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Atopic Eczema in Children: Management of Atopic Eczema in Children from Birth up to the Age of 12 Years

Atopic eczema (atopic dermatitis) is a chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbation (flares, which may occur as frequently as two or three per month) and remissions, except for severe cases where it may be continuous. Certain patterns of atopic eczema are recognised. In infants, atopic eczema usually involves the face and extensor surfaces of the limbs and, while it may involve the trunk, the napkin area is usually spared. A few infants may exhibit a discoid pattern (circular patches). In older children flexural involvement predominates, as in adults. Diagnostic criteria are discussed in Chapter 3. As with other atopic conditions, such as asthma and allergic rhinitis (hay fever), atopic eczema often has a genetic component. In atopic eczema, inherited factors affect the development of the skin barrier, which can lead to exacerbation of the disease by a large number of trigger factors, including irritants and allergens. Many cases of atopic eczema clear or improve during childhood while others persist into adulthood, and some children who have atopic eczema `will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the ‘atopic march’. The epidemiology of atopic eczema is considered in Chapter 5, and the impact of the condition on children and their families/caregivers is considered in Sections 4.2 and 4.3.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: December 2007
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Constipation in Children and Young People: Diagnosis and Management of Idiopathic Childhood Constipation in Primary and Secondary Care

Without early diagnosis and treatment, an acute episode of constipation can lead to anal fissure and become chronic. By the time the child or young person is seen they may be in a vicious cycle. Children and young people and their families are often given conflicting advice and practice is inconsistent, making treatment potentially less effective and frustrating for all concerned. Early identification of constipation and effective treatment can improve outcomes for children and young people. This guideline provides strategies based on the best available evidence to support early identification, positive diagnosis and timely, effective management. Implementation of this guideline will provide a consistent, coordinated approach and will improve outcomes for children and young people.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: 2010
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Pregnancy and birth: What is effective against nausea in pregnancy?

Common medications for nausea and vomiting as well as ginger are often used in pregnancy. But there is only little scientific research on their effectiveness in pregnant women.Nausea and vomiting are common in early pregnancy: At least half of all women are affected by some nausea in the first few months of pregnancy. Although it is called morning sickness, and it can actually be worse in the mornings, it may last all through the day too. Nausea and vomiting can be difficult to deal with for some weeks, but they usually do not have any consequences for the mother and her child.It is not known why pregnancy is so often accompanied by these symptoms. One theory is that it is due to hormonal changes. It is unknown whether stress or psychological problems cause or worsen the symptoms.Morning sickness typically starts between the sixth and eighth week of pregnancy and is gone by the end of 16 weeks. For some women, it will go on even longer. It is not only a problem because it makes pregnant women feel so unwell – it can also be more difficult to eat a healthy diet or to stay well-nourished.About 1 out of 100 women experience a severe form of nausea with frequent and violent vomiting. This can lead to weight and fluid loss which can also endanger the child and needs to be treated in hospital. There, the woman will receive medication and her body will be supplied with fluids.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 24, 2014

Pregnancy and birth: Overview

A pregnancy is associated with a great deal of change, especially if it is the woman’s first. Parents-to-be often feel a whole spectrum of emotions, ranging from joy to hope to anxiety: How will everything go? How will life change once the baby has arrived?

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 12, 2014

Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS): a mixed-methods study to inform trial design

The study found that incentives for smoking cessation in pregnancy and breastfeeding provided with other tailored intervention components show promise but that reach is a concern.

Health Technology Assessment - NIHR Journals Library.

Version: April 2015
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Gastro-Oesophageal Reflux Disease: Recognition, Diagnosis and Management in Children and Young People

This guideline focuses on symptoms of and interventions for gastro-oesophageal reflux disease (GORD). Commonly observed events, such as infant regurgitation, are covered, as well as much rarer but potentially more serious problems, such as apnoea. Where appropriate, clear recommendations are given as to when and how reassurance should be offered. In contrast, advice is given to health care professionals regarding when investigations should be considered or treatments are indicated. Finally, it is emphasised that other, and on occasion more serious, conditions that need different management can be confused with some of the relatively common manifestations of GOR or GORD. These warning signs are defined under the headings of ‘red flags’, along with recommended initial actions.

NICE Guideline - National Collaborating Centre for Women's and Children's Health (UK).

Version: January 2015
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Diabetes in Pregnancy: Management of Diabetes and Its Complications from Preconception to the Postnatal Period

Clinical guidelines have been defined as ‘systematically developed statements which assist clinicians and patients in making decisions about appropriate treatment for specific conditions’. This clinical guideline concerns the management of diabetes and its complications from preconception to the postnatal period. It has been developed with the aim of providing guidance on:

NICE Guideline - National Collaborating Centre for Women's and Children's Health (UK).

Version: February 2015

Antenatal and Postnatal Mental Health: Clinical Management and Service Guidance: Updated edition

The guideline makes recommendations for the use of pharmacological, psychological and service-level interventions. It aims to:

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: December 2014
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Antenatal Care: Routine Care for the Healthy Pregnant Woman

The original antenatal care guideline was published by NICE in 2003. Since then a number of important pieces of evidence have become available, particularly concerning gestational diabetes, haemoglobinopathy and ultrasound, so that the update was initiated. This update has also provided an opportunity to look at a number of aspects of antenatal care: the development of a method to assess women for whom additional care is necessary (the ‘antenatal assessment tool’), information giving to women, lifestyle (vitamin D supplementation, alcohol consumption), screening for the baby (use of ultrasound for gestational age assessment and screening for fetal abnormalities, methods for determining normal fetal growth, placenta praevia), and screening for the mother (haemoglobinopathy screening, gestational diabetes, pre-eclampsia and preterm labour, chlamydia).

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: March 2008
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Rheumatoid Arthritis: National Clinical Guideline for Management and Treatment in Adults

There are over 400,000 people with rheumatoid arthritis (RA) in the UK. Although this makes it a common disorder, there are numerous other conditions ahead of it in terms of numbers, and indeed as causes of excess mortality. What this does not capture however, is the dreadful morbidity associated with the disease. The synovitis of RA affects multiple sites causing widespread pain, and the subsequent destruction of the joints can lead to severe disability affecting all aspects of motor function from walking to fine movements of the hand. Furthermore, RA is not simply a disease of the joints but can affect many other organs causing, for example, widespread vasculitis or severe lung fibrosis. More recently it has become apparent that RA is associated with an increased prevalence of coronary artery disease and significant increased risk of premature mortality.

NICE Clinical Guidelines - National Collaborating Centre for Chronic Conditions (UK).

Version: February 2009
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Guidelines for the Treatment of Malaria. 3rd edition

Malaria case management, which consists of prompt diagnosis and effective treatment, remains a vital component of malaria control and elimination strategies. This third edition of the WHO Guidelines for the treatment of malaria contains updated recommendations based on new evidence as well as a recommendation on the use of drugs to prevent malaria in high-risk groups.

World Health Organization.

Version: 2015
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Hepatitis B (Chronic): Diagnosis and Management of Chronic Hepatitis B in Children, Young People and Adults

Chronic hepatitis B describes a spectrum of disease usually characterised by the presence of detectable hepatitis B surface antigen (HBsAg) in the blood or serum for longer than 6 months. In some people, chronic hepatitis B is inactive and does not present significant health problems, but others may progress to liver fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The progression of liver disease is associated with hepatitis B virus (HBV) DNA levels in the blood. Without antiviral treatment, the 5-year cumulative incidence of cirrhosis ranges from 8 to 20%. People with cirrhosis face a significant risk of decompensated liver disease if they remain untreated. Five-year survival rates among people with untreated decompensated cirrhosis can be as low as 15%. Chronic hepatitis B can be divided into e antigen- (HBeAg) positive or HBeAg-negative disease based on the presence or absence of e antigen. The presence of HBeAg is typically associated with higher rates of viral replication and therefore increased infectivity.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: June 2013
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Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth

The guideline is intended to cover the care of healthy women with uncomplicated pregnancies entering labour at low risk of developing intrapartum complications. In addition, recommendations are included that address the care of women who start labour as ‘low risk’ but who go on to develop complications. These include the care of women with prelabour rupture of membranes at term, care of the woman and baby when meconium is present, indications for continuous cardiotocography, interpretation of cardiotocography traces, and management of retained placenta and postpartum haemorrhage. Aspects of intrapartum care for women at risk of developing intrapartum complications are covered by a range of guidelines on specific conditions (see section 1.8) and a further guideline is planned on intrapartum care of women ‘at high risk’ of complications during pregnancy and the intrapartum period.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Version: December 2014

Type 1 Diabetes in Adults: Diagnosis and Management

Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: August 2015

Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment

Study found evidence that some treatments (ginger, vitamin B6, antihistamines, metoclopramide) were better than placebo for mild symptoms of nausea and vomiting in pregnancy (NVP), but there is little on the effectiveness of treatments in more severe NVP/hyperemesis gravidarum.

Health Technology Assessment - NIHR Journals Library.

Version: October 2016

Nocturnal Enuresis: The Management of Bedwetting in Children and Young People

This guideline aims to provide advice on the assessment and management of children and young people with bedwetting. The guidance is applicable to children and young people up to 19 years with the symptom of bedwetting. It has been common practice to define enuresis as abnormal from 5 years and only to consider children for treatment when they are 7 years. While the prevalence of symptoms decreases with age the guideline scope did not specify a younger age limit in order to consider whether there were useful interventions that might be of benefit to children previously excluded from advice and services.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: 2010
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Non-Alcoholic Fatty Liver Disease: Assessment and Management

This guideline covers identifying, diagnosing and assessing disease severity in adults, children and young people with non-alcoholic fatty liver disease (NAFLD). It also covers both pharmacological and non-pharmacological treatments, disease monitoring and the risk of extra-hepatic conditions associated with NAFLD.

NICE Guideline - National Guideline Centre (UK).

Version: July 2016

Autism: Recognition, Referral, Diagnosis and Management of Adults on the Autism Spectrum

Autism is a lifelong condition with particular issues for adults, which are addressed by this NICE guideline. While some people are diagnosed in childhood, a large proportion of adults with autism find obtaining a diagnosis in adulthood difficult or impossible. Under-recognition of autism in adults can lead to inadequate care, masking of coexisting mental and physical health problems, and to social and economic exclusion. This guideline aims to address these widespread problems and increase the uptake of interventions by adults with autism to enable them to live more independent lives.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2012
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Tuberculosis: Prevention, Diagnosis, Management and Service Organisation

This guideline makes recommendations on the prevention, diagnosis and management of latent and active tuberculosis (TB), including both drug susceptible and drug resistant forms of the disease. It covers the organisation of relevant TB services. It relates to activities undertaken in any setting in which NHS or public health services for TB are received, provided or commissioned in the public, private and voluntary sectors.

NICE Guideline - Internal Clinical Guidelines Team (UK).

Version: January 2016

Dyspepsia and Gastro-Oesophageal Reflux Disease: Investigation and Management of Dyspepsia, Symptoms Suggestive of Gastro-Oesophageal Reflux Disease, or Both

The guideline applies to adults (aged 18 and over) with symptoms suggestive of dyspepsia, symptoms suggestive of gastro-oesophageal reflux disease (GORD), or both.

NICE Clinical Guidelines - Internal Clinical Guidelines Team (UK).

Version: September 2014
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