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Cerebrovascular Accident Risk in Women


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141. 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

142. 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

143. 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

144. 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

145. 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

146. Treatment for Bipolar Disorder in Adults: A Systematic Review

on harms was limited across all studies. Future research examining BD treatments will require innovative ways to increase study completion rates. xi Contents Evidence Summary 1 Chapter 1. Introduction 1 Background 1 Treatment Strategies 2 Scope and Key Questions 4 Key Questions 5 PICOTS 6 Analytic Framework 9 Report Organization 9 Chapter 2. Methods 10 Topic Refinement and Review Protocol 10 Literature Search Strategy 10 Risk of Bias Assessment of Individual Studies 11 Data Extraction 12 Data Synthesis (...) 106 Table 47. Population and inclusion criteria for studies examining a somatic therapy 109 Table 48. Summary of low-strength* evidence findings by intervention class 111 Table 49. Interventions/comparators with insufficient strength of evidence for all outcomes (unless otherwise noted) 114 Figures Figure 1. Analytic framework for treatment for bipolar disorder 9 Figure 2. Literature flow diagram 16 Appendixes Appendix A. Search Strategies Appendix B. Risk of Bias Assessment Tool Appendix C

2018 Effective Health Care Program (AHRQ)

147. 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

148. Brodalumab (Kyntheum) - plaque psoriasis

. Ecotoxicity/environmental risk assessment 24 2.3.6. Discussion on non-clinical aspects 24 2.3.7. Conclusion on the non-clinical aspects 25 2.4. Clinical aspects 25 2.4.1. Introduction 25 2.4.2. Pharmacokinetics 29 2.4.3. Pharmacodynamics 34 2.4.4. Discussion on clinical pharmacology 36 2.4.5. Conclusions on clinical pharmacology 37 2.5. Clinical efficacy 37 2.5.1. Dose response study 37 2.5.2. Main studies 40 2.5.3. Discussion on clinical efficacy 93 2.5.4. Conclusions on the clinical efficacy 96 2.6 (...) . Clinical safety 96 2.6.1. Discussion on clinical safety 113 2.6.2. Conclusions on the clinical safety 121 2.7. Risk Management Plan 121 2.8. Pharmacovigilance 125 2.9. New Active Substance 125 2.10. Product information 125 Assessment report EMA/381484/2017 Page 3/135 2.10.1. User consultation 125 2.10.2. Additional monitoring 126 3. Benefit-Risk Balance 126 3.1. Therapeutic Context 126 3.1.1. Disease or condition 126 3.1.2. Available therapies and unmet medical need 126 3.1.3. Main clinical studies 126

2017 European Medicines Agency - EPARs

149. Identifying and Assessing Core Components of Collaborative-care Models for Treating Mental and Physical Health Conditions

. • The relationship between mental and physical health appears to be bi-directional, meaning that individuals experiencing a mental illness are at high risk of developing long-term chronic physical health conditions and conversely, the risk of developing a mental health condition greatly increases for individuals with long-term chronic physical health conditions. • One approach to addressing these concerns has been to develop models of collaborative care that address both mental and physical health conditions (...) of multimorbidity that include both mental health and physical health conditions are of particular concern. Although the clinical pathways are not well understood, the relationship between mental and physical health seems to be bi-directional. This means that individuals experiencing a mental illness are at high risk of developing long-term chronic conditions and, conversely, the risk of developing a mental health condition greatly increases for individuals with long-term chronic physical health conditions.(4

2017 McMaster Health Forum

150. Diagnosis and Treatment of Peripheral Arterial Diseases Full Text available with Trip Pro

. See . 3.3 Prognosis Atherosclerosis is often generalized. Patients affected at one site are overall at risk for fatal and non-fatal CV events. Beyond the risk of cerebrovascular events, patients with CAD are also at risk for myocardial infarction (MI) and cardiac death. In a systematic review of 17 studies including 11 391 patients with >50% asymptomatic carotid stenosis, 63% of late deaths were related to cardiac events, with a mean cardiac-related mortality rate of 2.9%/year. Many studies have (...) therapy as well as non-pharmacological measures such as smoking cessation, healthy diet, weight loss and regular physical exercise. 4.1 Diagnostic approach 4.1.1 Clinical history Personal and family clinical history should always be assessed. Family history includes CAD, cerebrovascular disease, aortic aneurysm as well as LEAD. Clinical history includes the evaluation of CV risk factors and comorbidities as well as a review of the symptoms related to different vascular territories (see ). Lifestyle

2017 European Society of Cardiology

151. Adalimumab (Imraldi) - psoriasis, psoriatic arthritis, axial spondyloarthritis, Crohn?s disease, ulcerative colitis

risk assessment 24 2.3.5. Discussion on non-clinical aspects 25 2.3.6. Conclusion on the non-clinical aspects 25 2.4. Clinical aspects 25 2.4.1. Introduction 25 2.4.2. Pharmacokinetics 26 2.4.3. Pharmacodynamics 32 2.4.4. Discussion on clinical pharmacology 33 2.4.5. Conclusions on clinical pharmacology 36 2.5. Clinical efficacy 37 2.5.1. Dose response study(ies) 37 2.5.2. Main study 37 2.5.3. Discussion on clinical efficacy 63 2.5.4. Conclusions on the clinical efficacy 67 2.6. Clinical safety 68 (...) 2.6.1. Discussion on clinical safety 90 2.6.2. Conclusions on the clinical safety 93 2.7. Risk Management Plan 93 2.8. Pharmacovigilance 102 2.9. Product information 102 2.9.1. User consultation 102 2.9.2. Additional monitoring 102 3. Benefit-Risk Balance 102 3.1. Therapeutic Context 102 Assessment report EMA/CHMP/559383/2017 Page 3/111 3.1.1. Disease or condition 102 3.1.3. Main clinical studies 103 3.2. Favourable effects 103 3.3. Uncertainties and limitations about favourable effects 104 3.4

2017 European Medicines Agency - EPARs

152. 2017 Focused update on Dual Antiplatelet Therapy (DAPT) Full Text available with Trip Pro

, MI at presentation, prior MI or PCI, diabetes, stent diameter <3 mm, smoking, and paclitaxel-eluting stent] resulting in a score ranging from −2 to + 10. Within the DAPT trial, a high-risk score (i.e. a score ≥2) selected patients who showed a reduction in MI/stent thrombosis and cardiovascular or cerebrovascular events risk [number needed to treat (NNT) for benefit for ischaemic event reduction = 34] after a prolonged, 30-month DAPT, with only a modest increase in bleeding risk (NNT for harm (...) for the recommendations see . Table of Contents Abbreviations and acronyms 215 1. Preamble 216 2. Introduction 218 2.1 Short- and long-term outcomes after percutaneous coronary intervention 219 2.2 Risk of stent thrombosis in relation to stent type 219 2.3 Short- and long-term outcomes after coronary artery bypass surgery 219 2.4 Short- and long-term outcomes after medically managed acute coronary syndrome 219 3. Efficacy and safety of dual antiplatelet therapy and risk stratification tools 219 3.1 Dual antiplatelet

2017 European Society of Cardiology

153. Pembrolizumab (Keytruda) - non-small cell lung cancer (NSCLC)

) 99 (3.5) Dehydration 1 (1.6) 3 (3.6) 24 (0.9) Musculoskeletal and connective tissue disorders 3 (4.8) 1 (1.2) 75 (2.7) Back pain 1 (1.6) 0 (0.0) 15 (0.5) Flank pain 1 (1.6) 0 (0.0) 2 (0.1) Musculoskeletal pain 1 (1.6) 0 (0.0) 8 (0.3) Neck pain 0 (0.0) 1 (1.2) 3 (0.1) Neoplasms benign, malignant and unspecified (incl cysts and polyps) 0 (0.0) 1 (1.2) 96 (3.4) Malignant pleural effusion 0 (0.0) 1 (1.2) 4 (0.1) Nervous system disorders 2 (3.2) 3 (3.6) 106 (3.8) Cerebrovascular accident 1 (1.6) 0 (...) aspects 10 2.2.1. Ecotoxicity/environmental risk assessment 10 2.3. Clinical aspects 10 2.3.1. Introduction 10 2.3.2. Pharmacokinetics 10 2.3.3. Pharmacodynamics 11 2.3.4. PK/PD modelling 11 2.3.5. Discussion and Conclusions on clinical pharmacology 15 2.4. Clinical efficacy 16 2.4.1. Dose response study(ies) 17 2.4.2. Main study(ies) 17 2.4.3. Discussion on clinical efficacy 47 2.4.4. Conclusions on the clinical efficacy 49 2.5. Clinical safety 49 2.5.1. Discussion on clinical safety 76 2.5.2

2017 European Medicines Agency - EPARs

154. Adalimumab (Cyltezo) - Juvenile Rheumatoid Arthritis, Psoriatic Arthritis, Rheumatoid Arthritis, Ulcerative Colitis, Crohn Disease, Hidradenitis Suppurativa, Psoriasis, Ankylosing Spondylitis, Uveitis

23 2.2.6. Recommendations for future quality development 23 2.3. Non-clinical aspects 23 2.3.1. Pharmacology 23 2.3.2. Pharmacokinetics 24 2.3.3. Toxicology 24 2.3.4. Ecotoxicity/environmental risk assessment 25 2.3.5. Discussion on non-clinical aspects 26 2.3.6. Conclusion on the non-clinical aspects 26 2.4. Clinical aspects 27 2.4.1. Introduction 27 2.4.2. Pharmacokinetics 28 2.4.3. Pharmacodynamics 44 2.4.4. Discussion on clinical pharmacology 44 2.4.5. Conclusions on clinical pharmacology 47 (...) 2.5. Clinical efficacy 47 2.5.1. Discussion on clinical efficacy 69 2.5.2. Conclusions on the clinical efficacy 72 2.6. Clinical safety 72 2.6.1. Discussion on clinical safety 96 2.6.2. Conclusions on the clinical safety 98 2.7. Risk Management Plan 98 2.8. Pharmacovigilance 105 2.9. Product information 106 2.9.1. User consultation 106 2.9.2. Additional monitoring 106 3. Benefit-Risk Balance 106 3.1. Therapeutic Context 106 3.1.1. Disease or condition 106 Medicinal product no longer authorised

2017 European Medicines Agency - EPARs

155. 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

156. 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

157. CRACKCast E171 – Pediatric Cardiac Disorders

, cerebrovascular accidents, and even death have been reported with more severe tet spells.) Pathophysiology Event that suddenly lowers the SVR, such as crying or defecation, and hypovolemia or tachycardia will produce a large right-to-left shunt across the VSD, beginning the vicious circle of a hypoxic spell. Shunt through the VSD bypasses the lungs and causes hypercarbia, hypoxemia, and acidosis Respiratory centres are stimulated and the child hyperventilates More negative intrathoracic pressure increases (...) setting is best done with the higher dose) Children with cardiac conditions are at risk of post-intubation cardiovascular collapse due to positive pressure ventilation, increased intrathoracic pressures, and decreased venous return (eg, cyanotic heart disease is often preload dependent). What are complications of IV prostaglandin? APNEA! (30%) Seizures, Bradycardia, Hypotension, Fever Flushing, Decreased platelet aggregation Examination: The mere presence of femoral pulses does not rule out clinically

2018 CandiEM

158. Stroke Prevention in Patients With Atrial Fibrillation: A Systematic Review Update

, and female sex, and several of these factors are associated with AF. These risk factors are the elements that form the CHADS2 and CHA2DS2-VASc scores. 14,15 The CHADS2 score (...) Strategies in Atrial Fibrillation 2 Scope and Key Questions 5 Scope of the Review 5 Key Questions 6 Contextual Question (CQ) 6 Analytic Framework 7 Organization of This Report 8 Methods 9 Review Protocol 9 Literature Search Strategy 9 Search Strategy 9 Inclusion and Exclusion Criteria 10 Study Selection 15 Data Extraction 15 Quality (Risk of Bias) Assessment of Individual Studies 16 Data Synthesis 17 Strength of the Body of Evidence 18 Applicability 19 Peer Review and Public Commentary 20 Results 21

2018 Effective Health Care Program (AHRQ)

159. CRACKCast E187 – The Combative and Difficult Patient

Mutual hostility Miscommunication Fear of dependence or rejection Fear of illness Guilt about disease process Antisocial Behavior Violence with no associated medical or psychiatric explanation (these patients may be managed by the police or security) Organic Diseases Delirium Dementia Trauma Central nervous system infection Seizure Neoplasm Cerebrovascular accident Vascular malformation Hypoglycemia Hypoxia Acquired immunodeficiency syndrome (AIDS) Electrolyte abnormality Hypothermia or hyperthermia (...) or sedative-hypnotic drug withdrawal, as well as cocaine, amphetamines, and sympathomimetic drug ingestions. Side effects: sedation, ataxia, confusion, nausea, and respiratory depression, which may be amplified in the presence of concurrent alcohol and other depressant use. Antipsychotics Typical (Haldol) vs. Atypical (Olanzapine) Side effects: Vary based on the drug, but some are: Sedation, hypotension, anticholinergic, EPS, QTc prolongation (highest risk when given IV) EPS: akathisia (extreme

2018 CandiEM

160. 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

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