The guidelines were developed by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America.
The guideline, published in the journal Neurology, provides recommendations on initiating, switching, and discontinuing DMTs relevant to patients with relapsing-remitting MS (RRMS), secondary progressive MS, primary progressive MS (PPMS), and clinically isolated syndromes of demyelination.
Clinicians should use a total testosterone level below 300ng/dL as a reasonable cut-off in support of the diagnosis of low testosterone.
Men should only be diagnosed with hypogonadism, says the new guideline, if they display symptoms of a testosterone deficiency and their measurements of total or free testosterone are unequivocally and consistently low.
"Excess facial or body hair is not only distressing to women, it is often a symptom of an underlying medical problem," said Kathryn Martin, MD, Massachusetts General Hospital and lead author of the study.
Based on international clinical trials (ACCORD, ADVANCE, VADT and UKPDS), the ADA recommends a reasonable A1C goal for adults with type 2 diabetes of ≤7%.
The Advisory Committee on Immunization Practices (ACIP) has voted in favor of a renewed recommendation for the use of Flumist Quadrivalent (Influenza Vaccine Live, Intranasal).
Changes in the 2018 adult immunization schedule from the previous year's schedule include new ACIP recommendations for the use of recombinant zoster vaccine (RZV) for adults aged 50 years or older and the use of an additional dose of measles, mumps, and rubella vaccine (MMR) in a mumps outbreak setting.
The recommended childhood and adolescent immunization schedules for 2018 have been approved by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC), the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists.
"The 2017 guideline uses a different classification system for BP than previous guidelines; emphasizes out-of-office BP measurements to confirm the diagnosis of and monitor success in control of hypertension," the authors write.
"Our review of the current evidence has pointed to more questions than answers about the benefits and harms of screening children and teenagers with no symptoms of scoliosis," said USPSTF member Alex R. Kemper, MD, MPH.
Although the research found opioid use to have a favorable risk-benefit ratio, other avenues of treatment should be considered before opioid prescription including addressing iron stores and combination therapy.
Based on these findings, the USPSTF concluded that for most postmenopausal women with an intact uterus, combined estrogen and progestin had no net benefit for primary prevention of chronic conditions (D recommendation).
All PWLH should receive brief standardized screening for chronic pain. A biopsychosocial approach should be used; and appropriate monitoring should take place.
"The risks of ventricular arrhythmias and sudden cardiac death vary in specific populations with different underlying cardiac conditions and with specific family history and genetic variants, and this variation has important implications for studying and applying therapies," a guideline co-author said in a statement.
Patients should be offered individualized diabetes self-management education, as well as individualized glycemic management plans and target ranges for HbA1c.
"In this policy, we emphasize the importance of public health interventions, including vaccination for patients and health care personnel," the authors write.