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161. Ustekinumab (Stelara) - For the treatment of adult patients with moderately to severely active ulcerative colitis

-score >1. 4 At week 8, clinical remission was achieved by a significantly greater proportion of patients in 4 both the ustekinumab 6mg/kg and ustekinumab 130mg groups compared with those in the placebo group. 3, 4 At week 44, a significantly greater proportion of patients were in clinical remission in both the ustekinumab 12 weekly group and 8 weekly group compared with the placebo group. 3, 4 A hierarchical statistical testing strategy was applied in the study for key secondary outcomes (...) , with no formal testing of outcomes after the first non-significant outcome in the hierarchy. All key secondary outcomes achieved statistical significance in favour of ustekinumab over placebo with the exception of maintaining clinical remission in those who were in clinical remission at baseline in the maintenance study (ustekinumab 8 weekly treatment group). Results for the primary and key secondary outcomes are included in Tables 2 and 3. Table 2: Primary and key secondary outcomes at week 8 of the UNIFI

2020 Scottish Medicines Consortium

162. Consensus Practice Guidelines on Interventions for Lumbar Facet Joint Pain

assigned to 4–5 person modules, who worked with the Subcommittee Lead and Committee Chair on preliminary versions, which were sent to the full committee. We used a modified Delphi method, whereby the questions were sent to the committee en bloc and comments were returned in a non- blinded fashion to the Chair, who incorporated the comments and sent out revised versions until consensus was reached. r esults 17 questions were selected for guideline development, with 100% consensus achieved by committee

2020 American Academy of Pain Medicine

163. Review of restrictive public policy measures to limit COVID-19

; ? cancellation of all sporting events, including those played behind closed doors; ? closure of playgrounds and holiday or caravan parks; ? restriction on all organised social indoor or outdoor events of any size, such as parties or weddings; ? closure of non-essential retail outlets; ? everyone must exercise within a two kilometre radius of their house. To limit the spread of COVID-19, governments around the world are also implementing strict public policy measures, such as restricting the movement (...) cancelled including the Saudi Olympics, and sports centres, parks and gyms have been closed, as is the case in the United Arab Emirates and Serbia. In some countries, the data was unclear, such as in Spain and Pakistan, for example. Sweden have not imposed any restrictions. (53) Public transport restrictions Public transport restrictions have been implemented in many countries. Currently Ireland is providing public transport, but this is restricted to those who are buying food or medicines, carers

2020 Health Information and Quality Authority

164. Diagnosis and Treatment of Clinical Alzheimer’s-Type Dementia

with suspected cognitive impairment had several limitations. We found few eligible studies for most individual cognitive tests, fewer for test combinations, none for several common tests (e.g., Mini-Cog, Saint Louis University Mental Status test [SLUMS], Telephone Interview for Cognitive Status [TICS]), and minimal data on web-based tests. Similarly, few studies evaluated the accuracy of brain imaging and CSF tests compared with autopsy-confirmed diagnoses, and none examined blood tests. Studies for both (...) of quetiapine showed no difference in mean change for agitation compared with placebo. No eligible trials of antipsychotics reported data on stroke and just three (n=451) reported data on deaths (4.4% for the antipsychotic group vs. 1.8% for placebo), too few to draw conclusions but not inconsistent with FDA warnings. 1, 2 For antidepressants, one trial of citalopram up to 30 mg/day reported statistically significant improvement compared with placebo for a minority of agitation and psychosis outcomes

2020 Effective Health Care Program (AHRQ)

165. Opioid Treatments for Chronic Pain

Report: Highlights of the 2010 Drug Abuse Warning Network (DAWN) findings on drug-related emergency department visits. Rockville, MD: Substance Abuse and Mental Health Services Administration; Center for Behavioral Health Statistics and Quality; 2012. https://www.samhsa.gov/data/sites/default/fi les/DAWN096/DAWN096/SR096EDHighli ghts2010.htm. 5. Dowell D, Haegerich TM, Chou R. CDC Guideline for prescribing opioids for chronic pain--United States, 2016. JAMA. 2016 Apr 19;315(15):1624-45. doi: https (...) and mental functioning and reduced quality of life, and is the leading cause of disability in the United States. 1 Chronic pain is caused by a variety of conditions and is influenced by multiple biological, psychological, and social factors. Therefore, optimal approaches to the management of chronic pain should consider psychological and social factors as well as underlying biological mechanisms and physical manifestations of chronic pain (the “biopsychosocial” framework or perspective). 3 Opioids

2020 Effective Health Care Program (AHRQ)

166. Nonopioid Pharmacologic Treatments for Chronic Pain

No evidence No evidence QoL = quality of life; SOE = strength of evidence; MCS = Mental Component Score; PCS = Physical Component Score Effect size: none (i.e., no effect/no statistically significant effect), small, moderate, or large increased risk SOE: + = low, ++ = moderate, +++ = high Table D. Effects of anticonvulsants in placebo-controlled and head-to-head trials Condition Drug Pain Short Term Effect Size SOE Function Short Term Effect Size SOE QoL Short Term Effect Size SOE Neuropathic pain (...) %), reflecting statistical heterogeneity. See Appendix B for additional details on data synthesis. 8 Grading the Strength of Evidence for Major Comparisons and Outcomes The strength of evidence (SOE) was rated for priority clinical outcomes (pain, function, quality of life) for each pain condition-treatment pair, using the approach described in the AHRQ Methods Guide. 21 To ensure consistency and validity of the evaluation, the grades were reviewed by a second reviewer. The domains assessed were study

2020 Effective Health Care Program (AHRQ)

167. Noninvasive Nonpharmacological Treatment for Chronic Pain

for common chronic pain conditions. Key Messages • Interventions that improved function and/or pain for =1 month: o Low back pain: Exercise, psychological therapy, spinal manipulation, low-level laser therapy, massage, mindfulness-based stress reduction, yoga, acupuncture, multidisciplinary rehabilitation (MDR) o Neck pain: Exercise, low-level laser, mind-body practices, massage, acupuncture o Knee osteoarthritis: Exercise, cognitive behavioral therapy (CBT) o Hip osteoarthritis: Exercise, manual (...) no effects on intermediate-term (5 trials [2 new]) or long-term (1 trial) function (SOE: moderate for short term, low for intermediate and long term). For pain, exercise was associated with moderate effects versus usual care, an attention control, or a ES-6 placebo intervention at short-term (11 trials [5 new]) and long-term (1 trial), and a small effect at intermediate-term (5 trials [2 new]) followup (SOE: low). • Psychological Therapies: Psychological therapy (cognitive behavioral therapy [CBT

2020 Effective Health Care Program (AHRQ)

168. EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke

is increasing in this group [1]. Stroke is a heterogeneous condition with a variety of underlying mechanisms and causes. The risk of stroke is a?ected by non-modi?able (e.g.age,familyhistory)andpotentiallymodi?ablefac- tors (e.g. hypertension, current smoking, alcohol con- sumption, obesity, diabetes, lack of physical activity, psychosocialstressanddepression)[2]. Sleep–wake disorders (SWDs) are very frequent in the general population and have a major impact on performance, quality of life as well (...) . • Eight primary studies of class II and III quality were included [132,134–140]. Overview of the evidence. In a study of 277 consecutive patients assessed in the ?rst month after onset 56.7% had complaints of insomnia and 37.5% had insomnia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV criteria [135]. In 18% of patients, insomnia appeared for the ?rst time (de novo) after brain damage (Table S18). In a study of 100 stroke patients, complaints of insomnia (as assessed

2020 European Academy of Neurology

169. Monogenic cerebral small-vessel diseases

monogenic cause of cSVD, after genetic diagnosis the vascular risk factor pro?le of patients with monogenic cSVD should be carefully evaluated and lifestyle changes such as stopping smoking, healthy diet and physical exercise should be advised 4.84 100 Patients with cSVD should have a yearly evaluation of their vascular risk factor pro?le 4.92 100 At genetic diagnosis of cSVD, a cerebral MRI should be considered, irrespective of signs or symptoms 4.15 84.6 Follow-up cerebral MRI is not indicated unless (...) childbirth 4.71 100 Antiplatelet and anticoagulant treatments are not recommended in COL4A1/2 cSVD 4.71 100 (continued) 2020 European Academy of Neurology MONOGENIC CEREBRAL SMALL-VESSEL DISEASE RECOMMENDATIONS 5Table 1 (Continued) Query Mean score Percentage of people voting 4or5 Intravenous thrombolysis is not recommended in a patient with a diagnosis of COLA1/2 cSVD 4.71 100 Sporting activities with a high risk of head trauma or excessive or prolonged exercise should be avoided in a patient

2020 European Academy of Neurology

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

benefit and should be considered first-line therapy for patients with T2DM and CAD whose triglycerides remain elevated (>135 mg/dL) despite maximally tolerated statin and lifestyle changes, as now recommended in the American Diabetes Association Standards of Medical Care. Lifestyle Modification and Weight Management Lifestyle and health behavior management, including smoking cessation, heart-healthy diet, weight loss (if overweight or obese), sleep and stress management, and exercise/physical activity (...) outcomes. In addition to obstructive sleep apnea, insufficient or short sleep duration without obstructive sleep apnea has been associated with adverse effects on serum lipids, insulin resistance, and perturbations of the autonomic nervous system associated with CAD. Physical Activity and Exercise The American Diabetes Association guidelines recommend that patients interrupt prolonged sitting with light activity every 30 minutes and engage in at least 150 min/wk of moderate to vigorous physical

2020 American Heart Association

171. Addressing Social Determinants of Health in the Care of Patients With Heart Failure: A Scientific Statement From the American Heart Association

more walkable communities amenable to physical activity. Yet, in the more focused context of clinical care of patients with HF, physical activity recommendations must be tailored to fit the patient’s home environment or to help the patient identify an accessible place (eg, community center) more suitable for exercise given functional capabilities. Race, Ethnicity, Sex, Age, and Sexual Minorities Race, defined as self-identified physical and genetic traits shared by a group of people, and its (...) to support health and suggest a potential opportunity for closing the gap in access to care for the poor and underserved. , One mainstay of HF self-care recommendations is physical activity. , However, many individuals with HF may be less able to implement those recommendations because of either the absence of accessible sidewalks or green space or perceptions of lower physical safety. There is a role for broader societal approaches to better facilitate physical activity for some individuals by building

2020 American Heart Association

172. Open versus Closed: The Risks Associated with Retail Liquor Stores during COVID-19

/canada/article-amid-coronavirus-prince-edward-islanders- scramble-to-stockpile-liquor/ Paradis, C., Demers, A., Picard, E., & Graham, K. (2009). The importance of drinking frequency in evaluating individuals' drinking patterns: Implications for the development of national drinking guidelines. Addiction, 104(7), 1179–1184. Pearson, C., Janz, T., & Alis, J. (2012). Mental and substance use disorders in Canada. Ottawa, Ont.: Statistics Canada. Retrieved from https://www150.statcan.gc.ca/n1/pub/82-624- x (...) (St. John, 2020). In Quebec, a spokesperson for the Société des alcools du Québec reported that since the beginning of the COVID-19 crisis, shops have been as busy as during the holidays and online sales resemble those of Black Friday (Lortie, 2020). The Canadian drinking culture is one where alcohol consumption serves as a boundary between weekday and weekend, work and leisure; it marks a “time out” (Paradis, Demers, Picard, & Graham, 2009). With the ongoing threat of COVID-19

2020 Canadian Centre on Substance Abuse

173. Prostate Cancer

, 2014. 23: 1494. 50. Nyame, Y.A., et al. Associations Between Serum Vitamin D and Adverse Pathology in Men Undergoing Radical Prostatectomy. J Clin Oncol, 2016. 34: 1345. 51. Cui, Z., et al. Serum selenium levels and prostate cancer risk: A MOOSE-compliant meta-analysis. Medicine (Baltimore), 2017. 96: e5944. 52. Allen, N.E., et al. Selenium and Prostate Cancer: Analysis of Individual Participant Data From Fifteen Prospective Studies. J Natl Cancer Inst, 2016. 108. 53. Lippman, S.M., et al. Effect (...) Multiparametric Prostate Resonance Imaging with Subsequent Magnetic Resonance-guided Biopsy in Biopsy-naive Men with Elevated Prostate-specific Antigen: A Large Prospective Multicenter Clinical Study. Eur Urol, 2018. S0302: 30880. 170. Weinreb, J.C., et al. PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2. Eur Urol, 2016. 69: 16. 171. Rosenkrantz, A.B., et al. Interobserver Reproducibility of the PI-RADS Version 2 Lexicon: A Multicenter Study of Six Experienced Prostate Radiologists

2020 European Association of Urology

174. European Academy of Neurology guideline on the management of medication-overuse headache

. At week 24, statistically signi?cant results favoring onabotulinum toxin A versus placebo were observed for headache days (primary endpoint: 8.2 vs. 6.2; P < 0.001). Signi?cant bene?t was observed for sec- ondary endpoints such as frequencies of migraine days (P < 0.001), moderate/severe headache days (P < 0.001), cumulative headache hours on headache days (P < 0.001), headache episodes (P = 0.028) and migraine episodes (P = 0.018) [56]. A post hoc analysis of the pooled data obtained from these two (...) -mg groups, =50% reductions in monthly migraine days were achieved by 18%, 36% [oddsratio(95%con?denceintervals),2.67(1.36–5.22)] and 35% [odds ratio, 2.51 (1.28–4.94)]. Erenumab 70- and 140-mg treatment arms had statistically signi?cant and clinically meaningful improvements in headache- related disability measured both by the Headache Impact Test-6 and Migraine Disability Assessment Scale. These data support the use of erenumab in patients with chronic migraine, including those with MOH[62

2020 European Academy of Neurology

175. EAN guideline on palliative care of people with severe, progressive multiple sclerosis

. Patti t , R. Voltz u,v , D. Oliver w and on behalf of the guideline task force , * a Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan; b Department of Psychology, University of Turin, Turin, Italy; c Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d’Hebron, Universitat Aut onoma de Barcelona, Barcelona, Spain; d Institute of Clinical Nursing Science, University of Cologne, Cologne; e Institute (...) Keywords: clinical practice guideline, GRADE assessment, multiple sclerosis, palliative care Received 3 March 2020 Accepted 25 March 2020 European Journal of Neurology 2020, 0: 1–20 doi:10.1111/ene.14248 Background and purpose: Patients with severe, progressive multiple sclerosis (MS) have complex physical and psychosocial needs, typically over several years. Few treatment options are available to prevent or delay further clinical worsen- ing in this population. The objective was to develop an evidence

2020 European Academy of Neurology

176. The impact of care farms on quality of life, depression and anxiety among different population groups: A systematic review (Full text)

aim to support offenders by developing self‐esteem and providing work‐based skills that provide hope for the future. Being able to be physically active in nature may help to improve both the physical and mental well‐being of older people (Elings, Haubenhofer, Hassink, Rietberg, & Michon, ). Levels of depression and anxiety are often higher among these groups than the general populations (Pedersen et al., 2011), and findings suggest that depression can cause worse health outcomes in older people (...) also provide support for offenders referred from probation services either as a rehabilitative intervention or as a way of “paying‐back” to the community for crimes committed (Elsey et al., ). Elderly people, including those with dementia, are a more recent group to use care farming (Elings et al., ). Care farms can offer an alternative to day centres by providing a home from home environment that can involve some outdoor work for mental stimulation and physical activity. The number of care farms

2019 Campbell Collaboration PubMed abstract

177. Consensus Practice Guidelines on Interventions for Lumbar Facet Joint Pain from a Multispecialty, International Working Group (Full text)

to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: . Statistics from Altmetric.com Introduction There are few conditions in interventional pain medicine as controversial as lumbar facet joint pain. Everything from incidence, to diagnostic criteria, patient selection for interventions and the effectiveness (...) represented the Department of Defense in interagency and task force guidelines. Supplementary data The Lumbar Facet Intervention Guidelines Committee was charged with preparing guidelines on the use of facet blocks and RFA that span the entire spectrum of care to include patient selection, optimizing accuracy, interpreting results and risk mitigation. Questions and formats were developed by the committee chair based on input from the committee, and refined during conference calls. Guidelines

2020 American Society of Regional Anesthesia and Pain Medicine PubMed abstract

178. Overview of pregnancy complications

=bestpractice.com Zhang C, Solomon CG, Manson JE, et al. A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Arch Intern Med. 2006 Mar 13;166(5):543-8. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/409910 http://www.ncbi.nlm.nih.gov/pubmed/16534041?tool=bestpractice.com and prior gestational diabetes. Kim C, Berger DK, Chamany S. Recurrence of gestational diabetes mellitus: a systematic review. Diabetes Care (...) , but the onset of a depressive episode within 4 weeks of childbirth can be recorded via the postpartum-onset specifier in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., (DSM-5). Washington, DC: American Psychiatric Publishing; 2013. There is evidence to suggest that the DSM-5 specifier is too narrow. Forty L, Jones L, Macgregor S, et al. Familiality of postpartum depression in unipolar

2018 BMJ Best Practice

179. Chronic fatigue syndrome/Myalgic encephalomyelitis

considered historical precedents of CFS/ME. Sigurdsson B. Clinical findings six years after outbreak of Akureyri disease. Lancet. 1956 May 26;270(6926):766-7. http://www.ncbi.nlm.nih.gov/pubmed/13320872?tool=bestpractice.com The World Health Organization classifies CFS/ME as a neurological illness. World Health Organization. International classification of diseases 11th revision for mortality and morbidity statistics (ICD-11 MMS). 2018 [internet publication]. https://icd.who.int/browse11/l-m/en History (...) syndrome versus myalgic encephalomyelitis/chronic fatigue syndrome. Fatigue. 2013 Jun 1;1(3):168-83. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728084/ http://www.ncbi.nlm.nih.gov/pubmed/23914329?tool=bestpractice.com PEM has been described as a group of symptoms following mental or physical exertion, lasting 24 hours or more. Symptoms of PEM include fatigue, headaches, muscle aches, cognitive deficits, and insomnia. It can occur after even simple tasks (e.g., walking, or holding a conversation

2018 BMJ Best Practice

180. Cardiac arrhythmias in coronary heart disease

recommendations that should be prioritised for implementation. 2.1 ARRHYTHMIAS ASSOCIATED WITH CARDIAC ARREST R Efforts to prevent sudden cardiac death should include: y risk factor intervention in those individuals who are at high risk for coronary heart disease y health promotion measures and encouragement of moderate-intensity physical activity in the general population. 2.2 ARRHYTHMIAS ASSOCIATED WITH ACUTE CORONARY SYNDROME R All patients with ST-elevation acute coronary syndrome should undergo (...) QRS duration, and it could have a potentially harmful effect in patients with a QRS duration of less than 126 milliseconds. In the absence of robust data for this particular patient group (QRS of 120–149 milliseconds) and the risk of harm, a more cautious approach to the use of CRT was suggested for these patients. 139 Shocks from the devices are associated with poor psychological outcomes, although the reassurance patients experience from having the device may outweigh the anxiety over shocks

2018 SIGN

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