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Cardiovascular rehabilitation

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161. Hepatitis B: Scenario: Managing hepatitis B infection

infections is appropriate, and/or Drug rehabilitation agency (if appropriate). Ensure people with confirmed chronic hepatitis B have been vaccinated against hepatitis A if they are not already immune. For more information on administering hepatitis A vaccine, see the CKS topic on . Ensure contacts of people with confirmed chronic hepatitis B are offered hepatitis B vaccination and immunoglobulin if . This may include sexual partners, other household members (including children), and other contacts (...) . There have also been very rare cases of serious cardiovascular adverse effects, particularly after injection of the drug. The recommendations to try simple measures and to consider offering chlorphenamine to treat itch are based on the opinion of previous expert reviewers of this CKS topic. There was no consensus regarding the use of ursodeoxycholic acid, colestyramine, and corticosteroids, and as liver-associated itch can be difficult to treat, CKS pragmatically recommends seeking specialist advice

2020 NICE Clinical Knowledge Summaries

162. Hepatitis A: Scenario: Managing hepatitis A infection

infections is appropriate, and/or Drug rehabilitation agency (if appropriate). Follow-up at least every one to two weeks. Consider more frequent follow-up if the person is symptomatic and/or has jaundice, and depending on the results of ). Repeat liver function tests until amino-transferase levels are normal (usually 4 -12 weeks). Seek specialist advice if If the person has significantly abnormal liver function tests (for example aspartate aminotransferase [AST] or alanine aminotransferase [ALT] levels (...) in conditions requiring long-term treatment. There have also been very rare cases of serious cardiovascular adverse effects, particularly after injection of the drug. The recommendations to try simple measures and to consider offering chlorphenamine to treat itch are based on the opinion of previous expert reviewers of this CKS topic. There was no consensus regarding the use of ursodeoxycholic acid, colestyramine, and corticosteroids, and as liver-associated itch can be difficult to treat, CKS pragmatically

2020 NICE Clinical Knowledge Summaries

163. Heart failure - chronic: Scenario: Information and advice, follow-up, and referral

referral for people with comorbidities This recommendation is based on expert opinion in a review article which recommends optimizing the management of comorbidities [ ], and is pragmatic and based on what CKS considers to be good medical practice. Referral of women planning a pregnancy and women who are pregnant These recommendations are based on information in the guidelines from the European Society of Cardiology Guidelines on the management of cardiovascular diseases during pregnancy [ ], the Royal (...) interaction of prescribed medication with over-the-counter treatment for depression such as St John's wort, and recommends a review of all medication and adverse effects. Assessing the person's nutritional status This recommendation is based on information in the NICE guideline Chronic heart failure in adults: diagnosis and management [ ]. Offering a group exercise-based rehabilitation programme Information to ensure people have been offered a supervised group exercise-based heart failure rehabilitation

2020 NICE Clinical Knowledge Summaries

164. Heart failure - chronic: Scenario: Confirmed heart failure with reduced ejection fraction

on the effects of moderate-high intensity resistance training in people with chronic heart failure found 10 trials, all with methodological flaws, which concluded that the evidence on benefits was weak and inconsistent but that there was no evidence of harm [ ]. The British Association for Cardiovascular Prevention and Rehabilitation Cardiac Rehabilitation Standards document has defined that cardiac rehabilitation is associated with a reduction in morbidity, a 28-56% reduction in unplanned admissions (...) the person has been offered referral to a supervised exercise-based group rehabilitation programme for people with heart failure. The programme should offer psychological and education-based components. The person's heart failure should be . Comorbidities which may not be suitable for referral include uncontrolled ventricular response to atrial fibrillation, uncontrolled hypertension, and high-energy pacing devices set to be activated at rates likely to be achieved during exercise. Ensure the person

2020 NICE Clinical Knowledge Summaries

165. Heart failure - chronic: Scenario: Confirmed heart failure with preserved ejection fraction

) or hospitalization, and a small but statistically significant improvement in self-reported health status [ ]. A systematic review on the effects of moderate-high intensity resistance training in people with chronic heart failure found 10 trials, all with methodological flaws, which concluded that the evidence on benefits was weak and inconsistent but that there was no evidence of harm [ ]. The British Association for Cardiovascular Prevention and Rehabilitation (BACPR) Cardiac Rehabilitation Standards document (...) . If depression is likely to have been precipitated by heart failure symptoms then reassess psychological status once the physical condition has stabilised. If depression is co-existing with heart failure then the person should be treated taking into account potential risks and benefits of drug treatment. Further information is available in the CKS topics on and . If suitable, ensure the person has been offered referral to a supervised exercise-based group rehabilitation programme for people with heart

2020 NICE Clinical Knowledge Summaries

166. Quality Indicators for the Care and Outcomes of Adults with Atrial Fibrillation: Task Force for the Development of Quality Indicators in Atrial Fibrillation of the European Heart Rhythm Association (EHRA) of the European Society of Cardiology (ESC)

. Villarroel 170, Esc 3, Planta 6, 08036 Barcelona, Spain; Institut d’Investigacio ´ August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigacio ´n Biome ´dica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; 2 Leeds Institute for Data Analytics, University of Leeds, UK; Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, UK; Department of Cardiology, Leeds Teaching Hospitals NHS Trust, UK; 3 Department of Electrophysiology, Heart Centre Leipzig (...) Hospital, Jacksonville, FL, USA; 9 Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 10 Centre for Heart Rhythm Disorders, The University of Adelaide and Department of Cardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia; 11 Cardiovascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy; 12

2020 Heart Rhythm Society

167. Nutrition screening and use of oral nutrition support for adults in the acute care setting

Hospital Ms Fiona Willis (until Oct 2017) Office of Nursing and Midwifery Services Director, NMPD Officer Cork/Kerry Speech and Language Therapy personnel (alphabetical order) Ms Alanna Ni Mhiochain (until Dec 2017) Clinical Specialist Speech and Language Therapist, Sligo University Hospital, Irish Association of Speech and Language Therapy (IASLT) Ms Roisin O’Grady (from Jan 2018) Senior Speech and Language Therapist, National Rehabilitation Hospital, IASLT Ms Sheila Robinson Senior Speech (...) Irish data was not included in this audit, Western Europe had the highest patient representation (32% of all patients). 2.2 Clinical and financial impact of malnutrition 2.2.1 Summary of clinical impact of malnutrition Malnutrition, particularly in the face of inflammation, adversely affects every system in the body and is associated with impaired cognitive function, muscle function, cardiovascular function, renal function, respiratory function, gastrointestinal function, thermoregulation, immune

2020 National Clinical Guidelines (Ireland)

168. Genitourinary syndrome of menopause

rehabilitation favored combined therapy. 69 A comparison of the estradiol ring to oral oxybutynin showed similar efficacy for treatment of overactive bladder but with different AEs; oxybutynin resulted in more dry mouth, con- stipation, and blurry vision, whereas the estradiol ring resulted in more vaginal discharge. 116 When women present with both vulvovaginal and urinary symptoms, an initial trial of vaginal ET is prudent. If urinary symptoms are not sufficiently improved or resolved after 3 months (...) related and suggest that the dose was large enough to result in significant systemic absorption. Adverse events associated with use of vaginal ET include vaginal discharge, vulvovaginal candidiasis, vaginal bleed- ing, and breast pain. Differing AE profiles may reflect variations in product formulation and dose. 133,134 The risks typically associated with systemic ET, including breast and endometrial cancer and cardiovascular disease (CVD), have been evaluated in several trials of vaginal ET. Clinical

2020 The North American Menopause Society

169. National Practice Guideline For the Treatment of Opioid Use Disorder

and responsibility to change is a goal beyond passive compli- ance. Given the importance of shared decision-making to improve collaboration and outcomes, patients are encour- aged to actively participate in treatment decisions and take responsibility for their treatment, rather than to pas- sively comply. Concomitant conditions: Medical conditions (e.g., HIV, cardiovascular disease) and/or psychiatric conditions (e.g., depression, schizophrenia) that occur along with a substance use disorder. Contingency

2020 American Society of Addiction Medicine

172. The Primary Care Management of Headache

for the Management of Concussion-mild Traumatic Brain Injury. Available at: https://www.healthquality.va.gov/guidelines/Rehab/mtbi/ VA/DoD Clinical Practice Guideline for the Primary Care Management of Headache July 2020 Page 9 of 150 Medication overuse headache, which has previously been called medication-misuse headache, rebound headache, or drug-induced headache, is an exceedingly common type of headache seen in primary and specialty care settings resulting from the excessive and inappropriate use of non (...) that is of particular interest to VA/DoD providers is a persistent headache attributed to a traumatic injury to the d See the VA/DoD Clinical Practice Guideline for the Management of Concussion-mild Traumatic Brain Injury. Available at: https://www.healthquality.va.gov/guidelines/Rehab/mtbi/ VA/DoD Clinical Practice Guideline for the Primary Care Management of Headache July 2020 Page 11 of 150 head, also known as a PTH. According to ICHD-3, to be defined as a PTH, the onset of the headache must be within seven days

2020 VA/DoD Clinical Practice Guidelines

173. The Non-Surgical Management of Hip & Knee Osteoarthritis

Gastrointestinal Events 88 C. Non-steroidal Anti-inflammatory Drugs and Risk of Cardiovascular Events 89 D. Non-steroidal Anti-inflammatory Drugs and Risk of Renal Disease 90 VA/DoD Clinical Practice Guideline for the Non-surgical Management of Hip & Knee Osteoarthritis July 2020 Page 5 of 127 Appendix G: Nutraceuticals and Dietary Supplements 92 A. Avocado and Soybean Extract 92 B. Boswellia Serrata Extract 92 C. Chondroitin, Glucosamine, and Glucosamine plus Chondroitin 92 D. Curcumin 92 E. Collagen 93 F (...) to the management of OA, from which Work Group members were recruited. The specialties and clinical areas of interest included: primary care, nursing, physical therapy, clinical pharmacology, internal medicine, dietetics, orthopedic surgery, rheumatology, family medicine, sports medicine, physical medicine and rehabilitation, and pain management. The guideline development process for the 2020 CPG update consisted of: 1. Formulating and prioritizing KQs and defining critical outcomes 2. Convening a patient focus

2020 VA/DoD Clinical Practice Guidelines

174. Endovascular Aortic Repair of Aneurysms Involving the Renal-Mesenteric Arteries (FEVAR) Full Text available with Trip Pro

by cardiovascular risk factors, pre-existing symptoms and medical history.( Chaikof E.L. Blankensteijn J.D. Harris P.L. White G.H. Zarins C.K. Bernhard V.M. et al. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg. 2002; 35 : 1048-1060 , Fillinger M.F. Greenberg R.K. McKinsey J.F. Chaikof E.L. Society for Vascular Surgery Ad Hoc Committee on TRS Reporting standards for thoracic endovascular aortic repair (TEVAR). J Vasc Surg. 2010; 52 ( 33 e15 ) : 1022-1033 ) Clinical comorbidity score (...) systems Cardiac complications remain one of the main outcome measures and several clinical scoring systems have been developed to assess risk of cardiac events.( Chaikof E.L. Blankensteijn J.D. Harris P.L. White G.H. Zarins C.K. Bernhard V.M. et al. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg. 2002; 35 : 1048-1060 , Fleisher L.A. Fleischmann K.E. Auerbach A.D. Barnason S.A. Beckman J.A. Bozkurt B. et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation

2020 Society for Vascular Surgery

175. Obesity Prevention and Management

and activity habits. Medical factors contributing to obesity, such as: • medications that can cause weight gain: e.g., hormonal contraceptives, insulins, thiazolidinedions, sulfonylureas, corticosteroids, anticonvulsants, some antidepressants, atypical antipsychotics. • endocrine abnormalities (rare) Risk factors for cardiovascular complications (requires heightened efforts at risk factor modification): • established coronary heart disease (CHD) • obstructive sleep apnea • atherosclerotic disease (...) supervised weight loss program for a minimum of six months (including monthly documentation of weight, dietary, exercise and lifestyle modifications at each visit) without achieving significant weight loss. The supervised weight loss program usually should have occurred within the past 2 years, although some insurance companies will include the past 4 years. Absolute contraindications to bariatric surgery include pregnancy, lactation, active substance abuse, end-stage cardiovascular disease, severe

2020 University of Michigan Health System

176. Appropriate Use Criteria: Level of Care for Musculoskeletal Surgery and Procedures

., hemoglobin = 10) ? Coagulopathy ? Recent unexplained weight loss ? Malnutrition ? Chronic pulmonary disease Level of Care for Musculoskeletal Surgery Copyright © 2020. AIM Specialty Health. All Rights Reserved. 8 o COPD, severe and/or oxygen dependent o Respiratory distress ? Obstructive sleep apnea ? Liver disease including but not limited to cirrhosis ? Vascular o Cardiovascular disease ? Myocardial infarction within 6 months of intended surgery ? Angina pectoris with severe functional limitation (...) rehabilitation after surgery (example: moderate to severe myelopathy) ? Patient is at high risk for falls Outpatient Surgical Setting (excluding Observation) The nonobservation surgical setting includes Ambulatory Surgery Center or Hospital-based Outpatient Department and may be considered medically necessary for elective spine and joint surgery in low risk patients and procedures as follows: Note: These requirements do not prohibit providers from performing these procedures in Ambulatory Surgery Center

2020 AIM Specialty Health

177. 2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure

rehabilitation Rehab PM-2 Exercise training referral for HF from inpatient setting Inpatient Facility Process COR: 1, LOE: A Rehab PM-4 Exercise training referral for HF from outpatient setting Outpatient Individual practitioner, Facility Process COR: 1, LOE: A ACC indicates American College of Cardiology; ACE, angiotensin–converting enzyme; AHA, American Heart Association; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor–neprilysin inhibitor; COR, class of recommendation; CRT, cardiac (...) for adults with heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circ Cardiovasc Qual Outcomes . 2020;13:e000099. doi:10.1161/HCQ.0000000000000099 Developed in Collaboration With the Heart Failure Society of America Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, American Society of Health-System Pharmacists, Heart Rhythm Society, and the International Society for Heart and Lung

2020 American Heart Association

178. Hypertrophic Cardiomyopathy

Diagnosis e172 6.2. Echocardiography e174 6.3. Cardiovascular Magnetic Resonance Imaging e177 6.4. Cardiac Computed Tomography e178 6.5. Heart Rhythm Assessment e179 6.6. Angiography and Invasive Hemodynamic Assessment e180 6.7. Exercise Stress Testing e181 6.8. Genetics and Family Screening e182 6.9. Genotype-Positive, Phenotype-Negative e186 7. SCD Risk Assessment and Prevention e187 7.1. SCD Risk Assessment e187 7.2. Patient Selection for ICD Placement e189 7.3. Device Selection Considerations e192 8 (...) interventions for left ventricular outflow tract obstruction and sudden cardiac death (SCD) prevention. Echocardiography continues to be the foundational imaging modality for patients with HCM. Cardiovascular magnetic resonance imaging will also be helpful in many patients, especially those in whom there is diagnostic uncertainty, poor echocardiographic imaging windows, or where uncertainty persists regarding decisions around implantable cardioverter-defibrillator (ICD) placement. 5. Assessment

2020 American College of Cardiology

180. Guidance on Establishing and Delivering Enhanced Perioperative Care Services

based care, individualised to the patient’s specific needs. In most hospitals, the only environment in which this type of care is available is the critical care unit. However, the majority of postoperative patients, including those at increased risk of adverse outcomes, do not require specific critical care interventions such as invasive ventilation or complex cardiovascular support. Critical Care units are always under pressure from emergency admissions, and now in the COVID-19 era, this pressure (...) of healthcare professionals involved in their care during admission to an EPC facility. • To receive information on their role in the perioperative pathway including, where indicated, the need for preoperative lifestyle modification, adherence to treatment for long term conditions, and participation in prehabilitation, postoperative rehabilitation and discharge planning. • To receive information to support their continuing recovery in hospital and in the community. • A COVID-19 compliant pathway. • Equity

2020 Faculty of Intensive Care Medicine

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