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Dyspepsia in Pregnancy

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141. Management of Uterine Fibroids

Table 16. Change in fibroid volume with uterine artery embolization by study arm 43 Table 17. Change in bleeding outcomes with uterine artery embolization by study arm 45 Table 18. Change in quality of life (SF-36) with uterine artery embolization by study arm 46 Table 19. Patient satisfaction with uterine artery embolization 48 Table 20. Subsequent fibroid treatment following uterine artery embolization by study arm 48 Table 21. Pregnancy and fertility status following uterine artery embolization (...) of medications to the end of the section. To summarize outcomes we move from changes in the fibroids, to changes in symptoms, including bleeding characteristics, pain, and sexual function. When reported we also summarize fertility status and pregnancy outcomes as well as satisfaction with treatment and subsequent treatments over time. Only hemoglobin/hematocrit laboratory values, severity of uterine bleeding, and standardized quality of life and functional status measures were reported using validated

2017 Effective Health Care Program (AHRQ)

142. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Gui Full Text available with Trip Pro

Annular VA e242 7.2. Papillary Muscle VA e242 7.3. Interfascicular Reentrant VT (Belhassen Tachycardia) e242 7.4. Idiopathic Polymorphic VT/VF e242 8. PVC-Induced Cardiomyopathy e243 9. VA and SCD Related to Specific Populations e243 9.1. Pregnancy e243 9.2. Older Patients With Comorbidities e243 9.3. Medication-Induced Arrhythmias e243 9.4. Adult Congenital Heart Disease e243 10. Defibrillators Other than Transvenous ICDs e246 10.1. Subcutaneous Implantable Cardioverter-Defibrillator e246 10.2

2017 American Heart Association

143. Treatment of Helicobacter pylori Infection

. L e o n tiadis , MD , PhD 2 , C o lin W . H o w den , MD , F A C G 3 a n d S t e v en F . M os s , MD , F A C G 4 Helicobacter pylori ( H. pylori ) infection is a common worldwide infection that is an important cause of peptic ulcer disease and gastric cancer. H. pylori may also have a role in uninvestigated and functional dyspepsia, ulcer risk in patients taking low-dose aspirin or starting therapy with a non-steroidal anti-in? ammatory medication, unexplained iron de? ciency anemia (...) been documented), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H. pylori infection. Th ose who test positive should be off ered treatment for the infection (strong recommendation, quality of evidence: high for active or history of PUD, low for MALT lymphoma, low for history of endoscopic resection of EGC). In patients with uninvestigated dyspepsia who are under the age of 60 years

2017 American College of Gastroenterology

144. Probiotics and Prebiotics

Organization recommendation on probiotic use during pregnancy, breastfeeding, and weaning in families with a high risk of allergic disease. Probiotics and prebiotics are also being tested for the prevention of some manifestations of the metabolic syndrome, including excess weight, type 2 diabetes, and dyslipidemia. 4 Summaries of evidence for probiotics and prebiotics in adult and pediatric conditions —the global picture Tables 8 and 9 summarize a number of gastrointestinal conditions for which

2017 World Gastroenterology Organisation

146. Diagnosis and Treatment of Low Back Pain

(29.2%) and 2010 (28.4%). Additionally, women are more likely than men to experience LBP (29.6% versus 25.4%, respectively).[5] More than two-thirds of pregnant women experience LBP and symptoms typically increase with advancing pregnancy;[6] however, pregnancy-related LBP often resolves itself in the post-partum period and may require specialist care when LBP persists or red flags are present. In a study of U.S. healthcare costs from 1996 through 2013, spending related to LBP and neck pain (...) of a provider’s clinical judgment and patient values and preferences, for the care of an individual patient. A. Scope of this Clinical Practice Guideline This LBP CPG is designed to assist healthcare providers in diagnosing or treating patients with LBP. This CPG is not intended for and does not provide recommendations for the diagnosis and treatment of LBP in children or adolescents, or pregnant women. Surgical procedures (including procedures using spinal cord stimulators) are outside the scope

2017 VA/DoD Clinical Practice Guidelines

147. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Hea Full Text available with Trip Pro

(Belhassen Tachycardia) e335 8.4. Idiopathic Polymorphic VT/VF e336 9. PVC-Induced Cardiomyopathy e337 10. VA and SCD Related to Specific Populations e338 10.1. Athletes e338 10.2. Pregnancy e338 10.3. Older Patients With Comorbidities e339 10.4. Chronic Kidney Disease e340 10.5. Valvular Heart Disease e340 10.6. Sex-Related Differences in the Risk of SCD e340 10.7. Medication-Induced Arrhythmias e341 10.8. Adult Congenital Heart Disease e342 11. Defibrillators Other than Transvenous ICDs e347 11.1

2017 American Heart Association

148. ASCIA Position Paper - Hereditary Angioedema (HAE)

although one must investigate the legality of carrying certain medications if unregistered in the destination country. 7.2.2 Pregnancy and delivery Danazol needs to be ceased prior to conception. Tranexamic acid may be used with caution if frequent attacks occur. C1-INH ncentrate on demand, as individual replacement therapy, or at scheduled regular intervals if frequent attacks are occurring is now considered optimal therapy in the pregnant woman with HAE. There is no data on the use of icatibant (...) attack 3.2 Manifestations 3.3 Other features 3.4 Trigger factors 3.5 Special circumstances 3.5.1 Pregnancy 3.5.2 Perioperative period 3.5.3 Dental procedures 3.6 Paediatric presentations 3.6.1 Delayed diagnosis 3.6.2 Implications of paediatric presentation 3.6.3 Special clinical features 4.0 Diagnosis 14 4.1 Indications for testing 4.2 Testing for HAE 4.3 Acquired C1-INH deficiency (AAE) 5.0 Genetic Diagnosis of HAE 16 6.0 Management 17 6.1 Treatment of acute attacks of angioedema 6.2 Short term

2017 Australasian Society of Clinical Immunology and Allergy

149. CRACKCast E089 – Esophagus, Stomach & Duodenum

complications of GERD Some physiologic GER occurs in everyone, when it becomes symptomatic then it is “GERD”. Conditions associated with GERD: (ie. anything that causes the LES to relax of become overwhelmed) – this comes from Box 79-2 Decreased LES pressure Meds: CCB, nitrates, anticholinergics, albuterol, benzos, Fatty meals / Chocolate / Caffeine / Ethanol / Peppermint / nicotine Pregnancy Estrogen / progesterone Increased gastric emptying time / Increased intra-abd. Pressure Anticholinergic drugs (...) Pregnancy Obesity Coughing / bending / Supine position Gastroparesis / neuromuscular disease leading to gastric outlet obstruction Decreased esophageal motility Achalasia DM Scleroderma GEeRD = “gastric emptying; esophageal relaxation drugs” mnemonic Complications of GERD Esophagitis Progressing to Barrett’s metaplasia, erosion, ulcerations, scarring Stricture formation due to persistent scarring and inflammation Reflux induced asthma Microaspiration of Adenocarcinoma of the esophagus Esophageal

2017 CandiEM

150. CRACKCast E032 – Constipation

agents Psych Abuse, eating disorders, affective disorders Other: Dehydration / immobility / dietary factors Pregnancy / post-operative pain Diagnostic algorithm Pivotal findings: History ..usually tells you the dx Alarm symptoms: Fever, anorexia, vomiting, blood in stool, wt loss, Onset in age > 50 yrs Thorough review of medications! And OTC agents Physical examination Key to do: Abdominal exam Rectal exam Fissures, hemorrhoids, rectal prolapse, DRE for masses, proctitis, gross blood Ancillary (...) that is indigestible Psyllium (metamucil) – up to 20 g daily WITH plenty liquids Prunes, figs osmotic salts Sodium phosphate – 30 ml prn. citrate – milk of magnesia – 30-45 ml daily sugars Lactulose – PEG 3350 – 17 g BID Golytely or miralax stool softeners Mineral oil – 5 – 15 ml qhs Colace 100 mg BID – of little use stimulant laxatives Senokot 8 – 34 mg daily suppositories and enemas For poop in the rectum Glycerin suppositories Warm tap water enemas for large amounts of stool in the rectum Fecal disimpaction

2017 CandiEM

151. Truberzi (eluxadoline) - for the treatment of adults who have irritable bowel syndrome with diarrhoea

-month oral study [1808-004]. Exposure increased with increasing doses, and higher exposure could be achieved by an accompanying subcutaneous administration of eluxadoline. Total body clearance of eluxadoline decreased as the dose increased [1808-012]. Accumulation was observed in 9-month oral toxicity study and there were no consistent gender differences. In humans the drug did not accumulate upon repeated dosing. Data in pregnant animals obtained in rats and rabbits revealed similar results (...) . Eluxadoline does not cross the blood/placental barrier in pregnant rats. The absorption and first-pass clearance of eluxadoline was investigated in male rats by measuring plasma concentrations in the hepatic portal and jugular veins after a 10 mg/kg oral dose [DD07389]. Hepatic portal vein concentrations (Cmax = 72 ng/mL) were very low after oral administration indicating that absorption through the gastrointestinal wall was limited. The concentrations in jugular vein were below the limit

2016 European Medicines Agency - EPARs

154. Neofordex - dexamethasone. To treat adults with multiple myeloma

fertility are contradictory (SmPC, section 5.3). Women should avoid pregnancy during Neofordex treatment. Dexamethasone may cause congenital malformations. Dexamethasone may be used with known teratogens (e.g. thalidomide, lenalidomide, pomalidomide, plerixafor), or with cytotoxic substances which are not recommended in pregnancy. Patients receiving Neofordex in combination with products containing thalidomide, lenalidomide or pomalidomide should adhere to the pregnancy prevention programmes of those

2016 European Medicines Agency - EPARs

156. Alcohol: Adult Unhealthy Drinking

in a guideline does not imply coverage. A decision to adopt any particular recommendation must be made by the provider in light of the circumstances presented by the individual patient. 2 Summary of Changes as of October 2016 Added recommendations for screening and intervention for PREGNANT WOMEN: • Abstinence is recommended for pregnant women and for women planning pregnancy. • Pregnant women should be screened with the AUDIT-C at least once per trimester and at the 6- week postpartum visit. o The timeframe (...) for the questions should be the last 3 months rather than the last year. o The threshold for “binge drinking” in the third question is 4 or more drinks on one occasion. • Pregnant women should be screened for alcohol use disorder (AUD) using the Alcohol Symptom Checklist if: o They score a 3 or greater on the AUDIT-C, or o They are currently drinking at any level since learning of their pregnancy, regardless of their AUDIT-C score. • Pregnant women who are negative for AUD should receive brief behavioral

2016 Kaiser Permanente Clinical Guidelines

157. Dyslipidaemias Full Text available with Trip Pro

. Autoimmune chronic inflammatory conditions such as rheumatoid arthritis, systemic lupus erythematosus (SLE) and psoriasis are associated with increased CV risk and dyslipidaemia. Furthermore, in women, diabetes or hypertension during pregnancy are risk indicators, and in men, erectile dysfunction. Patients with CKD are also at increased risk for CVD events and should be screened for dyslipidaemias. Clinical manifestations of genetic dyslipidaemias, including xanthomas, xanthelasmas and premature arcus

2016 European Society of Cardiology

158. Smokeless tobacco: South Asian communities

to cost effectiveness and duration of effect. It also takes into account any harmful/negative side effects. 5.1 What is the natural progression of disease for South Asian users of smokeless tobacco (for example, how prevalent is oropharyngeal cancer and periodontal disease among users)? 5.2 How prevalent is smokeless tobacco use among South Asian women who are pregnant and why? Is there a particular stage during pregnancy when smokeless tobacco is used? What impact does its use during pregnancy have (...) of services to help people quit challenges the perceived benefits – and the relative priority that users may place on these benefits (compared with the health risks). For example, some people think smokeless tobacco is an appropriate way to ease indigestion or relieve dental pain, or helps freshen the breath addresses the needs of people whose first language is not English (by providing translations) addresses the needs of people who cannot read in any language (by providing material in a non-written form

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

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