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122. Best Practices for Pain Management in Infants, Children, Adolescents, and Individuals with Special Health Care Needs

class of drugs and have anti-inflammatory, analgesic, antipyretic, and antiplatelet properties. 78 They inhibit prostaglandin synthesis, with speci- fic action on cyclooxygenase (COX). 50 Representatives of the major categories of NSAIDs are salicylic acids (aspirin), acetic acids (ketorolac), proprionic acids (ibuprofen, naproxen), and cyclooxygenase-2 selective (celecoxib). Ibuprofen in oral or intravenous (IV) form is a commonly used analgesic and antipyretic agent in pediatrics. 78 Ketorolac (...) -acting oxycodone has a longer half-life than morphine and is more potent. Oxycodone is available as a single agent or is combined with aspirin, ibuprofen, or acetaminophen. It comes in tablets, capsules, oral solution, and oral concentrate, and use is considered off label in children 12 years of age and younger. 50 Opioid concerns and Centers for Disease Control and Prevention (CDC) recommendations. Trends in opioid overdose, opioid misuse, and concerns for opioid addiction prompted the CDC to issue

2018 American Academy of Pediatric Dentistry

123. Risk estimation and the prevention of cardiovascular disease

this reduction. 2.3 PHYSICAL ACTIVITY R Physical activity of at least moderate intensity (eg breathing faster than normal) is recommended for the whole population (unless contraindicated by an individual’s condition). 2.4 SMOKING R All people who smoke should be advised to stop and offered support to help facilitate this in order to minimise cardiovascular and general health risks. 2.5 ANTIPLATELET THERAPY R Aspirin is not recommended for primary prevention of cardiovascular disease. 2.6 LIPID LOWERING R

2017 SIGN

124. Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy

in for an example of how to implement this recommendation; additional cases are available in the Data Supplement. Box 1. Application of Guideline Recommendations 1 to 4: Assessment and Management of an Older Patient Considering Adjuvant Chemotherapy Case 1 A 75-year-old man with coronary artery disease (status post recent coronary artery bypass surgery), hypertension, hyperlipidemia, and osteoarthritis. He describes his own health as “good.” Medications include aspirin, atenolol, and lovastatin. Laboratory

2018 American Society of Clinical Oncology Guidelines

127. Atrial Fibrillation Burden: Moving Beyond Atrial Fibrillation as a Binary Entity: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

) Although antiplatelet therapy currently plays only a very small role in the prevention of stroke in AF, a reexamination of studies involving antiplatelet therapy can shed some light on the relationship between AF pattern and stroke in patients who have not undergone anticoagulation. Analyses of aspirin-treated patients in the ACTIVE-A (Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events) and AVERROES (Apixaban Versus Acetylsalicylic Acid to Prevent Stroke in Atrial (...) Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment) trials suggest that the pattern of AF is related to stroke risk among patients who have not undergone anticoagulation. This study demonstrated yearly ischemic stroke rates of 2.1%, 3.0%, and 4.2% for paroxysmal, persistent, and permanent AF, respectively, with an adjusted HR of 1.83 ( P <0.001) for permanent versus paroxysmal AF and 1.44 ( P =0.02) for persistent versus paroxysmal AF. Conversely, analysis of aspirin

2018 American Heart Association

128. Management of Crohn's Disease in Adults

- gens ( 137 ). In a comparison study of acetaminophen, naproxen, nabumetone, nimesulide, and aspirin, there was a 17–28% relapse rate of quiescent IBD within 9 days of therapy with the nonselec- tive NSAIDS (naproxen and nabumetone) ( 138 ). Recent NSAID use has been associated with an increased risk of emergency admission to the hospital for patients with IBD ( 139,140 ). Th ere have been other studies that have not found this association ( 141 ). Selective cyclooxygenase-2 inhibitors in short-term

2018 American College of Gastroenterology

129. Postpartum Pain Management

and ibuprofen tablets in postoperative dental pain. Br J Oral Maxillofac Surg 1996; 34:110–4. 22. Sostres C, Gargallo CJ, Arroyo MT, Lanas A. Adverse ef- fects of non-steroidal anti-inflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract. Best Pract Res Clin Gastroenterol 2010;24:121–32. 23. Viteri OA, England JA, Alrais MA, Lash KA, Villegas MI, Ashimi Balogun OA, et al. Association of nonsteroidal antiinflammatory drugs and postpartum hypertension in women with preeclampsia

2018 American College of Obstetricians and Gynecologists

130. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

thrombosis vs bleeding). The more rigorous and critical evaluation of the literature resulted in many weak recommendations (2A–C) replacing the strong recommendations (1A–C) of previous editions. One remarkable result was a major change on the use of aspirin in thromboprophylaxis in orthopedic surgery. The authors of the eighth edition (AT8) had concluded that there was “high-quality evidence justifying a strong recommendation against aspirin as the sole agent for thromboprophylaxis in surgical patients (...) .” After reevaluation of the evidence and inclusion of a very large trial, the AT9 authors concluded “that the trial provides moderate-quality evidence supporting the use of aspirin in patients undergoing major orthopedic procedures, which is now offered as an option for thromboprophylaxis in patients undergoing major orthopedic procedures.” Thus, with AT8, for patients undergoing major orthopedic surgery, LMWH, fondaparinux, and vitamin K agonists were the only recommended agents of thromboprophylaxis

2018 American Society of Regional Anesthesia and Pain Medicine

131. Optimizing Postpartum Care

pregnancy sooner than 18 months • Review recommendations for prevention of recurrent pregnancy complications, such as 17 a-hydroxyprogesterone caproate to reduce risk of recurrent preterm birth, or aspirin to reduce risk of preeclampsia • Select a contraceptive method that reflects patient’s stated needs and preferences, with same-day placement of LARC, if desired 11 (continued)e146 Committee Opinion Optimizing Postpartum Care OBSTETRICS & GYNECOLOGY Box 1. Components of Postpartum Care (continued (...) pregnancies, such as recommendations for 17 a-hydroxyprogesterone caproate to reduce risk of recurrent preterm birth, or aspirin to reduce risk of preeclampsia. Any placental pathology reports should be reviewed and shared with the patient. Recommendations should be made to opti- mize maternal health during the interpregnancy period (44), such as controlling diabetes and attaining optimal weight (45). Adverse Pregnancy Outcomes and Cardiovascular Risk There are risk factors for cardiovascular disease

2018 American College of Obstetricians and Gynecologists

132. Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease Full Text available with Trip Pro

aspirin use. †For comparative effectiveness recommendations (Class I and IIa; Level of Evidence A and B only), studies that support the use of comparator verbs should involve direct comparisons of the treatments or strategies being evaluated. Downloaded from by on March 27, 2019Marino et al CPR in Infants and Children With Cardiac Disease Circulation. 2018;137:e691–e782. DOI: 10.1161/CIR.0000000000000524 May 29, 2018 e695 CLINICAL STATEMENTS AND GUIDELINES the pulmonary vascular (...) Norwood Downloaded from by on March 27, 2019Marino et al CPR in Infants and Children With Cardiac Disease May 29, 2018 Circulation. 2018;137:e691–e782. DOI: 10.1161/CIR.0000000000000524 e698 CLINICAL STATEMENTS AND GUIDELINES palliation, the need for an unplanned shunt interven- tion is higher with the RVPAS. 28 Prophylactic anticoagulation strategies include hepa- rin therapy early after shunt placement, with a transi- tion to aspirin when enteral medications are tolerated. 23

2018 American Heart Association

133. Cardiovascular Disease Risk: Screening With Electrocardiography

with a combination of diet and exercise modifications, lipid-lowering medications, aspirin, hypertension management, and interventions to encourage tobacco cessation. Recommendations for diet and exercise modifications, lipid-lowering medications, and aspirin are based on level of cardiovascular risk. Recent guidelines also recommend risk stratification of hypertension treatment; the recommendation for tobacco cessation applies to all persons regardless of CVD risk. Useful Resources The USPSTF has made (...) recommendations on many factors related to CVD prevention, including screening for high blood pressure, use of statins, counseling on smoking cessation, and counseling to promote healthful diet and physical activity. In addition, the USPSTF recommends low-dose aspirin use in certain persons at increased risk of CVD events. Other resources are also available from the National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; and Healthy People 2020. Other Considerations Research

2018 U.S. Preventive Services Task Force

134. Length of stay following percutaneous coronary intervention: An expert consensus document update from the society for cardiovascular angiography and interventions

or hemodynamic collapse during PCI • Femoral artery sheath • External consideration precluding SDD • Allergy, intolerance to aspirin or thienopyridines • INR >2.0 Heyde et al. (EPOS) Circulation. 2007;115:2299‐2306 800 TF without VCD • No difference in 24‐hour safety endpoint between groups • 19% of patients assigned to SDD developed indication for extended observation during/after PCI 4 hr post PCI • Elective planned PCI • Home factors allowed SDD • Preprocedure factors : • Acute coronary syndrome • Ad hoc (...) for heart disease □ Patient has copy of stent card □ Follow up appointments are listed in After Visit Summary including: ✓ Cardiac Rehab ✓ Cardiology ✓ Primary Care Physician □ For Same Day PCI: Aspirin, P2Y12 (Clopidogrel, Ticagrelor, Prasugrel), Statin, and Nitroglycerin are ordered as medically appropriate □ For STEMI: Aspirin, P2Y12 (Clopidogrel, Ticagrelor, Prasugrel), Statin, Nitroglycerin, Beta‐Blocker, ACEI/ARB and Aldosterone Antagonist (if EF <40%) are ordered as medically appropriate

2018 Society for Cardiovascular Angiography and Interventions

135. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

-thirds of the participants (67%) had separate protocols regarding aspirin (acetylsalicylic acid [ASA]) or nonsteroidal anti-inflammatory drugs (NSAIDs). Moreover, 55% stopped ASA before spinal cord stimulation (SCS) trials and implants, and 32% stopped ASA before epidural steroid injections (ESIs). However, 17% admitted that they used different protocols for cervical spine injections as compared with lumbar spine injections. Most did not express familiarity with selective serotonin reuptake (...) prothrombotic effects including vasoconstriction. There are multiple classes of NSAIDs including salicylates, acetic acid derivatives, enolic acid derivatives, and selective COX-2 inhibitors. | Aspirin's Effects on Hemostasis Aspirin is rapidly absorbed from the gastrointestinal (GI) tract, with peak levels occurring approximately 30 minutes following ingestion, resulting in significant platelet inhibition at 1 hour. The peak plasma levels for enteric-coated ASA may be delayed until 3 to 4 hours after

2018 American Society of Regional Anesthesia and Pain Medicine

137. Renal Transplantation

, A., et al. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. Eur Heart J, 2009. 30: 2769. 85. Douketis, J.D., et al. Perioperative Management of Antithrombotic Therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012. 141. 86. Benahmed, A., et al. Ticlopidine and clopidogrel, sometimes combined with aspirin, only minimally increase

2018 European Association of Urology

138. Urolithiasis

. 274. Fischer, C., et al. [Extracorporeal shock-wave lithotripsy induced ultrastructural changes to the renal parenchyma under aspirin use. Electron microscopic findings in the rat kidney]. Urologe A, 2007. 46: 150. 275. Becopoulos, T., et al. Extracorporeal lithotripsy in patients with hemophilia. Eur Urol, 1988. 14: 343. 276. Ishikawa, J., et al. Extracorporeal shock wave lithotripsy in von Willebrand’s disease. Int J Urol, 1996. 3: 58. 277. Zanetti, G., et al. Cardiac dysrhythmiastreated

2018 European Association of Urology

139. Thromboprophylaxis

of venous thromboembolism in middle aged women: prospective cohort study. BMJ, 2009. 339: b4583. 15. Devereaux, P.J., et al. Aspirin in patients undergoing noncardiac surgery. N Engl J Med, 2014. 370: 1494. 16. Lassen, M.R., et al. Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial. Lancet, 2010. 375: 807. 17. Lassen, M.R., et al. Apixaban versus enoxaparin for thromboprophylaxis after hip replacement. N Engl J Med, 2010. 363: 2487. 18 (...) of antithrombotic agents in surgery [ , ] preceded recent major studies, including large, rigorous randomised trials [ , ]. With respect to anti-platelet agents, a recent large, rigorous randomised trial comparing aspirin to placebo has demonstrated that aspirin increases post-operative bleeding without reducing arterial thrombotic events [ ]. These results provide indirect evidence for antiplatelet agents other than aspirin. Although the absence of large, rigorous placebo-controlled trials to inform

2018 European Association of Urology


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