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141. Home Oxygen Therapy for Children

appear to be influential in the development of PH in SCD ( , ). Hemolysis, hypercoagulability, ischemia-reperfusion injury, oxidative stress, inflammation, and genetic susceptibility are additional factors that impact the development of PH ( ). Although the response to mild levels of alveolar hypoxia may have minimal effects in many children, others may have adverse effects at similar levels of inspired oxygen with regard to heightened pulmonary vascular reactivity or remodeling, as reflected (...) . Neurodevelopment and Cognition The adverse cognitive and behavioral outcomes of hypoxemia in children with obstructive sleep apnea (OSA) have been extensively investigated and published elsewhere. Those data highlight the effects of hypoxemia on brain development and subsequent functioning as major concerns in children. For example, a post hoc analysis of a large international trial including 1,019 premature infants surviving to a postmenstrual age of 36 weeks found that prolonged hypoxemic episodes of more

2019 American Thoracic Society

142. Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies

insufficiency , chronic renal/chronic kidney , acute kidney injury , end-stage renal or end-stage kidney disease, albuminuria , congestive/myocardial/heart failure , cardiomyopathy , cardiorenal , predialysism , and ultrafiltration . Key search abbreviations included CRS , CKD , CRF , CRD , AKI, RI , WRF , KT , CRT , ICD , CRT-D , ACEi/ARB , MRA , BB , ARNI , DM , T1DM , T2DM , SGLT-2 inhibitors , GLP-1 agonists , DPP-4 inhibitors , HF , HFrEF , HFpEF , and UF . (A full list of abbreviations, including (...) CRS Systemic process resulting in HF and kidney failure Amyloidosis, sepsis, cirrhosis ACS indicates acute coronary syndrome; AHF, acute heart failure; AKI, acute kidney injury; CKD, chronic kidney disease; CRS, cardiorenal syndrome; HF, heart failure; and LVH, left ventricular hypertrophy. The Acute Dialysis Quality Initiative classification of CRS overcame some of the initial ambiguity in defining CRS and helped clinicians deliver phenotype-based goal-directed therapies for CRS at the bedside

2019 American Heart Association

143. Safe provision of anaesthesia in magnetic resonance units

. | AnaesthesiainmagneticresonanceunitsLondon. 2012. king_anaesthetic_equipment_2012.pdf (accessed 02/05/ 2018). 42. Kanal E, Gillen E, Evans JA, Savitz DA, Shellock FG. Survey of reproductive health among female MR workers. Radiology 1993;187:395–9. 43. Tanaka R, Yumato T, Shiba N, et al. Overheated and melted intracranial pressure transducer as a cause of thermal brain injury during magnetic resonance imaging: case report. Neurosurgery2012;117:1100–9. 44. Clasen S, Pereira PL. Magnetic (...) . | AnaesthesiainmagneticresonanceunitsshuntshavenowbeendevelopedthatareunaffectedbyMR scanners up to 3 T, but the settings should be checked beforeandafterscanningtoensurepatientsafety[16]. Neurostimulatorsandimplantableprogrammable devices Neurostimulators are now implanted for many indications, for example, vagal nerve, deep brain or spinal cord stimulation,andmaybeaffectedbyRFandmagnetic?elds. Inaddition,theymaycausethermalinjuryduringscanning. Itisrecommendedthatpatients withimplantedstimulators donotundergoMRI,buttherisksmaybebalancedagainst bene?ts to allow scanning under

2019 Association of Anaesthetists of GB and Ireland

144. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: an AUA/SUFU Guideline

be considered complicated OAB patients. These co-morbid conditions include neurologic diseases (i.e., stroke, multiple sclerosis, spinal cord injury), mobility deficits, medically complicated/uncontrolled diabetes, fecal motility disorders (fecal incontinence/ constipation), chronic pelvic pain, history of recurrent urinary tract infections (UTIs), gross hematuria, prior pelvic/vaginal surgeries (incontinence/prolapse surgeries), pelvic cancer (bladder, colon, cervix, uterus, prostate) and pelvic radiation

2019 American Urological Association

145. Hereditary Hemochromatosis

, pancreas, heart, joints, and pituitary gland. The primary goal in the management of HH is to identify patients before end-organ injury and initiate treatment via iron depletion before irreversible end-organ damage. | REVIEW OF IRON ABSORPTION AND ITS CONTROL Iron absorption occurs primarily in the second portion of the duodenum in the form of heme and non-heme iron. Heme iron is absorbed via mechanisms that are not yet fully understood ( ). Non-heme or inorganic iron absorption follows a coordinated (...) quadrant pain, or complications of end-stage liver disease ( ). The risk of developing cirrhosis rises significantly with SF levels of >1,000 ng/mL at diagnosis ( ). Increased alcohol consumption of more than 60 g/d can increase the risk of developing cirrhosis in HH by 9-fold ( ), and excess of 80 g of daily alcohol consumption can significantly reduce survival ( ). The key mechanism of iron-related tissue injury has been suggested to be oxidative injury that overwhelms cellular antioxidant mechanisms

2019 American College of Gastroenterology

146. Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache

setting. 79 Regardless of headache etiology, response to treatment should not be solely used to determine whether a cause is 80 benign. 4 Access to care can further complicate this decision process in clinical practice, a variable not accounted 81 for in most studies. When the evidence is evaluated, the outcome measures used in determining the need for 82 neuroimaging in the ED must also be clinically relevant to practice. For example, diagnosing a brain tumor may 83 not require immediate neurosurgery (...) the strengths and limitations of current decision tools, 250 the imaging technology available, and possible biomarkers is essential to determine the need for advanced brain 251 imaging. If these tools or tests were able to rule out SAH, the advantages would not only improve overall diagnosis 252 but also improve patient safety with decreased radiation exposure. This critical question seeks to address whether 253 there are risk-stratification strategies that reliably rule out SAH in the acute headache

2019 American College of Emergency Physicians

147. Mild fetal ventriculomegaly: diagnosis, evaluation, and management

that the outcome is likely to be favorable but that there is an increased risk of neurodevelopmental disabilities (GRADE 1B). Keywords: dilated cerebral ventricles, fetal brain, fetal magnetic resonance imaging, hydrocephalus, ventriculomegaly Introduction Ventriculomegaly is characterized by dilation of the fetal cerebral ventricles and is a relatively common ?nding on prenatal ultrasound. Prenatally detected fetal Corresponding author:Society for Maternal-Fetal Medicine:Publications Committee. (...) abnormalities are noted and if aneuploidy screening or diagnostic genetic testing results are normal. The chance that mild ventriculomegaly repre- sents a normal variant decreases with increasing degrees FIGURE Correcttechniqueformeasurementoflateral ventricle Normal fetal brain in transventricular (axial) plane. Photograph courtesy of Alfred Abuhamad, MD. CSP, cavum septi pellucidi. Society forMaternal-FetalMedicine.Mildfetalventriculomegaly.AmJObstetGynecol2018. BOX

2019 Society for Maternal-Fetal Medicine

148. American Society for Parenteral and Enteral Nutrition Clinical Guidelines: The Validity of Body Composition Assessment in Clinical Populations

on physical function in patients with traumatic brain injury To compare the accuracy of US with DXA To assess the relationships between anthropometrical data and self‐reported physical function N = 37 adults with moderate to severe traumatic injury (87% male, 13% female) BMI: 26.7 ± 6.5 kg/m 2 Age: 45 ± 16 y (mean ± SD) DXA (Prodigy GE Healthcare) vs US (SonoSite X Porte, 13‐6 MHz Transducer) LM (DXA) vs muscle layer thickness (US) LLM (DXA) vs QMT (US) DXA measures were obtained within 7 days after (...) hospital discharge and 3‐mo follow‐up Time between body composition tests not specified Pearson correlations reported LM (DXA) vs QMT (US): r = 0.74, P = 0.037, n = 8 LLM (DXA) vs QMT (US): r = 0.59, P = 0.12, n = 8 Emmons et al, 2011 To evaluate associations between DXA‐measured and US‐measured adiposity in men with spinal cord injury N = 24 males (8 paraplegic, 16 tetraplegic) BMI: 26.2 ± 5.4 kg/m 2 Age: 39 ± 11 y (mean ± SD) DXA (GE Lunar Prodigy Advance) vs US (GE Logiq Book XP with a GE 3C‐RS 2‐5

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2019 American Society for Parenteral and Enteral Nutrition

150. Practice Advisory Interim Guidance for Care of Obstetric Patients During a Zika Virus Outbreak

data and experience from other flaviviruses and has not been confirmed. It is not believed that pregnant women are at greater risk of Zika virus transmission than non-pregnant individuals. However, there is demonstrated causation between Zika virus infection during pregnancy and devastating adverse birth outcomes such as severe brain abnormalities, microcephaly, eye and hearing abnormalities and joint contractures. Zika can lead to a distinct pattern of birth defects among fetuses and infants born (...) and expected outcomes (Polan, 2018). Those couples who are not planning to delay pregnancy should talk with their health care providers about the risks. Obstetrician-gynecologists and other health care providers should counsel patients on the risks of Zika virus as part of their pregnancy planning and counseling. This should include counseling about the potential consequences to the fetus associated with Zika virus infection during pregnancy, such as microcephaly and other serious brain abnormalities (see

2019 American College of Obstetricians and Gynecologists

151. Society of Interventional Radiology Training Guidelines for Endovascular Stroke Treatment

neurointerventional fellowships have historically provided and continue to provide EVT in substantial numbers with good outcomes, comparable to those achieved by neurointerventional physicians during similar years ( x 29 Behzadi, G.N., Fjetland, L., Advani, R., Kurz, M.W., and Kurz, K.D. Endovascular stroke treatment in a small-volume stroke center. Brain Behav . 2017 ; 7 : e00642 , x 30 Belisle, J.G., McCollom, V.E., Tytle, T.L. et al. Intraarterial therapy for acute ischemic strokes. J Vasc Interv Radiol . 2009 (...) of the brain and its associated pathophysiologic vascular processes, clinical syndromes, the full array of ischemic stroke presentations, and pre-, peri-, and postprocedural care; 2) Procedural skill, including management of complications secondary to endovascular procedures, that is achieved by supervised training by a qualified instructor; and 3) Diagnostic and therapeutic acumen, including the ability to recognize procedural/angiographic complications. This is achieved by studying, performing

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2019 Society of Interventional Radiology

152. Management of symptomatic hypermobility in children and young people

such fears, as fear can lead to avoidance. Challenging unhelpful beliefs and behaviours, such as excessive rest, catastrophising or avoidance are helpful to understand their role in the fear and pain cycle. It is helpful to establish realistic expectations. There will be times of increased pain, after a lot of sport or injury, and a management plan for dealing with these times should be discussed. It is really important to discuss a relapse plan to ensure that during these times, long periods of rest (...) ranging from open to closed chain exercise, lower impact to start with, and including functional exercises graded individually for each patient ? Advice on postural alignment, avoiding extremes at end range positions and prolonged static loading can help to protect against injury and enables muscles to function most efficiently ? Core strengthening – exercises to build core strength, muscle strength and endurance improve stability, balance and coordination. Every day, age-appropriate, functional

2019 British Society for Rheumatology

153. Pediatric ICU Admission, Discharge, and Triage Practice Statement and Levels of Care Guidance

consult and provide guidance on all critically ill children admitted to a PICU. Trauma patients should be cared for by both the surgical/trauma service (including trainees) and the PICU service in a collaborative manner. The ACS requires that surgeons be the primary provider on all patients admitted with traumatic injuries ( ). To deliver multispecialty care required for the trauma patient, surgical/trauma consultation or comanagement with the pediatric intensivists is advised. Trauma care should

2019 Society of Critical Care Medicine

154. Pediatric Endoscopy and High-risk Patients: A Clinical Report From the NASPGHAN Endoscopy Committee

for cardiopulmonary events during endoscopy (13). Food and Drug Administration Warning Related to Anesthetics As an additional sedation risk, the United States Food and Drug Administration has recently called attention to concerns that almostallcommonsedativesmayposeariskofneurotoxicityinthe developing brain (14). In 2016, the Food and Drug Administration released a black box warning for a number of common anesthetic agents used to induce sedation for pediatric GI procedures, includ- ing midazolam, fentanyl (...) on the clinical condition of the patient, blood products such as packed red blood cells, fresh frozen plasma, platelets, cryoprecipitate, and recombinant activated factor VII should be available in the blood bank or in the operating room during the procedure. PERFORATION-RELATED EVENTS Patients at High Risk for Perforation Perforationduringendoscopycanbedefinedasinstrumental injury leadingto evidence ofair or luminal contents outsidethe GI tract (3). Incidence of perforation during endoscopy ranges from 0.06

2019 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

155. Renal Transplantation

strategies to reduce ischemic injury in kidney transplantation: pharmacological and genetic approaches. Curr Opin Organ Transplant, 2011. 16: 180. 40. Jochmans, I., et al. Past, Present, and Future of Dynamic Kidney and Liver Preservation and Resuscitation. Am J Transplant, 2016. 16: 2545. 41. O’Callaghan, J.M., et al. Systematic review and meta-analysis of hypothermic machine perfusion versus static cold storage of kidney allografts on transplant outcomes. Br J Surg, 2013. 100: 991. 42. Martinez Arcos (...) uncontrolled donors after cardiac death. Transplant Proc, 2008. 40: 1023. 45. Jochmans, I., et al. Hypothermic machine perfusion of kidneys retrieved from standard and high-risk donors. Transpl Int, 2015. 28: 665. 46. Treckmann, J., et al. Machine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death. Transpl Int, 2011. 24: 548. 47. Gill, J., et al. Pulsatile perfusion reduces the risk of delayed graft function in deceased donor kidney transplants

2019 European Association of Urology

156. ACR–ASNR–SPR Practice Parameter for the Performance and Interpretation of Magnetic Resonance (MR) Spectroscopy of the Central Nervous System

of traumatic brain injury. 11. Evidence or suspicion of brain developmental abnormality and cerebral palsy. 12. Evidence or suspicion of other neurodegenerative diseases such as amyotrophic lateral sclerosis. 13. Evidence or suspicion of chronic pain syndromes. 14. Evidence or suspicion of chromosomal and inherited neurocutaneous disorders such as neurofibromatosis and tuberous sclerosis. 15. Evidence or suspicion of neurotoxicity, such as misuse of medications, exposure to environmental hazards (...) this objective. I. INTRODUCTION This practice parameter was revised collaboratively by the American College of Radiology (ACR), the American Society of Neuroradiology (ASNR), and the Society for Pediatric Radiology (SPR). Magnetic resonance spectroscopy (MRS) is a proven and useful method for the evaluation, assessment of severity, therapeutic planning, post-therapeutic monitoring, and follow-up of diseases of the brain and other regions of the body [1-4]. It should be performed only for a valid medical

2019 American Society of Neuroradiology

157. ACR–ASNR–SIR–SNIS Practice Parameter for the Performance of Endovascular Embolectomy and Revascularization in Acute Stroke

the usefulness/effectiveness is considered uncertain or less well established by evidence or opinion. A Class 3 recommendation represents a course of action for which there is evidence and/or general agreement that the procedure or treatment is not useful/effective, and in some cases may be harmful [15,16]. CNS infarction – CNS infarction is brain, spinal cord, or retinal cell death attributable to ischemia, based on pathological, imaging, other objective evidence of cerebral, spinal cord, or retinal focal (...) ischemic injury in a PRACTICE PARAMETER 3 Acute Stroke defined vascular distribution, or clinical evidence of cerebral, spinal cord, or retinal focal ischemic injury based on symptoms persisting >24 hours or until death, and other etiologies excluded. (Note: CNS infarction includes hemorrhagic infarctions (HI), types I and II; see “Hemorrhagic Infarction” [15-18].) Diagnostic catheter angiography – a minimally invasive procedure involving percutaneous catheterization of any of the arteries or veins

2019 American Society of Neuroradiology

158. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults

., stroke, multiple sclerosis, spinal cord injury), mobility deficits, medically complicated/uncontrolled diabetes, fecal motility disorders (fecal incontinence/constipation), chronic pelvic pain, history of recurrent urinary tract infections (UTIs), gross hematuria, prior pelvic/vaginal surgeries (incontinence/prolapse surgeries), pelvic cancer (bladder, colon, cervix, uterus, prostate) and pelvic radiation. The female patient with significant prolapse (i.e., prolapse beyond the introitus) also may

2019 American Urological Association

159. Comprehensive Systematic Review Summary: Treatment of Tics in People with Tourette Syndrome and Chronic Tic Disorders

Intervention for Tics CBT: cognitive behavioral therapy CI: confidence interval COI: conflict of interest DBS: deep brain stimulation DSM-5: Diagnostic and Statistical Manual of Mental Disorders (DSM–5), Fifth Edition GDDI: Guideline Development, Dissemination, and Implementation GRADE: Grading of Recommendations Assessment, Development, and Evaluation HRT: habit reversal training OCD: obsessive-compulsive disorder rTMS: repetitive transcranial magnetic stimulation SMD: standardized mean difference THC (...) and deep brain stimulation of the globus pallidus were probably more likely than placebo to reduce tics. There was low confidence that pimozide, ziprasidone, metoclopramide, guanfacine, topiramate, and tetrahydrocannabinol were possibly more likely than placebo to reduce tics. Evidence of harm associated with various treatments was also demonstrated. Recommendations: Forty-six recommendations were made regarding the assessment and management of tics in individuals with TS and chronic tic disorders

2019 American Academy of Neurology

160. Valvular Heart Disease: A Proposal to Optimize Care for Patients

of representa- tives from the AATS, ACC, ASE, SCAI, and STS. Existing organized and tiered systems of care for the treatment of several other acute disorders (trauma, stroke, S-T segment elevation myocardial infarction [STEMI]) and non-acute (bariatric surgery, cancer) were reviewed by the committee. A leading member of the Brain Attack Coalition had previously presented the elements of that systemtotheRoundtable.Whereappropriate,thewriting committee referred to multisocietal recommendations for operator (...) in 1960 by the National Institutes of Health, with the objective of addressingresearchandtraining(36).Currently,thereare 70 specialized cancer centers across 35 states. Motivated Nishimura et al. JACC VOL. -,NO. -,2019 VHD Systems of Care Document -,2019:-–- 6by the wide variability in the quality of care and the disparate outcomes of patients with traumatic injuries, the American College of Surgeons published a statement in 1976 (37) describing 3 tiers of trauma centers with graded infrastructure

2019 American College of Cardiology


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