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121. Canadian Cardiovascular Society/Canadian Cardiac Transplant Network Position Statement on Heart Transplantation: Patient Eligibility, Selection, and Post-Transplantation Care Full Text available with Trip Pro

morbidity and mortality with an approximate 25% reduction in 1-year post-HTx survival in frail patients. Sze S. Pellicori P. Zhang J. Weston J. Clark A.L. Identification of frailty in chronic heart failure. JACC Heart Fail. 2019; 7 : 291-302 The presence of cachexia, self-reported physical exhaustion or decrease in hand grip strength, walking speed, or physical activity Fang J.C. Ewald G.A. Allen L.A. et al. Advanced (stage D) heart failure: a statement from the Heart Failure Society of America (...) Phenotype Grip strength Handheld dynamometer (in kilograms) and stratified according to gender and body mass index quartiles; 1 point All values are summed with ≥ 3 consistent with frailty in HF patients Walk time Time to walk 15 feet stratified according to gender and height; 1 point Low level of physical activity “How often do you engage in activities that require a low or moderate level of energy, such as walking, chores (moderately strenuous), mowing the lawn, raking, gardening, hiking, jogging

2020 Canadian Cardiovascular Society

122. Cycling in Scotland: review of cycling casualties

77 4.1.13 Driver behaviour 77 4.1.14 Cycling infrastructure 79 4.1.15 Risk associated with cycling 80 4.2 Strengths 81 4.3 Limitations 82 4.4 Recommendations 83 4.4.1 Data 83 4.4.2 Policing 84 4.4.3 Investment 85 4.4.4 Infrastructure, training and speed restriction 85 5 Conclusion 87 References 89 5 Glossary Adults: Persons aged 16 years and over. Active travel: making journeys by a physically active means such as walking, cycling, or scooting. Bicycle: pedal bike Bike library: a site where (...) physical activity or 75 minutes of vigorous physical activity every week, in addition to strength exercises at least twice a week. Children and young people aged 5-18 years are advised to engage in at least 60 minutes of moderate to vigorous physical activity each day in addition to strength building activities three days per week. Building active travel into everyday life can be an effective way to boost levels of physical activity in a country where only two thirds of adults (66%) meet the moderate

2020 Glasgow Centre for Population Health

123. Covid-19 Transmission of the coronavirus by children

with contact patterns assortative with age. 1 Schoolchildren and young adults mixed with people of the same age; contacts lasting at least one hour or occurring on a daily basis mostly involved physical contact. Contacts at home, school, or leisure were more likely to be physical than contacts at the workplace or while travelling. Modeling the data for an emerging epidemic, transmitted by the respiratory route or close-contact, in a completely susceptible population, estimated that the age range 5-19 years (...) environnement favorable à la prévention de la propagation du virus au sein des écoles doit être cohérent avec les mesures de prévention mises en œuvre au domicile des enfants. • L’apprentissage des gestes « barrières » par les enfants apparaît être une stratégie positive pour impliquer les enfants en tant que promoteurs/défenseurs de la prévention. • Des mesures spécifiques pour prévenir la stigmatisation et soutenir la santé mentale devraient être déployées. • Les parents et les enseignants sont inquiets

2020 Belgian Health Care Knowledge Centre

124. Sinusitis (acute): antimicrobial prescribing

available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. Local commissioners (...) 2019. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 8 of 24Erythromycin (in pregnancy) 250 mg to 500 mg four times a day or 500 mg to 1000 mg twice a day for 5 days Second choice (worsening symptoms on first choice tak Second choice (worsening symptoms on first choice taken for at least 2 to 3 en for at least 2 to 3 da days) ys) Co-amoxiclav 2 500/125 mg three times a day for 5 days Alternativ Alternative second choice

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

125. Cystic fibrosis: diagnosis and management

intravenous antibiotic services, including intravenous access. 1.3.13 Specialist physiotherapists should assess and advise people with cystic fibrosis at clinic, at inpatient admissions, during pulmonary exacerbations and at their annual review. Assessment and advice could cover airway clearance, nebuliser use, musculoskeletal disorders, exercise, physical activity and urinary incontinence. 1.3.14 Specialist dietitians should assess and advise people with cystic fibrosis about all aspects of nutrition (...) (as appropriate), taking into account the need to prevent cross-infection (see preventing cross-infection) and local infection control guidelines. Psy Psychological assessment chological assessment 1.7.34 At the annual review, the specialist clinical psychologist should include assessments of: general mental health and wellbeing quality of life any factors that are making treatment adherence difficult indicators of emerging psychosocial problems behaviours that affect health outcomes. 1.7.35 If a severe

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

126. Child abuse and neglect

Child abuse and neglect Child abuse and neglect Child abuse and neglect NICE guideline Published: 9 October 2017 © NICE 2019. All rights reserved. Subject to Notice of rights ( rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals (...) and young people is a criminal offence, and child abuse and neglect can have serious adverse health and social consequences for children and young people. These include: effects on growth and physical development (The impact of abuse and neglect on the health and mental health of children and young people NSPCC) impaired language development and behaviour by age 4 impaired ability to socialise, play and learn (Developing an effective response to neglect and emotional harm to children NSPCC) increased

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

127. Antimicrobial stewardship: changing risk-related behaviours in the general population

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances (...) ) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. This guideline should be read in conjunction with NICE's guideline on antimicrobial stewardship: systems and processes for effective antimicrobial medicine use. 1.1 Overarching principles The following recommendations are for directors of public health: 1.1.1 Work with health and wellbeing boards

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

128. Guidelines on Supraventricular Tachycardia (for the management of patients with) Full Text available with Trip Pro

Electrical cardioversion 45 14.2.3 Catheter ablation 45 15 Tachycardia-induced cardiomyopathy 45 15.1 Definition 45 15.2 Mechanism 45 15.3 Diagnosis 45 15.4 Therapy 45 16 Supraventricular tachycardia in sports 46 17 Supraventricular tachycardia and driving restrictions 46 18 Key messages 47 19 Gaps in the evidence 47 20 Evidence-based ‘what to do’ and ‘what not to do’ messages from the Guidelines 48 21 Areas for further research 49 22 Supplementary data 50 23 Appendix 50 24 References 51 Recommendations (...) and complications rates of catheter ablation for supraventricular tachycardia 23 Table 12 Classification of atrioventricular nodal re-entrant tachycardia types 30 Table 13 Recommendations for sports participation in athletes with ventricular pre-excitation and supraventricular arrhythmias 46 Table 14 European Working Group 2013 report on driving and cardiovascular disease: driving in arrhythmias and conduction disorders: supraventricular tachycardia 47 List of figures Figure 1 Differential diagnosis of narrow

2019 European Society of Cardiology

129. Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases developed in collaboration with the EASD Full Text available with Trip Pro

Carbohydrate 17 Fats 17 Proteins 17 Vegetables, legumes, fruits, and wholegrain cereals 17 Alcohol consumption 17 Coffee and tea 17 Vitamins and macronutrients 17 6.1.2 Physical activity 18 6.1.3 Smoking 18 6.2 Glucose 18 6.2.1 Glycaemic targets 18 Additional glucose targets 18 6.2.2 Glucose-lowering agents 19 6.2.3 Special considerations 19 Hypoglycaemia 19 Glucose monitoring 19 6.3 Blood pressure 20 6.3.1 Treatment targets 20 6.3.2 (...) peptidase-4 DYNAMIT Do You Need to Assess Myocardial Ischemia in Type 2 Diabetes EACTS European Association for Cardio-Thoracic Surgery EAS European Atherosclerosis Society EASD European Association for the Study of Diabetes ECG Electrocardiogram EDIC Epidemiology of Diabetes Interventions and Complications EET Exercise electrocardiogram test eGFR Estimated glomerular filtration rate ELIXA Evaluation of Lixisenatide in Acute Coronary Syndrome EMPA-REG OUTCOME Empagliflozin Cardiovascular Outcome Event

2019 European Society of Cardiology

130. Management of Poisoning

. Standards of medical care are determined on the basis of all clinical data available for an individual case and are subject to change as scienti? c knowledge advances and patterns of care evolve. The contents of this publication are guidelines to clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not ensure a successful outcome in every case, nor should they be construed as including all proper methods of care or excluding other (...) acceptable methods of care. Each physician is ultimately responsible for the management of his/her unique patient in the light of the clinical data presented by the patient and the diagnostic and treatment options available.Contents Page Executive summary of recommendations 1 1 Poison management systems 36 2 Principles of management of acute poisoning 55 3 Decontamination after poisoning 62 4 Enhancing the elimination of toxic substances from the body 75 5 Antidotes 80 6 Analgesics 84 7 Antihistamines

2020 Ministry of Health, Singapore

131. International Review – consent models for health information

is necessary for the purposes of carrying out the obligations and exercising specific rights of the controller ? processing is necessary to protect the vital interests of the data subject or of another natural person where the data subject is physically or legally incapable of giving consent ? processing is necessary for reasons of substantial public interest ? processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee (...) Statistics Office and health profession regulatory bodies. The definition of secondary purposes in the 2014 Act is quite narrowly cast: it includes ‘(d) the carrying out of health research that is the subject of a research ethics approval (or any cognate expression) under an enactment or European act prescribed for the purposes of this paragraph’. (12) 2.2.5 The Health (Provision of Information) Act 1997 The Health (Provision of Information) Act 1997 provides a general exception to the Data Protection

2020 HIQA Health Information

132. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children Full Text available with Trip Pro

published in 2018, serves as a regional representative to the UK NHS England Clinical Reference Group for commissioning pediatric specialist medicine care (immunology and infection ). Dr. Hall receives funding from La Jolla Pharmaceuticals (consultant on the data safety monitoring board for a clinical trial of a sepsis therapeutic), and he participates in the ATS (online journal club editor) and the American Board of Pediatrics (Critical Care Medicine sub-board). Dr. Ishimine participates in SAEM (...) , statistically summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations Assessment , Development , and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or weak, or as a best practice statement. In addition, “in our practice” statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate. Results: The panel

2020 Society of Critical Care Medicine

133. Mexiletine hydrochloride (Namuscla) - symptomatic treatment of myotonia in adult patients with non-dystrophic myotonic disorders

decrements that describe extreme impact of non-dystrophic myotonic on leisure activities and daily activities as well as extreme and moderate impact on mental health. All sensitivity analyses on cost and resource use parameters had a negligible impact on the ICER. Scenario analyses explored alternative data sources to inform compliance estimates, dosing schedules and alternative worst case assumptions for relating the worst INQoL rating to the worst EQ-5D score possible. The model results were relatively (...) experience stiffness in skeletal muscles but patients can also experience muscle weakness, pain and impairment in physical activity. Mexiletine is a class Ib antiarrhythmic medicine which acts by blocking sodium channels and is mainly active on muscle fibres subject to repeated discharges (such as skeletal muscle). It improves myotonic symptoms by decreasing muscle stiffness through reduction in the delay of muscle relaxation. 1, 2 The key evidence comes from a randomised, double-blind, phase III

2020 Scottish Medicines Consortium

134. A palliative approach to care in the last 12 months of life

information, please refer to Appendix C (Education Statements G ), the Ontario Palliative Care Network (OPCN) The Ontario Palliative Care Competency Framework—Nursing Competencies (summarized in Appendix K) and the Framework on Palliative Care in Canada (available at reports-publications/palliative-care/framework-palliative-care-canada.html#p2.3.1). In March 2017, RNAO convened an expert panel to determine the scope of this BPG. The RNAO (...) palliative care. Palliative care aims to: ? Relieve suffering and improve the quality of living and dying. ? Address the physical, psychological, social, spiritual (existential G ) and practical issues of persons and their families, and their associated expectations G , needs, hopes and fears. ? Prepare persons and their families for self-determined life closure and the dying process and help them manage it. ? Help families cope with loss and grief G during the illness and bereavement G experience

2020 Registered Nurses' Association of Ontario

135. Macrosomia

) 4,500–4,999 g, and 3) more than 5,000 g. Frequency of Occurrence Data from the National Center for Health Statistics show that 7.8% of all live-born newborns in the United States weigh 4,000 g or more (6). Only 1% weigh more than e18 VOL. 135, NO. 1, JANUARY 2020 OBSTETRICS & GYNECOLOGY4,500 g and 0.1% more than 5,000 g. The rate of new- borns weighing at least 4,000 g has decreased in the United States from the reported rate of 10% in 1996 (7). Women with gestational diabetes mellitus (GDM (...) 2020 Practice Bulletin Macrosomia e23analysis of overweight women or women with GDM, combined diet plus exercise resulted in a 15% reduced risk of macrosomia (RR 0.85; 95% CI, 0.73 to 1.00). Similarly, in a recent meta-analysis using individual par- ticipant data, there was no decrease in LGA or GDM, although less weight gain occurred in the dietary inter- vention arms compared with the control group (109). Control of maternal hyperglycemia reduces the risk of macrosomia; therefore, maternal

2020 American College of Obstetricians and Gynecologists

136. Clinical Practice Guideline on the Management of Rotator Cuff Injuries

Unsupervised Exercise 58 View background material via the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 6 Multiple Steroid Injections for Rotator Cuff Tears 58 Platelet Rich Plasma (PRP) Injection in Full-Thickness Tears 58 Partial Rotator Cuff Tear 58 Unrepairable Tears without Arthropathy (Non-Reverse Arthroplasty) 59 Massive, Unrepairable Rotator Cuff Tear (Reverse Arthroplasty) 59 Unrepairable Tears with Arthropathy 59 References 60 Guideline Development Group Disclosures 77 View (...) the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 14 SUMMARY OF CONSENSUS STATEMENTS There is no or conflicting supporting evidence. In the absence of reliable evidence, the systematic literature review development group is making a recommendation based on their clinical opinion. SUPERVISED EXERCISE VS UNSUPERVISED EXERCISE In the absence of reliable evidence, it is the opinion of the work group that supervised physical therapy is more appropriate than unsupervised home exercise

2020 American Academy of Orthopaedic Surgeons

137. What works to improve early grade literacy in Latin America and the Caribbean? A systematic review and meta?analysis Full Text available with Trip Pro

an emphasis on a specific program. We defined these studies as “qualitative nonintervention studies.” 2.5 Data collection and analysis We systematically coded information from the studies included in the review and critically appraised them. We conducted statistical meta‐analysis and sensitivity analysis using the data extracted from quantitative experimental and quasiexperimental studies. We also used narrative synthesis techniques to synthesize the findings from qualitative studies and studies (...) the average and statistically significant effects of development programs on EGL outcomes, but a narrative synthesis of the limited number of high‐quality quantitative intervention studies did show some examples of development programs that may have positive effects on EGL outcomes in specific circumstances and contexts. For example, a meta‐analysis that focused on teacher training did not show positive effects on EGL outcomes (95% confidence interval [CI] = −0.17, 0.48; evidence from two programs

2019 Campbell Collaboration

138. Surgical mesh repair of primary inguinal hernia in men

=0.0004 118 vs. 76 p 0) when resting, coughing, rising from lying to sitting or during physical activity. Following surgery, quality of life scores improved significantly for all domains of the SF36. The VAS pain scores were negatively correlated with post-surgery quality of life on the SF36, with the strongest correlation between VAS score and the SF36 bodily pain domain. Compared with patients who reported no post-operative pain, patients with pain at 6 months follow-up had significantly lower (...) having a groin hernia and having hernia repair surgery affected many aspects of patient’s lives, including work/employment, exercise, mental health and relationships. For a more detailed summary of the results of the engagement exercise, and a complete listing of relevant comments received, please see the Groin Hernia Public Engagement Survey Feedback Report which is available on the Healthcare Improvement Scotland website alongside this advice. Organisational issues/Context A groin hernia service

2020 SHTG Advice Statements

139. Diagnosis and Treatment of Low Back Pain

. Chutkan, MD, FACS Adam C. Lipson, MD Anthony J. Lisi, DC Tom E. Reinsel, MD Robert L. Rich, MD; Stakeholder Representative, American Academy of Family Physicians (AAFP) Contributor: Robert C. Nucci, MD Imaging Section Section Co-Chairs: Charles H. Cho, MD, MBA Gary Ghiselli, MD Authors: Sean D. Christie, MD Bernard A. Cohen, PhD S. Raymond Golish, MD, PhD, MBA Murat Pekmezci, MD Walter S. Bartynski, MD; Stakeholder Representative, American Society of Spine Radiology (ASSR) Medical & Psychological (...) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 II. Guideline Development Methodology and Process 8 III. Glossary and Acronyms 12 IV . Guideline De finition and Inclusion/Ex clusion Crit eria 16 V. Summary of Recommendations 17 VI. Recommendations for Diagnosis and Treatment of Low Back Pain 40 A. Diagnosis 40 B. Imaging 60 C. Medical and Psychological Treatment 69 D. Physical Medicine & Rehabilitation 101 E. Interventional T reatment 158 F. Surgical T reatment 190 G. Cost-Utility 198 VII. Appendices 213 A full bibliography and technical

2020 North American Spine Society

140. Osseointegrated Prosthetic Implants for People With Lower-Limb Amputation

(Integral Leg Prosthesis, ILP) 13 Osseointegration Group of Australia–Osseointegration Prosthetic Limb (OGAP-OPL) 13 Other Systems in Development 13 Regulatory Information 14 Ontario Context 14 Expert Consultation 15 PROSPERO Registration 15 CLINICAL EVIDENCE 16 Research Question 16 Methods 16 Clinical Literature Search 16 Eligibility Criteria 16 Literature Screening 17 Data Extraction 17 Statistical Analysis 18 Critical Appraisal of Evidence 18 Results 18 Literature Search 18 Characteristics (...) of bias Statistical Analysis Performing a meta-analysis by pooling data for each outcome was not possible because of substantial variation in duration of follow-up, implant systems, and treatment protocols among the studies. Instead, we did a qualitative synthesis of the included studies, summarizing outcomes in tables. We compared functional and quality-of-life outcomes where reported for before and after surgery, stratifying outcomes by implant type and treatment protocol. For harm outcomes, we used

2019 Health Quality Ontario

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