PONS ore EPIL) New Guidelines and Recommendations Review the latest information released by the following organizations: ¥ American Academy of Otolaryngology-Head and Neck Surgery Foundation Y American Academy of Pediatrics Y American Bar Association Y American College of Cardiology Y American College of Gastroenterology Y American College of Obstetricians and Gynecologists Y American Heart Association ¥ US Couneil for Responsible Nutrition ¥_ US Food and Drug Administration Safe Use Initiative wasn L1e Forges en hi content pase corte Mose Mace | neonsncbn netGuidelines on measles from the American Academy of Pediatrics!” > Any of the following constitutes evidence of immunity to measles: Documentation of age-appropriate vaccination with a live measles virus— containing vaccine (one dose for preschool-aged children, two doses for children in kindergarten through 12th grade) Laboratory evidence of immunity Laboratory confirmation of disease Birth before 1957 > Use of immune globulin Clinicians can administer immune globulin either intramuscularly or intravenously within 6 days of exposure to prevent or modify measles response in people who lack evidence of measles immunity. The recommended dose is 0.50 ml/kg administered intramuscularly, with a maximum volume of 15 mL. Groups who are at higher risk for complications from severe measles should receive intravenous application at a dose of 400 mg/kg. Continued on next slide Mulacpe |, Matcape Dro: & Oseasee ©2016 Yat LLC Fer pemsson ores es corte peasa coat Medscape atpemnsors(wibnd etPAM Co} Guidelines on measles from the American Academy of Pediatrics?” > People with HIV infections Measles immunization (in the form of the measles, mumps, and rubella vaccine) for everyone older than 12 mo who is infected by HIV, except those who have evidence of severe immunosuppression. Measles can be fatal in patients with HIV. Immune globulin prophylaxis for HIV-infected children who are exposed to measles, depending on their immune status and measles vaccine history. > Healthcare personnel Immunization programs for healthcare personnel, including students, who may be in contact with patients with measles. Birth before 1957 is not a guarantee of measles immunity; facilities should consider vaccination of unimmunized healthcare personnel who lack laboratory evidence of immunity who were born before 1957. Continued on next slide Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peasa coat Medscape atpemnsors(wibnd etSls Guidelines on measles from the American Academy of Pediatrics?? > Management of susceptible individuals * Clinicians can best manage immunodeficient and immunosuppressed patients exposed to measles if they have previous knowledge of the patients’ immune status. + Children should receive measles vaccination prior to treatment with biological response modifiers, such as tumor necrosis factor antagonists. + Susceptible patients with immunodeficiencies should receive immune globulin after measles exposure. + Warning against giving live-virus measles vaccines to immunocompromised patients with disorders associated with increased severity of viral infections (except people with HIV who do not have evidence of severe immunosuppression). + Recommendation not to give immunization for at least a month after a patient has finished a high-dose course of corticosteroids, such as prednisone. Matsaqse | Meccan Ong &Dacabes 2015 Webi LIC Fer pemision to esos ott peso corte Modcps et camsine@sb nt+ Transitioning Young Women to Adult Care Guidelines on the transition of young women from pediatric care to adult care from the American College of Obstetricians and Gynecologists?4 + Sexual health: The healthcare provider should discuss the patient's sexual health, orientation, behaviors, partners, satisfaction, and function. Discussion of contraceptive needs should include emergency contraception, nonemergency contraception, and prevention of sexually transmitted diseases. + Sleep disorders: Clinicians should educate patients that lack of sleep can lead to increased risk for diabetes, weight gain, heart disease, depression, and driving accidents. = Appearance, nutrition: Providers should ask the patient whether she has concerns about her weight or whether she has used diet pills, laxatives, fasting, ‘or vomiting to lose weight. *+ Safety and violence: Providers should ask about abuse, neglect, physical or sexual violence, and reproductive coercion (sabotage of contraceptive methods, pregnancy coercion or pressure). Clinicians should counsel patients on risk for sexual assault and responsible and safe Internet use. Continued on next slide Mosc | Mascape Or & Osases ©2016 Web LLC Fer pemsson ores es ote peas coat Medstapatpemnssons(wibnd etPWC hem oucukenaerieme Guidelines on the transition of young women from pediatric care to adult care from the American College of Obstetricians and Gynecologists?4 * Breast and pelvic exams: Recommendation of clinical breast exams every 1-3 yr beginning at age 20 yr, and clinicians should educate patients about breast self-exams. Whether to perform a complete pelvic examination during periedic health checks for an asymptomatic patient should be a shared decision between the patient and her healthcare provider. Cervical cancer screening should begin at age 21 yr and continue every 3 yr through age 29 yr. Additional ‘options are available for women aged 30 yr and older. * Substance abuse: Providers should ask about use of tobacco, alcohol, and other drugs, including designer and performance-enhancing drugs and stimulants prescribed for disorders such as attention-deficit/hyperactivity disorder. Continued on next slide Mosc | Mascape Or & Osases ©2016 Web LLC Fer pemsson ores es ote peas coat Medstapatpemnssons(wibnd etPMc hen oucuenisecicmes Guidelines on the transition of young women from pediatric care to adult care from the American College of Obstetricians and Gynecologists?4 + Herbal supplements: Healthcare providers should assess use, because some supplements can interfere with prescription medications (eg, St. John's wort interferes with the efficacy of oral contraceptives). + Mental health: Screening tools are available, but the following 2 questions can help determine whether further help is needed: (1) Over the past 2 weeks, have youever felt down, depressed, or hopeless? (2) Have you felt little interest or pleasure in doing things? Mosc | Mascape Or & Osases ©2016 Web LLC Fer pemsson ores es ote peas coat Medstapatpemnssons(wibnd etGB Pioneer kO need iastie ens Guidelines on robot-assisted gynecologic surgery from the American College of Obstetricians and Gynecologists * Robot-assisted cases should be appropriately selected based on the available data and expert opinion. In addition to the didactic and hands-on training necessary for any new technology, ongoing quality assurance is essential to ensure appropriate use of the technology and, most importantly, patient safety. * Adoption of new surgical techniques should be driven by what is best for the patient, as determined by evidence-based medicine rather than external pressures. + Adequate informed consent should be obtained from patients before surgery. In the case of robotic procedures, this includes a discussion of the indications for surgery and risks and benefits associated with the robotic technique compared with alternative approaches and other therapeutic options. Continued on next slide Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retGF Posie hO umes insti en means Guidelines on robot-assisted gynecologic surgery from the American College of Obstetricians and Gynecologists + Surgeons should describe their experience with robotic-assisted surgery or any new technology when counseling patients regarding these procedures. + Surgeons should be skilled at abdominal and laparoscopic approaches for a specific procedure before undertaking robotic approaches. * Surgeon training, competency guidelines, and quality metrics should be developed at the institutional level. + Reporting of adverse events is currently voluntary and unstandardized, and the true rate of complications is not known. The American College of Obstetricians and Gynecologists and the Society of Gynecologic Surgeons recommend the development of a registry of robot-assisted gynecologic procedures and the use of the Manufacturer and User Facility Device Experience Database to report adverse events, Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retTere TT SMa A ACLU Recommendations for iodine in prenatal vitamins from the US Council for Responsible Nutrition”* + The US Council for Responsible Nutrition’s new guidelines call for all dietary- supplement manufacturers and marketers to begin including at least 150 yg of iodine in all daily multivitamin/mineral supplements intended for pregnant and lactating women in the United States within the next 12 mo. + The US recommended daily allowances (RDA) for iodine intake are 150 ug in adults, 220-250 pig in pregnant women, and 250-290 ug in breastfeeding women. Dietary sources such as iodized salt, dairy products, some breads, and seafood usually contain enough to meet the RDA for most people who are not pregnant or lactating. + However, there is an upper safety limit, with ingestion of more than 1100 g/day not recommended because of the risk for thyroid dysfunction. In particular, infants, the elderly, pregnant and lactating women, and people with preexisting thyroid disease are at risk for adverse effects of excess iodine on the thyroid. Matsaqse | Meccan Og &Dacanen 2015 Webi LLC Forges hi one pe se corte Moscapeatpemesnegistn ntPea ee any Clinical considerations for safer epidural injections from the US Food and Drug Administration Safe Use Initiative, an expert multidisciplinary working group, and 13 specialty societies?” All cervical interlaminar (IL) epidural steroid injections (ESIs) should be performed using image guidance, with appropriate AP, lateral, or contralateral oblique views anda test dose of contrast medium. Cervical transforaminal (TF) ESis should be performed by injecting contrast medium under real-time fluoroscopy and/or digital subtraction imaging, using an AP view, before injecting any substance that may be hazardous to the patient. Cervical IL ESIs are recommended to be performed at C7-T1, but preferably not higher than the C5-C7 level. No cervical IL ES! should be undertaken, at any segmental level, without reviewing, before the procedure, prior imaging studies that show there is adequate epidural space for needle placement at the target level. Particulate steroids should not be used in therapeutic cervical TF injections. A nonparticulate steroid (eg, dexamethasone) should be used for the initial injection in lumbar TF ESIs. Continued on next slide Mouse || Maicape Dro & Oseasee 2016 Vath LLC Fer pemsson ores es corte peasa coat Medscape atpemnsors(wibnd ret7 Epidural Injections cont'd Clinical considerations for safer epidural injections from the US Food and Drug Administration Safe Use Initiative, an expert multidisciplinary working group, and 13 specialty societies??° Extension tubing is recommended for all TF ESIs. ‘A face mask and sterile gloves must be worn during the procedure. The ultimate choice of what approach or technique (IL vs. TF ESI) to use should be made by the treating physician by balancing potential risks and benefits with each technique for each given patient. Cervical and lumbar IL ESIs can be performed without contrast in patients with documented contraindication to use of contrast (eg, significant history of contrast allergy or anaphylactic reaction). TF ESis canbe performed without contrast in patients with documented contraindication to use, but in these circumstances, particulate steroids are contraindicated and only preservative-free, particulate-free steroids should be used. Moderate to heavy sedation is not recommended for ESls, but if light sedation is used, the patient should remain able to communicate pain or other adverse sensations or events Muacpe |, Macape Dro: & Oseasee 2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd reteure Recommendations regarding firearm-related injury and death from medical associations and the American Bar Association'12 * Criminal background checks for all firearm purchases, including sales by gun dealers, sales at gun shows, and private sales between individuals. + Opposition to state and federal mandates that interfere with physician free speech and the patient-physician relationship, including laws that forbid physicians to discuss a patient's gun ownership. + Improved access to mental health care and caution against broadly including all persons with any mental or substance use disorder in a category of persons prohibited from purchasing firearms. + Adequate resources to facilitate coordination among physicians and state, local, and community-based behavioral health systems so they can provide care to patients, raise awareness, and reduce social stigma. Continued on next slide Mosc | Mascape Or & Osases ©2016 Web LLC Fer pemsson ores es ote peas coat Medstapatpemnssons(wibnd eteC ued ecmce Recommendations regarding firearm-related injury and death from medical associations and the American Bar Association'12 + For persons whose right to purchase or possess a firearm has been suspended on grounds relating to a mental or substance use disorder, there should be a fair, equitable, and reasonable process established for restoration that balances the individual's rights with public safety. + Restrictions for civilian use on the manufacture and sale of large-capacity magazines and firearms with features designed to increase their rapid and extended killing capacity. + Robust research about the causes and consequences of firearm violence and unintentional injuries and for strategies to reduce firearm-related injuries. ‘Access to data should not be restricted, so researchers can do studies that enable the development of evidence-based policies to reduce the rate of firearm injuries and deaths in this nation. Mosc | Mascape Or & Osases ©2016 Web LLC Fer pemsson ores es ote peas coat Medstapatpemnssons(wibnd et& Acute Coronary Syndromes Guidelines on the management of non-ST-elevation acute coronary syndromes from the American College of Cardiology/American Heart Association 13 + Patients with chest pain or other symptoms suggesting acute coronary syndromes (ACS) should have 12-lead electrocardiography (ECG) performed and evaluated within 10 min of arrival at an emergency facility, and serial ECGs should be performed to detect ischemic changes. + Serial cardiac troponin | or T levels (using a contemporary assay) should be obtained at presentation and at 3-6 hr after symptom onset. Risk scores can help assess prognosis. * In patients with symptoms consistent with ACS without objective evidence of myocardial ischemia (nonischemic ECG and normal cardiac troponin levels), noninvasive imaging is reasonable before emergency department discharge or within 72 hr after discharge. Continued on next slide Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd ret& Acute Coronary Syndromes coi Guidelines on the management of non-ST-elevation acute coronary syndromes from the American College of Cardiology/American Heart Association 13 + Standard initial medical therapies include supplemental oxygen for arterial oxygen saturation <90% or respiratory distress; sublingual nitroglycerin; oral beta-blocker therapy within the first 24 hr in the absence of heart failure, low output state, increased risk for cardiogenic shock, or other contraindications to beta-blockade; nondihydropyridine calcium channel blocker for continuing or recurrent ischemia and contraindication to beta-blockade (in the absence of clinically significant left ventricular dysfunction). + Nonsteroidal anti-inflammatory drugs (except aspirin) should not be initiated and should be discontinued during the hospitalization for NSTE-ACS because of the increased risk of major adverse cardiac events associated with their use. * Initial antiplatelet/anticoagulant therapy includes 325-mg chewable aspirin at presentation, followed by a daily maintenance dose of aspirin at 81-126 mg daily. A P2Y,p inhibitor (clopidogrel or ticagrelor) should be used in addition to aspirin for up to 12 mo in patients treated with either an early-invasive or ischemia-guided strategy. In addition to antiplatelet therapy, parenteral anticoagulation is indicated with enoxaparin, bivalirudin, fondaparinux, or unfractionated heparin. Continued on next slide Molscpe | Maicpe Ong & sear ©2016 YSU, LLC Ferpomscn tors scart as cone Medicap a passions ibe nat& Acute Coronary Syndromes coi Guidelines on the management of non-ST-elevation acute coronary syndromes from the American College of Cardiology/American Heart Association 13 + Ahigh-intensity statin should be initiated or continued in all patients without contraindications. Angiotensin-converting enzyme inhibitors should be started and continued indefinitely with a left ventricular ejection fraction <40% or hypertension, diabetes, or stable chronic kidney disease unless contraindicated. + An early invasive strategy is indicated for patients with refractory angina or hemodynamic or electrical instability and those at elevated risk for clinical events. An early invasive strategy is not recommended for patients with extensive comorbidities (eg, hepatic, renal, or pulmonary failure; cancer) in whom the risks of revascularization and comorbid conditions are likely to outweigh the benefits of revascularization. An ischemia-guided strategy is appropriate for low-risk score patients (Thrombolysis In Myocardial Infarction or Global Registry of Acute Coronary Events), for low-risk troponin-negative women, and by patient or clinician preference in the absence of high- risk features. When an ischemia-guided strategy is chosen, noninvasive stress testing is recommended prior to hospital discharge to detect severe ischemia occurring at a low- stress threshold. Continued on next slide Mosse || Mescape Or & Osases ©2018 WabiO LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd ret& Acute Coronary Syndromes coi Guidelines on the management of non-ST-elevation acute coronary syndromes from the American College of Cardiology/American Heart Association 13 + Patients undergoing percutaneous coronary intervention (PCI) should be treated with a P2Y) inhibitor: clopidogrel, prasugrel, or ticagrelor. Discharge planning should include detailed patient education about symptoms, lifestyle interventions, standard medication with dual antiplatelet therapy, cholesterol management, referral to cardiac rehabilitation, timely follow-up with the healthcare team, and influenza and pneumococcal vaccines. *+ NSTE-ACS patients with prior revascularization PCI or coronary artery bypass grafting should receive antiplatelet and anticoagulant therapy and be strongly considered for an early invasive strategy because of their increased risk. Medical treatment in the acute phase of NSTE-ACS and decisions to perform stress testing, angiography, and revascularization should be similar in patients with and without diabetes mellitus. + Patients who develop NSTE-ACS following noncardiac surgery should receive guideline- directed medical therapy, with additional management directed at the underlying cause of the pathophysiologic process. Continued on next slide Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd ret& Acute Coronary Syndromes coi Guidelines on the management of non-ST-elevation acute coronary syndromes from the American College of Cardiology/American Heart Association 13 * Older patients with NSTE-ACS, because of their high-risk status, should be treated with guideline-cirected medical therapy and an early invasive strategy with revascularization as appropriate; pharmacotherapy should be individualized and dose adjusted by weight and creatinine clearance to reduce adverse events. Management decisions should be patient centered, incorporating patient preferences, comorbidities, functional and cognitive status, and life expectancy. * Women with NSTE-ACS should be managed with the same pharmacologic therapy as men for acute care and secondary prevention, with attention to weight and/or renally calculated doses of antiplatelet and anticoagulant agents to reduce bleeding risk. Women with NSTE-ACS and high-risk features (eg, troponin positive) should undergo an early invasive strategy. Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retPCcicmacecuenurkerncan Guidelines on genetic testing and management of hereditary gastrointestinal cancer syndromes from the American College of Gastroenterology “ + This guideline presents recommendations for the management of patients with hereditary gastrointestinal cancer syndromes and specifically discusses genetic testing and management of Lynch syndrome, familial adenomatous polyposis (FAP), attenuated familial adenomatous polyposis (AFAP), MUTYH-associated polyposis (MAP), Peutz-Jeghers syndrome, juvenile polyposis syndrome, Cowden syndrome, serrated (hyperplastic) polyposis syndrome, hereditary pancreatic cancer, and hereditary gastric cancer. + The initial assessment is the collection of a family history of cancers and premalignant gastrointestinal conditions and should provide enough information to develop a preliminary determination of the risk of a familial predisposition to cancer, Continued on next slide Mosc | Mascape Or & Osases ©2016 Web LLC Fer pemsson ores es ote peas coat Medstapatpemnssons(wibnd etPcie acecuen ur kecnccmes Guidelines on genetic testing and management of hereditary gastrointestinal cancer syndromes from the American College of Gastroenterology “ + Age at diagnosis and lineage (maternal and/or paternal) should be documented for all diagnoses, especially in first- and second-degree relatives. * When indicated, genetic testing for a germline mutation should be done on the most informative candidate(s) identified through the family history evaluation and/or tumor analysis to confirm a diagnosis and allow for predictive testing of atrrisk relatives. + Genetic testing should be conducted in the context of pre- and post-test genetic counseling to ensure the patient's informed decision making. + Patients who meet clinical criteria for a syndrome as well as those with identified pathogenic germline mutations should receive appropriate ‘surveillance measures in order to minimize their overall risk of developing syndrome-specific cancers. Mosc | Mascape Or & Osases ©2016 Web LLC Fer pemsson ores es ote peas coat Medstapatpemnssons(wibnd etAllergic Rhinitis Guidelines on allergic rhinitis from the American Academy of Otolaryngology-Head and Neck Surgery Foundation 1 + Strong recommendation that clinicians recommend intranasal steroids for patients with a clinical diagnosis of allergic rhinitis (AR) whose symptoms affect their quality of life. + Strong recommendation that clinicians recommend oral second-generation/less sedating antihistamines for patients with AR and primary complaints of sneezing and itching. * Clinicians should make the clinical diagnosis of AR when patients present with a history and physical examination consistent with an allergic cause and one or more of the following symptoms: nasal congestion, runny nose, itchy nose, or sneezing. + Findings of AR consistent with an allergic cause include, but are not limited to, clear rhinorrhea, nasal congestion, pale discoloration of the nasal mucosa, and red and watery eyes. Continued on next slide Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retronan Guidelines on allergic rhinitis from the American Academy of Otolaryngology-Head and Neck Surgery Foundation 1 + Clinicians should perform and interpret, or refer to a clinician who can perform and interpret, specific igE (skin or blood) allergy testing for patients with a clinical diagnosis of AR who do not respond to empiric treatment, or when the diagnosis is uncertain, or when knowledge of the specific causative allergen is. needed to target therapy. * Clinicians should assess patients with a clinical diagnosis of AR for, and document in the medical record, the presence of associated conditions such as asthma, atopic dermatitis, sleep-disordered breathing, conjuncti rhinosinusitis, and otitis media. + Clinicians should offer, or refer to a clinician who can offer, immunotherapy (sublingual or subcutaneous) for patients with AR who have inadequate response to symptoms with pharmacologic therapy with or without environmental controls. Continued on next slide Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retronan Guidelines on allergic rhinitis from the American Academy of Otolaryngology-Head and Neck Surgery Foundation 1 + The panel recommends against clinicians routinely performing sinonzsal imaging in patients presenting with symptoms consistent with a diagnosis of AR and clinicians offering oral leukotriene receptor antagonists as primary therapy for patients with AR. + Clinicians may advise avoidance of known allergens or may advise environmental controls (ie, removal of pets; the use of air filtration systems, bed covers, and acaricides [chemical agents formulated to kill dust mites}) in patients with AR who have identified allergens that correlate with clinical symptoms. + Clinicians may offer intranasal antihistamines for patients with seasonal, perennial, or episodic AR. * Clinicians may offer combination pharmacologic therapy in patients with AR who have inadequate response to pharmacologic monotherapy. Continued on next slide Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retronan Guidelines on allergic rhinitis from the American Academy of Otolaryngology-Head and Neck Surgery Foundation 1 *+ Clinicians may offer, or refer to a surgeon who can offer, inferior turbinate reduction in patients with AR with nasal airway obstruction and enlarged inferior turbinates who have failed medical management. * Clinicians may offer acupuncture, or refer to a clinician who can offer acupuncture, for patients with AR who are interested in nonpharmacologic therapy. + The development group provided no recommendation regarding the use of herbal therapy for patients with AR. Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retaaa} a 2 3 Harrison L. AAP updates measles recommendations. Medscape Medical News. WebMD Inc. February 12, 2015. Available at: http://www. medseape.com/viewarticle/839688, 2015 Report of the Committee on Infectious Diseases. Early Release from Red Book. ‘American Academy of Pediatrics. February 20, 2015. Available at: http://redbook.solutions.2ap.org/DocumentLibrary/2015RedBookMeasles.odf. Frellck M, ACOG guideline aids transition from pediatric to adult care. Medscape Medical ‘News. WebMD Ine. February 23, 2015. Available at: http://www.medscape.com/viewarticle/840213. The transition from pediatric to adult health care: preventive care for young women aged 18-26 years. Committee Opinion No. 626: American College of Obstetricians and Gynecologists. Obstet Gynecol. 2015;125:752-4, Available at: http://iournals.luw.com/greenjournal/Fulltext/2015/03000/Committee Opinion No 626 The Transition From.45.aspx. Laidman J. ACOG issues guidelines for robot-assisted gynecologic surgery. Medscape Medical News. WebMD Inc. February 23, 2015. Available at: http://www.medscape.com/viewarticle/840170. Robotic surgery in gynecology. Committee Opinion No. 628. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2015;125:760-7. Available at: http://iournals.lww.com/greenjournal/Fulltext/2015/03000/Committee Opinion No_ 628 Robotic Surgery_in.47.aspx. Mulacpe || Matcape Dra: & Oseasee ©2016 Yat, LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retaaa} 7. Tucker ME. New recommendations call for iodine in all prenatal vitamins. Medscape Medical News. WebMD Inc. February 19, 2015. Available at: http://Awww.medscape.com/viewarticle/840056. 8 Leung AM, Avram AM, Brenner AV, et al. Potential risks of excess iodine ingestion and exposure: statement by the American Thyroid Association Public Health Committee. Thyroid. February 2015, 25(2): 145-6. doi:10.1089/thy,2014,0331. Available at: http://online liebertoub.com/doi/abs/10.1089/thy.2014.0331 9. Osterwell N. Panel recommends steps for safer epidural injections. Medscape Medical News. WebMD Inc, February 13, 2015. Available at: htto://www.medscape.com/viewarticle/839757. 10, Rathmell JP, Benzon HT, Dreyfuss P, et al. Safeguards to prevent neurologic complications after epidural steroid injections: consensus opinions from a multidisciplinary working group and national organizations. Anesthesiology. 2015 Feb 9. [Epub ahead of print] Available at: http://anesthesiology.pubs.asaha.org/Article.asox?articleid=2119175, 11. Barclay L. Medical societies call for reducing gun-related injury, death, Medscape Medical ‘News. WebMD Inc. February 23, 2015. Available at: http://www. medscape.com/viewarticle/240244, Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retaaa} 12. Weinberger SE, Hoyt DB, Lawrence HC Ill, et al. Firearm-related injury and death in the United States: a call to action from 8 health professional organizations and the American Bar Association. Ann Intern Med. Published online February 23, 2015. Available at: http://annals.org/article.aspx2articleid=2151828, 13, Amsterdam E A, Wenger NK. The 2014 American College of Cardiology ACC/Americen Heart Association guideline for the mangement of patients with non-ST-elevation acute coronary syndromes: ten contemporary recommendations to aid clinicians in optimizing patient outcomes. Clin Cardiol. 2015 Feb; 38(2):121-3. Available at: http://Awww.nebi.nlm.nih.gov/pubmed/25648849, 14, Syngal S, Brand RE, Church JM, et al. ACG clinical guideline: genetic testing and management of hereditary gastrointestinal cancer syndromes. Am J Gastroenterol, 2015 Feb;110(2):223-62, Available at: hhttp://wwnw.nature.com/ejg/journal/v110/n2/full/ajg2014435a.htm|. 35. Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: allergic rhinitis executive summary. Otolaryngol Head Neck Surg. 2015 Feb;152(2):197-206. Available at: http://oto.sagepub.com/content/152/2/197.long. Muss |, Matcape Dra & Oseaee ©2016 Yat LLC Fer pemsson ores es corte peas coat Medscape atpemnsons(wibnd retJohn Anello Richard Lindsey Editorial Director, Medscape Drugs & Diseases Senior Editor, Medscape Drugs & Diseases Brian Feinberg Cristina Wojdylo Senior Editor, Medscape Drugs & Diseases Senior Editor, Medscape Drugs & Diseases John Heinegg Olivia Wong, DO Senior Editor, Medscape Drugs & Diseases Senior Editor, Medscape Drugs & Diseases Maaco |, Matcape Dr: & Oseasee 2016 Yat LLC Fer pemsson ores es ote peas coat Medstapatpemnssons(wibnd et