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161. Guidelines for the Administration of Electroconvulsive Therapy

to the brain sufficient to induce a seizure for therapeutic purposes while the patient is under anaesthetic. When can ECT be used? ECT must be performed within legislative requirements as defined in Australian state and territory and New Zealand Mental Health Acts. It is advised that psychiatrists read and familiarise themselves with the relevant requirements for ECT within the jurisdiction in which they practice. The RANZCP has prepared a comparison table of regulation of ECT in Australian and New Zealand (...) depression with psychotic features, major depression with melancholic features and major depression with peripartum onset. • • Other psychiatric disorders such as bipolar disorder (manic, mixed and depressed phases), acute and chronic treatment-resistant schizophrenia, schiz- oaffective disorder, catatonia, acute psychosis, puerperal psychosis and neuroleptic malignant syndrome. ECT may also have a role in the treatment of severe and repetitive self-injurious behaviours in autism (Ghaziuddin and Walter

2019 American Psychiatric Association

162. Assessment and Management of Patients at Risk for Suicide

be considered, if appropriate. This CPG is designed to assist providers in managing or co-managing patients at risk for suicide as well as any co-occurring conditions (e.g., major depressive disorder [MDD], generalized anxiety disorder, SUD, posttraumatic stress disorder [PTSD], traumatic brain injury [TBI]). VA/DoD CPGs exist for MDD 2 , mild TBI 3 , PTSD 4 , SUD 5 , and opioid therapy for chronic pain 6 . Moreover, the patient population of interest for this CPG is patients at risk for suicide who (...) are eligible for care in the VA and DoD healthcare delivery systems 2 See the VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder. Available at: https://www.healthquality.va.gov/guidelines/MH/mdd/ 3 See the VA/DoD Clinical Practice Guideline for the Management of Concussion-mild Traumatic Brain Injury. Available at: https://www.healthquality.va.gov/guidelines/Rehab/mtbi/ 4 See the VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute

2019 VA/DoD Clinical Practice Guidelines

163. Management of Stroke Rehabilitation

stroke center. At this time, the DoD has no certified stroke centers. The DoD has limited inpatient rehabilitation beds and often partners with VA or civilian network providers when these services are needed. At some of the larger MTFs, comprehensive outpatient stroke rehabilitation services may be available. Some military medical facilities may offer these services through their traumatic brain injury (TBI) rehabilitation clinics. Survivors of stroke who live outside of military medical center

2019 VA/DoD Clinical Practice Guidelines

164. Neonatal seizures

or injury 4 Hyperekplexia Neurologic disorder where there is a pronounced startle response to tactile or acoustic stimuli, and hypertonia 5 Hypsarrhythmia Abnormal inter-ictal pattern with electroencephalogram (EEG) high amplitude and irregular waves and spikes with background of chaotic and disorganised activity 1 Ictal Relating to seizures 1 Lissencephaly Rare, gene-linked brain malformation where there is absence of normal convolutions (folds) in the cerebral cortex and an abnormal, small head (...) are multifactorial and include the relative excitability of the developing neonatal brain as well as the high risk for brain injury due to hypoxia, ischaemia, stroke, intracranial haemorrhage and metabolic disturbance. 13 Seizures can be associated with greater risk of long term neurodevelopmental disablities. 8 Both clinical and electrographic seizures are associated with neurological sequalae including motor and cognitive deficits, an increased risk of epilepsy in later life and hypoxic induced brain injury

2019 Queensland Health

165. Stillbirth care

); notched uterine arteries § Suspected prenatally with small for gestational age biometry and increased pulsatility index (PI) (greater than 90th percentile) 28 at Doppler ultrasonography from second trimester 29 · Diabetes in Aboriginal and Torres Strait Islander women 6 and pre-existing maternal diabetes 19,27 Isoimmunisation · Reduced fetal movement history · Post-term pregnancy (greater than or equal to 42 weeks gestation) 25 · Intrapartum obstructed labour and fetal injury Lifestyle/pre- existing (...) parents of multiple pregnancy where one or more baby has died 70 o Avoid negative comments such as “You still have one baby to take home” o Parents may appreciate a photograph of the babies together 70 · Inform parents about baby’s physical appearance with regard to gestational age and development, physical abnormalities and potential injuries such as peeling skin · Avoid confronting descriptions that may impact their decisions about seeing their baby 61 Labour · Timing between diagnosis and birth: o

2019 Queensland Health

166. Suspected Upper-Extremity Deep Vein Thrombosis.

. 52. Pedrosa I, Morrin M, Oleaga L, Baptista J, Rofsky NM. Is true FISP imaging reliable in the evaluation of venous thrombosis? AJR Am J Roentgenol. 2005;185(6):1632-1640. 53. Denson K, Morgan D, Cunningham R, et al. Incidence of venous thromboembolism in patients with traumatic brain injury. Am J Surg. 2007;193(3):380-383; discussion 383-384. 54. Tanju S, Sancak T, Dusunceli E, Yagmurlu B, Erden I, Sanlidilek U. Direct contrast-enhanced 3D MR venography evaluation of upper extremity deep venous

2019 American College of Radiology

167. Head Trauma- Child

replace clinical assessment, and physician judgment still holds a significant role in determining the imaging workup. Minor Head Injury in Patients Under 2 Years of Age Without Neurologic Signs or High Risk Factors The reported prevalence of clinically significant brain injury from minor trauma in patients <2 years old is similar to that of older children, with an estimated overall risk of <1% and an increased incidence in the setting of mental status changes (4%) or clinically suspected fracture (3.6 (...) present with symptoms that would not otherwise indicate trauma, such as apneic spells, poor feeding, or irritability. In a series of 173 children with inflicted brain injury, 31% were initially misdiagnosed [38]. Head injury may also be unrecognized even when abuse is suspected. In one study, 37% of children under 2 years of ACR Appropriateness Criteria ® 8 Head Trauma — Child age with suspected abuse but no overt signs of head injury demonstrated occult head injury by imaging [39]. Another study

2019 American College of Radiology

168. Integrated care for older people (?ICOPE)?: guidance for person-centred assessment and pathways in primary care

Martin (King’s College London, United Kingdom). Sarah Johnson and Ward Rinehart of Jura Editorial Services were responsible for writing the final text. Many other WHO staff from the regional offices and a range of departments contributed both to specific sections relevant to their areas of work and to the development of the care pathways: Shelly Chadha (WHO Department of Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention), Neerja Chowdhary (WHO Department of Mental (...) Health and Substance Abuse), Tarun Dua (WHO Department of Mental Health and Substance Abuse), Maria De Las Nieves Garcia Casal (WHO Department of Nutrition for Health and Development), Zee A Han (WHO Department of Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention), Dena Javadi (WHO Department of Alliance for Health Policy and Systems Research), Silvio Paolo Mariotti (WHO Department of Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention

2019 World Health Organisation Guidelines

169. Stroke, Diagnosis and Initial Treatment of Ischemic Stroke

III: Harm; LOE C-EO) Agree 2. There remains insufficient evidence to identify a threshold of hypoattenuation severity or extent that affects treatment response to alteplase. However, administering IV alteplase to patients whose CT brain imaging exhibits extensive regions of clear hypoattenuation is not recommended. These patients have a poor prognosis despite IV alteplase, and severe hypoattenuation defined as obvious hypodensity represents irreversible injury. (Class III: No Benefit; LOE A) Agree (...) early care for persons with an onset of stroke symp- toms. The recommendations in this guideline are for early management of stroke due to ischemic brain ischemia/infarction. This guideline does not address stroke prevention, transient ischemic stroke (TIA) or management of hemorrhagic stroke. To increase access to appropriate early care for stroke, Minnesota passed legislation to authorize the Minnesota Department of Health (MDH) to designate hospitals as Acute Stroke-Ready Hospitals, Primary

2019 Institute for Clinical Systems Improvement

170. Vaccine-preventable Infections and Immunization in Multiple Sclerosis

cases for Physicians Review Organization of Michigan and serves as a blinded rater for multiclinic clinical drug trials for MS, Parkinson disease, dementia, and epilepsy. Her spouse reviews adult cases for the Physician Review Organization of Michigan and serves as a principal investigator. 5 Y. Holler-Managan receives funding for travel from the AAN and serves on the editorial advisory board for Brain & Life. N. Kachuck has served on speakers bureaus for Teva Pharmaceuticals and Acorda Therapeutics (...) , continuing medical education companies, the University of South Florida, and the University of Massachusetts; and has provided expert testimony as a defense expert witness. M. Beilman reports no disclosures. G. Gronseth serves as an associate editor of Neurology; serves on the editorial advisory board for Brain & Life; served as a paid evidence-based medicine methodologist for the AAN; and received honoraria for presentations given at the AAN Annual Meeting. D. Michelson receives publishing royalties

2019 American Academy of Neurology

171. Identifying Child Abuse Fatalities During Infancy

abuse fatalities, with approximately 3700 sudden unexpected infant deaths in 2015 in the United States. However, deaths reported as child maltreatment fatalities are believed to be underestimates, with more than triple the number officially reported being estimated to occur. , Closed head injury is considered the leading cause of fatal abuse, with a peak incidence at 1 to 2 months of age, a time period that overlaps with sudden unexpected infant deaths. Several findings, such as subdural hematoma (...) and computed tomography (CT) imaging performed before autopsy may reveal evidence of traumatic skeletal injury or skeletal abnormalities indicative of a naturally occurring illness. The presence of both old and new traumatic injuries as well as fractures specific for abuse may suggest inflicted injuries and may lend focus to the postmortem examination, investigation of the circumstances of death, and police investigation. Ideally, such imaging should only be performed at the direction of the medical

2019 American Academy of Pediatrics

172. Dementia

Alzheimer disease (AD), frontotemporal dementia (FTD), Lewy bodies disease, vascular dementia (VaD), and mixed dementias [2]. Although the causes of most dementias remain elusive, genetic research has opened many frontiers to understanding the pathophysiology of heretofore enigmas such as AD [1,3]. Additionally, infectious, autoimmune, and toxic etiologies have become increasingly more appreciated as causes of cognitive decline. Trauma with brain injury may also be associated with premature dementia (...) of the final document. Reprint requests to: publications@acr.org ACR Appropriateness Criteria ® 5 Dementia The major AD biomarkers that have been widely investigated at this time [7] can be subdivided into two classes based on the biology that is measured. Biomarkers of brain amyloid-beta (Aß) protein deposition are low CSF Aß42 and positive PET amyloid imaging. The second category is that of biomarkers of downstream neuronal degeneration or injury. The three major biomarkers in this category are 1

2019 American College of Radiology

173. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

. – Treatment discontinuation also places individuals with ADHD at higher risk for catastrophic outcomes, such as motor vehicle crashes , ; criminality, including drug-related crimes and violent reoffending ; depression ; interpersonal issues ; and other injuries. , To continue providing the best care, it is important for a treating pediatrician or other PCC to engage in bidirectional communication with teachers and other school personnel as well as mental health clinicians involved in the child

2019 American Academy of Pediatrics

174. Movement Disorder and Neurodegenerative Diseases.

contrast Usually Appropriate O CT head without IV contrast May Be Appropriate ??? FDG-PET/CT brain May Be Appropriate ???? Tc-99m HMPAO SPECT/CT brain May Be Appropriate ???? MR spectroscopy head without IV contrast Usually Not Appropriate O CT head with IV contrast Usually Not Appropriate ??? CT head without and with IV contrast Usually Not Appropriate ??? MRI functional (fMRI) head without IV contrast Usually Not Appropriate O Variant 2: Chorea; suspected Huntington disease. Initial imaging (...) . Procedure Appropriateness Category Relative Radiation Level MRI head without IV contrast Usually Appropriate O MRI head without and with IV contrast May Be Appropriate O CT head without IV contrast May Be Appropriate ??? CT head with IV contrast Usually Not Appropriate ??? CT head without and with IV contrast Usually Not Appropriate ??? FDG-PET/CT brain Usually Not Appropriate ???? MR spectroscopy head without IV contrast Usually Not Appropriate O MRI functional (fMRI) head without IV contrast Usually

2019 American College of Radiology

175. Risk estimation and the prevention of cardiovascular disease

as the potential for intervention prior to the disease presenting through a specified event (any incident linked to critical disruption of blood flow that may cause damage to the heart, brain or peripheral tissues), and secondary prevention, defined as the potential for intervention after an event has occurred. The guideline development group has tried to consider CVD as a continuum from the preclinical to the end-stage disease, potentially offering different opportunities to intervene, both prior

2017 SIGN

176. Standards for post-concussion care from diagnosis to the interdisciplinary concussion clinic

Organization, Health Sciences North, Northern Ontario School of Medicine Shannon Bauman, MD, CCFP, Dip. Sports Med - Concussion North, Royal Victoria Regional Health Centre Sheree Davis, MSW, CDR, CPF - Consultant, Health Systems Advisor Carol Di Salle, MSc(S), Reg CASLPO, S-LP (C) - Health Sciences North Melissa Freedman, MSW, RSW, Patient/Family Expert - Ontario Brain Injury Association Donna Ouchterlony, MD, CCFP - St. Michael's Hospital Deanna Quon, MD, FRCPC - Ottawa Hospital Rehabilitation Centre (...) Nick Reed, MScOT, PhD - Holland Bloorview Kid’s Rehabilitation Hospital, Concussion Centre Katelin Sims, MScPT - Physiotherapy Kingston and Spinal Rehabilitation Centre Ruth Wilcock - Ontario Brain Injury Association Roger Zemek, MD, FRCPC - Children’s Hospital of Eastern Ontario Ontario Neurotrauma Foundation: Corinne Kagan, BA, BPS (Cert) - Senior Program Director, ABI Judy Gargaro, BSc, MEd - Clinical and Systems Implementation Associate, ABI Melissa Hansen, MScOT - Concussion Standards Project

2017 CPG Infobase

177. Canadian stroke best practice recommendations: telestroke best practice guidelines update

. Telerehabilitation – a new model for community-based stroke rehabilita- tion. J Telemed Telecare 2004; 10: 199–205. 22. Piron L, Turolla A, Agostini M, et al. Exercises for par- etic upper limb after stroke: a combined virtual-reality and telemedicine approach. J Rehabil Med 2009; 41: 1016–1102. 23. Huijgen BC, Vollenbroek-Hutten MM, Zampolini M, et al. Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple (...) ) for additional details and examples. (iv) The consultant should be a physician with specialized training in hyperacute stroke management, and must have timely access to diagnostic-quality neurovascular (e.g., brain CT, CTA) images during the Telestroke consultation (Evidence Level A). Refer to Telestroke Resource Toolkit Technical section (online supplementary material) for additional details. Note: The decision to use acute stroke therapies in emergency management requires imaging to rule out hemorrhage

2017 CPG Infobase

179. Risk factors for breast cancer: A review of the evidence 2018

Cancer Australia to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Publications and Copyright contact officer, Cancer Australia, Locked Bag 3, Strawberry Hills, NSW 2012. Disclaimer Cancer Australia does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information. Cancer Australia develops material based on the best available evidence, however it cannot guarantee and assumes no legal liability or responsibility (...) and protective factors for breast cancer in women. 1.2 What is a risk factor? The World Health Organization (WHO) defines a risk factor as ‘any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury’. Strictly speaking, risk factors for cancer are factors associated with an increased likelihood of developing cancer. Protective factors are the opposite: they are associated with decreased likelihood of developing cancer. 2 In this and many similar

2018 Cancer Australia

180. Guidelines on autopsy practice: Third trimester antepartum and intrapartum stillbirth

without an expert external examination of the body having first been performed by an appropriately trained and experienced individual. Imaging modalities, in addition to X-ray, which may be of value include MRI 12 and micro-CT. 13 The role of MRI imaging in perinatal autopsies has been investigated. 12 MRI imaging can give useful information, particularly on structural malformations in the situation of stillbirth, however, it is poor in detecting infection and hypoxic-ischaemic brain injury, two (...) (CNS) examination: median posterior or transverse scalp incision skull incisions to allow assessment of falx and venous sinuses assessment of falcine and tentorial injury and meningeal haemorrhage (intrapartum death) examination for skull fracture or occipital osteodiastasis (intrapartum death) exclusion of spinal injury by posterior approach (intrapartum death) if suspected CNS malformation (including ventriculomegaly), examination of posterior fossa structures by posterior approach observation

2017 Royal College of Pathologists

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