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Cerebrovascular Accident Risk in Women

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121. Appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia

with caution and only in cases where there is aggression, agitation or psychosis that either causes an identifiable risk of harm to the person with dementia and/ or others or causes severe distress to the person. People with Alzheimer’s disease, vascular dementia or mixed dementias with mild-to-moderate non-cognitive symptoms should NOT be prescribed antipsychotic medication due to the increased risk of cerebrovascular adverse events and death. People with dementia with Lewy bodies 3 and Parkinson’s (...) General principles of care 34 3.1.1 Person-centred, individualised care 343.1.2 Initial comprehensive assessment 35 3.1.3 Non pharmacological versus pharmacological interventions 37 3.1.4 Route of administration of psychotropic medications 39 3.2 Antipsychotic medication 41 3.2.1 Indications for antipsychotics 41 3.2.2 Risks of antipsychotics in dementia 42 3.2.3 Risk/ benefit discussion with family 46 3.2.4 Choice of antipsychotic medication 47 3.2.5 Initiation and titration of antipsychotics 49

2019 National Clinical Guidelines (Ireland)

122. Management of Rheumatod Arthritis

with increased risk of myocardial infarction and cerebrovascular accidents in RA. 36 - 37, level II-2 • Corticosteroids can be used as an add-on therapy to conventional synthetic or biologic DMARDs. Recommendation 7 • Short-term* low-dose corticosteroids** may be used in active rheumatoid arthritis. *short-term refers to 2.8 to =10 - Moderate disease activity: >10 to =22 - High disease activity: >22 A composite index based on summation of parameters similar to CDAI but with the addition of CRP in mg/dL (...) of RA is still unclear but certain factors are thought to increase the risk of developing it: ? environment - e.g. infection ? genes - the chance of developing RA is partly genetic ? hormones - women are more likely to have RA ? lifestyle - smoking cigarettes can double the risk of developing RA III. Diagnosis • There is no single test to diagnose RA. The diagnosis is made based on symptoms, physical examination, x-rays and/or ultrasound and blood tests.42 Management of Rheumatoid Arthritis Figure 5

2019 Ministry of Health, Malaysia

123. Left atrial appendage occlusion (LAAO) in patients with atrial fibrillation who have contraindications to oral anticoagulation

3.6 (1.5) CtE (2018) 15 Mixed 525 74.5 (8.0) 68.7 4.3 (1.5) 61.1% bleeding or embolic event on anticoagulation; 23.4% history of bleeding; 7.1% high bleeding risk; 6.9% intolerance Huang (2017) 22 LAmbre™ 153 69.3 (9.4) 56.2 4.0 (1.7) All contraindicated: history of cerebrovascular or gastrointestinal bleeding, poor compliance, warfarin allergy SHTG Advice | 13 Huang (2017) 26 WATCHMAN™ 106 64.2 (8.6) 59.4 3.6 (1.6) 77.3% failed to tolerate warfarin; 18.9% history of haemorrhage or embolism (...) fibrillation deemed to be at high risk of ischaemic stroke, who have absolute contraindications to oral anticoagulation with warfarin and direct oral anticoagulants. Prior to undergoing the LAAO procedure, an individual patient risk assessment must be carried out by a multidisciplinary team. The potential future benefits of LAAO, the risks associated with the procedure, and the need for long- term antiplatelet therapy, should be discussed with each patient prior to making a treatment decision. LAAO

2019 SHTG Advice Statements

124. Treatment of Diabetes in Older Adults Full Text available with Trip Pro

University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado Search for other works by this author on: Jeffrey B Halter University of Michigan, Ann Arbor, Michigan National University of Singapore, Singapore, Singapore Search for other works by this author on: Irl B Hirsch University of Washington Medical Center–Roosevelt, Seattle, Washington Search for other works by this author on: Marie E McDonnell Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Search for other (...) remark: This recommendation is most applicable to high-risk patients with any of the following characteristics: overweight or obese, first-degree relative with diabetes, high-risk race/ethnicity ( e.g. , African American, Latino, Native American, Asian American, Pacific Islander), history of cardiovascular disease, hypertension (≥140/90 mm Hg or on therapy for hypertension), high-density lipoprotein cholesterol level <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L), sleep

2019 The Endocrine Society

125. Heart Disease and Stroke Statistics Full Text available with Trip Pro

. Physical Inactivity e99 5. Nutrition e119 6. Overweight and Obesity e138 Health Factors and Other Risk Factors 7. High Blood Cholesterol and Other Lipids e161 8. High Blood Pressure e174 9. Diabetes Mellitus e193 10. Metabolic Syndrome e212 11. Kidney Disease e233 12. Sleep e249 Cardiovascular Conditions/Diseases 13. Total Cardiovascular Diseases e257 14. Stroke (Cerebrovascular Disease) e281 15. Congenital Cardiovascular Defects and Kawasaki Disease e327 16. Disorders of Heart Rhythm e346 17. Sudden (...) (Nationwide) Inpatient Sample, hospitalizations for acute ischemic stroke increased significantly for both males and females and for certain racial/ethnic groups among younger adults aged 18 to 54 years. From 1995 through 2011 to 2012, stroke hospitalization rates almost doubled for males aged 18 to 34 and 35 to 44 years, with a 41.5% increase among males aged 35 to 44 years from 2003 to 2004 through 2011 to 2012. In analyses using data from the Global Burden of Disease Study, ≈90% of the stroke risk

2019 American Heart Association

126. AIM Clinical Appropriateness Guidelines for Sleep Disorder Management

sleep study which did not diagnose OSA in a patient with ongoing clinical suspicion of OSA. 10. Patient is oxygen dependent for any reason 11. History of cerebrovascular accident (CVA) within the preceding 30 days 12. Chronic opiate narcotic use, when discontinuation is not an option. Diagnostic sleep testing for patients using opiate narcotics for acute self-limited conditions should ideally be deferred until the medications have been stopped. 13. Body Mass Index (BMI) >33 and elevated serum (...) (persistent hypertension in a patient taking three or more antihypertensive medications). Because of daytime sleepiness, deaths related to motor vehicle accidents are also more common in patients with OSA. Diagnosis of OSA: Although OSA may be suspected based on the symptoms described above, physical exam findings (e.g., obesity, increased neck circumference, retrognathia etc.), or presence of comorbidities, the diagnosis must be confirmed by a sleep test. During sleep testing, various physiological

2019 AIM Specialty Health

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

, or exercise-induced dizziness, lightheadedness, or near syncope, etc. ? With high risk of CAD (SCORE) ? Patients with any cardiac symptom who have diseases/conditions with which coronary artery disease commonly coexists such as: ? Diabetes mellitus; 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 ? 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 ? Patients awaiting solid organ transplantation who have not undergone

2019 AIM Specialty Health

128. Vascular imaging

disease 12 Arteriovenous malformation or arteriovenous fistula 12 Carotid aneurysm or dissection 12 Carotid stenosis or occlusion 12 Cerebrovascular accident or transient ischemic attack 13 Dissection – intracranial 13 Fibromuscular dysplasia 13 Hematoma 13 Hemorrhage – intracranial or subarachnoid 13 Horner’s syndrome 13 Pulsatile tinnitus 14 Stenosis or occlusion – intracranial arteries 14 Trigeminal neuralgia 14 Venous thrombosis or compression – extracranial 14 Venous thrombosis or compression (...) actions that affect clinical outcomes. Vascular Imaging Copyright © 2019. AIM Specialty Health. All Rights Reserved. 13 Cerebrovascular accident or transient ischemic attack Also see Brain Imaging guidelines. Advanced imaging is considered medically necessary for the diagnosis or management of underlying vascular pathology following transient ischemic attack or confirmed cerebrovascular accident. IMAGING STUDY - CTA or MRA brain Dissection – intracranial Advanced imaging is considered medically

2019 AIM Specialty Health

129. 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza Full Text available with Trip Pro

of illness duration prior to hospitalization (A-II) . Outpatients of any age with severe or progressive illness, regardless of illness duration (A-III) . Outpatients who are at high risk of complications from influenza, including those with chronic medical conditions and immunocompromised patients (A-II) . Children younger than 2 years and adults ≥65 years (A-III) . Pregnant women and those within 2 weeks postpartum (A-III) . Clinicians can consider antiviral treatment for adults and children who (...) sequelae, but some persons are considered to be at increased risk for severe and fatal influenza, including children aged <5 years (but especially <2 years), adults aged ≥65 years, pregnant and postpartum women, people with certain chronic medical conditions including pulmonary, cardiac, and metabolic disease, people with immunosuppression, people with extreme obesity, residents of nursing homes, and American Indians and Alaska Natives [2–8] (Table 4). Elderly persons have the highest mortality rates

2019 Infectious Diseases Society of America

130. Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

providers are ill-prepared to tackle these challenges, as well as specific needs such as contraception and pregnancy in female patients. The role of therapies such as cardiovascular drugs to prevent and treat complications, heart transplantation, and mechanical circulatory support remains undetermined. There is a clear need for consensus on how best to follow up patients with Fontan circulation and to treat their complications. This American Heart Association statement summarizes the current state (...) a controlled right-to-left shunt. Because fenestration augments ventricular preload and partially offloads systemic venous hypertension, some centers have routinely adopted fenestration for all Fontan procedures, whereas others have used it only in high-risk patients. The primary clinical benefit of a fenestration appears to be in reducing the amount and duration of pleural drainage after the Fontan procedure, thus decreasing the duration of hospital stay. Some centers proceed with planned anticipatory

2019 American Heart Association

131. 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

2019 European Association of Urology

132. Neuro-urology

of lower urinary 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 (...) outcome of transobturator tape (TOT) for treatment of stress urinary incontinence in females with neuropathic bladders. Spinal Cord, 2015. 53: 544. 265. El-Azab, A.S., et al. Midurethral slings versus the standard pubovaginal slings for women with neurogenic stress urinary incontinence. Int Urogynecol J, 2015. 26: 427. 266. Athanasopoulos, A., et al. Treating stress urinary incontinence in female patients with neuropathic bladder: the value of the autologous fascia rectus sling. Int Urol Nephrol, 2012

2019 European Association of Urology

133. 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

2019 European Association of Urology

134. AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm Full Text available with Trip Pro

status. Other considerations include antihyperglycemic efficacy; mechanism of action; risk of inducing hypoglycemia; risk of weight gain; other adverse effects; tolerability; ease of use; likely adherence; cost; and safety or risk reduction in heart, kidney, or liver disease. The choice of therapy depends on the individual patient's cardiac, cerebrovascular, and renal status. Combination therapy is usually required and should involve agents with complementary mechanisms of action. Comorbidities must (...) Comprehensive Type 2 Diabetes Management Algorithm—ASCVD Risk Factor Modifications Algorithm). The classic major risk factors that modify the low-density-lipoprotein cholesterol (LDL-C) goal for all individuals include cigarette smoking, hypertension (BP ≥140/90 mm Hg or use of antihypertensive medications), high-density-lipoprotein cholesterol (HDL-C) <40 mg/dL, family history of CHD, and age ≥45 years for males or ≥55 years for females ( ). Recognizing that T2D carries a high lifetime risk for developing

2019 American Association of Clinical Endocrinologists

135. Living Guideline for Diagnosing and Managing Pediatric Concussion

Level of Evidence: B 2.1b Note common modifiers that may delay recovery and use a clinical risk score to predict risk of prolonged symptoms. Link: Predicting Persistent Post-Concussive Problems in Pediatrics (5P): Score Calculator Modifiers that may delay recovery: • Age (increased risk with increased age). • Sex (female). • Duration of recovery from a previous concussion. • High pre-injury symptom burden. • High symptom burden at initial presentation. • Clinical evidence of vestibular or oculomotor (...) /caregivers of children/adolescents who have sustained a concussion may experience is common. • Children typically recover in 1-4 weeks but some children/adolescents will have symptoms at one month and beyond and need to be monitored/seek additional care. Females aged 13-18 years have an increased risk of prolonged recovery. • Recommendation 2.3 Recommend graduated return to physical and cognitive activity • Domain 12: Return-to-School and Work Summary of online tools to consider related to lifestyle

2019 Ontario Neurotrauma Foundation

136. Canadian Contraception Consensus Part 4 of 4 Chapter 9: Combined Hormonal Contraception

thromboembolism (II-2). Potential differences in the risk of venous thromboembolism attributable to different progestin types and estrogen dosing in low-dose COCs do not currently justify preferential prescribing (III). 5. Low-dose combined oral contraceptive pills (containing less than 50 μg of ethinyl estradiol) are not associated with an increased risk of myocardial infarction or cerebrovascular accident in women with no additional risk factors (II-2). 6. Current epidemiological studies suggest (...) ; however, a small increase in contraceptive failure in women with a body mass index greater than 30 cannot be excluded (II-2). 3. Combined oral contraceptive pills are associated with a number of non-contraceptive benefits, including but not limited to decreased menstrual bleeding, decreased acne, fewer endometriosis-related symptoms, and a decreased risk of ovarian and endometrial cancers (II-2). 4. Combined oral contraceptive pills (COCs) are associated with an increased risk of venous

2017 Society of Obstetricians and Gynaecologists of Canada

137. 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

138. 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 (...) due to sphincter incompetence. J Urol, 1995. 153: 644. 262. Mingin, G.C., et al. The rectus myofascial wrap in the management of urethral sphincter incompetence. BJU Int, 2002. 90: 550. 263. Abdul-Rahman, A., et al. Long-term outcome of tension-free vaginal tape for treating stress incontinence in women with neuropathic bladders. BJU Int, 2010. 106: 827. 264. Losco, G.S., et al. Long-term outcome of transobturator tape (TOT) for treatment of stress urinary incontinence in females with neuropathic

2018 European Association of Urology

139. 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

140. 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

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