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Screening and Management of the Hyperandrogenic Adolescent ACOGCOMMITTEEOPINION Number 789 Committee on Adolescent Health Care This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Adolescent Health Care in collaboration with committee members Jennie Yoost, MD and Ashlyn Savage, MD. Screening and Management of the Hyperandrogenic Adolescent ABSTRACT: Although androgen excess can manifest in many ways, the most common and recognizable (...) of PCOS and those of normal puberty,whichmakesthediagnosisofPCOSintheadolescentdifficult.Treatmentofacneandhirsutismshould not be withheld during the ongoing longitudinal evaluation for possible PCOS. On physical examination, body mass index, blood pressure, and signs of hyperandrogenism, such as acne and hirsutism, should be evaluated. Although guidelines differ on recommended laboratory studies, most include measurement of total testoster- one, free testosterone, or both, and screening
Screening for Asymptomatic Bacteriuria in Adults: US Preventive Services Task Force Recommendation Statement. Among the general adult population, women (across all ages) have the highest prevalence of asymptomatic bacteriuria, although rates increase with age among both men and women. Asymptomatic bacteriuria is present in an estimated 1% to 6% of premenopausal women and an estimated 2% to 10% of pregnant women and is associated with pyelonephritis, one of the most common nonobstetric reasons (...) for hospitalization in pregnant women. Among pregnant persons, pyelonephritis is associated with perinatal complications including septicemia, respiratory distress, low birth weight, and spontaneous preterm birth.To update its 2008 recommendation, the USPSTF commissioned a review of the evidence on potential benefits and harms of screening for and treatment of asymptomatic bacteriuria in adults, including pregnant persons.This recommendation applies to community-dwelling adults 18 years and older and pregnant
Syphilis Screening in Pregnancy September 2019 INTERIM GUIDELINE ON SYPHILIS SCREENING IN PREGNANCY In April 2019, the first case of congenital syphilis in British Columbia since 2013 was reported. A second case of congenital syphilis was reported in May 2019 in a stillborn delivered in January 2019. Current and past practice in BC has included screening for syphilis as part of routine care in the first trimester; historically subsequent syphilis screening has not been routinely recommended (...) unless there was concern for syphilis risk during pregnancy. There have been ongoing discussions between the BC Centre for Disease Control’s Sexually Transmitted Infections (BCCDC STI) team and expert partners and stakeholders about the best way to approach syphilis screening in pregnancy. Recent epidemiologic syphilis trends seen in BC – including increased overall rates, increased rates in females of reproductive age, along with an increasing number of infectious syphilis cases among males who
School dental screening programmes for oral health. School dental screening refers to visual inspection of children's oral cavity in a school setting followed by making parents aware of their child's current oral health status and treatment needs. Screening at school intends to identify children at an earlier stage than symptomatic disease presentation, hence prompting preventive and therapeutic oral health care for the children. This review evaluates the effectiveness of school dental (...) screening in improving oral health status. It is an update of the original review, which was first published in December 2017.To assess the effectiveness of school dental screening programmes on overall oral health status and use of dental services.Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 4 March 2019), the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Register of Studies, to 4 March 2019), MEDLINE
Screening for Pancreatic Cancer: US Preventive Services Task Force Reaffirmation Recommendation Statement. Pancreatic cancer is an uncommon cancer with an age-adjusted annual incidence of 12.9 cases per 100 000 person-years. However, the death rate is 11.0 deaths per 100 000 person-years because the prognosis of pancreatic cancer is poor. Although its incidence is low, pancreatic cancer is the third most common cause of cancer death in the United States. Because of the increasing incidence (...) of pancreatic cancer, along with improvements in early detection and treatment of other types of cancer, it is estimated that pancreatic cancer may soon become the second-leading cause of cancer death in the United States.To update the 2004 US Preventive Services Task Force (USPSTF) recommendation on screening for pancreatic cancer.The USPSTF reviewed the evidence on the benefits and harms of screening for pancreatic cancer, the diagnostic accuracy of screening tests for pancreatic cancer, and the benefits
External Validation of Two Models to Predict Delirium in Critically Ill Adults Using Either the Confusion Assessment Method-ICU or the Intensive Care Delirium Screening Checklist for Delirium Assessment To externally validate two delirium prediction models (early prediction model for ICU delirium and recalibrated prediction model for ICU delirium) using either the Confusion Assessment Method-ICU or the Intensive Care Delirium Screening Checklist for delirium assessment.Prospective (...) Care Delirium Screening Checklist. Discrimination was determined using the area under the receiver operating characteristic curve. The predictive performance was determined for the Confusion Assessment Method-ICU and Intensive Care Delirium Screening Checklist cohort, and compared with both prediction models' original reported performance. A total of 1,286 Confusion Assessment Method-ICU-assessed patients and 892 Intensive Care Delirium Screening Checklist-assessed patients were included. Compared
Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding - ACOG Menu ▼ Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding Page Navigation ▼ Number 785 Committee on Adolescent Health Care This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Adolescent Health Care (...) in collaboration with committee members Oluyemisi Adeyemi-Fowode, MD and Judith Simms-Cendan, MD. Screening and Management of Bleeding Disorders in Adolescents With Heavy Menstrual Bleeding ABSTRACT : Heavy menstrual bleeding is defined as excessive menstrual blood loss that interferes with a woman's physical, social, emotional, or material quality of life. If obstetrician–gynecologists suspect that a patient has a bleeding disorder, they should work in coordination with a hematologist for laboratory
Screening for dihydropyrimidine dehydrogenase deficiency to decrease the risk of severe toxicities related to fluoropyrimidines (5-fluorouracil or capecitabine) Screening for dihydropyrimidine dehydrogenase deficiency to decrease the risk of severe toxicities related to fluoropyrimidines (5-fluorouracil or capecitabine) - INAHTA Brief
What is the pathophysiology behind hepatic osteopenia/osteoporosis and who should be screened for it? Chiefs’ Inquiry Corner August 5th, 2019 – Clinical Correlations Search Chiefs’ Inquiry Corner August 5th, 2019 August 5, 2019 2 min read Patients with chronic liver disease are nearly three times more likely to develop osteoporosis than matched controls. In contrast to patients with post-menopausal osteoporosis, in whom increased osteoclast activity depletes bone density, the mechanism (...) in patients with liver disease is thought to be driven by decreased osteoblast activity. Patients with liver disease see decreases in osteoblastogenesis stimulating factors such as IGF-1 and vitamin K and increases in serum bilirubin, which directly inhibits osteoblastogenesis. It is recommended to screen the following female and male patients for hepatic osteopenia: All patients with cirrhosis All patients with chronic cholestasis (bilirubin >3mg/dL for 6 months) All potential liver transplant candidates
Choosing Wisely Canada recommendation - Don’t routinely do screening mammography for average risk women aged 40 – 49. Individual assessment of each woman’s preferences and risk should guide the discussion and decision regarding mammography screening in th Don’t do imaging for lower-back pain unless red flags are present. Red flags include, but are not limited to, severe or progressive neurological deficits or when serious underlying conditions such as osteomyelitis are suspected. Imaging (...) all cases are viral. Though cases of bacterial sinusitis can benefit from antibiotics, evidence of such cases does not typically surface until after at least seven days of illness. Not only are antibiotics rarely indicated for upper respiratory illnesses, but some patients experience adverse effects from such medications. Don’t order screening chest X-rays and ECGs for asymptomatic or low risk outpatients. There is little evidence that detection of coronary artery stenosis in asymptomatic patients
Strategies to Identify Women at High Risk of Advanced Breast Cancer During Routine Screening for Discussion of Supplemental Imaging Federal legislation proposes requiring that screening mammography reports to practitioners and women incorporate breast density information and that women with dense breasts discuss supplemental imaging with their practitioner given their increased risk of interval breast cancer. Instead of discussing supplemental imaging with all women with dense breasts, it may (...) be more efficient to identify women at high risk of advanced breast cancer who may benefit most from supplemental imaging.To identify women at high risk of advanced breast cancer to target woman-practitioner discussions about the need for supplemental imaging.This prospective cohort study assessed 638 856 women aged 40 to 74 years who had 1 693 163 screening digital mammograms taken at Breast Cancer Surveillance Consortium (BCSC) imaging facilities from January 3, 2005, to December 31, 2014. Data
Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders No. 383-Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 41, Issue 7, Pages 1035–1049 No. 383-Screening, Diagnosis, and Management of Placenta Accreta Spectrum Disorders x Sebastian R. Hobson , MD MPH PhD Toronto, ON x John C. Kingdom , MD Toronto, ON x Ally Murji , MD (...) accreta spectrum (PAS) disorders are a potentially life-threatening complication of pregnancy that demand coordinated interdisciplinary care to achieve safer outcomes. The rising incidence of this disease is due to a growing number of uterine surgical procedures, including the rising incidence of pregnancy following Caesarean section. Objective To provide current evidence-based guidelines on the optimal methods used to effectively screen, diagnose, and manage PAS disorders. Methods Members
Screening for Hepatitis B Virus Infection in Pregnant Women: US Preventive Services Task Force Reaffirmation Recommendation Statement. Screening for hepatitis B virus (HBV) infection during pregnancy identifies women whose infants are at risk of perinatal transmission. Data from a nationally representative sample showed a prevalence of maternal HBV infection of 85.8 cases per 100 000 deliveries from 1998 to 2011 (0.09% of live-born singleton deliveries in the United States). Although (...) there are guidelines for universal infant HBV vaccination, rates of maternal HBV infection have increased annually by 5.5% since 1998. Children infected with HBV during infancy or childhood are more likely to develop chronic infection. Chronic HBV infection increases long-term morbidity and mortality by predisposing infected persons to cirrhosis of the liver and liver cancer.To update the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for HBV infection in pregnant women.The USPSTF
Impact of community based screening for hypertension on blood pressure after two years: regression discontinuity analysis in a national cohort of older adults in China. To estimate the causal impact of community based blood pressure screening on subsequent blood pressure levels among older adults in China.Regression discontinuity analysis using data from a national cohort study.2011-12 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey, a national cohort of older adults (...) in China.3899 older adults who had previously undiagnosed hypertension.Community based hypertension screening among older adults in 2011-12.Blood pressure two years after initial screening.The intervention reduced systolic blood pressure: -6.3 mm Hg in the model without covariates (95% confidence interval -11.2 to -1.3) and -8.3 mm Hg (-13.6 to -3.1) in the model that adjusts additionally for demographic, social, and behavioural covariates. The impact on diastolic blood pressure was smaller and non
Two-view digital breast tomosynthesis versus digital mammography in a population-based breast cancer screening programme (To-Be): a randomised, controlled trial Digital breast tomosynthesis is an advancement of mammography, and has the potential to overcome limitations of standard digital mammography. This study aimed to compare first-generation digital breast tomo-synthesis including two-dimensional (2D) synthetic mammograms versus digital mammography in a population-based screening (...) programme.BreastScreen Norway offers all women aged 50-69 years two-view (craniocaudal and mediolateral oblique) mammographic screening every 2 years and does independent double reading with consensus. We asked all 32 976 women who attended the programme in Bergen in 2016-17, to participate in this randomised, controlled trial with a parallel group design. A study-specific software was developed to allocate women to either digital breast tomosynthesis or digital mammography using a 1:1 simple randomisation method
Towards risk-stratified colorectal cancer screening. Adding risk factors to the fecal immunochemical test: Evidence, evolution and expectations With increasing incidence and mortality, colorectal cancer (CRC) is a growing health problem worldwide. An effective way to address CRC is by screening for fecal (occult) blood by the fecal immunochemical test (FIT). However, there is room for improvement since precursor lesions and CRC bleed intermittent and can therefore be missed by the FIT (false