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Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy): Diagnosis and Management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy) in Adults and Children [Internet]

The guideline covers care provided by healthcare professionals who have direct contact with and make decisions about the care of people with chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy) (CFS/ME). It covers care provided in primary and secondary care, and in specialist centres/teams.

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

Version: August 2007
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Crohn's Disease: Management in Adults, Children and Young People

This guideline intends to show the place of both new and established treatments in the wider care pathway for Crohn's disease. This will be useful for clinicians and people with Crohn's disease because new drugs have been licensed for Crohn's disease in the last decade. The guideline also deals with those medications which are unlicensed for treatment of the condition, but which have been used in this way (off-label) for many years and their role is recognised in other NICE documents as well as the British National Formulary. They include azathioprine, mercaptopurine and methotrexate. The guideline aims to help improve the care offered to people with Crohn's disease and provide information about the clinical and cost effectiveness of potential care pathways. Management of Crohn's disease in specific populations (for example, in pregnancy) may require special consideration.

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

Version: October 10, 2012
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Anaemia Management in Chronic Kidney Disease: Partial Update 2015 [Internet]

Anaemia is defined internationally as a state in which the quality and/or quantity of circulating red blood cells is below normal. Blood haemoglobin (Hb) concentration serves as the key indicator for anaemia because it can be measured directly and has an international standard. In response to low tissue oxygen levels in anaemia the kidney produces the hormone erythropoietin which stimulates the bone marrow to produce red blood cells. A major cause of the anaemia of chronic kidney disease (CKD) is a reduction in erythropoietin production due to kidney damage.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: June 2015
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Homocysteine lowering interventions for peripheral arterial disease (PAD) and bypass grafts

Homocysteine is one of the amino acids, the building blocks for proteins. High levels of homocysteine in the blood are associated with narrowing or blocking of arteries (atherosclerosis). However, it is not clear that the homocysteine itself causes the problem. Blood levels of homocysteine can be normalised by taking folic acid, vitamins B12 and B6, or betaine.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Preventing Alzheimer's Disease and Cognitive Decline

To assess whether previous research on purported risk or protective factors for Alzheimer’s disease (AD) and cognitive decline is of sufficient strength to warrant specific recommendations for behavioral, lifestyle, or pharmaceutical interventions/modifications targeted to these endpoints.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: April 2010
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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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Effectiveness of Recombinant Human Growth Hormone (rhGH) in the Treatment of Patients With Cystic Fibrosis [Internet]

This is an evidence report prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center (EPC) examining the benefits and harms associated with using recombinant human growth hormone (rhGH) in patients with cystic fibrosis (CF).

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: October 2010

Gonzalez Regimen (PDQ®): Health Professional Version

Expert-reviewed information summary about the Gonzalez regimen as a treatment for people with cancer. Note: The information in this summary is no longer being updated and is provided for reference purposes only.

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

Version: April 11, 2016

Higher versus lower protein intake in formula‐fed low birth weight infants

Dietary protein is needed for normal growth and development. The protein intake required for growth of the low birth weight infant has been estimated by the growth rate of the fetus to be 3.5 to 4.0 g/kg/d. Controlling the amount of protein given to low birth weight babies (less than 2.5 kg) fed with formula is important. Too much protein can raise blood urea and amino acid (phenylalanine) levels, and this may harm neurodevelopment. Too low protein intake may limit the growth of these infants. The review authors searched the medical literature to identify studies that compared protein intake as follows: between 3 and 4 g of protein per kg of infant body weight each day versus less than 3.0 g/kg/d or greater than 4.0 g/kg/d by low birth weight infants fed formula during their initial hospital stay. Increased protein intake resulted in greater weight gain of around 2.0 g/kg/d. Based on increased body incorporation of nitrogen, this was associated with increased lean body mass. The present conclusion was based on six studies that changed only the protein content of the formula and was supported by three additional studies that made changes in other nutrients as well. No significant difference in the concentration of plasma phenylalanine was noted between infants fed high or low protein content formula. The review was limited in the conclusions made because differences in protein content among comparison groups in some of the individual trials were small and formulas differed substantially across studies; some studies included healthier and more mature premature infants. Study periods varied from eight days to two years, so information on long‐term outcomes was limited. Existing research is not adequate to allow specific recommendations regarding formula with protein content that provides more than 4.0 g/kg/d.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Donor Breast Milk Banks: The Operation of Donor Milk Bank Services

Seventeen donor breast milk banks are currently in operation in the UK. These provide donor milk to babies, including pre-term babies and babies with growth restriction.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Version: February 2010
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Diagnosis and Treatment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

This systematic review summarizes research on methods of diagnosing myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and benefits and harms of multiple medical and nonmedical treatments. It identifies evidence gaps and limitations to inform future research.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: December 2014
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Prostate Cancer: Diagnosis and Treatment

The original Prostate Cancer: Diagnosis and Treatment Guideline published in 2008 was the first clinical guideline produced by the National Collaborating Centre for Cancer (NCC-C); accordingly this is now the first NCC-C clinical guideline to be reviewed and updated. Many areas of the original guideline are unchanged as there is little or no new evidence; other aspects have been completely rewritten. As ever there are still many topics where the research evidence is incomplete or conflicting, and so the Guideline Development Group (GDG) have been required to reach a consensus using the evidence available to them in several areas. In places where it was clear that further work needed to be done, new research recommendations have been made which we hope will be used as the basis for future research work.

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

Version: January 2014

Neonatal Jaundice

Jaundice is one of the most common conditions requiring medical attention in newborn babies. Approximately 60% of term and 80% of preterm babies develop jaundice in the first week of life, and about 10% of breastfed babies are still jaundiced at 1 month of age. In most babies with jaundice thevre is no underlying disease, and this early jaundice (termed ‘physiological jaundice’) is generally harmless. However, there are pathological causes of jaundice in the newborn, which, although rare, need to be detected. Such pathological jaundice may co-exist with physiological jaundice.

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

Version: May 2010
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Evolution of Translational Omics: Lessons Learned and the Path Forward

Technologies collectively called omics enable simultaneous measurement of an enormous number of biomolecules; for example, genomics investigates thousands of DNA sequences, and proteomics examines large numbers of proteins. Scientists are using these technologies to develop innovative tests to detect disease and to predict a patient's likelihood of responding to specific drugs. Following a recent case involving premature use of omics-based tests in cancer clinical trials at Duke University, the NCI requested that the IOM establish a committee to recommend ways to strengthen omics-based test development and evaluation. This report identifies best practices to enhance development, evaluation, and translation of omics-based tests while simultaneously reinforcing steps to ensure that these tests are appropriately assessed for scientific validity before they are used to guide patient treatment in clinical trials.

National Academies Press (US).

Version: March 23, 2012
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Urinary Tract Infection in Children: Diagnosis, Treatment and Long-term Management

In the past 30–50 years, the natural history of urinary tract infection (UTI) in children has changed as a result of the introduction of antibiotics and improvements in health care. This change has contributed to uncertainty about the most appropriate and effective way to diagnose and treat UTI in children and whether or not investigations and follow-up are justified.

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

Version: August 2007

Colistimethate sodium powder and tobramycin powder for inhalation for the treatment of chronic Pseudomonas aeruginosa lung infection in cystic fibrosis: systematic review and economic model

Study found that both colistimethate sodium dry powder for inhalation (DPI) and tobramycin DPI were non-inferior to nebulised tobramycin for the treatment of Pseudomonas aeruginosa lung infection in cystic fibrosis, and their cost-effectiveness was uncertain.

Health Technology Assessment - NIHR Journals Library.

Version: December 2013

Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care: Partial Update of NICE Clinical Guideline 2

Since the publication of the NICE clinical guideline on the prevention of healthcare-associated infections (HCAI) in primary and community care in 2003, many changes have occurred within the NHS that place the patient firmly at the centre of all activities. First, the NHS Constitution for England defines the rights and pledges that every patient can expect regarding their care. To support this, the Care Quality Commission (CQC), the independent regulator of all health and adult social care in England, ensures that health and social care is safe, and monitors how providers comply with established standards. In addition, the legal framework that underpins the guidance has changed since 2003.

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

Version: March 2012

Comparative Effectiveness of In-Hospital Use of Recombinant Factor VIIa for Off-Label Indications vs. Usual Care [Internet]

This report evaluates the level of evidence currently available to support the effectiveness and safety of using recombinant activated coagulation factor VII (rFVIIa) for clinical indications not approved by the U. S. Food and Drug Administration (FDA). rFVIIa is approved for a variety of uses in hemophilia patients who have developed antibody inhibitors that compromise the use of standard factor replacement. Use of this costly biologic product has expanded beyond these hemophilia-related indications to encompass a range of off-label uses, most of which are in-hospital uses. These uses differ substantially from the drug’s FDA approved label. The purpose of this report is two-fold: (1) To document the full range of clinical indications for which rFVIIa is being used and the types of studies available to evaluate these uses and (2) To provide a comparative effectiveness review of rFVIIa vs. usual care for several in-hospital clinical indications: intracranial hemorrhage, massive bleeding secondary to trauma, and the selected surgical procedures of cardiac surgery, liver transplantation, and prostatectomy.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: May 2010

Parkinson's Disease: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care

It is almost 200 years since James Parkinson described the major symptoms of the disease that came to bear his name. Slowly but surely our understanding of the disease has improved and effective treatment has been developed, but Parkinson’s disease remains a huge challenge to those who suffer from it and to those involved in its management. In addition to the difficulties common to other disabling neurological conditions, the management of Parkinson’s disease must take into account the fact that the mainstay of pharmacological treatment, levodopa, can eventually produce dyskinesia and motor fluctuation. Furthermore, there are a number of agents besides levodopa that can help parkinsonian symptoms, and there is the enticing but unconfirmed prospect that other treatments might protect against worsening neurological disability. Thus, a considerable degree of judgement is required in tailoring individual therapy and in timing treatment initiation. It is hoped that this guideline on Parkinson’s disease will be of considerable help to those involved at all levels in these difficult management decisions. The guideline has been produced using standard NICE methodology and is therefore based on a thorough search for best evidence.

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

Version: 2006

Ivacaftor for the treatment of patients with cystic fibrosis and the G551D mutation: a systematic review and cost-effectiveness analysis

Study found that ivacaftor is a clinically effective treatment for patients with cystic fibrosis and the G551D mutation; however, the high cost of ivacaftor may be a barrier to its uptake. Ivacaftor resulted in significant improvements compared with placebo for all but one of the subgroups investigated; further research should prioritise investigating its long-term effectiveness.

Health Technology Assessment - NIHR Journals Library.

Version: March 2014

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