach, M.D., 2,3 Jolene R. Bostwick, PharmD, BCPS, BCPP, 4 Christopher M. Celano, M.D., 2,3 Mehrul Hasnain, M.D., 5 Ananda Pandurangi, M.B.B.S., M.D., 6 Abhisek C. Khandai, M.D., M.S., 7 Adrienne Taylor, M.D., 7 James L. Levenson, M.D., 6 Michelle Riba, M.D., 8 and Richard J. Kovacs, M.D. 9 1 Mental Health Service Line, Veterans Affairs Southern Oregon Rehabilitation Center and Clinics, White City, OR; 2 Department of Psychiatry, Massachusetts

2018 American Psychiatric Association

87. Global Vascular Guidelines for patients with chronic limb-threatening ischemia Full Text available with Trip Pro

on smoking cessation, diet, exercise, and preventive foot care. Following EBR, long-term limb surveillance is advised. The effectiveness of nonrevascularization therapies (eg, spinal stimulation, pneumatic compression, prostanoids, and hyperbaric oxygen) has not been established. Regenerative medicine approaches (eg, cell, gene therapies) for CLTI should be restricted to rigorously conducted randomizsed clinical trials. The GVG promotes standardization of study designs and end points for clinical trials (...) lipoprotein cholesterol LMICs Low- and middle-income countries LS Lumbar sympathectomy MACE Major adverse cardiovascular event MALE Major adverse limb event MRA Magnetic resonance angiography OPG Objective performance goal PAD Peripheral artery disease PBA Plain balloon angioplasty PFA Profunda femoris artery PLAN Patient risk estimation, limb staging, anatomic pattern of disease PROM Patient-reported outcomes measure PSV Peak systolic velocity PT Posterior tibial PVR Pulse volume recording RCT Randomized

2019 Society for Vascular Surgery

88. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

impairments that might increase the potential for airway obstruction, obesity, a history of snoring or OSA, – or cervical spine instability in Down syndrome, Marfan syndrome, skeletal dysplasia, and other conditions; (4) pregnancy status (as many as 1% of menarchal females presenting for general anesthesia at children’s hospitals are pregnant) – because of concerns for the potential adverse effects of most sedating and anesthetic drugs on the fetus , – ; (5) history of prematurity (may be associated

2019 American Academy of Pediatrics

89. Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome

of patients with mild to moderate CTS for the treatment of clinical signs and symptoms. B Clinicians should not use or recommend the use of mag- nets in the intervention for individuals with CTS. INTERVENTIONS – MANUAL THERAPY TECHNIQUES C Clinicians may perform manual therapy, directed at the cervical spine and upper extremity, for individuals with mild to moderate CTS in the short term. D There is conflicting evidence on the use of neurodynamic mobilizations in the management of mild to moderate CTS (...) internation- ally accepted terminology, of the practice of orthopaedic physical therapists and hand rehabilitation • Provide information for payers and claims reviewers re- garding the practice of orthopaedic and hand therapy for common musculoskeletal conditions • Create a reference publication for clinicians, academic in- structors, clinical instructors, students, interns, residents, and fellows regarding the best current practice of ortho- paedic physical therapy and hand rehabilitation STATEMENT

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

91. Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients

/dose given IV pre- therapy x 1 and then 16 mg/m 2 /day IV either divided q6h or divided into 2 doses given q4h) were given; however, the results were provided in aggregate. 22 These studies did not evaluate AINV control using common antiemetic backbones so comparison of the performance of the dexamethasone doses used in these studies is not possible. The fourth randomized controlled trial involved too few children to permit evaluation of the outcome in this subset of the study sample. 21 40 Version

2013 SickKids Supportive Care Guidelines

92. Spasticity in under 19s: management

the spinal cord (the intrathecal space) using a lumbar puncture needle or a temporary spinal catheter in order to assess the likely response to continuous pump-administered baclofen treatment. Kyphosis Abnormal curvature of the spine when viewed from the side of the body that results in a hunched or slouching position. Low-load active stretching A physical therapy intervention in which the child or young person actively stretches their muscles with the aim of increasing range of movement. Low-load (...) Passive range of movement 10 Range of movement 10 Spasticity in under 19s: management (CG145) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 41Scoliosis 10 Secondary complication of spasticity 10 Secondary consequence of spasticity 10 Selective dorsal rhizotomy 10 Serial casting 11 Spasticity 11 Spinal fusion 11 T ask-focused active-use therapy 11 Key priorities for implementation 12 1 Guidance 14 1.1 Principles

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

93. Urinary incontinence in neurological disease: assessment and management

function lumbar and sacral spinal segment function. 1.1.5 Undertake a urine dipstick test using an appropriately collected sample to test for the presence of blood, glucose, protein, leukocytes and nitrites. Appropriate urine samples include clean-catch midstream samples, samples taken from a freshly inserted intermittent sterile catheter and samples taken from a catheter port. Do not take samples from leg bags. 1.1.6 If the dipstick test result and person's symptoms suggest an infection, arrange (...) Neuromuscular electrical stimulation 43 Overactive bladder 43 Pelvic floor muscle training 43 Pelvic floor prolapse 43 Pressure-flow studies 44 Urinary incontinence in neurological disease: assessment and management (CG148) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 4 of 47Prompted voiding 44 Renal scintigraphy 44 Sacral agenesis 44 Spina bifida 44 Spinal dysraphism 44 Stress incontinence 45 Timed voiding 45 Urethral

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

94. Improving outcomes in breast cancer

coughing, paralysis due to spinal cord compression, and bone fractures. The intention of treatment at this stage is not curative – although some prolongation of life may be possible – but to relieve symptoms and improve quality of life. Patients may be offered radiotherapy, hormone treatment, chemotherapy and, possibly, immunotherapy. Supportive and palliative care and practical help with everyday activities are essential to maintain quality of life in the later stages of the disease. Breast cancer

2002 National Institute for Health and Clinical Excellence - Clinical Guidelines

95. Workplace health: long-term sickness absence and incapacity to work

reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 4 of 84Rehabilitation 43 Return-to-work credit 44 Shift 44 Short-term sickness absence (including recurring short-term sickness absence) 44 Statutory sick pay (SSP) 44 Stress 44 Usual care and treatment 45 Vocational rehabilitation 45 Worklessness 45 9 References 46 Appendix A: Membership of the Programme Development Group, the NICE project team and external contractors 49 The Programme (...) and eradicate child poverty. Helping people who are off sick and on incapacity benefit to resume work and draw a full salary will help achieve these targets (Department for Work and Pensions 2007). More recently, the review of Britain's working-age population made a number of proposals to help achieve these targets (Health, Work and Wellbeing Programme 2008). In addition, they are supported by a recent review of vocational rehabilitation interventions (Waddell et al. 2008). Workplace health: long-term

2009 National Institute for Health and Clinical Excellence - Clinical Guidelines

96. Advanced breast cancer: diagnosis and treatment

in the bones of the axial skeleton using bone windows on a CT scan or MRI or bone scintigraphy. [2009] [2009] 1.1.3 Assess proximal limb bones for the risk of pathological fracture in patients with evidence of bone metastases elsewhere, using bone scintigraphy and/or plain radiography. [2009] [2009] 1.1.4 Use MRI to assess bony metastases if other imaging is equivocal for metastatic disease or if more information is needed (for example, if there are lytic metastases encroaching on the spinal canal). [2009 (...) -of-rights). Page 10 of 181.5.20 Offer active rehabilitation to patients who have surgery and/or whole brain radiotherapy. [2009] [2009] 1.5.21 Offer referral to specialist palliative care to patients for whom active treatment for brain metastases would be inappropriate. [2009] [2009] [1] This recommendation is from gemcitabine for the treatment of metastatic breast cancer (NICE technology appraisal guidance 116; 2007). It was formulated as part of that technology appraisal and not by the guideline

2009 National Institute for Health and Clinical Excellence - Clinical Guidelines

97. Hip fracture: management

of surgery 5 1.3 Analgesia 6 1.4 Anaesthesia 7 1.5 Planning the theatre team 7 1.6 Surgical procedures 7 1.7 Mobilisation strategies 8 1.8 Multidisciplinary management 8 1.9 Patient and carer information 10 Putting this guideline into practice 11 Context 13 More information 14 Recommendations for research 15 1 Imaging options in occult hip fracture 15 2 Anaesthesia 15 3 Undisplaced intracapsular hip fractures 16 4 Intensive rehabilitation therapies after hip fracture 16 5 Early supported discharge (...) with suspected hip fracture, including people with cognitive impairment. [2011] [2011] 1.3.3 Ensure analgesia is sufficient to allow movements necessary for investigations (as indicated by the ability to tolerate passive external rotation of the leg), and for nursing care and rehabilitation. [2011] [2011] 1.3.4 Offer paracetamol every 6 hours preoperatively unless contraindicated. [2011] [2011] 1.3.5 Offer additional opioids if paracetamol alone does not provide sufficient preoperative pain relief. [2011

2011 National Institute for Health and Clinical Excellence - Clinical Guidelines

98. Fractures (non-complex): assessment and management

. It aims to improve practice so that people with fractures receive the care that they need without unnecessary tests and treatments. The guideline should be read alongside the NICE guidelines on major trauma, major trauma: service delivery, spinal injury and fractures (complex). Who is it for? Healthcare professionals and practitioners who provide care for people with fractures People with fractures, their families and carers Fractures (non-complex): assessment and management (NG38) © NICE 2018. All (...) and after treatment. 1.6.10 Provide people with fractures with both verbal and written information on the following when the management plan is agreed or changed: expected outcomes of treatment, including time to returning to usual activities and the likelihood of any permanent effects on quality of life (such as pain, loss of function or psychological effects) activities they can do to help themselves home care options, if needed rehabilitation, including whom to contact and how (this should include

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

99. Fractures (complex): assessment and management

the NICE guidelines on major trauma, major trauma: service delivery, spinal injury and fractures (non-complex). NHS England's clinical reference group (CRG) produce the service specification for major trauma. The CRG intends to consider the NICE guidelines on major trauma, major trauma: service delivery, spinal injury and complex fractures in future updates to the service specification which are planned for 2017. Who is it for? Healthcare professionals and practitioners who provide care for people (...) the person and their family members or carers (as appropriate) in a full discussion of the options if this is possible. 1.2.25 Base the decision whether to perform limb salvage or delayed primary amputation on multidisciplinary assessment involving an orthopaedic surgeon, a plastic surgeon, a rehabilitation specialist and the person and their family members or carers (as appropriate). 1.2.26 When indicated, perform the delayed primary amputation within 72 hours of injury. Debridement, staging of fix

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

100. Multiple sclerosis in adults: management

Introduction 5 Drug recommendations 6 Key priorities for implementation 7 Diagnosing MS 7 Information and support 7 Coordination of care 8 MS symptom management and rehabilitation 8 Treating acute relapse of MS with steroids 8 1 Recommendations 9 1.1 Diagnosing MS 9 1.2 Providing information and support 11 1.3 Coordination of care 12 1.4 Modifiable risk factors for relapse or progression of MS 13 1.5 MS symptom management and rehabilitation 14 1.6 Comprehensive review 18 1.7 Relapse and exacerbation 20 1.8 (...) Other treatments 23 More information 23 2 Research recommendations 25 2.1 Cognitive rehabilitation 25 2.2 Continued relapses 25 2.3 Mobility 25 2.4 Spasticity 26 2.5 Vitamin D 26 Update information 28 Multiple sclerosis in adults: management (CG186) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 28This guideline replaces CG8. This guideline is the basis of QS108. Ov Overview erview This guideline covers

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

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