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141. Pediatric Home Mechanical Ventilation

Division of Respiratory Medicine, Children’s Hospital of Eastern Ontario, Ottawa, Canada; d Division of Respiratory Medicine, Montreal Children’s Hospital, Montreal, Canada; e Division of Paediatric Critical Care, British Columbia Children’s Hospital, Vancouver, Canada; f Division of Paediatric Critical Care, Montreal’s Children’s Hospital, Montreal, Canada; g Division of Complex Continuing Care, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; h Division of Paediatric Respirology (...) that employed in adults on long-term home ventilation. As with the adult guidelines, 1 this document providesadisease-speci?creviewofillnessesassociatedwiththenecessityforlong-termventilationinchildren, including children with chronic lung disease, spinal muscle atrophy, muscular dystrophies, kyphoscoliosis, obesity hypoventilation syndrome, and central hypoventilation syndromes. It also covers important common themes such as airway clearance, the ethics of initiation of long-term ventilation in individuals

2017 Canadian Thoracic Society

143. Oral Health Care for the Pregnant Adolescent

and B-12. 18 Maternal levels of vitamin D during pregnancy may affect the developing pri- mary dentition, with lower levels altering enamel integrity and increasing the risk for early childhood caries. 19 Folic acid, a B vitamin, plays an important role in the production of cells and helps in the development of the neural tube, the brain, and spinal cord. 20 Folic acid supplementation has been shown to decrease the risk of isolated cleft lip with or without cleft palate. 21 A recent study supports (...) , it is the dentist’s responsibility to follow the as low as reasonably achievable (ALARA principle) to minimize the patient’s exposure. 70 Suppression of the mother’s reservoirs of Mutans strep- tococci (MS) by dental rehabilitation and antimicrobial treatments may prevent or at least delay infant acquisition of these cariogenic microorganisms. 73 MS, present in children with early childhood caries, is predominantly acquired from mother’s saliva. 74 The transmission of cariogenic bacteria from mother to infant

2016 American Academy of Pediatric Dentistry

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

of prematurity); and • health history, including (1) food and medication al- lergies and previous allergic or adverse drug reactions; (2) medication/drug history, including dosage, time, route, and site of administration for prescription, over- the-counter, herbal, or illicit drugs; (3) relevant diseases, physical abnormalities (including genetic syndromes), neurologic impairments that might increase the potential for airway obstruction, obesity, a history of snoring or OSA, 325–328 or cervical spine

2016 American Academy of Pediatric Dentistry

145. Back Pain

with Chronic Conditions workshops X X Physical therapy X X Yoga X X Tai chi X X Relaxation therapy (meditation, progressive muscle relaxation, biofeedback, guided visualization) X X Acupuncture X X Spinal manipulation (chiropractic) X X Massage X X NSAIDs X X Duloxetine X X Physical Medicine & Rehabilitation/Spine Care Clinic (where available) X Psychotherapy (cognitive behavioral therapy for pain, mindfulness- based stress reduction) Note: Self-referral for physical therapy, acupuncture, or spinal (...) without disc herniation or radiculitis. Pain Physician. 2008 Nov-Dec;11(6):785-800. Manchikanti L, Knezevic NN, Boswell MV, Kaye AD, Hirsch JA. Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative systematic review and meta-analysis. Pain Physician. 2016 Mar;19(3):E365-410. 16 Mandel S, Schilling J, Peterson E, Sudhaker Rao D, Sanders W. A retrospective analysis of vertebral body fractures following epidural steroid injections. J Bone Joint Surg Am. 2013 Jun 5;95(11):961-964

2017 Kaiser Permanente Clinical Guidelines

146. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians.

Massage Acupuncture Spinal manipulation Exercise Multidisciplinary rehabilitation Mindfulness-based stress reduction Tai chi Yoga Motor control exercise (MCE) Progressive relaxation Electromyography biofeedback Low-level laser therapy (LLLT) Operant therapy Cognitive behavioral therapy Reduction or elimination of low back pain (including related leg symptoms) Improvement in back-specific and overall function Improvement in health-related quality of life Reduction in work disability Return to work (...) are the comparative benefits and harms of different nonpharmacologic, noninvasive therapies for acute or chronic nonradicular low back pain, radicular low back pain, or spinal stenosis, including but not limited to interdisciplinary rehabilitation, exercise (various types), physical modalities (ultrasound, transcutaneous electrical nerve stimulation [TENS], electrical muscle stimulation, interferential therapy, heat [various forms], and ice), traction tables/devices, back supports/bracing, spinal manipulation

2017 National Guideline Clearinghouse (partial archive)

147. Nonpharmacologic pain interventions: a review of evidence-based practices for reducing chronic cancer pain.

movement therapy, exercise, expressive writing, hypnosis, relaxation/progressive muscle relaxation and guided imagery, yoga, acupressure, acupuncture, foot massage, massage, reiki, therapeutic touch, institutional initiative, multicomponent rehabilitation, palliative care, celiac ganglion irradiation, cranial stimulation, cryoablation, fat graft, gene therapy, hypogastric neurolysis, microwave ablation, neural block, radiofrequency ablation and osteoplasty, radiosurgery, scrambler therapy, spinal cord (...) therapy Exercise Expressive writing Hypnosis Relaxation/progressive muscle relaxation and guided imagery Yoga Body-based Acupressure Acupuncture Foot massage Massage Energy-based Reiki Therapeutic touch Organizational Institutional initiative Multicomponent rehabilitation Palliative care Procedural Celiac ganglion irradiation Cranial stimulation Cryoablation Fat graft Gene therapy Hypogastric neurolysis Microwave ablation Neural block Radiofrequency ablation and osteoplasty Radiosurgery Scrambler

2017 National Guideline Clearinghouse (partial archive)

148. VA/DoD clinical practice guideline for diagnosis and treatment of low back pain.

Duloxetine Non-benzodiazepine muscle relaxant Non-surgical invasive therapy (epidural steroid injection) Multidisciplinary or interdisciplinary rehabilitation program Note : The following were considered but no recommendation was made due to insufficient evidence: lumbar supports; transcutaneous electrical nerve stimulation (TENS); lumbar traction; electrical muscle stimulation; time-limited opioid therapy; time-limited acetaminophen therapy; antiepileptics (gabapentin, pregabalin); topical preparations (...) with acute low back pain, there is insufficient evidence to support the use of specific clinician-directed exercise. ( Not Applicable; Reviewed, New-replaced ) For patients with chronic low back pain, the Work Group suggests offering clinician-directed exercises. ( Weak For; Reviewed, New-replaced ) For patients with acute or chronic low back pain, the Work Group suggests offering spinal mobilization/manipulation as part of a multimodal program. ( Weak For; Reviewed, New-replaced ) For patients

2017 National Guideline Clearinghouse (partial archive)

149. Neck pain: revision 2017.

An algorithm titled "Imaging Conditions for Suspected Spine Trauma from the American College of Radiology Appropriateness Criteria" is provided in the original guideline document. Neck pain Diagnosis Evaluation Management Treatment Family Practice Neurology Physical Medicine and Rehabilitation Radiology Rheumatology Sports Medicine Health Care Providers Physical Therapists Physician Assistants Physicians Students To describe evidence-based physical therapy practice including diagnosis, prognosis (...) , Orthopaedic Physical Therapy Residency, University of Southern California, Los Angeles, CA, Spine Rehabilitation Fellowship, Beijing, China; Timothy Flynn, PT, PhD, Professor, School of Physical Therapy, South College, Knoxville, TN; Sandra Kaplan, PT, PhD, Clinical Practice Guidelines Coordinator, Academy of Pediatric Therapy, APTA, Inc, Professor, Doctoral Programs in Physical Therapy, Rutgers University, Newark, NJ; David Killoran, PhD, Patient/Consumer Representative for the ICF-Based Clinical

2017 National Guideline Clearinghouse (partial archive)

150. Chronic pain disorder medical treatment guideline.

walking tolerance for those with spinal stenosis compared to local anesthetic (Design: Randomized clinical trial ). Intradiscal steroid injection is unlikely to relieve pain or provide functional benefit in patients with non-radicular back pain (Design: Randomized clinical trial ). Evidence Against Good Evidence There is good evidence against the use of lumbar facet or epidural injections for relief of non-radicular low back pain (Design: Systematic review of randomized clinical trials ). See original (...) to current lack of evidence. This procedure is not recommended for patients with multiple pain generators or involvement of more than 3 levels of medial branch nerves or 2 facet levels unilateral or bilateral. Evidence Statements Regarding Radio Frequency Denervation - Medial Branch Neurotomy/Facet Rhizotomy Good Evidence For the lumbar spine, carefully selected patients who had 80% relief with medial branch controlled blinded blocks and then had RF neurotomy will have improved pain relief over 6 months

2017 National Guideline Clearinghouse (partial archive)

151. Final recommendation statement: adolescent idiopathic scoliosis: screening.

children and adolescents aged 10 to 18 years. This recommendation does not apply to children and adolescents presenting for evaluation of back pain, breathing difficulties, abnormal radiography findings or other imaging studies, or obvious deformities in spinal curvature. Screening Tests Most screening tests for adolescent idiopathic scoliosis are noninvasive. Screening is usually done by visual inspection of the spine to look for asymmetry of the shoulders, shoulder blades, and hips. In the United (...) the 2004 USPSTF recommendation on screening for idiopathic scoliosis in adolescents Asymptomatic children and adolescents aged 10 to 18 years Note : This recommendation does not apply to children and adolescents presenting for evaluation of back pain, breathing difficulties, abnormal radiography findings or other imaging studies, or obvious deformities in spinal curvature. Screening for idiopathic adolescent scoliosis using visual inspection of the spine and forward-bending test, with or without

2018 National Guideline Clearinghouse (partial archive)

152. Guideline for the management of knee and hip osteoarthritis

Director, Medibank Private Ltd Associate Professor Marie Pirotta, general practitioner; Department of General Practice, University of Melbourne, Victoria Dr Michael Ponsford, rehabilitation medicine specialist, Epworth Hospital, Victoria Associate Professor Morton Rawlin, general practitioner, Macedon Medical Centre, Victoria Dr Xia Wang, epidemiologist, University of Sydney, New South Wales Dr Samuel Whittle, Senior consultant rheumatologist, Queen Elizabeth Hospital, Woodville South, South Australia

2018 Clinical Practice Guidelines Portal

154. Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU Full Text available with Trip Pro

, Delirium , Immobility ( mobilization /rehabilitation), and Sleep (disruption). Each section created Population, Intervention, Comparison, and Outcome, and nonactionable, descriptive questions based on perceived clinical relevance. The guideline group then voted their ranking, and patients prioritized their importance. For each Population, Intervention, Comparison, and Outcome question, sections searched the best available evidence, determined its quality, and formulated recommendations as “strong (...) ,” “conditional,” or “good” practice statements based on Grading of Recommendations Assessment, Development and Evaluation principles. In addition, evidence gaps and clinical caveats were explicitly identified. Results: The Pain , Agitation/ Sedation , Delirium , Immobility ( mobilization /rehabilitation), and Sleep (disruption) panel issued 37 recommendations (three strong and 34 conditional), two good practice statements, and 32 ungraded, nonactionable statements. Three questions from the patient-centered

2018 Society of Critical Care Medicine

155. Guidelines on the Management of Acute Respiratory Distress Syndrome (ARDS)

of prone positioning found that over 12 hours of prone positioning was associated with significantly reduced mortality (>12hr, RR 0.75, 95%CI 0.65-0.87; 12 hours per day Patients with moderate/severe ARDS (P:F ratio 3 or pH 12 hr/day) Neuro-muscular blockade (first 48 hour) Higher PEEP 4 Refer to local ECMO centre 5 Other measures 6 Non ARDS-specific support Rehabilitation: early mobilisation, NICE CG83 7 Nutrition: enteral where possible, trophic feeding acceptable initially, consider naso-jejunal (...) + 2 = 7.5 (3) Patient with history of diabetes mellitus and urosepsis with shock sepsis + shock + diabetes 1 + 2 - 1 = 2 Aspiration 2 Sepsis 1 Pneumonia 1.5 High-risk surgery* Orthopaedic spine 1 Acute abdomen 2 Cardiac 2.5 Aortic vascular 3.5 High-risk trauma Traumatic brain injury 2 Smoke inhalation 2 Near drowning 2 Lung contusion 1.5 Multiple fractures 1.5 Risk modifiers Alcohol abuse 1 Obesity (BMI>30) 1 Hypoalbuminemia 1 Chemotherapy 1 FIO2 > 0.35 (>4 L/min) 2 Tachypnoea (RR > 30) 1.5 SpO2 2

2018 Faculty of Intensive Care Medicine

156. Best Practices for Pain Management in Infants, Children, Adolescents, and Individuals with Special Health Care Needs

been shown that nearly 50 percent of patients undergoing dental rehabilitation describe moderate to severe pain 36 , and there is data to support pre-emptive measures to optimize pain control for a variety of dental and surgical pro- cedures. 37 However, level of evidence is low due to sparse well-controlled trials. 38-40 Achieving profound anesthesia prior to initiating treatment decreases central sensitization. 37 Topical anesthetics are used in a dentistry to minimize pain; however (...) , but it is also rare that pediatric dental patients should require opioid analgesics following dental treatment. 50 Major concerns of opioid analgesics in the pediatric population are efficacy, safety, misuse, and accidental deaths. 77,86,87 Opioids interact differentially with µ, ?, and d receptors in the central nervous system. Opioid agonists act on receptors located in the brain, spinal cord, and digestive tract. Pathways of opioid receptor signaling are multiple and include G- protein receptor coupling

2018 American Academy of Pediatric Dentistry

157. Knee stability and movement coordination impairments: knee ligament sprain revision 2017.

Ferland, DPT, Clinical Faculty, Intech Rehabilitation Group/Division of Biokinesiology and Physical Therapy, Orthopaedic Physical Therapy Residency, University of Southern California, Los Angeles, CA and Spine Rehabilitation Fellowship, Beijing, China; G. Kelley Fitzgerald, PT, PhD, Professor and Associate Dean of Graduate Studies, School of Health and Rehabilitation Sciences and Director, Physical Therapy Clinical and Translational Research Center, University of Pittsburgh, Pittsburgh, PA; Sandra (...) of motion, reduce joint pain, and reduce the risk of adverse responses of surrounding soft tissue structures, such as those associated with knee extension range-of-motion loss. ( Grade of Recommendation: B ) Cryotherapy Clinicians should use cryotherapy immediately after ACL reconstruction to reduce postoperative knee pain. ( Grade of Recommendation: B ) Supervised Rehabilitation Clinicians should use exercises as part of the in-clinic supervised rehabilitation program after ACL reconstruction

2017 National Guideline Clearinghouse (partial archive)

158. Hip pain and mobility deficits&mdash

of Medicine, University of California at Los Angeles, Los Angeles, CA; John Dewitt, DPT, Director, Physical Therapy Sports and Orthopaedic Residencies, The Ohio State University, Columbus, OH; Amanda Ferland, DPT, Clinical Faculty, Intech Rehabilitation Group/Division of Biokinesiology and Physical Therapy, Orthopaedic Physical Therapy Residency, University of Southern California, Los Angeles, CA and Spine Rehabilitation Fellowship, Beijing, China; Marcie Harris-Hayes, DPT, MSCI, Associate Professor (...) studies, from conceptual models/principles, or from basic sciences/bench research support this conclusion F Expert opinion Best practice based on the clinical experience of the guidelines development team None provided Hip pain and mobility deficits associated with hip osteoarthritis Diagnosis Evaluation Management Rehabilitation Treatment Family Practice Geriatrics Orthopedic Surgery Physical Medicine and Rehabilitation Rheumatology Sports Medicine Health Care Providers Physical Therapists Physician

2017 National Guideline Clearinghouse (partial archive)

159. Complex regional pain syndrome/reflex sympathetic dystrophy medical treatment guideline.

evaluation, overview of care for complex regional pain syndrome (CRPS) or sympathetically mediated pain, and diagnostic criteria and procedures for patients with CRPS/reflex sympathetic dystrophy and for further descriptions of the therapies discussed below. The grades of recommendations ( Some, Good, Strong ) are defined at the end of the Major Recommendations field. Therapeutic Procedures—Non-operative Non-operative therapeutic rehabilitation is applied to patients with CRPS or sympathetically mediated (...) : Patients undergoing therapeutic procedure(s) should be released or returned to modified or restricted duty during their rehabilitation at the earliest appropriate time. Refer to the section "Return-to-Work" below for detailed information. Reassessment of the patient's status in terms of functional improvement should be documented after each treatment. If patients are not responding within the recommended time periods, alternative treatment interventions, further diagnostic studies, or consultations

2017 National Guideline Clearinghouse (partial archive)

160. Early-Stage and Locally Advanced (non-metastatic) Non-Small-Cell Lung Cancer: ESMO Clinical Practice Guidelines

surgery should be considered [98–105]. The IASLC has de?ned ‘central tumours’ as tumours located within 2 cm in all directions of any mediastinal critical structure, including the bronchial tree, oesophagus, heart, brachial plexus, major vessels, spinal cord, phrenic nerve and recurrent laryngeal nerve [106]. For tumours located in the hilar region, SABR using ‘risk-adapted’ fractionation schemes can achieve high local control rates with limited toxicity [107]. However, care should be taken

2017 European Society for Medical Oncology


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