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181. Magnesium sulfate as neuroprotection in preterm birth

SA. Perinatal white matter injury: the changing spectrum of pathology and emerging insights into pathogenetic mechanisms. Ment Retard Dev Disabil Res Rev. 2006;12(2):129– 40. 2. Antonov SM, Johnson JW. Permeant ion regulation of N-methyl-D-aspartate receptor channel block by Mg2+. Proc Natl Acad Sci U S A. 1999 Dec;96(25):14571–6. 3. Escalona-Vargas DI, Thagard AS, McGrail K, Napolitano PG, Magann EF, Lowery CL, et al. Observations of fetal brain activity via non-invasive magnetoencephalography (...) . 11 6. Koning G, Leverin A-L, Nair S, Schwendimann L, Ek J, Carlsson Y, et al. Magnesium induces preconditioning of the neonatal brain via profound mitochondrial protection. J Cereb Blood Flow Metab. 2017 Jan 1;271678X17746132. 7. Koning G, Lyngfelt E, Svedin P, Leverin A-L, Jinnai M, Gressens P, et al. Magnesium sulphate induces preconditioning in preterm rodent models of cerebral hypoxia-ischemia. Int J Dev Neurosci. 2018 Nov;70:56–66. 12 PICO spørgsmål 1-10 PICO 1: Nedsætter MgSO4 risikoen

2020 Nordic Federation of Societies of Obstetrics and Gynecology

182. Ménière’s Disease (Meniere) Full Text available with Trip Pro

< .001). Major injuries, including hip fractures, occur more frequently when falls are experienced by individuals with vertigo than by those without and may result in nursing home placement and further loss of independence. , Quality of Life Based on validated metrics, the overall QOL of MD patients appears to be similar to patients experiencing other chronic illnesses. , As they face a chronic battle with fluctuating balance and auditory dysfunction, MD patients also experience a heavy emotional

2020 American Academy of Otolaryngology - Head and Neck Surgery

184. Covid-19: Epilepsy

COVID-19 May 13, 2020 COVID-19 May 5, 2020 COVID-19 May 5, 2020 Educational May 5, 2020 E-Brain May 1, 2020 E-Brain February 28, 2020 E-Brain April 1, 2019 E-Brain November 1, 2018 Grand Rounds October 2, 2017 Grand Rounds July 1, 2016 Grand Rounds July 1, 2016 Grand Rounds February 1, 2016 Continuing medical education June 3, 2019 Continuing medical education February 21, 2019 Continuing medical education October 1, 2018 Continuing medical education July 24, 2018 Resident and Research Fellows May (...) Corner January 17, 2020 Scientific Corner January 17, 2020 Scientific Corner December 19, 2019 COVID-19 May 13, 2020 COVID-19 May 5, 2020 COVID-19 May 5, 2020 Educational May 5, 2020 E-Brain May 1, 2020 E-Brain February 28, 2020 E-Brain April 1, 2019 E-Brain November 1, 2018 Grand Rounds October 2, 2017 Grand Rounds July 1, 2016 Grand Rounds July 1, 2016 Grand Rounds February 1, 2016 Continuing medical education June 3, 2019 Continuing medical education February 21, 2019 Continuing medical education

2020 European Academy of Neurology

185. European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness

, Finland; and r Laboratory for NeuroImaging of Coma and Consciousness – Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA See editorial by V. De Herdt on page 739 Keywords: electroencephalography, evoked potentials, functional magnetic resonance imaging, minimally conscious state, positron emission tomography, resting state fMRI, transcranial magnetic stimulation, traumatic brain injury, unresponsive wakefulness syndrome, vegetative state Received 12 (...) October 2019 Accepted 9 January 2020 European Journal of Neurology 2020, 27: 741–756 doi:10.1111/ene.14151 Background and purpose: Patients with acquired brain injury and acute or prolonged disorders of consciousness (DoC) are challenging. Evidence to sup- port diagnostic decisions on coma and other DoC is limited but accumulating. This guideline provides the state-of-the-art evidence regarding the diagnosis of DoC, summarizing data from bedside examination techniques, functional neu- roimaging

2020 European Academy of Neurology

186. Practice Guidelines for Central Venous Access 2020: An Updated Report by the American Society of Anesthesiologists Task Force on Central Venous Access

of arterial trauma or injury arising from central venous catheterization. Focus These guidelines apply to patients undergoing elective central venous access procedures performed by anesthesiologists or healthcare professionals under the direction/supervision of anesthesiologists. The guidelines do not address (1) clinical indications for placement of central venous catheters; (2) emergency placement of central venous catheters; (3) patients with peripherally inserted central catheters; (4) placement (...) and residence of a pulmonary artery catheter; (5) insertion of tunneled central lines ( e.g. , permacaths, portacaths, Hickman, Quinton); (6) methods of detection or treatment of infectious complications associated with central venous catheterization; (7) removal of central venous catheters‡; (8) diagnosis and management of central venous catheter-associated trauma or injury ( e.g. , pneumothorax or air embolism), with the exception of carotid arterial injury; (9) management of periinsertion coagulopathy

2020 American Society of Anesthesiologists

187. Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

venous stasis, and endothelial trauma during delivery. Elevated blood pressures are not the only cause of acute strokes in pregnancy. In fact, rates of cerebral hemorrhage are low in women with preeclampsia, including those with sustained severe hypertension. Another contributory cause of stroke in women with preeclampsia is endothelial dysfunction, which leads to proteinuria and edema and, as a result, injury to the normal blood-brain barrier system. , Intravenous thrombolysis in acute ischemic (...) heparin. Adapted from American College of Obstetricians and Gynecologists and American Society of Hematology guidelines. , Cerebrovascular Disease in Pregnancy Pregnancy introduces specific cerebrovascular risk factors uncommon in an otherwise healthy young-adult female population. Cerebrovascular risk is highest in the third trimester and within 6 weeks postpartum (puerperium) and includes ischemic stroke, cerebral venous thrombosis (CVT), intracerebral hemorrhage, reversible cerebral

2020 American Heart Association

188. Call to Action to Prevent Venous Thromboembolism in Hospitalized Patients: A Policy Statement From the American Heart Association

is elevated up to 7-fold over patients without cancer; in certain subgroups such as those with pancreatic cancer or primary brain tumors, the risk for VTE may be increased up to 28-fold. Hospitalization is a major risk factor for VTE in patients with cancer. In a recent large US analysis of nearly 6 million hospitalizations for cancer, VTE was observed in 8.4%. In-hospital mortality occurred in 5.5% of patients with cancer without a VTE diagnosis, in 15.0% of those with any VTE, and in 19.4% of those (...) optimization. Patient weight and extent of surgical injury, in addition to other patient-level factors, correlate with rapidity of enoxaparin metabolism. , , Studies have shown that weight-tiered or weight-based enoxaparin dosing significantly increases the proportion of patients with adequate anti–factor Xa levels. Pharmacist-driven real-time dose adjustment algorithms are also impactful in high-risk patients to optimize anti–factor Xa levels and to decrease symptomatic VTE. , , Anticoagulant dose

2020 American Heart Association

189. Guidance for Return to Practice for Otolaryngology-Head and Neck Surgery: Part Two

if not addressed immediately. Surgery may be undertaken regardless of COVID-19 status, although rapid testing, if available, may inform the use of appropriate PPE. Examples include: • Coalescent mastoiditis with or without extra- or intracranial complications (sigmoid sinus thrombosis, epidural abscess, brain abscess, labyrinthitis, facial palsy) • Cerebellopontine angle tumor with neurological deterioration and/or threatened brainstem herniation • Temporal bone trauma with vascular or severe facial nerve (...) injury Diagnoses Necessitating “Urgent” Operative Management (Tier 2) These are diagnoses where timely surgery is indicated but where surgery may be delayed for clarification or resolution of acute COVID-19 infection. Examples include: • Chronic ear disease associated with acute facial nerve paresis or paralysis • Temporal bone malignancy or adjacent malignancy requiring temporal bone resection • Impending cochlear ossification (e.g., from bacterial meningitis) requiring cochlear implant surgery due

2020 American Academy of Otolaryngology - Head and Neck Surgery

190. Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus: A Scientific Statement From the American Heart Association

that provides optimal cardiovascular protection in patients with T2DM and coexistent CAD. The 2017 Hypertension Clinical Practice Guidelines recommended a goal blood pressure <130/80 mm Hg in patients with T2DM. However, as described above, such targets might not be optimal for all patients with T2DM and coexistent CAD. , , There appears to be heterogeneity in the impact of intensive blood pressure lowering on coronary versus cerebral events, and the effects can also vary based on comorbid conditions (eg

2020 American Heart Association

191. Cardiovascular Health in American Indians and Alaska Natives: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

Heart Study demonstrates that age and diabetes mellitus are important predictors, as well as smoking status, hypertension, ratio of HDL/LDL, renal function, history of CHD or left ventricular hypertrophy, parental history of stroke, waist circumference, and alcohol consumption. When echocardiographic measures were added to the model for risk prediction, they did not improve the estimate of risk. In the Strong Heart Study, high levels of vascular brain injury were also identified among older American

2020 American Heart Association

192. Triage of Scarce Critical Care Resources in COVID-19: An Implementation Guide for Regional Allocation: An Expert Panel Report of the Task Force for Mass Critical Care and the American College of Chest Physicians

, with greater variability and less accuracy at lower scores than at higher scores, and is not immediately applicable to all disease states: a patient with sepsis may have a SOFA score of 4 and a low mortality risk, for example, whereas a patient with an intracranial hemorrhage and a Glasgow Coma Scale score of 3 could share this SOFA score of 4 but have a very high risk of death. Potentially subjective elements, such as the dose of vasopressor administered or the assessment of Glasgow Coma Scale during (...) these professionals, who themselves will require support because of secondary moral distress. HCW Support The term moral injury has been increasingly suggested to describe the distress that HCWs can experience from theexcessivedemands ofenergy,strength,andresources often experienced within current health-care systems. 32 The resulting constellation of symptoms—fatigue, frustration, cynicism, and inef?ciency—has historically chestjournal.org 11 1101 1102 1103 1104 1105 1106 1107 1108 1109 1110 1111 1112 1113 1114

2020 American College of Chest Physicians

193. Tobacco and Nicotine Cessation During Pregnancy

and combustion products from the heating mechanism occurs. Nicotine crosses the placenta and intake in any form has considerable health risks with known adverse effects on fetal brain and lung tissue . Hookah (water pipe) tobacco smoking is more commonly used by adolescents and young adults because many perceive it to be a safer alternative to conventional cigarettes . However, users are exposed to nicotine and charcoal briquette combustion products, including carbon monoxide, particulates, oxidants, heavy (...) . Varenicline is a partial agonist for nicotinic receptors in the brain. Several small studies that evaluated its safety in pregnancy have not shown teratogenicity but, overall, data are limited. Bupropion is an antidepressant with limited data on its use in pregnancy, but there is no known risk of fetal anomalies or adverse pregnancy effects with its use . The U.S. Food and Drug Administration (FDA) mandated a product warning about the risk of psychiatric symptoms and suicide associated with varenicline

2020 American College of Obstetricians and Gynecologists

195. AIM Clinical Appropriateness Guidelines for Whole Exome and Whole Genome Sequencing

encephalopathy (onset before three years of age) for which likely non-genetic causes of epilepsy (e.g. environmental exposures; brain injury secondary to complications of extreme prematurity, infection, trauma) have been excluded Or two of the following four criteria: - Abnormality affecting a single organ system - Significant intellectual disability or severe psychological/psychiatric disturbance (e.g. self-injurious behavior, reversed sleep-wake cycles) - Family history strongly implicating a genetic (...) etiology - Period of unexplained developmental regression (unrelated to autism or epilepsy) ? No other causative circumstances (e.g. environmental exposures, injury, infection) can explain symptoms ? Clinical presentation does not fit a well-described syndrome for which single-gene or targeted panel testing is available ? The differential diagnosis list and/or phenotype warrant testing of multiple genes, and at least one of the following: - WES is more practical than the separate single gene tests

2020 AIM Specialty Health

196. AIM Clinical Appropriateness Guidelines for Genetic Testing for Single-Gene and Multifactorial Conditions

encephalopathy (onset before three years of age) for which likely non-genetic causes of epilepsy (e.g. environmental exposures; brain injury secondary to complications of extreme prematurity, infection, trauma) have been excluded For oncologic indications, please see Clinical Appropriateness Guidelines for Molecular Testing of Solid and Hematologic Tumors and Malignancies. For reproductive indications, please see Reproductive Carrier Screening and Prenatal Diagnosis Guidelines. HLA Histocompatibility Testing (...) levels in transplant heart biopsy tissue, with allograft rejection and injury algorithm reported as a probability score 0088U Tissue rejection (allograft organ kidney), mRNA gene expression analysis of 1,494 genes utilizing microarray, measuring mRNA transcript levels in transplant kidney biopsy tissue, with allograft rejection and injury algorithm reported as a probability score Background Genetic Testing The number of commercially available genetic tests is increasing rapidly, with some estimates

2020 AIM Specialty Health

197. Seizures-Child

following birth. Seizures occurring beyond the seventh day of life are more likely to be related to infection or developmental defects [9]. Ultrasound (US) is the mainstay for imaging the neonatal brain. Its portability and ease of evaluation at the bedside make it an ideal method of evaluation. US does not involve radiation exposure in these susceptible patients. Magnetic resonance imaging (MRI) is increasingly valuable, particularly in defining the extent of parenchymal injury [10,11]. Diffusion (...) with seizures. J Child Neurol. 2009;24(9):1105-1111. 12. Krishnamoorthy KS, Soman TB, Takeoka M, Schaefer PW. Diffusion-weighted imaging in neonatal cerebral infarction: clinical utility and follow-up. J Child Neurol. 2000;15(9):592-602. 13. Hsieh DT, Chang T, Tsuchida TN, et al. New-onset afebrile seizures in infants: role of neuroimaging. Neurology. 2010;74(2):150-156. 14. Hesdorffer DC, Chan S, Tian H, et al. Are MRI-detected brain abnormalities associated with febrile seizure type? Epilepsia. 2008;49(5

2020 American College of Radiology

198. Consensus Practice Guidelines on Interventions for Lumbar Facet Joint Pain from a Multispecialty, International Working Group Full Text available with Trip Pro

that radiographic guidance is typically employed during facet injections to ensure accurate needle placement and to avoid unnecessary injury. In 2018, Noridian, a major carrier for the Centers for Medicare and Medicaid Services, provided a local coverage determination for Medicare that asserted facet joint interventions must be performed under fluoroscopic or CT guidance and that interventions performed under ultrasound would not be reimbursed. Multiple insurance companies have pursued similar requirements

2020 American Society of Regional Anesthesia and Pain Medicine

199. Unhealthy Drug Use: Screening

at school, and community poverty. Adolescent substance use, including use of heroin and misuse of prescription opioids, is associated with the leading causes of death—suicide, overdose, unintentional injury, and violence in adolescents and young adulthood. Substance use during this period of rapid brain development can also harm neurocognitive development and endocrine function that, in turn, can impair academic, occupational, and social functioning. Adolescents with drug use disorders are also (...) relievers (2.1% and 1.3%, respectively) and opioids (1.2% and 0.7%, respectively). In both age groups, less than 1% reported use of heroin, cocaine, hallucinogens, inhalants, or methamphetamines in the last month. An estimated 8 million persons 12 years or older met diagnostic criteria for drug dependence or abuse of drugs in the past year. Drug use is one of the most common causes of preventable death, injuries, and disability. , In 2017, unhealthy drug use caused more than 70,000 fatal overdoses. Drug

2020 U.S. Preventive Services Task Force

200. Safety guideline: neurological monitoring associated with obstetric neuraxial block

to lower body, e.g. a?ecng arms/ face/cranial nerves, headache, convulsions Con?ned to lower body Consider: PDPH; pre-eclampsia; posterior reversible encephalopathy syndrome/ reversible cerebral vasoconstricon syndrome; cerebral vein thrombosis; migraine; stroke/ subarachnoid haemorrhage Consider: imaging and/or neurological referral depending on severity, local referral routes/ policies etc Consider: Peripheral nerve lesions e.g. lumbosacral nerve roots/trunk, sciac nerve, peroneal nerve, femoral (...) –6. 9. Hewson DW, Bedforth NM, Hardman JG. Spinal cord injury arisinginanaesthesiapractice.Anaesthesia2018;73(Suppl.1): 43–50. 10. Bos EME, Haumann J, de Quelerij M, et al. Haematoma and abscess after neuraxial anaesthesia: a review of 647 cases. BritishJournalofAnaesthesia2018;120:693–704. 11. Kelly E, Lee T. The Institute for Fiscal Studies Brie?ng Note BN215. Under Pressure? NHS Maternity Services in England. London: IFS, 2017. https://www.ifs.org.uk/uploads/publica tions/bns/BN215.pdf

2020 Association of Anaesthetists of GB and Ireland

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