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Contraction Stress Test

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161. Cardiac arrhythmias in coronary heart disease

of ischaemic VT induced at electrophysiological study, sudden death and out-of-hospital collapse. R Revascularisation should be considered in patients who have had sustained VT or VF. 9 Patients with previous sustained VT/VF should undergo assessment for inducible ischaemia by stress testing or myocardial perfusion imaging followed, if appropriate, by coronary arteriography and revascularisation. These patients should all be considered for implantable cardioverter defibrillator therapy. 5.2.2 IMPLANTABLE

2018 SIGN

162. Assessment of palpitations

aetiologies that occur during normal sinus rhythm. A significant proportion of palpitations are due to non-life-threatening, treatable cardiac conditions. They include premature ventricular contractions, premature atrial contractions, and supraventricular tachycardias such as atrial fibrillation, atrial flutter, atrioventricular nodal re-entry tachycardia, atrial tachycardia, and atrioventricular re-entry tachycardia or Wolff-Parkinson-White syndrome. Ironically, the most common rhythm seen when (...) evaluating patients for palpitations is sinus rhythm. A heightened sense of normal rhythm can be seen in settings of emotional or physical stress, or in conjunction with use of caffeine, alcohol, or other stimulants. However, palpitations are occasionally a manifestation of potentially life-threatening conditions, especially in the setting of structural heart disease - for example, ventricular tachycardia, which may lead to sudden cardiac death. Inherited conditions such as hypertrophic cardiomyopathy

2018 BMJ Best Practice

163. Premature labour

contractions preterm premature rupture of membranes (PPROM) advanced cervical dilation cervical length <2 cm increased maternal or fetal heart rate non-specific lower abdominal or back pain fever vaginal bleeding previous premature labour previous cervical trauma previous induced abortion maternal infections multifetal pregnancies short cervical length positive fetal fibronectin test preterm premature rupture of membranes (PPROM) fetal abnormalities smoking body mass index (BMI) <19 kg/m^2 social factors (...) and ethnicity polyhydramnios domestic violence poor dental hygiene Diagnostic investigations non-stress cardiotocogram tocography transvaginal ultrasound of the cervix cervico-vaginal swab for fetal fibronectin FBC CRP urine dipstick urine microscopy, culture, and sensitivity high vaginal/rectal swab nitrazine test microscopy of vaginal fluid Kleihauer blood test urine toxicology screen IGFBP-1 (insulin-like growth factor binding protein-1) test placental alpha microglobulin-1 (PAMG-1) Treatment algorithm

2018 BMJ Best Practice

164. Overview of pregnancy complications

. 2016;388:891-897. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30902-3/fulltext http://www.ncbi.nlm.nih.gov/pubmed/27372398?tool=bestpractice.com It is recommended that all pregnant women be tested for HIV infection as early as possible. Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1-137. http://www.cdc.gov/std/tg2015/ http://www.ncbi.nlm.nih.gov/pubmed/26042815?tool (...) the uterus may be caused by trauma, hypertension, or coagulopathy. Oyelese Y, Ananth CV. Placental abruption. Obstet Gynecol. 2006;108:1005-1016. http://www.ncbi.nlm.nih.gov/pubmed/17012465?tool=bestpractice.com It is a common cause of bleeding in the third trimester. Pre-term birth occurs between 24 and 37 weeks' gestation. In two-thirds of cases, it occurs following spontaneous onset of labour. Only a minority of women who present with pre-term contractions known as threatened pre-term labour (TPTL

2018 BMJ Best Practice

165. Diagnosis and management of epilepsy in adults

3.5 Hand-held video 11 3.6 Brain imaging 11 3.7 Electrocardiography 11 3.8 Genetic testing 12 4 Treatment 13 4.1 When to start antiepileptic treatment 13 4.2 Antiepileptic drug monotherapy 13 4.3 Management of drug-resistant epilepsy 14 4.4 Antiepileptic drug blood levels 16 4.5 Management of provoked seizures 17 4.6 Antiepileptic drug adverse effects 17 4.7 Antiepileptic drug withdrawal 19 4.8 Complementary therapy 20 4.9 Surgical referral 23 4.10 Management of prolonged seizures including status (...) CLINICAL FACTORS AND DIAGNOSIS Attack disorders such as faint and epilepsy produce their effects because some element of physiology becomes disordered, temporarily disturbing the function of the brain. For a test to positively identify the nature of an attack disorder, an attack must be recorded, and the disturbed physiology detected. As this is usually impractical, the routine diagnosis of attack disorders is largely clinical, based on history. The history should make clear what occurred before

2018 SIGN

166. What helps to support people affected by Adverse Childhood Experiences? A Review of Evidence

and running the stakeholder workshop. We are also grateful to Amber Derosa from the National Children’s Bureau, Young NCB, and the seven young people who contributed so generously to the stakeholder workshop. Funding This review was commissioned by the National Institute for Health Research (NIHR) Policy Research Programme (PRP) for the Department of Health and Social Care (DHSC). It was funded through the NIHR PRP contract with the EPPI Centre at UCL (Reviews facility to support national policy (...) a person who is under the age of 18. ABBREVIATIONS ACE Adverse Childhood Experience CBT Cognitive Behavioural Therapy CDC Centers for Disease Control and Prevention EMDR Eye Movement Desensitisation and Reprocessing Therapy nRCT Non-Randomised Controlled Trial OoHC Out-of-Home-Care PTSD Post-Traumatic Stress Disorder RCT Randomised Controlled Trial RoB Risk of Bias RoR Review of Reviews (used to describe the systematic review of systematic reviews) SMD Standardised Mean Difference TAU Treatment

2019 EPPI Centre

167. Our data-driven future in healthcare

stewards Individuals in NHS organisations, or those acting on their behalf, who are responsible for the stewardship and curation of patient data, including controlling how, when and by whom it is collected, stored, accessed or otherwise used. Patient data Health-related information about patients that is created or used as part of their NHS care (such as a healthcare professional’s notes and care records, vital signs, laboratory test results, medical images and letters). For the purposes of this report (...) professionals and patients. 5. Enable safe and effective health and social care. 6. Support people to manage their own health. 7. Enable research and innovation. Principle A. Purpose, value and benefitsUpholding the social contract and ethos of the NHS Society expects that the NHS, and those working for it, will act in the interests of ‘public good’. This may be characterised as a ‘social contract’ between the NHS, patients and society that reflects social values. 23 This is consistent with the NHS

2018 Academy of Medical Sciences

168. Fetal Health Surveillance: Antepartum Consensus Guideline

or amniotic fluid volume assessment within 24 hours. The woman should continue with daily fetal movement counting (III-B). • Non-stress test is atypical/abnormal: further testing (biophysical profile and/or contraction stress test and assessment of amniotic fluid volume) should be performed as soon as possible (III-B). Recommendation 2: Non-Stress Test 1. Antepartum non-stress testing may be considered when risk factors for adverse perinatal outcome are present (III-B). 2. In the presence of a normal non (...) -stress test, usual fetal movement patterns, and absence of suspected oligohydramnios, it is not necessary to conduct a biophysical profile or contraction stress test (III-B). 3. A normal non-stress test should be classified and documented by an appropriately trained and designated individual as soon as possible, (ideally within 24 hours). For atypical or abnormal non-stress tests, the nurse should inform the attending physician (or primary care provider) at the time that the classification

2018 Society of Obstetricians and Gynaecologists of Canada

169. Canadian Urological Association guideline for the diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction

, renal function) Review of relevant systems Bowel function Sexual function Coexisting non-NLUTD dysfunction (prostatic enlargement, stress incontinence) Gross hematuria Gynecological/pregnancy history Genitourinary/pelvic pain Motor abilities (hand function, ability to transfer) Cognitive function Support systems/caregivers CIC: clean intermittent catheterization; MS: multiple sclerosis; NLUTD: neurogenic lower urinary tract dysfunction; SCI: spinal cord injury; UTI: urinary tract infection.CUAJ (...) , and the behaviour of the urinary sphincters during voiding. The availability of videoUDS is not universal, and a voiding cystogram is an acceptable alternative in some cases. Urodynamic diagnoses, such as neurogenic detrusor overactivity (NDO), impaired compli- ance, reduced bladder capacity, or a high detrusor leak point pressure (DLPP, defined as the lowest vesical pressure at which urine leaks from the bladder in the absence of a detrusor contraction or increased abdominal straining) can identify a patient

2019 Canadian Urological Association

170. Chronic Asthma

diagnosis, but a definitive diagnosis requires confirmation by objective measures. ? DO refer for pre- and post-bronchodilator spirometry to confirm an asthma diagnosis (Table 2). ? If necessary, peak expiratory flow can also be used, however it is less specific. Table 2: Diagnosis content adapted from GINA Guideline update 2017 1 Age Documented airflow limitation on spirometry AND Documented excessive variability in airflow limitation =1 of tests below: Preferred Alternatives Reversibility (post (...) .) but spirometry is negative for asthma: o Repeat spirometry when the patient is symptomatic; use Accredited Pulmonary Function Labs. o Consider referral to a specialist for further testing such as methacholine and exercise challenges. X DO NOT order full pulmonary function testing or chest radiography to confirm asthma, unless questioning a diagnosis other than asthma. Chronic Asthma | April 2018 Clinical Practice Guideline Page 3 of 23 Recommendations MANAGEMENT PRACTICE POINT It is difficult to achieve

2018 Toward Optimized Practice

171. Human Papillomavirus (HPV), Cervical Screening and Cervical Cancer

/04.” (Cancer Research UK, 2014b) Key findings supporting the UK NSC recommendations • The HPV vaccination offered to girls aged 12 to 13 strengthens the rationale for primary HPV screening. The vaccination will offer prevention of HPV and result in a falling number of women who remain at risk of [contracting] HPV and developing cervical cancer. • A primary test for HPV will save more lives by determining a woman’s risk earlier. Work to assess extending the screening interval with HPV screening (...) informed of the reason for the procedure and the implications for their future health and wellbeing. A screening test should be taken in such a way as to provide an adequate sample for assessment, with the minimum of distress or discomfort. The importance of action, regular screening and effective follow up cannot be over emphasised – early diagnosis and treatment saves lives, plus reduces stress and anxiety for the woman and her family. Access to services should be local and easily accessible

2018 Royal College of Nursing

172. European Championships Glasgow 2018: survey of volunteer applicants

information obtained during the application phase with responses to an online questionnaire exploring expectations, experiences and potential influence of the volunteer programme on volunteer applicants and to reflect on how learning from the Glasgow 2014 Commonwealth Games recruitment strategy shaped this. 2.2 Survey design A draft questionnaire was developed predominately using questions tested in previous studies and validated scales. The questionnaire covered a variety of topics exploring experiences (...) % 46% 16% 5% Long-term condition or illness (n=2,331) Yes No 15% 85% Employment (n=2,341) Employed full time (including self-employed) Employed part time (including self-employed) Employed casually (e.g. temporary contract) Retired or pensioner Unemployed and/or looking for employment Full-time pupil or student Full-time carer or parent Other 39% 13% 2% 28% 3% 10% 1% 4% Ethnicity (n=2,344) White Scottish White English White Welsh White Northern Irish White British White Irish White Polish White

2019 Glasgow Centre for Population Health

173. Sexually Transmitted Infections in primary care consultations: development of an online tool to guide healthcare practitioners

2.3.10 How are partners best contacted While reviewing the guidance several methods for contacting the sexual partner(s) of a patient with an STI were retrieved i.e. patient-initiated referral, provider-initiated referral, contract referral, dual referral notification, and third-party referral notification. To use these methods several instruments have been used i.e. testing reminders by SMS and email, patient information folders, mobile or home telephone, social media, and a letter to pass (...) healthcare practitioners, patients’ representatives, members of the GDG, members of the National Guideline Centre (UK), and KCE colleagues who tested the intermediate versions of the tool, and who, thanks to their constructive comments, helped us to improve the readability and user-friendly use of the tool. We also thank Mrs Christiana Nöstlinger (Institute of Tropical Medicine) for the revision of the German version of the tool and Mrs Murielle Mendez (Kaleido Ostbelgien) and Mr Nicolas Breuer

2019 Belgian Health Care Knowledge Centre

174. Asylum seekers in Belgium: options for a more equitable access to health care. A stakeholder consultation

), these three key points and possible options and components for solutions were tested with a large panel of Belgian experts, field workers and policymakers during an online survey (April-May 2018). Participants to this survey were selected because of their expertise in the field of migration and/or health care (purposive sampling). Stakeholders included: the local welfare centres (Centre Public d’Action Sociale CPAS – Openbaar Centrum voor Maatschappelijk Welzijn OCMW (n=593), reception centres of Fedasil (...) exploratory phase and identify preferences, consensual and non- consensual points. It was, however, possible for stakeholders to freely add relevant components/options or modify the proposed options. The survey was initially developed in French, subsequently translated in Dutch, and pre- tested with a panel of KCE researchers (not part of the research team of this study). The survey was structured around the three themes: (i) governance of health policy, (ii) organisation of health care, and (iii) funding

2019 Belgian Health Care Knowledge Centre

175. Organisation of mental health care for adults in Belgium

216 Table 25 – Flowchart of sampling process 217 Table 26 – Stakeholders’ characteristics (n = 469) 220 Table 27 – Priority objectives of the reform in mental health care 221 Table 28 – Fixed effect tests on priority scores* 222 Table 29 – Priority objectives of the reform in mental health care, differences between regions 223 Table 30 – Priority objectives of the reform in mental health care, differences between stakeholders 223 Table 31 – Differences in priority organisational interventions (...) according to the goals of social integration and care in the community 224 Table 32 – Levels of the organisation of mental health care preferred by stakeholders according to the goal of social integration vs care in the community 225 Table 33 – Conjoint analysis on the dimensions and levels of the organisation of mental health care 227 Table 34 – Fixed effect tests on utility scores (U)* 228 Table 35 – Levels of the organisation of mental health care, differences between regions 229 Table 36 – Levels

2019 Belgian Health Care Knowledge Centre

176. Deployment of personnel to military operations: impact on mental health and social functioning

of scenarios. Military deployment is defined as performing military service in an operation at a location outside the home country for a limited time period, pursuant to orders. The review included studies that reported outcomes for individuals who had been deployed. This review looked at the effect of deployment on mental health outcomes. The mental health outcomes are: post-traumatic stress disorder (PTSD), major depressive disorder (MDD), common mental disorders (depression, anxiety and somatisation (...) . These experiences may lead to severe mental stress. The adverse impact on mental health is the psychological cost of war, and it is of interest to policymakers to learn the magnitude of these effects. This review sets out to synthesise available evidence about the consequences of deployment for deployed military personnel in the mental health and social functioning domains. OBJECTIVES The objective of this review is to synthesise the consequences of deployment to military operation on the mental health

2018 Campbell Collaboration

177. Infliximab (Zessly) - Psoriatic Arthritis, Rheumatoid Arthritis, Ulcerative Colitis, Crohn Disease, Psoriasis, Ankylosing Spondylitis

Analytical Ultracentrifugation-Sedimentation Equilibrium BL Baseline BLQ Below the limit of quantification BMI Body mass index BP Blood pressure CDC Complement-Dependent Cytotoxicity CGE Capillary Gel Electrophoresis CHO Chinese Hamster Ovary CI Confidence Interval C max Observed serum drug concentration prior to the end of infusion C trough Observed pre-dose trough serum drug concentration CPP Critical Process Parameter CRF Case report form CRO Contract research organization CSR Clinical study report DA (...) for infusion • Marketing authorisation holder: Janssen Biologics B.V., NL • Date of authorisation: 13-08-1999 • Marketing authorisation granted by: - Community Marketing authorisation number: EU/1/99/116/001-005 Medicinal product which is or has been authorised in accordance with Union provisions in force and to which comparability tests and studies have been conducted: • Product name, strength, pharmaceutical form: Remicade, 100 mg, Powder for concentrate for solution for infusion • Marketing

2018 European Medicines Agency - EPARs

178. Accountable care organisations

for review questions 1 and 2 41 Appendix 4 — US Centers for Medicare & Medicaid Services ACO quality outcome measures 69 Appendix 5 — Case studies 71 6 ACCOUNTABLE CARE ORGANISATIONS| SAX INSTITUTE List of acronyms ACC Accountable Care Collaborative ACCHS Aboriginal Community Controlled Health Service ACO Accountable Care Organisation AHC Accountable Health Community AQC Alternative Quality Contract A & E Accident & Emergency BCBSMA Blue Cross Blue Shield of Massachusetts CCG Clinical Commissions Group (...) of patient-centred medical homes) and contractual options (e.g. alliance contracting and contractual joint ventures). In addition, Accountable Care Communities (ACCs) are emerging as a broader arrangement in which non-traditional healthcare providers such as social and other community service providers are engaged to achieve cost and quality outcomes on a community-wide population basis. The NSW Health Integrated Care Strategy is focused on delivery system redesign to improve health outcomes and patient

2018 Sax Institute Evidence Check

179. Cost-effectiveness analysis of HPV vaccination of boys in Belgium

in Belgium in 2015 and those due to the HPV types included in each vaccine, per gender (Table 4). These numbers are approximations as no systematic HPV testing is applied on cancer cases in Belgium and we used different sources for cases (Cancer Registry) and for the proportion of HPV types by disease (literature). For penile cancers, we selected the Belgian study for the proportion of HPV-attributable penile cancers, i.e. 61%, although this might be an overestimation. 27 . Overall, we estimated

2019 Belgian Health Care Knowledge Centre

180. Management of Cardiovascular Diseases during Pregnancy

and offspring complications 3174 3.3.3 Pregnancy heart team 3176 3.4 Cardiovascular diagnosis in pregnancy 3176 3.4.1 Electrocardiography 3176 3.4.2 Echocardiography 3176 3.4.3 Exercise testing 3177 3.4.4 Ionizing radiation exposure 3177 3.4.5 Chest radiography and computed tomography 3177 3.4.6 Cardiac catheterization 3177 3.4.7 Magnetic resonance imaging 3177 3.5 Genetic testing and counselling 3177 3.5.1 Pre-natal diagnosis 3178 3.6 Foetal assessment 3178 3.6.1 Screening for congenital heart disease 3178 (...) Ventricular tachycardia 3203 9.7 Bradyarrhythmias 3204 9.7.1 Sinus node dysfunction 3204 9.7.2 Atrioventricular block 3204 9.8 Interventions 3204 9.8.1 Electrical cardioversion 3204 9.8.2 Catheter ablation 3204 9.8.3 Implantable cardioverter-defibrillator and pacing 3204 9.9 Recommendations 3206 10. Hypertensive disorders 3207 10.1 Diagnosis and risk assessment 3207 10.1.1 Blood pressure measurement 3207 10.1.2 Laboratory tests 3207 10.2 Definition and classification of hypertension in pregnancy 3207 10.3

2018 European Society of Cardiology

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