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Cerebrovascular Accident Risk in Women


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101. What national and subnational interventions and policies based on Mediterranean and Nordic diets are recommended or implemented in the WHO European Region, and is there evidence of effectiveness in reducing noncommunicable diseases?

) and abdominal adiposity (waist circumference: >102 cm for men, >88 cm for women), which are key risk factors for CVD, diabetes and some cancers. 2.2.2. Swedish dietary guidelines The Swedish national dietary guidelines are based on the 2012 NNR, with consideration of Swedish food culture and the ability of local consumers to adhere to recommendations (62). The guidelines promote three key messages: (i) eat more berries, fish, fruit, nuts, seeds, shellfish and vegetables; (ii) switch to whole grains, healthy (...) ischaemic heart disease) (62). The study found that adherence to the high-quality diet may reduce the risk of CVD events (by 32% in men and 27% in women).WHAT NATIONAL AND SUBNATIONAL INTERVENTIONS AND POLICIES BASED ON MEDITERRANEAN AND NORDIC DIETS ARE RECOMMENDED OR IMPLEMENTED IN THE WHO EUROPEAN REGION, AND IS THERE EVIDENCE OF EFFECTIVENESS IN REDUCING NONCOMMUNICABLE DISEASES? HEALTH EVIDENCE NETWORK SYNTHESIS REPORT 26 Study Method Findings Cross-sectional study; 6717 aged 35–69 years (77% women

2018 WHO Health Evidence Network

102. The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea Guideline

program and have no contraindications or active cardiovascular disease, we suggest an evaluation for potential antiobesity pharmacotherapy (conditional recommendation, very low certainty in the estimated effects). REMARKS. “Active cardiovascular disease” refers to a myocardial infarction or cerebrovascular accident within the past 6 months, uncontrolled hypertension, life- threatening arrhythmias, or decompensated congestive heart failure. Question 7: Should Bariatric Surgery Be Recommended (Rather (...) maybedifferentbasedonethnicand/orracial differences de?ning the risks for weight- related disorders in different populations. Methods This clinical practice guideline was developed in accordance with ATS policies and procedures. Panel Composition Theprojectwasproposedbythechairandco- chair through the ATS Sleep and Respiratory NeurobiologyAssemblyandwasapprovedby theATSBoardofDirectors.Potentialpanelists were identi?ed by the chair and co-chair on the basis of their expertise in sleep-disordered breathing, weight management

2018 American Thoracic Society

103. AIM Clinical Appropriateness Guidelines for Advanced Imaging of the Heart

aneurysm; OR ? Established and symptomatic peripheral vascular disease; OR ? Prior history of cerebrovascular accident (CVA), transient ischemic attack (TIA) or carotid endarterectomy (CEA) or high grade carotid stenosis (>70%); OR ? Chronic renal insufficiency or renal failure; OR ? Patients who have undergone cardiac transplantation and have had no evaluation for coronary artery disease within the preceding one (1) year; OR ? Patients in whom a decision has been made to treat with interleukin 2 (...) ; OR ? Abdominal aortic aneurysm; OR ? Established and symptomatic peripheral vascular disease; OR ? Prior history of cerebrovascular accident (CVA), transient ischemic attack (TIA) or carotid endarterectomy (CEA) or high grade carotid stenosis (>70%); OR ? Chronic renal insufficiency or renal failure; OR ? Patients who have undergone cardiac transplantation; OR ? Patients in whom a decision has been made to treat with Interleukin 2; OR ? Patients awaiting solid organ transplantation Established coronary

2018 AIM Specialty Health

104. Appropriate Use Criteria: Imaging of the Head & Neck

Diagnostic Indications Vascular indications This section contains indications for aneurysm, cerebrovascular accident/transient ischemic attack, congenital/developmental vascular anomalies, hemorrhage/hematoma, and venous thrombosis. Aneurysm ? Screening in asymptomatic high-risk individuals ? At least two (2) first degree relatives with intracranial aneurysm or subarachnoid hemorrhage ? Presence of a heritable condition which predisposes to intracranial aneurysm (examples include autosomal dominant (...) -up after treatment with clips, endovascular coil or stenting Cerebrovascular accident (CVA or stroke) and transient ischemic attack (TIA) Diagnosis of signs or symptoms suggestive of acute infarction Note: CT is preferred for evaluation of acute intracranial hemorrhage. MRI is preferred for evaluation of subacute and chronic hemorrhage. Management of CVA when imaging is required to direct treatment Congenital or developmental vascular anomaly Diagnosis or management of known or suspected vascular

2018 AIM Specialty Health

105. Adults With Congenital Heart Disease

control for women of child-bearing potential (intrauterine device may be a preferred option). Avoidance of birth control entirely is not a safe, acceptable option. • Patients can travel safely on commercial airlines without undue risk (S3.16-23). Preflight simulation testing or mandated supplemental oxygen are not usually indicated, although adequate hydration and movement during the flight are appropriate. • Measurement of coagulation parameters (e.g., activated partial thromboplastin time (...) size and rate of progression. Pregnancy in Turner syndrome, which often requires assisted reproductive technology, is associated with an increased risk of aortic dissection, especially if there is a preexisting abnormality of the aortic valve or aorta (S4.2.4.1-4). Recommendation-Specific Supportive Text 1. Women with Turner syndrome are at substantial risk of BAV, CoA, and aortic enlargement, which can result in morbidity and mortality if left untreated. Therefore, evaluation is necessary to help

2018 American College of Cardiology

106. Adult Urodynamics

(SCI), multiple sclerosis, Parkinson's disease, stroke/cerebrovascular accident, traumatic brain injury, myelomeningocele (MMC), brain or spinal cord tumor, transverse myelitis, back or spine disease (including herniated disk, cauda equina syndrome), diabetes, peripheral nerve injury and other lower motor neuron diseases. Neurogenic bladder dysfunction can include problems of bladder storage (including ability to maintain continence) as well as bladder emptying and also introduces the concern (...) then re-filled to an acceptable volume. The catheter may then be removed and the LPP measured. The risks/harms of removing the catheter for LPP testing include loss of the ability to measure intravesical pressure at the time of stress leakage, the additional risk of UTI or trauma as a result of catheter removal and reinsertion and the additional time and potential expense if the catheter becomes contaminated. Close Guideline Statement 5 In women with high grade POP but without the symptom of SUI

2018 American Urological Association

107. Evaluation and Management of Testosterone Deficiency

hemoglobin and hematocrit and inform patients regarding the increased risk of polycythemia. (Strong Recommendation; Evidence Level: Grade A) 12. PSA should be measured in men over 40 years of age prior to commencement of testosterone therapy to exclude a prostate cancer diagnosis. (Clinical Principle) Counseling Regarding Treatment of Testosterone Deficiency 13. Clinicians should inform testosterone deficient patients that low testosterone is a risk factor for cardiovascular disease. (Strong (...) Recommendation; Evidence Level: Grade B) 18. Patients with testosterone deficiency and a history of prostate cancer should be informed that there is inadequate evidence to quantify the risk-benefit ratio of testosterone therapy. (Expert Opinion) 19. Patients should be informed that there is no definitive evidence linking testosterone therapy to a higher incidence of venothrombolic events. (Moderate Recommendation; Evidence Level: Grade C) 20. Prior to initiating treatment, clinicians should counsel patients

2018 American Urological Association

108. Improving Quality of Life: Substance Use and Aging

, becoming noticeable only later in life. And although prevalence of substance use is much lower among older adults than other age groups, they are at elevated risk for experiencing harms associated with non-prescription substance use. Most importantly, we know quality of life can be improved significantly by addressing problematic substance use, regardless of a person’s age. Older adults can indeed live long, healthy and productive lives while in recovery. Unfortunately, addressing the issue (...) for the healthcare system, and why treating these complex cases requires new and innovative approaches. Licit and Illicit Drug Use during Pregnancy addressed the medical and obstetrical consequences of problematic drug use and dependency in pregnant women, as well as the short- and long-term effects that prenatal exposure to drugs can have on a child’s development. Childhood and Adolescent Pathways to Substance Use Disorders explored influences during childhood and adolescence that can affect problematic

2018 Canadian Centre on Substance Abuse

109. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update

risk of hypertension in insomnia with objectively measured short sleep duration (II) ? Absenteeism, accidents at work and road accidents are increased in insomnia (II) What is not known ? What are the potential confounding effects of medication and comorbid disorders in reports of increased accidents? ? To what extent do treatments rectify the health risks of insomnia? Severallargestudieshavedemonstratedreducedqualityoflife, increasedfunctionalimpairmentandincreasedhealthcarecosts in insomnia (...) and depression, or by physical illness such as cancer or arthritis. The nature of sleep changes with age. Older age is associ- atedwithpoorerobjectivelymeasuredsleepwithshortersleep time,diminishedsleepe?ciency,andmorearousals,andthese changesmaybemoremarkedinmenthaninwomen,accord- ingtoaverylargestudyofelderlypeoplelivingathomeinthe USA (Sleep Heart Health Study, Unruh et al., 2008). In the same study the association of subjective report of poor sleep with older age was stronger in women. The higher

2019 British Association for Psychopharmacology

110. Urolithiasis

undergoing urologic surgery: is it still no man’s land? Eur Urol, 2013. 64: 101. 271. Eberli, D., et al. Urological surgery and antiplatelet drugs after cardiac and cerebrovascular accidents. J Urol, 2010. 183: 2128. 272. Razvi, H., et al. Risk factors for perinephric hematoma formation after shockwave lithotripsy: a matched case-control analysis. J Endourol, 2012. 26: 1478. 273. Rassweiler, J.J., et al. Treatment of renal stones by extracorporeal shockwave lithotripsy: an update. Eur Urol, 2001. 39: 187 (...) Int, 2003. 63: 1817. 10. Hesse, A., et al. Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000. Eur Urol, 2003. 44: 709. 11. Sanchez-Martin, F.M., et al. [Incidence and prevalence of published studies about urolithiasis in Spain. A review]. Actas Urol Esp, 2007. 31: 511. 12. Zhe, M., et al. Nephrolithiasis as a risk factor of chronic kidney disease: a meta-analysis of cohort studies with 4,770,691 participants. Urolithiasis, 2017. 45: 441. 13. Yasui

2018 European Association of Urology

111. Neuro-urology

tract symptoms (LUTS) in stroke patients: a cross-sectional, clinical survey. Neurourol Urodyn, 2008. 27: 763. 13. Marinkovic, S.P., et al. Voiding and sexual dysfunction after cerebrovascular accidents. J Urol, 2001. 165: 359. 14. Rotar, M., et al. Stroke patients who regain urinary continence in the first week after acute first-ever stroke have better prognosis than patients with persistent lower urinary tract dysfunction. Neurourol Urodyn, 2011. 30: 1315. 15. Lobo, A., et al. Prevalence (...) . Med Clin North Am, 2011. 95: 111. 48. Çetinel, B., et al. Risk factors predicting upper urinary tract deterioration in patients with spinal cord injury: A retrospective study. Neurourol Urodyn, 2017. 36: 653. 49. Elmelund, M., et al. Renal deterioration after spinal cord injury is associated with length of detrusor contractions during cystometry-A study with a median of 41 years follow-up. Neurourol Urodyn., 2016. 50. Ineichen, B.V., et al. High EDSS can predict risk for upper urinary tract damage

2018 European Association of Urology

112. Male Sexual Dysfunction

in the general population. Urology, 2001. 57: 970. 6. Kulmala, R.V., et al. Priapism, its incidence and seasonal distribution in Finland. Scand J Urol Nephrol, 1995. 29: 93. 7. Furtado, P.S., et al. The prevalence of priapism in children and adolescents with sickle cell disease in Brazil. Int J Hematol, 2012. 95: 648. 8. Adeyoju, A.B., et al. Priapism in sickle-cell disease; incidence, risk factors and complications - an international multicentre study. BJU Int, 2002. 90: 898. 9. Emond, A.M., et al. Priapism (...) of general male health status? The case for the International Index of Erectile Function-Erectile Function domain. J Sex Med, 2012. 9: 2708. 31. Dong, J.Y., et al. Erectile dysfunction and risk of cardiovascular disease: meta-analysis of prospective cohort studies. J Am Coll Cardiol, 2011. 58: 1378. 32. Gandaglia, G., et al. A systematic review of the association between erectile dysfunction and cardiovascular disease. Eur Urol, 2014. 65: 968. 33. Gupta, B.P., et al. The effect of lifestyle modification

2018 European Association of Urology

113. Recent mortality trends in Glasgow: 1981-2015

9), it can be seen that, in 1981, the two most common causes of death were cancer (29%) and cerebrovascular disease (13%). In 2015, the most common causes were drug related (25%) and cancer (19%). In the rest of Scotland, the two most common causes of death among women aged 15-44 in 1981 were cancer (34%) and motor vehicle traffic accidents (10%), and in 2015 they were cancer (24%) and drug related (15%) (data not shown). Figure 9: Relative distribution of causes of death, 1981-2015, Glasgow (...) , women aged 15-44. Among Glaswegian men, the most common causes of death in 1981 were motor vehicle traffic accidents (14%) and cancer (14%), while, in 2015, the most common causes were drug related (30%), and suicide and self-inflicted injury (14%) (Figure 10). 20 In the rest of Scotland, the most common causes of death among men aged 15-44 in 1981 were also motor vehicle traffic accidents (19%) and cancer (14%), while in 2015, as in Glasgow, the majority of deaths among men in this age group were

2017 Glasgow Centre for Population Health

114. Acute coronary syndrome

Acute coronary syndrome SIGN 148 • Acute coronary syndrome A national clinical guideline April 2016 EvidenceKEY TO EVIDENCE STATEMENTS AND RECOMMENDATIONS LEVELS OF EVIDENCE 1 ++ High-quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias 1 + Well-conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias 1 - Meta-analyses, systematic reviews, or RCTs with a high risk of bias 2 ++ High-quality systematic reviews of case-control or cohort (...) studies High-quality case-control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal 2 + Well-conducted case-control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal 2 - Case-control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal 3 Non-analytic studies, eg case reports, case series 4 Expert opinion

2016 SIGN

115. CRACKCast E125 – Electrolyte Disorders

) Pneumonia Tuberculosis Abscess Central Nervous System Disorders Infection (meningitis, brain abscess) Mass (subdural, postoperative, cerebrovascular accident) Psychosis (with psychogenic polydipsia) Drugs Thiazide diuretics Narcotics Oral hypoglycemic agents Barbiturates Antineoplastics Treatment: free water restriction! [12] Describe the management of hyponatremia in the following patients: Actively seizing In more severe cases when the sodium value is 120 mEq/L or less and the patient has alterations (...) potential, to decrease cell excitability, and for function of the Na+ K+-ATPase pump. Patients With Acute Coronary Artery Disease and Ventricular Arrhythmias Make sure you check and correct any low serum K / Mg levels, otherwise these patients are at high risk for dysrhythmias Patients on certain medications: Long term PPI use, patients with bowel preps for colonoscopy aminoglycosides, amphotericin B, cisplatin, and pentamidine [19] What are the five most common causes of hyperphosphatemia

2017 CandiEM

116. Endovascular therapy using mechanical thrombectomy devices for patients with acute ischaemic stroke

: 3. World Health Organization. Stroke, cerebrovascular accident [online]. [cited 2016 Feb 15]; Available from: 4. Scottish Intercollegiate Guidelines Network. Management of patients with stroke or TIA: assessment, investigation, immediate management and secondary prevention. 2008 [cited 2016 Feb 12]; Available from: 5. National (...) ). Over 75% of cases were in patients aged 65 or over. The European age-sex standardised incidence rate was 192 per 100,000 population for men and 159.2 per 100,000 population for women. There were 2,318 deaths due to stroke in Scotland in 2014. (A. Deas, Principal Information Analyst, ISD Scotland. Personal Communication, 9 February 2016.) In the Scottish Health Survey 2014, 3.3% of men and 3.1% of women reported that they had experienced a stroke 7 . Table 1 Mechanical thrombectomy clinical

2016 Evidence Notes from Healthcare Improvement Scotland

117. Diagnosis and treatment of osteoporosis.

thrombosis and pulmonary embolism, hot sweats, leg cramp, and cerebrovascular accident. Conjugated estrogens/bazedoxifene acetate (Duavee) carries a risk of endometrial cancer, cardiovascular disorders and probable dementia. Other side effects include diarrhea, indigestion, nausea, upper abdominal pain, neck pain, spasm, dizziness, pain in throat, venous thromboembolism (VTE), cerebrovascular accident, retinal vascular disorder, primary malignant neoplasm of endometrium. Peripheral DXA (pDXA (...) . Benefit-Harm Assessment : For most patients with osteoporosis, the benefits of the medication outweigh the risks. However, the benefit-harm assessment should be done for each individual patient to evaluate whether this medication is appropriate. Relevant Resources : Postmenopausal women with osteoporosis: Eriksen, Diez-Perez, & Boonen, 2014; Miller et al., 2012; Eisman et al., 2008; Black et al., 2007; Chestnut et al., 2005; Chestnut et al., 2004; McClung et al., 2001; Black et al., 2000; Fogelman et

2017 National Guideline Clearinghouse (partial archive)

118. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society

-Term Risk Factors (>30 d) History: Outpatient Clinic or ED Evaluation Male sex , Male sex , Older age (>60 y) Older age , , , No prodrome Absence of nausea/vomiting preceding syncopal event Palpitations preceding loss of consciousness VA , Exertional syncope Cancer Structural heart disease , , , , Structural heart disease , HF , , , HF Cerebrovascular disease Cerebrovascular disease Family history of SCD Diabetes mellitus Trauma , High CHADS-2 score Physical Examination or Laboratory Investigation (...) 2. General Principles e30 2.1. Definitions: Terms and Classification e30 2.2. Epidemiology and Demographics e31 2.3. Initial Evaluation of Patients with Syncope: Recommendations e31 2.3.1. History and Physical Examination: Recommendation e31 2.3.2. Electrocardiography: Recommendation e31 2.3.3. Risk Assessment: Recommendations e32 2.3.4. Disposition After Initial Evaluation: Recommendations e32 3. Additional Evaluation and Diagnosis e33 3.1. Blood Testing: Recommendations e33 3.2. Cardiovascular

2017 American Heart Association

119. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope

that estimated risk scores are summarized in . , , , , , , , , Table 5. Short- and Long-Term Risk Factors Short-Term Risk Factors (≤30 d) Long-Term Risk Factors (>30 d) History: Outpatient Clinic or ED Evaluation Male sex , , , Male sex , Older age (>60 y) Older age , , , No prodrome Absence of nausea/vomiting preceding syncopal event Palpitations preceding loss of consciousness VA , Exertional syncope Cancer Structural heart disease , , , , Structural heart disease , HF , , , HF Cerebrovascular disease (...) Cerebrovascular disease Family history of SCD Diabetes mellitus Trauma , High CHADS-2 score Physical Examination or Laboratory Investigation Evidence of bleeding Abnormal ECG , , Persistent abnormal vital signs Lower GFR Abnormal ECG , , , , Positive troponin * Definitions for clinical endpoints or serious outcomes vary by study. The specific endpoints for the individual studies in this table are defined in and summarized in for selected studies. This table includes individual risk predictors from history

2017 American Heart Association

120. American Association of Clinical Endocrinologists and American College of Endocrinology Guidelines for Management of Dyslipidemia and Prevention of Cardiovascular Disease

incidence of MI is 550,000 new and 200,000 recurrent attacks. The average age at first MI is 65.1 years for men and 72.0 years for women (1 [EL 4; NE]). Dyslipidemia is a primary, major risk factor for ASCVD and may even be a prerequisite for ASCVD, occurring before other major risk factors come into play. Epidemiologic data also suggest that hypercho- lesterolemia and perhaps coronary atherosclerosis itself are risk factors for ischemic cerebrovascular accident (CVA) (2 [EL 4; NE]). According to data (...) = cerebrovascu- lar; CVA = cerebrovascular accident; EL = evidence level; FH = familial hypercholesterolemia; FIELD = Secondary Endpoints from the Fenofibrate Intervention and Event Lowering in Diabetes trial; FOURIER = Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects With Elevated Risk trial; HATS = HDL-Atherosclerosis Treatment Study; HDL-C = high- density lipoprotein cholesterol; HeFH = heterozygous familial hypercholesterolemia; HHS = Helsinki Heart Study; HIV = human

2017 American Association of Clinical Endocrinologists

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