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21. Ovarian Stimulation for IVF/ICSI

DEHYDROEPIANDROSTERONE (DHEA) 73 8.5 ASPIRIN 74 8.6 INDOMETACIN 75 8.7 SILDENAFIL 75 REFERENCES 76 [5] 9. Non-conventional start of ovarian stimulation 78 KEY QUESTION: WHAT IS THE SAFETY AND EFFICACY OF NON-CONVENTIONAL START STIMULATION COMPARED TO STANDARD EARLY FOLLICULAR PHASE STIMULATION? 78 9.1 NON-CONVENTIONAL START 78 9.2 LUTEAL PHASE STIMULATION 78 9.3 DOUBLE STIMULATION 80 REFERENCES 81 10. Ovarian stimulation for fertility preservation 82 KEY QUESTION: WHAT IS THE PREFERRED STIMULATION PROTOCOL (...) responders following IVF treatment. SoF table 28 8 37 Use of aspirin before and/or during ovarian stimulation is not recommended in the general IVF/ICSI population and for poor responders. Strong ? ? ? ? The existing evidence suggests that adjuvant aspirin before and/ or during ovarian stimulation does not improve ovarian response in terms of number of oocytes retrieved and clinical outcomes of clinical or ongoing pregnancy, or live birth rates following IVF treatment. SoF table 29 8 38 Use of sildenafil

2019 European Society of Human Reproduction and Embryology

22. Pregnancy and Renal Disease

to access this MDT (1D). 2. Medication in pregnancy and lactation Guideline 2.1 We recommend that low dose aspirin, low molecular weight heparin, labetalol, nifedipine, methyldopa, prednisolone, azathioprine, ciclosporin, tacrolimus and hydroxychloroquine are safe for use in pregnancy (1B). Guideline 2.2 We recommend concentrations of calcineurin inhibitors (tacrolimus, ciclosporin) are checked throughout pregnancy and immediately postpartum, as blood concentrations may change (1C). Guideline 2.3 We (...) Disease – September 2019 46 7. Hwang JL, Weiss RE. Steroid-induced diabetes: a clinical and molecular approach to understanding and treatment. Diabetes Metab Res Rev. 2014; 30:96-102. 4.3 Pre-eclampsia prophylaxis Guideline 4.3.1 We recommend women with CKD are offered low-dose aspirin (75-150mg) in pregnancy to reduce the risk of pre-eclampsia (1B). Guideline 4.3.2 We suggest kidney donors are offered low dose aspirin (75mg-150mg) to reduce the risk of pre-eclampsia (2D). Rationale Women with CKD

2019 Renal Association

23. Recommendations for good practice in Ultrasound: Oocyte retrieval

. There is no evidence suggesting value for FBC or any additional test before OPU with regard to preventing complications. - Taking accurate patient history before OPU is essential to highlight potential comorbidities and take actions to prevent any possible associated complications. Patients should at least be asked about the use of medications - more specifically the use of blood thinning agents (aspirin and others) -, relevant previous surgeries, and any relevant disease or deficit of coagulation factors

2019 European Society of Human Reproduction and Embryology

24. National Adult Diabetes Clinician Guide

• Simultaneous use of an ACEI, ARB, and/or renin inhibitor is potentially harmful and is not recommended. • Do not prescribe ACEIs/ARBs, to women of childbearing potential, unless there is a compelling indication. Additional Details CLINICAL PRACTICE GUIDELINES | NATL February 2019 • For additional details, see KP Blood Pressure guideline. CHOLESTEROL THERAPY • See Cholesterol and Cardiovascular Risk guideline. ASPIRIN THERAPY • See Integrated Cardiovascular Health Clinical Leads interim guidance on aspirin

2019 Kaiser Permanente National Guideline Program

25. Curriculum for endoscopic submucosal dissection training in Europe

, metachronous lesions, surgery because of non-curative resec- tion or because of recurrence, and medications that can inter- fere with outcomes (such as proton pump inhibitors, aspirin, nonsteroidal anti-inflammatory drugs [NSAIDs], and anti- coagulants). A clinical database suggested by ESGE for ESD training is available on the ESGE website (https://www.esge. com/esd-training-curriculum/). Givenalltheavailableevidenceandpublishedmeta-analyses [72,73,77], ESGE recommends that the goal of every endos- copist

2020 European Society of Gastrointestinal Endoscopy

26. Diagnosis and Management of Acute Pulmonary Embolism Full Text available with Trip Pro

weeks post-partum 38 Figure 8 Follow-up strategy and diagnostic workup for long-term sequelae of pulmonary embolism 44 Abbreviations and acronyms AcT Right ventricular outflow Doppler acceleration time AFE Amniotic fluid embolism ALT Alanine aminotransferase AMPLIFY Apixaban for the Initial Management of Pulmonary Embolism and Deep-Vein Thrombosis as First-line Therapy ASPIRE Aspirin to Prevent Recurrent Venous Thromboembolism trial AV Arteriovenous b.i.d Bis in die (twice a day) BNP B-type (...) Transoesophageal echocardiography/echocardiogram TTE Transthoracic echocardiography/echocardiogram TV Tricuspid valve U Unit UFH Unfractionated heparin VKA(s) Vitamin K antagonist(s) V/Q Ventilation/perfusion (lung scintigraphy) VTE Venous thromboembolism VTE-BLEED ActiVe cancer, male with uncontrolled hyperTension at baseline, anaEmia, history of BLeeding, agE ≥60 years, rEnal Dysfunction WARFASA Warfarin and Aspirin study 1 Preamble Guidelines summarize and evaluate available evidence with the aim

2019 European Society of Cardiology

28. Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases developed in collaboration with the EASD Full Text available with Trip Pro

Management of blood pressure lowering 20 6.3.2.1 Effects of lifestyle intervention and weight loss 20 6.3.2.2 Pharmacological treatments 20 6.3.2.3 Blood pressure changes with glucose-lowering treatments 20 6.4 Lipids 21 6.4.1 Lipid-lowering agents 21 6.4.1.1 Statins 21 6.4.1.2 Ezetimibe 22 6.4.1.3 Proprotein convertase subtilisin/kexin type 22 6.4.1.4 Fibrates 22 6.5 Platelets 23 6.5.1 Aspirin 23 6.5.1.1 Primary prevention 24 6.5.1.2 Secondary prevention 24 6.6 Multifactorial approaches 24 6.6.1 (...) OGTT Oral glucose tolerance test ORIGIN Outcome Reduction With Initial Glargine Intervention PAD Peripheral arterial disease PCI Percutaneous coronary intervention PEGASUS- TIMI 54 Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin−Thrombolysis In Myocardial Infarction 54 PCSK9 Proprotein convertase subtilisin/kexin type 9 PIONEER 6 A Trial Investigating the Cardiovascular Safety of Oral Semaglutide in Subjects

2019 European Society of Cardiology

29. Guidelines on Chronic Coronary Syndromes Full Text available with Trip Pro

antithrombotic therapy in combination with aspirin 75-100 mg daily in alphabetical order in patients who have a high or moderate risk of ischaemic events, and do not have a high bleeding risk. 34 Table 10 Blood pressure thresholds for definition of hypertension with different types of blood pressure measurement 44 Table 11 Potential treatment options for refractory angina and summary of trial data 47 List of figures Figure 1 Schematic illustration of the natural history of chronic coronary syndromes 7 Figure (...) at chronic coronary syndrome outpatient clinics 39 Abbreviations and acronyms ABI Ankle−brachial index ACE Angiotensin-converting enzyme ACS Acute coronary syndrome(s) ACTION A Coronary disease Trial Investigating Outcome with Nifedipine gastrointestinal therapeutic system AF Atrial fibrillation ARB Angiotensin receptor blocker AUGUSTUS An Open-label, 2 × 2 Factorial, Randomized Controlled, Clinical Trial to Evaluate the Safety of Apixaban vs. Vitamin K Antagonist and Aspirin vs. Aspirin Placebo

2019 European Society of Cardiology

33. Management of Type 2 Diabetes Mellitus

programs and use of alternative nicotine delivery systems or pharmacologic therapies. Aspirin. The ADA and most other organizations recommend use of aspirin in all patients with diabetes who have known coronary artery disease. Recent data suggest that aspirin may not be as effective as previously believed in people without coronary artery disease, even in those with diabetes. Current recommendations suggest that aspirin use for primary prevention be reserved for those with a greater than 10% 10-year (...) and aspirin is generally considered safe; however, megavitamin therapy should be discouraged. Relaxation therapy, yoga, and spiritual healing are helpful to individuals and can be encouraged. Interventions that are potentially harmful or have no real evidence of efficacy clearly should be discouraged. Patients should be commended, however, on their self-determination and encouraged to direct their efforts in areas that have proven benefits. When to Consider Endocrine Consultation or Referral Consider

2020 University of Michigan Health System

34. Heart Failure - Systolic Dysfunction

drugs, nonprescription drugs, natural products, and food. 15 UMHS Heart Failure Guideline, December, 2016 Antiplatelet. Heart failure is not an indication for aspirin therapy. However, heart failure is not a contraindication for aspirin therapy in patients with coronary artery disease. Controversial data suggest that aspirin may interfere with ACE inhibitor efficacy; however, the clinical relevance is not clear. Aspirin therapy has also been associated with an increase in hospitalization rates (...) for heart failure (compared to anticoagulant therapy), although this is controversial. However, patients with coronary artery disease or post myocardial infarction should be considered for low dose aspirin therapy (e.g. 81 mg/day). With the limited data available, it is reasonable to consider aspirin therapy for heart failure patients with a coronary history. Potential adverse effects of aspirin on gastric mucosa and on renal function should also be considered. In patients not able to tolerate aspirin

2020 University of Michigan Health System

35. Essential Hypertension

. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. HOT Study Group, Lancet. 351(9118):1755-62, 1998 Jun 13. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting–enzyme inhibitor, Ramipril, on cardiovascular events in high-risk patients, N Engl J Med 2000; 342:145-153, Jan 20, 2000 Jamerson K, Weber MA, Bakris GL et al

2020 University of Michigan Health System

36. Venous Thromboembolism (VTE)

prevention of VTE after discontinuation of traditional anticoagulation. The two main agents that have been investigated thus far are aspirin and the HMG-CoA reductase inhibitors (statins). Aspirin. Based on the limited data available, low-dose aspirin provides long-term benefit in secondary VTE prevention. The benefit is primarily in adult patients following a first episode of unprovoked (idiopathic) VTE after optimal duration anticoagulation and without an indication for indefinite anticoagulation (...) . Additionally, aspirin is both inexpensive and widely available. Results from the WARFASA trial demonstrated that low- dose aspirin (100mg daily) reduced the rate of VTE recurrence by 40% in adult patients following a first episode of unprovoked VTE, without any increase in the rate of bleeding. The second main trial investigating aspirin for this purpose, ASPIRE, demonstrated a non-significant decrease in rate of VTE recurrence with low-dose aspirin (4.8% vs. 6.5% per year respectively). However, low-dose

2020 University of Michigan Health System

37. Perioperative

) Elective noncardiac surgery should not be performed within 14 days of balloon angioplasty in patients in whom aspirin will need to be discontinued perioperatively. (ACC/AHA 2014 guideline recommendation) Elective noncardiac surgery should be delayed 30 days after BMS implantation and optimally six months after DES implantation. (ACC/AHA 2016 guideline recommendation) In patients treated with DAPT after coronary stent implantation who must undergo surgical procedures that mandate the discontinuation (...) of P2Y12 inhibitor therapy, it is recommended that aspirin be continued if possible and the P2Y12 platelet receptor inhibitor be restarted as soon as possible after surgery. (ACC/AHA 2016 guideline recommendation) Elective noncardiac surgery after DES implantation in patients for whom P2Y12 inhibitor therapy will need to be discontinued may be considered after three months if the risk of further delay of surgery is greater than the expected risk of stent thrombosis. (ACC/AHA 2016 guideline

2020 Institute for Clinical Systems Improvement

38. Laboratory diagnosis of G6PD deficiency Full Text available with Trip Pro

haemolysis in G6PD‐deficient subjects. Category of drug Predictable haemolysis Possible haemolysis Antimalarials Dapsone Chloroquine Primaquine Quinine Pamaquin * Not on UK market. Tafenoquine Methylene blue Analgesics/antipyretic Phenazopyridine Aspirin (high doses) † Acceptable up to a dose of at least 1 g daily in most G6PD‐deficient individuals. Paracetamol (Acetaminophen) Antibacterials Cotrimoxazole Sulfasalazine Sulfadiazine Quinolones ‡ Including ciprofloxacin, moxifloxacin, nalidixic acid

2020 British Committee for Standards in Haematology

39. Management of Chronic Kidney Disease

and symptoms; physical exam; laboratory tests; imaging; renin-angiotensin system blockade (ACEI, ARB, optimizing blood pressure, reducing albuminuria, inhibition of renal fibrosis); treatment of diabetes mellitus and of hypertension; management of dyslipidemia, smoking, and aspirin therapy; management of anemia, mineral bone disease, metabolic acidosis, potassium and sodium balance, fluid balance/volume management, and malnutrition; dietary recommendations (sodium, protein, malnutrition), medication dose

2020 University of Michigan Health System

40. Prenatal Care

with a history of prior preeclampsia, diabetes, chronic hypertension, renal disease, autoimmune disorder, or multiple gestation. Treatment with low-dose aspirin (81 mg by mouth once daily) beginning at 12 weeks’ gestation is recommended to reduce the risk for development of preeclampsia in these patients. Routine aspirin prophylaxis has not been shown to be beneficial in low-risk patients. Gestational hypertension and preeclampsia without severe features are indications for sonographic evaluation of fetal (...) ://www.uspreventiveservicestaskforce.org/Page/Topic/r ecommendation-summary/low-dose-aspirin-use-for-the- prevention-of-morbidity-and-mortality-from-preeclampsia- preventive-medication Wald NJ, Law MR, Morris JK, Wald DS. Quantifying the effect of folic acid. Lancet, 2001; 358: 2069-73. Review of studies of folic acid supplementation on risk of neural tube defects to determine effective dosing. Carrier screening for genetic conditions. Committee Opinion No. 691. American College of Obstetricians and Gynecologists. Obstet Gynecol

2020 University of Michigan Health System

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