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142. Prostate Cancer

: A Systematic Review and Meta-analysis. JAMA Intern Med, 2017. 177: 1273. 66. Cremers, R.G., et al. Self-reported acne is not associated with prostate cancer. Urol Oncol, 2014. 32: 941. 67. Huang, T.B., et al. Aspirin use and the risk of prostate cancer: a meta-analysis of 24 epidemiologic studies. Int Urol Nephrol, 2014. 46: 1715. 68. Bhindi, B., et al. The impact of the use of aspirin and other nonsteroidal anti-inflammatory drugs on the risk of prostate cancer detection on biopsy. Urology, 2014. 84: 1073 (...) anaesthetic freehand transperineal biopsies in the outpatient setting. BJU Int, 2018. 220. NCCN Clinical practice Guidelines in OncologyTM: Prostate Cancer Early Detection, Version 2. 2015. 2015. 221. Loeb, S., et al. Systematic review of complications of prostate biopsy. Eur Urol, 2013. 64: 876. 222. Giannarini, G., et al. Continuing or discontinuing low-dose aspirin before transrectal prostate biopsy: results of a prospective randomized trial. Urology, 2007. 70: 501. 223. Garcia C, et al. Does

2018 European Association of Urology

143. Cardiovascular Health in Turner Syndrome: A Scientific Statement From the American Heart Association

abnormalities; however, some effect on fetal birth weight has been described. , This recommendation holds for any woman with aortic dilatation. The National Institute for Health and Care Excellence recommends 75 to 81 mg aspirin daily from 12 weeks of gestation until delivery for women at risk of preeclampsia. This recommendation is based on data showing a benefit with aspirin use in patients with ≥2 moderate risk factors. Oocyte donation is not given as a specific risk factor, but consideration should (...) be given to prescribing aspirin in such pregnancies in a woman with TS. Mode of Delivery in Women With a Dilated Aorta and TS A delivery plan should be made by a multidisciplinary team consisting of at least an obstetrician, cardiologist, and anesthesiologist, all with expertise in pregnancy in the context of maternal heart disease or aortopathy. Vaginal delivery is the preferred mode of delivery in most women, according to the available literature. In the Registry of Pregnancy and Cardiac Disease

2018 American Heart Association

144. Stroke in childhood - clinical guideline for diagnosis, management and rehabilitation

recommendations, see Chapter 6.1.3 here. Acute medical interventions for AIS (Chapter 6.2.1) Use of thrombolysis or anti-thrombotic therapy • Prescribe and deliver 5mg/kg of aspirin up to a maximum of 300mg within 24 hours of diagnosis of AIS in the absence of contraindications (e.g. parenchymal haemorrhage). After 14 days reduce dose of aspirin to 1mg/kg to a max of 75mg. • The off label use of tissue plasminogen activator (tPA) could be considered in children presenting with AIS who are more than eight (...) . This will usually require exchange transfusion. • Provide a small top up transfusion to bring Hb to 100g/l to improve cerebral oxygenation if the start of the exchange is likely to be delayed by more than six hours. To access full recommendations, see Chapter 6.2.1 here. xix Interventions to prevent recurrence of AIS (Chapter 6.2.2) Medical interventions to prevent recurrence of AIS • Continue antithrombotic treatment initiated acutely in children and young people with AIS. Reduce dose of aspirin from 5mg/kg

2017 Royal College of Paediatrics and Child Health

145. Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions

as the primary focus of effective interventions for weight loss in adults. Additional Approaches to Prevention The USPSTF has made recommendations on screening for abnormal blood glucose levels and type 2 diabetes, screening for high blood pressure, statin use in persons at risk for cardiovascular disease, counseling for tobacco smoking cessation, aspirin use in certain persons for prevention of cardiovascular disease, and behavioral counseling interventions to promote a healthful diet and physical activity (...) . 2015;163(8):622-34. 17. U.S. Preventive Services Task Force. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med . 2016;164(12):836-45. 18. U.S. Preventive Services Task Force. Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: U.S. Preventive Services Task Force recommendation statement

2018 U.S. Preventive Services Task Force

146. Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report

or 1 in females), we suggest no antithrombotic therapy. The next step is to consider stroke prevention (ie, oral anticoagulation therapy) for patients with 1 or more non-sex CHA 2 DS 2 -VASc stroke risk factors. For patients with a single non-sex CHA 2 DS 2 -VASc stroke risk factor, we suggest oral anticoagulation rather than no therapy, aspirin,orcombinationtherapywithaspirinandclopidogrel;andforthoseathighriskofstroke(eg, CHA 2 DS 2 -VASc$2inmalesor$3infemales (...) ),werecommendoralanticoagulationratherthan notherapy,aspirin,orcombinationtherapywithaspirinandclopidogrel.Wherewerecommendor suggest in favor of oral anticoagulation, we suggest using a non-vitamin K antagonist oral anti- coagulant drug rather than adjusted-dose vitamin K antagonist therapy. With the latter, it is importanttoaimforgoodqualityanticoagulationcontrolwithatimeintherapeuticrange>70%. Attentiontomodi?ablebleedingriskfactors(eg,uncontrolledBP,labileinternationalnormalized ratios, concomitant use of aspirin or nonsteroidal

2018 American College of Chest Physicians

147. Management of Pregnancy

) ? Initiate low dose aspirin therapy for women at risk of preeclampsia ( ) Recommendation 17 ? Offer evaluation of MSAFP for pregnant women who did not have serum aneuploidy screening or who had non-invasive prenatal screening ( ) Recommendation 14 ? Offer antenatal progesterone therapy in consultation with an advanced prenatal care provider (e.g., obstetrician or maternal-fetal medicine) for women at high risk for recurrent preterm delivery ( ) Recommendation 18 ? Complete fetal anatomy ultrasound

2018 VA/DoD Clinical Practice Guidelines

148. The role of immunotherapy in IVF: a guideline

to improved live-birth outcome. While some of these medica- tions (e.g., aspirin and corticosteroids) have been used for many years and are relatively low cost, others (e.g., intravenous fat emulsions and granu- locyte colony–stimulating factor [G- CSF]) are newer, of higher cost, and with risks that have been poorly char- acterized. It is imperative that physi- cians providing ART treatments have a full understanding of the potential risks and bene?ts associated with adjuvant immunotherapy in order (...) to modern ART is uncertain. Additionally,manyoftheinvestigations areunderpoweredand/oraddresssurro- gateoutcomessuchasembryodevelop- ment and clinical pregnancy rate rather than live birth. Multiple investigations also include combined treatment regi- mens rather than single-component treatments, so it is dif?cult to attribute anychangeinoutcometoagiventreat- ment.Someoftheinvestigatedtherapies (e.g.,aspirin)mayhavemultiplemecha- nisms of action, such that an observed effect may or may not be due

2018 Society for Assisted Reproductive Technology

149. Guidelines on the Management of Acute Respiratory Distress Syndrome (ARDS)

of a series of epidemiological studies 143,144 . LIPS was designed to identify a population of patients at high risk of ARDS for prevention studies to be carried out by the National Institutes of Health’s Prevention and Early Treatment of Acute Lung Injury (PETAL) Network (http://petalnet.org/). LIPS-A was a large multi-centre study to address the question of whether ARDS can be prevented with a drug, in this case aspirin, the latest in a succession of promising therapeutics for ARDS, which was supported

2018 Faculty of Intensive Care Medicine

150. Kaiser Permanente National Dyslipidemia Clinician Guide

. ? Consider taking niacin with food or premedicating with aspirin 325 mg 30 minutes before niacin dosing to alleviate flushing symptoms. ? If an extended-release preparation is used, consider increasing the dose of extended-release niacin from 500 mg/day to a maximum of 2,000 mg/day over 4 to 8 weeks, with the dose of extended release niacin increasing not more than weekly. ? If immediate-release niacin is chosen, consider starting at a dose of 100 mg 3 times daily and up-titrate to 3 g/day, divided

2017 Kaiser Permanente National Guideline Program

151. Kaiser Permanente National Adult Diabetes Clinician Guide

interaction and consider patient preferences when deciding to initiate, continue, or intensify statin therapy. ACE Inhibitor Therapy for Primary and Secondary Prevention of ASCVD in Diabetes ? For patients with diabetes aged = 55 years with = 1 cardiovascular risk factor (total cholesterol > 200 mg/dl, HDL-C = 35 mg/dl, hypertension, microalbuminuria, or current smoking) or a history of CVD (coronary artery disease [CAD], stroke, or peripheral vascular disease), consider prescribing ACE-I therapy. Aspirin (...) Therapy in Diabetes for Prevention of ASCVD ? Refer to the KP National Aspirin Recommendations at: https://clm.kp.org/pkc/national/cmi/programs/aspirin/aspirin_recommendations.html Glucose Control ? In patients aged 2% above goal Risk of Severe Hypoglycemia* Metformin + Thiazoladinedione - Oral - Avg wt gain (1-3 kg) - Low hypoglycemia risk - Generic - Risk CHF/Fracture Metformin + DPP-4 Inhibitor - Oral - Avg wt neutral (0 kg) - Low hypoglycemia risk - Brand-name only Metformin + GLP-1 Agonist

2017 Kaiser Permanente National Guideline Program

152. Management of Hypertension (5th Edition)

Beta-Blockers 48 10.3 Calcium Channel Blockers 49 10.4 ACE Inhibitors 49 10.5 Angiotensin Receptor Blockers 50 10.6 Direct Renin Inhibitors 51 10.7 Miscellaneous Drugs 52 11 Resistant Hypertension 55 12 Aspirin in Hypertension 57 13 Lipid Lowering in Hypertension 58 Appendices 59 – 60 References 61 – 75xvi LIST OF TABLES & FIGURE Table No Title Page 1 Classification and Prevalence of Elevated Blood Pressure for Adults Age =18 Years in Malaysia (2006) 1 2 Criteria for Staging Hypertension based (...) %. These lesions should be monitored for progression using colour duplex sonography. Medical treatment of patients with ARAS include statins, low dose aspirin, cessation of smoking and management of diabetes when present. Pharmacologic management of renovascular hypertension follows the general principles of all antihypertensive therapy but is especially dependant on effective blockade of the RAAS. Angiotensin converting enzyme inhibitors or ARB can be used in patients with suspected ARAS if renal function

2018 Ministry of Health, Malaysia

153. Management of Acute Myocardial Infarction in patients presenting with ST-segment elevation

Smoking cessation 29 7.1.2 Diet, alcohol, and weight control 29 7.1.3 Exercise-based cardiac rehabilitation 30 7.1.4 Resumption of activities 30 7.1.5 Blood pressure control 30 7.1.6 Adherence to treatment 30 7.2 Antithrombotic therapy 30 7.2.1 Aspirin 30 7.2.2 Duration of dual antiplatelet therapy and antithrombotic combination therapies 31 7.3 Beta-blockers 32 7.3.1 Early intravenous beta-blocker administration 32 7.3.2 Mid- and long-term beta-blocker treatment 32 7.4 Lipid-lowering therapy 32 7.5 (...) CT computed tomography COMFORTABLE- AMI Effect of biolimus-eluting stents with biodegradable polymer vs. bare-metal stents on cardiovascular events among patients with acute myocardial infarction trial Compare-Acute Comparison Between FFR Guided Revascularization Versus Conventional Strategy in Acute STEMI Patients With Multivessel disease trial CURRENT- OASIS 7 The Clopidogrel and aspirin Optimal Dose usage to reduce recurrent events–Seventh organization to assess strategies in ischaemic

2017 European Society of Cardiology

154. Bruising

on exposed areas of the hands and forearms, or on the legs; are common in older people; are dark purple, and do not show the sequential colour changes of a normal bruise; and may persist for several weeks. Drugs which cause platelet function inhibition Aspirin. Nonsteroidal anti-inflammatory drugs. Clopidogrel. Selective serotonin reuptake inhibitors (SSRIs). Drugs which cause low platelets (thrombocytopenia) Alcohol. Cephalosporins, nitrofurantoin, penicillins, sulfonamides. Carbamazepine and valproic (...) review. Archives of Disease in Childhood. 90 ( 2 ), 187 - 189 . [ ] Mauer, A.C., Khazanov, N.A., Levenkova, N., et al. ( 2011 ) Impact of sex, age, race, ethnicity and aspirin use on bleeding symptoms in healthy adults. Journal of Thrombosis and Haemostasis. 9 ( 1 ), 100 - 108 . McIntosh,N., Mok,J.Y. and Margerison,A. ( 2007 ) Epidemiology of oronasal hemorrhage in the first 2 years of life: implications for child protection. Pediatrics. 120 ( 5 ), 1074 - 1048 . [ ] Murtagh,J. (2007) John Murtagh's

2017 Prodigy

156. Antiocoagulation - oral

. Rivaroxaban has also been approved as an option for prophylaxis of atherothrombotic events (with aspirin alone, or with aspirin and clopidogrel, or ticlodipine) for people with coronary heart disease and after an acute coronary syndrome in people with elevated cardiac biomarkers. It is also indicated for people with symptomatic peripheral artery disease at high risk of ischaemic events. Unlike warfarin, apixaban, dabigatran, edoxaban and rivaroxaban do not require regular international normalized ratio (...) disease with a record in the preceding 12 months that aspirin, an alternative anti-platelet therapy, or an anti-coagulant is being taken 7 56–96% STIA007 The percentage of patients with a stroke shown to be non-haemorrhagic, or a history of TIA, who have a record in the preceding 12 months that an anti-platelet agent, or an anti-coagulant is being taken 4 57–97% Data from: [ ] QIPP - Options for local implementation No QIPP indicators were found during the review of this topic. NICE quality standards

2017 Prodigy

158. 2017 Focused update on Dual Antiplatelet Therapy (DAPT)

Revascularisation Trial ASA Acetylsalicylic acid ATACAS Aspirin and Tranexamic Acid for Coronary Artery Surgery ATLANTIC Administration of Ticagrelor in the Cath Lab or in the Ambulance for New ST Elevation Myocardial Infarction to Open the Coronary Artery BARC Bleeding Academic Research Consortium b.i.d Bis in die (twice a day) BMS Bare-metal stent CABG Coronary artery bypass graft surgery CAD Coronary artery disease CHADS 2 Cardiac failure, Hypertension, Age, Diabetes, Stroke (Doubled) CHA 2 DS 2 -VASc (...) DES for Treatment of Coronary Revascularization INR International normalized ratio ISAR Intracoronary Stenting and Antithrombotic Regimen ISAR-SAFE Intracoronary Stenting and Antithrombotic Regimen: Safety and Efficacy of 6 Months Dual Antiplatelet Therapy After Drug-Eluting Stenting ISAR-TRIPLE Intracoronary Stenting and Antithrombotic Regimen–Testing of a 6-Week Versus a 6-Month Clopidogrel Treatment Regimen in Patients With Concomitant Aspirin and Oral Anticoagulant Therapy Following Drug

2017 European Society of Cardiology

159. Diagnosis and Treatment of Peripheral Arterial Diseases

-CLI Best Endovascular vs. Best Surgical Therapy in Patients with Critical Limb Ischaemia BMT Best medical therapy BP Blood pressure CABG Coronary artery bypass grafting CAD Coronary artery disease CAPRIE Clopidogrel versus Aspirin in Patients at Risk of Ischaemic Events CAPTURE Carotid ACCULINK/ACCUNET Post-Approval Trial to Uncover Rare Events CARESS Clopidogrel and Aspirin for the Reduction of Emboli in Symptomatic carotid Stenosis CASPAR Clopidogrel and Acetylsalicylic Acid in Bypass Surgery (...) Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial OR Odds ratio PADs Peripheral arterial diseases 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 PRODIGY PROlonging Dual antiplatelet treatment after Grading stent-induced intimal hYperplasia study PTA Percutaneous transluminal angioplasty

2017 European Society of Cardiology

160. 2018 guidelines for the early management of patients with acute ischemic stroke

is recommended for patients taking antiplatelet drug monotherapy before stroke on the basis of evidence that the benefit of alteplase outweighs a possible small increased risk of sICH. ( Class I; LOE A ) IV alteplase is recommended for patients taking antiplatelet drug combination therapy (eg, aspirin and clopidogrel) before stroke on the basis of evidence that the benefit of alteplase outweighs a probable increased risk of sICH. ( Class I; LOE B-NR ) End-stage renal disease In patients with end-stage renal

2018 American Academy of Neurology

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