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121. EHRA/HRS/APHRS/LAHRS Expert Consensus on Risk Assessment in Cardiac Arrhythmias: Use the Right Tool for the Right Outcome

. uncon- trolled hypertension, labile INR, concomitant aspirin, or NSAIDuse)thentoschedulethe‘high-risk’patientsforearly and more frequent follow-up visits (e.g. 4weeks rather than 4months). 15 Only focusing on modi?able bleeding risk fac- tors is an inferior strategy for bleeding risk assessment, compared to the HAS-BLED score. 8 Weshouldusethescoresonlyforthepurposestheywere designed for. Attention to appropriate methodology, statis- tics,etc.,aswellasotherclinicalstates,meritsconsideration Nielsen

2020 Heart Rhythm Society

122. European Academy of Neurology guideline on the management of medication-overuse headache

(paracetamol, non-ster- oidal anti-in?ammatory drugs, acetylsalicylic acid, others). Box 1. ICHD-3 diagnostic criteria of MOH [1]1 A Headache occurring on =15 days/month in a patient with a pre-existing headache disorder. B Regular overuse for >3 months of one or more drugs that can be taken for acute and/or symptomatic treatment of headache. C Not better accounted for by another ICHD-3 diagnosis. © 2020 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European (...) and onabotulinum toxin A and, more recently, to the RCTs on the e?cacy of calcitonin gene-related pep- tide (CGRP)-targeting monoclonal antibodies. Most patients with MOH accessing headache centers have already failed preventive therapy with beta-blockers, ?unarizine, valproic acid or amitriptyline. Topiramate was investigated in a European study and included patients with chronic migraine who were randomized to topiramate or placebo for a 16-week period in a double-blinded trial. A total of 32 patients

2020 European Academy of Neurology

124. Abdominal and pelvic imaging

systemic fibrosis, and should be avoided in Imaging of the Abdomen and Pelvis Copyright © 2020 AIM Specialty Health ® All Rights Reserved. 9 persons with advanced renal disease. Gadolinium contrast has also recently been shown to accumulate within the brain parenchyma, a finding of uncertain clinical significance.There are a number of alternative contrast agents which have been developed for specialized use including gadoxetic acid (hepatobiliary imaging), gadofosveset (a blood pool agent

2020 AIM Specialty Health

125. Navigating the COVID-19 Pandemic

Singapore. JBJS. 2) Velocity of Return a. Cancelled/Postponed Surgeries. i. Categorized based upon urgency “need” and “benefit” considerations (above). b. Ambulatory Cases First (avoid Hospitalization and COVID-19 exposure). c. Inpatient Cases (ASA I and II). d. Inpatient cases (ASA III and IV). i. Once COVID exposure as inpatient is minimized and testing is perfected. Note: Being able to answer these questions is a critical first step to ensuring the safety of patients, health care staff

2020 American Academy of Orthopaedic Surgeons

126. Practice advisory update: Patent foramen ovale and secondary stroke prevention

of the right atrium ASA: =10 mm excursion of the septum primum randomized to antiplatelet medication, none crossed over to closure and 2 (0.8%) were lost to follow up. therapy, and 33.2% of patients assigned to anticoagulation. Patients who underwent closure had a higher rate of atrial fibrillation, 6.6% compared to 0.4% of patients treated with medical therapy (p 6 months though up to 15% of patients were given Warfarin Warfarin (target INR 2.0 to 3.0) or antiplatelet regimen such as aspirin, aspirin plus (...) (periprocedural complication rate of 3.9% and increased absolute rate of nonperiprocedural atrial fibrillation of 0.33% per year)) (Level C). In patients who opt to receive medical therapy alone without PFO closure, clinicians may recommend an antiplatelet medication such as aspirin or anticoagulation (Level C). 10 INTRODUCTION The American Academy of Neurology (AAN) published a practice advisory in 2016 regarding secondary stroke in patients with patent foramen ovale (PFO). 1 Since then, additional

2020 American Academy of Neurology

127. Practical Advice for Management of IBD Patients during the COVID?19 Pandemic: A World Endoscopy Organization Statement Full Text available with Trip Pro

. If COVID‐19 is confirmed, we do not recommend colonoscopy but to wait 14 days until the course of the disease is clarified. When symptoms are severe and persisting after this period, we advise timely colonoscopy as described under Question No 9. QUESTION 2: WHAT THERAPY SHOULD BE USED IN NEWLY DIAGNOSED IBD? For mildly active disease in Crohn's Disease (CD) and ulcerative colitis (UC), 5‐ASA (oral and/or rectal application) and/or oral budesonide are reasonable. In general, steroids should be avoided

2020 World Endoscopy Organization

128. Microhematuria: AUA/SUFU Guideline

are not anticoagulated regardless of type or level of therapy (i.e., aspirin, warfarin, or other antiplatelet or antithrombotic agents) because these patients have a risk of malignancy that is similar to other populations. 55-57 Although few studies have specifically stratified cancer detection rates according to anticoagulation status, several prior studies of MH patients included a substantive representation of patients who were receiving antiplatelet or anticoagulant therapy. For example, Koo et al. demonstrated (...) a 5.8% detection of bladder cancer in 411 consecutive patients with MH, of whom 15.3% were anticoagulated. 21 Further, a series of patients with GH on either anticoagulant or aspirin therapy found tumors in a quarter of patients, and other treatable findings in approximately half the cohort. 58 Meanwhile, a population-based cohort study from Ontario reported that patients exposed to antithrombotic medications were significantly more likely to be diagnosed with bladder cancer within six months than

2020 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction

129. CIRSE Standards of Practice on Analgesia and Sedation for Interventional Radiology in Adults

, Demott K. Sedation for diagnostic and therapeutic procedures in children and young people : summary of NICE guidance. BMJ. 2011;342:45–8. . 7. Vargo JJ, Cohen LB, Rex DK, Kwo PY. Position statement: nonanesthesiologist administration of propofol for GI endoscopy. Gastrointest Endosc. 2009;50:1683–9. . 8. ASA. Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia (...) , the American Association of Oral and Maxillofacial Surgeons, American. Anesthesiology. 2018;128:437–79. . 9. The Royal College of Radiologists (2018) Sedation, analgesia and anaesthesia in the radiology department (second edition). 10. Commission The Joint. 2016. https// . Accessed 25 Aug 2016. 11. ASA. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures: an updated report

2020 Cardiovascular and Interventional Radiological Society of Europe

130. Management of Hypertension (HTN) in Primary Care

in the identification of LVH or ischemic heart disease. Other tests may be indicated depending upon presence of other risk factors and current comorbid conditions (e.g., uric acid for known gout). October 2014 Page 26 of 135 Measurement Techniques Recommendations 4. We recommend that blood pressure be measured with a technique recommended for the measurement of blood pressure in adults using a properly calibrated and validated sphygmomanometer. (Modified from 2004 VA/DoD HTN CPG without an updated systematic review

2020 VA/DoD Clinical Practice Guidelines

131. Microhematuria: AUA/SUFU Guideline

instrumentation. Close Guideline Statement 4 4. Clinicians should perform the same evaluation of patients with microhematuria who are taking antiplatelet agents or anticoagulants (regardless of the type or level of therapy) as patients not on these agents. (Strong Recommendation; Evidence Level: Grade C) × Discussion Patients on anticoagulants should be assessed in the same fashion as patients who are not anticoagulated regardless of type or level of therapy (i.e., aspirin, warfarin, or other antiplatelet (...) . 21 Further, a series of patients with GH on either anticoagulant or aspirin therapy found tumors in a quarter of patients, and other treatable findings in approximately half the cohort. 58 Meanwhile, a population-based cohort study from Ontario reported that patients exposed to antithrombotic medications were significantly more likely to be diagnosed with bladder cancer within six months than patients not exposed to these medications, 59 suggesting the potential that such anticoagulation may

2020 American Urological Association

132. Disorders of Ejaculation: An AUA/SMSNA Guideline

acid (GABA)-ergic activation opposes ejaculation and orgasm. Agonists of opioid receptors, principally mu subtypes, are also associated with impairment of ejaculatory and orgasmic response. Specific receptors may have actions that differ (e.g., stimulation of certain serotonergic receptors in the spinal cord may promote ejaculation and orgasm). 5 Orgasm is also a neuroendocrine process. Experimental and observational data in animals and humans indicate that androgens are necessary for at least

2020 American Urological Association

133. Guideline on the diagnosis and management of chronic myeloid leukaemia Full Text available with Trip Pro

. Cardiovascular risk assessment Risk should be assessed and treated in collaboration with the patient's GP ( ). Patients with previous cardiovascular events should be offered secondary prevention. All others, particularly those on TKIs associated with an increased incidence of arterial thrombotic events (ATEs), should have an assessment of cardiovascular risk ( ) and those with a 10‐year risk of >10% should be offered atorvastatin 20 mg daily. Aspirin should not be prescribed for primary prevention (...) in pregnancy In CP termination should not be advised unless this is at the patient's request. Management depends on the presenting laboratory and clinical parameters and gestational stage. Often the pregnancy can continue to term without intervention, although low dose aspirin and/or low molecular weight heparin are advisable if thrombocytosis is present. An increased risk of congenital abnormalities in children born to women who conceived while on imatinib and dasatinib has been reported. The major risk

2020 British Committee for Standards in Haematology

134. Anaesthesia and sedation in breastfeeding women

andsugammadex ? Anti-emetics: ondansetron, granisetron, cyclizine, prochlorperazine,dexamethasone,metoclopramide anddomperidone Usewithcautionwhilebreastfeeding: ? Tramadol–observechildforunusualdrowsiness ? Oxycodone – greater risk of drowsiness in doses > 40 mg.day -1 Analgesics that are contra-indicated while breastfeeding: ? Codeine–observechildforunusualdrowsiness ? Aspirin(analgesicdoses) 4 ©2020TheAuthors.AnaesthesiapublishedbyJohnWiley&SonsLtdonbehalfofAssociationofAnaesthetists Anaesthesia2020 (...) ,naproxeniswidelyusedaftercaesareansection; breastfeedingmaycontinueasnormal. Celecoxib:therelativedosethatinfantsareexposedto viamilkisverylow,andbreastfeedingmaycontinue. Ketorolac,parecoxib:lowlevelsaredetected inbreast milk without demonstrable adverse effects in the neonate. Compatiblewithbreastfeeding. Aspirin: this drug should not be used in analgesic doses.Lowdoseaspirinforanti-plateletactioncanbeused inbreastfeedingwomenifthisisstronglyindicated. Opioids Morphine:transferredtobreastmilkinsmallamounts. It has an active

2020 Association of Anaesthetists of GB and Ireland

135. Management of Bleeding in Patients on Oral Anticoagulants

be monitored; if abnormal, admin- istration of calcium is indicated. Early administration of tranexamic acid for trauma patients within the ?rst 3 hours is associated with decreased bleeding and overall mortality and should be considered (35). The writing committee recommends further resuscitation using a goal-directed strategy guided by the results of laboratory testing. Careful attention should be given to comorbidities and potential complications of aggressive ?uid resuscitation, which could worsen (...) function along with hematology consultation (40–43). Consideration might be given to the use of an anti- ?brinolyticagent, suchastranexamic acid orepsilon ami- nocaproic acid. In patients with portal hypertension and esophageal varices, plasma should be used cautiously, because large volumes may increase portal pressure and exacerbatebleeding(44).Patientswithinheritedbleeding disorders and other acquired hemostatic defects (e.g., those necessitating the use of dual antiplatelet therapy

2020 American College of Cardiology

136. Mitral Regurgitation Management

and cardiologist with experience managing HF and MR. CENTRAL ILLUSTRATION Figure 1 provides an overview of this ECDP. See the text for more detailed considerations and guidance. 4. DESCRIPTION AND RATIONALE MRisthemostcommontypeofmoderateorsevereheart valve disease among U.S. adults older than 55 years. Its prevalence increases further asa function of age (10). The 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease (2) emphasizes disease stag- ing, wherein patients are classi?ed

2020 American College of Cardiology

137. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2020

ThisGuidelineisanofficialstatementoftheEuropeanSo- cietyof Gastrointestinal Endoscopy(ESGE). Itis a revision of the previously published 2014 Guideline addressing the role of self-expandable metal stents for obstructing colonic and extracolonic cancer. ABBREVIATIONS ASA American Society for Anesthesiologists CI confidence interval CT computed tomography CTC computed tomography colonoscopy ECM extracolonic malignancy ESGE European Societyof Gastrointestinal Endoscopy GRADE Grading of Recommendations Assessment, De- velopment and Evaluation HR (...) different definitions (e.g. basedon symptoms, radiologic, orendoscopic findings) and reported inconsistent outcomes. Increasing age and American Society of Anesthesiologists (ASA) classification =III do not affect stenting outcome (i.e., clinical success and complications) in several observational studies [17–22], although these are well-known risk factors for postoperative mortality after surgical treatment of large-bowel obstruction [23–25]. When malignant colonic obstruction is suspected, contrast

2020 European Society of Gastrointestinal Endoscopy

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

Heart J. 2014; 35 : 2342-2343 ) Previously described cardiac scoring systems include several overlapping clinical conditions, including prior myocardial infarction, history of angina and prior congestive heart failure, which have been found to be associated with higher rates of perioperative cardiac events. The American Association of Anesthesiology (ASA) grading system has been widely utilized for endovascular procedures and has advantages in terms of simplicity, but mainly relies on subjective

2020 Society for Vascular Surgery

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