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Irritable Bowel Syndrome in Adults: Diagnosis and Management of Irritable Bowel Syndrome in Primary Care [Internet]

This guideline covers areas relevant to the diagnosis and management of irritable bowel syndrome (IBS) reflecting the complete patient journey, from the person presenting with IBS symptoms, positive diagnosis and management, targeted at symptom control. The guideline incorporates Cochrane reviews, published NICE clinical and public health guidance, Health Technology Assessment reports, systematic and health economic reviews produced by the National Collaborating Centre for Nursing and Supportive Care. Recommendations are based on clinical and cost effectiveness evidence, and where this is insufficient, the GDG used all available information sources and experience to make consensus recommendations using nominal group technique.

NICE Clinical Guidelines - National Collaborating Centre for Nursing and Supportive Care (UK).

Version: February 2008
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Effect of integrated traditional Chinese medicine and Western medicine on the treatment of severe acute respiratory syndrome: a meta-analysis

The authors concluded that the treatment of severe acute respiratory syndrome with combined traditional Chinese medicine and Western medicine appears encouraging, but further investigations are required. The authors appear to have considered the limitations of the included studies, and their conclusion for further research into the use of traditional Chinese medicine appears reasonable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Dasatinib and Nilotinib for Imatinib-Resistant or -Intolerant Chronic Myeloid Leukaemia: A Systematic Review and Economic Evaluation

Chronic myeloid leukaemia (CML) is a form of cancer affecting the blood, characterised by excessive proliferation of white blood cells in the bone marrow and circulating blood. In the UK, an estimated 560 new cases of CML are diagnosed each year.

Health Technology Assessment - NIHR Journals Library.

Version: April 2012
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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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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
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Menopause: Full Guideline

In summary, a large number of women in the UK experience menopausal symptoms which, in many cases, can significantly affect their quality of life. It is probable that a minority of these women seek medical treatment and for those who do there is considerable variation in the help available, with many being told that the symptoms will get better with time. Since symptoms may often continue for 7 years or more, this advice is inappropriate and help should be offered where possible. Women need to know about the available options and their risks and benefits, and be empowered to become part of the decision-making process.

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

Version: November 12, 2015
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MI - Secondary Prevention: Secondary Prevention in Primary and Secondary Care for Patients Following a Myocardial Infarction: Partial Update of NICE CG48 [Internet]

Myocardial infarction (MI) remains one of the most dramatic presentations of coronary artery disease (CAD). Complete occlusion of the artery often produces myocardial necrosis and the classical picture of a heart attack with severe chest pain, electrocardiographic (ECG) changes of ST-segment elevation, and an elevated concentration of myocardial specific proteins in the circulation. Such people are described as having a ST-segment elevation myocardial infarction (STEMI). Intermittent or partial occlusion produces similar, but often less severe clinical features, although no or transient and undetected ST elevation. Such cases are described as a non-ST segment elevation myocardial infarction (NSTEMI). People who have suffered from either of these conditions are amenable to treatment to reduce the risk of further MI or other manifestations of vascular disease, secondary prevention.

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

Version: November 2013

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
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Nutrition in Cancer Care (PDQ®): Patient Version

Expert-reviewed information summary about the causes and management of nutritional problems that occur in patients with cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 19, 2017

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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Sepsis: Recognition, Assessment and Early Management

Sepsis is a clinical syndrome caused by the body's immune and coagulation systems being switched on by an infection. Sepsis with shock is a life-threatening condition that is characterised by low blood pressure despite adequate fluid replacement, and organ dysfunction or failure. Sepsis is an important cause of death in people of all ages. Both a UK Parliamentary and Health Service Ombudsman enquiry (2013) and UK National Confidential Enquiry into Patient Outcome and Death (NCEPOD, 2015) have recently highlighted sepsis as being a leading cause of avoidable death that kills more people than breast, bowel and prostate cancer combined.

NICE Guideline - National Guideline Centre (UK).

Version: July 2016
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Cannabis and Cannabinoids (PDQ®): Health Professional Version

Expert-reviewed information summary about the use of Cannabis and cannabinoids in the treatment of cancer-related side effects, such as nausea and vomiting.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 7, 2017

Nutrition Support for Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition

These guidelines cover most aspects of nutrition support in adult patients (>18 years) who are either malnourished or are at ‘risk’ of malnutrition. In some cases specific guidance related to patients in specific care settings or with specific diseases has been provided but in general the guidance is applicable to patients whatever their setting (hospital or community) or disease. The guideline therefore includes: information on the prevalence of malnutrition and the benefits of good nutrition; guidance on the appropriate forums for the organisation of nutrition support in all settings; guidance on who should be screened for malnutrition and when, along with the criteria for consideration when assessing patients’ nutritional status; the general indications for nutrition support together with ethical and legal considerations that may arise; guidance on the process and special considerations required to prescribe nutrition support and details information on the important parameters to monitor for patients receiving nutrition support; detailed guidance on the administration of oral, enteral and parenteral nutrition including; the appropriate types of access for enteral and parenteral nutrition and the optimum mode of delivering these; specific guidance on the management of providing nutrition support to patients with dysphagia; issues to consider for patients receiving enteral and parenteral nutrition support in the community; issues arising for patients and their carers.

NICE Clinical Guidelines - National Collaborating Centre for Acute Care (UK).

Version: February 2006
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Diabetes (Type 1 and Type 2) in Children and Young People: Diagnosis and Management

Diabetes is a long-term condition that can have a major impact on the life of a child or young person, as well as their family or carers. In addition to insulin therapy, diabetes management should include education, support and access to psychological services, as detailed here and in this guideline. Preparations should also be made for the transition from paediatric to adult services, which have a somewhat different model of care and evidence base.

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

Version: August 2015
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Obesity: Identification, Assessment and Management of Overweight and Obesity in Children, Young People and Adults: Partial Update of CG43

NICE issued guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children in 2006 (CG43). This was a joint clinical and public health guideline developed by the National Collaborating Centre for Primary Care (now merged as part of the National Clinical Guidelines Centre) and NICE’s Centre for Public Health Excellence. Despite the guidance, there remain significant variations in existing service provision for people with obesity and, in many places, the multicomponent programmes that are required for both prevention and treatment are limited. The 2013 Royal College of Physicians report ‘Action on obesity: comprehensive care for all’ reported that access to surgery for obesity in some areas of the UK did not reflect the guideline recommendations.

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

Version: November 2014
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A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia

The study found that supervised person-centred care, communication skills and dementia-care mapping, as well as sensory therapy activities and structured music therapies, reduce agitation in care-home dementia residents. Health and social care costs were between £7000 and £15,000 depending on the severity of agitation. Further work is required to investigate interventions for agitation for use with people with dementia living in their own homes.

Health Technology Assessment - NIHR Journals Library.

Version: June 2014
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Nutrition in Cancer Care (PDQ®): Health Professional Version

Expert-reviewed information summary about the causes and management of nutritional problems that occur in patients with cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 19, 2017

Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet]

We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its recommendation on screening for cognitive impairment in older adults. Our review addresses five questions: 1) Does screening for cognitive impairment in community-dwelling older adults improve decisionmaking, patient, family/caregiver, or societal outcomes?; 2) What is the test performance of screening instruments to detect dementia or mild cognitive impairment (MCI) in community-dwelling older adult primary care patients?; 3) What are the harms of screening for cognitive impairment?; 4) Do interventions for early dementia or MCI in older adults improve decisionmaking, patient, family/caregiver, or societal outcomes?; and 5) What are the harms of interventions for cognitive impairment?

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: November 2013
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The Clinical Effectiveness and Cost-Effectiveness of Exercise Referral Schemes: A Systematic Review and Economic Evaluation

Exercise referral schemes (ERS) aim to identify inactive adults in the primary-care setting. The GP or health-care professional then refers the patient to a third-party service, with this service taking responsibility for prescribing and monitoring an exercise programme tailored to the needs of the individual.

Health Technology Assessment - NIHR Journals Library.

Version: December 2011

Smart Health Choices: Making Sense of Health Advice

This book aims to help consumers and practitioners develop the skills to assess health advice – and hopefully to make decisions that will improve the quality of their care. For some people, making better-informed decisions could be life saving. We hope that it will be useful if you are struggling to come to terms with an illness or injury, and the best ways of managing it. Or you may simply want to lead a healthier life, and may be wondering how to make sense of the often conflicting flood of health information that deluges us every day, through the media, and from our friends and health practitioners.

Hammersmith Press.

Version: 2008

Systematic Reviews in PubMed

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