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81. ESC/ESH Management of Arterial Hypertension

–creatinine ratio (30–300 mg/g; 3.4–34 mg/mmol) (preferentially on morning spot urine) Moderate CKD with eGFR >30–59 mL/min/1.73 m 2 (BSA) or severe CKD eGFR <30 mL/min/1.73 m 2 b Ankle−brachial index <0.9 Advanced retinopathy: haemorrhages or exudates, papilloedema Established CV or renal disease Cerebrovascular disease: ischaemic stroke, cerebral haemorrhage, TIA CAD: myocardial infarction, angina, myocardial revascularization Presence of atheromatous plaque on imaging Heart failure, including HFpEF (...) (30–300 mg/g; 3.4–34 mg/mmol) (preferentially on morning spot urine) Moderate CKD with eGFR >30–59 mL/min/1.73 m 2 (BSA) or severe CKD eGFR <30 mL/min/1.73 m 2 b Ankle−brachial index <0.9 Advanced retinopathy: haemorrhages or exudates, papilloedema Established CV or renal disease Cerebrovascular disease: ischaemic stroke, cerebral haemorrhage, TIA CAD: myocardial infarction, angina, myocardial revascularization Presence of atheromatous plaque on imaging Heart failure, including HFpEF Peripheral

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2018 European Society of Cardiology

82. Management of Cardiovascular Diseases during Pregnancy

mobile search navigation Article navigation 07 September 2018 Article Contents Article Navigation 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy Vera Regitz-Zagrosek Chairperson Corresponding authors. Vera Regitz-Zagrosek, Charité Universitaetsmedizin Berlin, Institute for Gender in Medicine, CCR, DZHK, partner site Berlin, Hessische Str 3-4, 10115 Berlin, Germany, Tel: +49 30 450 525 288, Fax: +49 30 450 7 525 288, E-mail: . Search for other works by this author (...) on: Jolien W Roos-Hesselink Co-Chairperson Jolien W. Roos-Hesselink, Department of Cardiology, Erasmus Medical Center Rotterdam, Dr Molewaterplein 40, 3015CGD, Rotterdam, Netherlands, Tel: +31 10 7032432, E-mail: Search for other works by this author on: Johann Bauersachs Search for other works by this author on: Carina Blomström-Lundqvist Search for other works by this author on: Renata Cífková Search for other works by this author on: Michele De Bonis Search for other works by this author on: Bernard

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2018 European Society of Cardiology

83. Placenta Praevia and Placenta Accreta: Diagnosis and Management

of Corresponding Author E-mail address: Correspondence : Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regent’s Park, London NW1 4RG. Email: on behalf of Corresponding Author E-mail address: Correspondence : Royal College of Obstetricians and Gynaecologists, 27 Sussex Place, Regent’s Park, London NW1 4RG. Email: First published: 27 September 2018 Cited by: This is the fourth edition of this guideline. The first, published in 2001, was entitled Placenta Praevia: Diagnosis and Management (...) edge is less than 20 mm from the internal os on TAS or TVS. [ New 2018 ] Grade of recommendation: D If the placenta is thought to be low lying (less than 20 mm from the internal os) or praevia (covering the os) at the routine fetal anomaly scan, a follow‐up ultrasound examination including a TVS is recommended at 32 weeks of gestation to diagnose persistent low‐lying placenta and/or placenta praevia. Grade of recommendation: D Placenta praevia is a well‐established complication of pregnancy

2018 Royal College of Obstetricians and Gynaecologists

84. Recommendations for the Delivery of Psychosocial Oncology Services in Ontario

to PSO services for patients and their families across Ontario. JOANNE M. Patient and Family Advisor, Chair of the PSO PFA Committee 4 | Executive Summary Executive Summary RECOMMENDATIONS FOR THE DELIVERY OF PSYCHOSOCIAL ONCOLOGY SERVICES IN ONTARIO one ORGANIZATION, STRUCTURE AND PHILOSOPHY OF THE PSO PROGRAM 1.1 Psychosocial Oncology is reflected as a distinct program within the internal organizational structures of all Regional Cancer Programs in order to enhance cohesion and communicate (...) Regional Cancer Programs continue to consistently use symptom screening tools as a component of the screen for PSO needs. 2.2 All sites develop an inter-professional approach for responding to clinically significant screening for all issues and/ or elevated symptom screen scores. Teams consider secondary assessment tools for elevated scores. 2.3 Symptom screens be addressed routinely at clinic visits; the symptom scores should be acknowledged followed by assessment, interventions and referral

2018 Cancer Care Ontario

85. Do general health checks prolong lifespan?

of the RCTs for adults under the age of 65 [20], only inactivated vaccines and live attenuated vaccines showed symptomatic effects. The number needed to treat to benefit was 70 showing only one person escaped influenza when 70 persons were vaccinated. There is no effect of split vaccine used in Japan. When you have influenza If you visit an outpatient clinic for consultation, there may be sick people or patients with high risk or elderlies in the waiting room. You may give your influenza to these people (...) , Ueshio 5-1-20, Tennouji, Osaka JAPAN E-mail: npojip@mbr.nifty.com C M ED HECK The Informed Prescriber 2018 Vol.4 No.10 https://www.ncbi.nlm.nih.gov/pubmed/1870247 18) Strandberg TE, Salomaa VV, Vanhanen HT, Naukkarinen VA, Sarna SJ, Miettinen TA. Mortality in participants and non-participants of a multifactorial prevention study of cardiovascular diseases: a 28 year follow up of the Helsinki Businessmen Study. Br Heart J 1995: 74: 449-454. Https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC484055/ 19

2018 Med Check - The Informed Prescriber

86. Creating a Rapid-learning Health System in Ontario

, based on the best available research evidence and systematically elicited citizen values and stakeholder insights. We aim to strengthen health systems – locally, nationally, and internationally – and get the right programs, services and drugs to the people who need them. Authors John N. Lavis, MD PhD, Director, McMaster Health Forum; Professor, McMaster University; and Adjunct Visiting Professor, University of Johannesburg François-Pierre Gauvin, PhD, Senior Scientific Lead, Citizen Engagement (...) that arise in a rapid-learning health system and it grouped the 67 distinct ethical issues within four phases of the rapid-learning health system: (10) o designing activities: the risk of negative outcomes (e.g., reducing the quality and usability of results) from designing learning activities less rigorously so they are not classified as research, and the risk of inadequate engagement of stakeholders (which can affect the success of the learning activity due to a lack of established trust and support

2018 McMaster Health Forum

87. Interpregnancy Care

, childhood injuries, and repeated childbearing. A randomized controlled trial. JAMA 1997;278:644–52. El-Kamary SS, Higman SM, Fuddy L, McFarlane E, Sia C, Duggan AK. Hawaii's healthy start home visiting program: determinants and impact of rapid repeat birth. Pediatrics 2004;114:e317–26. Dunlop AL, Dubin C, Raynor BD, Bugg GW Jr, Schmotzer B, Brann AW Jr. Interpregnancy primary care and social support for African-American women at risk for recurrent very-low-birthweight delivery: a pilot evaluation (...) live birth or pregnancy loss and the start of the next pregnancy; specifically, it will focus on this interval after a woman has transitioned from postpartum care. Existing Recommendations The concept of interpregnancy care is well established and multiple organizations have put forth their own distinct set of interpregnancy care recommendations (5, ). However, many of these recommendations are focused solely on improving neonatal outcomes of future pregnancies. This document will focus

2019 American College of Obstetricians and Gynecologists

88. Ethical Considerations for the Care of Patients With Obesity

, and specially designed instruments for use in the operating room. Additionally, surgical procedures that often are performed in more cost-effective outpatient surgical centers may need to be undertaken in hospitals because of increased anesthesia risks to patients with obesity, along with other medical considerations. These surgical procedures may be more complex, and they may be of longer duration. During pregnancy, more frequent ultrasonography may be required to monitor fetal growth and presentation (...) to address any identified bias to help ensure that it does not interfere with the delivery of respectful clinical care for patients with obesity. Box 1 includes questions for self-reflection to help obstetrician–gynecologists identify implicit bias. Patient-Centered Counseling to Address Obesity Obstetrician–gynecologists may find it difficult during a typical office visit to initiate a dialogue about weight, healthy diet, and lifestyle, especially when other problems must be addressed or if the patient

2019 American College of Obstetricians and Gynecologists

89. Clinical Practice Guideline for the Management of Infantile Hemangiomas

. Clinical Practice Guideline for the Management of Infantile Hemangiomas Daniel P. Krowchuk , Ilona J. Frieden , Anthony J. Mancini , David H. Darrow , Francine Blei , Arin K. Greene , Aparna Annam , Cynthia N. Baker , Peter C. Frommelt , Amy Hodak , Brian M. Pate , Janice L. Pelletier , Deborah Sandrock , Stuart T. Weinberg , Mary Anne Whelan , SUBCOMMITTEE ON THE MANAGEMENT OF INFANTILE HEMANGIOMAS Abstract Infantile hemangiomas (IHs) occur in as many as 5% of infants, making them the most common (...) clinical judgment, or to establish a protocol for all infants with IHs. Rather, it provides a framework for clinical decision-making. Methods The methods of this CPG are discussed in detail in the Methods section of the . Briefly, a comparative effectiveness review of potential benefits and harms of diagnostic modalities and pharmacologic and surgical treatments was conducted on behalf of the Agency for Healthcare Research and Quality (AHRQ). The literature search strategy employed Medline via

2019 American Academy of Pediatrics

90. Syphilis in pregnancy

at risk of congenital syphilis o Identify the most appropriate service as relevant to the local context (e.g. paediatric outpatient clinic or outreach service) o Establish a local process for initiating and ensuring follow-up occurs, including if baby discharged prior to pathology result availability · Use audit processes to monitor and review follow-up care and clinical outcomes Communication · Communicate with the multidisciplinary team—the identified referral pathways and responsibility for follow (...) purposes, as long as you attribute Queensland Clinical Guidelines, Queensland Health and abide by the licence terms. You may not alter or adapt the work in any way. To view a copy of this licence, visit https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en For further information, contact Queensland Clinical Guidelines, RBWH Post Office, Herston Qld 4029, email Guidelines@health.qld.gov.au, phone (07) 3131 6777. For permissions beyond the scope of this licence, contact: Intellectual Property

2019 Queensland Health

91. Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association

. There is no universally accepted method for capturing subjective adverse events. Typically, trialists ask an open-ended question at every clinic visit, such as “Have you had any health problems since your last visit?” In some cases, trialists also ask about a specific symptom or set of symptoms. Tolerability refers to the degree to which adverse effects of a medication can be endured. Intolerance refers to the inability to tolerate a treatment at any recommended dose, whether or not the symptoms are related (...) not exposed to the medication. Controlled observational studies can be performed much more quickly and cheaply than RCTs, and in some cases, the HR for a particular adverse effect is so large that it cannot be reasonably attributed to bias. The relationship between tobacco and lung cancer is a good example in which causality could be established because of the HR >10 comparing lung cancer mortality in lifelong smokers versus never-smokers (after accounting for known confounders). In this situation

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2019 American Gastroenterological Association Institute

92. 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza

. Hayden, Scott A. Harper, Jon Mark Hirshon, Michael G. Ison, B. Lynn Johnston, Shandra L. Knight, Allison McGeer, Laura E. Riley, Cameron R. Wolfe, Paul E. Alexander, and Andrew T. Pavia For full document, including tables and references, please visit the . Abstract These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding (...) 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza Influenza Search Search Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza Published : 19 December 2018 Timothy M. Uyeki, Henry H. Bernstein, John S. Bradley, Janet A. Englund, Thomas M. File Jr, Alicia M. Fry, Stefan Gravenstein, Frederick G

2019 Infectious Diseases Society of America

93. Enhancing Health System Integration of Nurse Practitioners in Ontario

that nurse practitioners have longer consultations and patients request more follow-up visits, but all of the reviews cited limitations as a result of the quality and amount of evidence available. • Improved patient satisfaction for care provided by nurse practitioners was found in emergency departments, long-term care, as well as care provided in rural and remote communities, and no significant differences were found for oncology care provided by nurse practitioners and in a comparison of nurse (...) costs resulted from lower salaries and a reduced number of patient visits, and that families who were cared for by nurse practitioners spent half the amount compared to families who saw dermatologists (accounted for by time costs and out-of-pocket expenditures).(29) The primary study compared outcomes for patients with rheumatoid arthritis who were cared for by a team that included a nurse practitioner to those that did not include a nurse practitioner.(43) The longitudinal study found supportive

2018 McMaster Health Forum

94. Enhancing Health Promotion and Disease Prevention in Networked Primary Care

, M.Sc., Lead, Evidence Synthesis, McMaster Health Forum Ahmed A. Belal, M.Sc., Research Assistant, Evidence Synthesis, McMaster Health Forum Eilish M. Scallan, M.Sc., Research Assistant, Evidence Synthesis, McMaster Health Forum Michael G. Wilson, PhD, Assistant Director, McMaster Health Forum, and Associate Professor, McMaster University Timeline Rapid syntheses can be requested in a three-, 10-, 30-, 60- or 90-business-day timeframe. This synthesis was prepared over a 30-businessday timeframe (...) primary care or have outlined plans to implement networked primary care in the health system. In Saskatchewan, the Ministry of Health in the most recent annual report has outlined actions to establish primary-care networks in Regina and Saskatoon.(4) Similarly, the Nova Scotia Health Authority’s guiding document for primary-care delivery outlines a Health Home model, which will use a population-health approach to primary care, and include wellness and chronic-disease management across a geographic

2018 McMaster Health Forum

95. Improving social and emotional wellbeing for Aboriginal and Torres Strait Islander people

, discrimination, violence, victimisation, offending and social disadvantage. 6, 7 There also needs to be a focus on reducing these stressors (risks) and improving the capacity of community members and service staff to cope with these. Thus, the concept provides a holistic perspective on what are commonly understood as mental health concerns, and acknowledges the impact of the social and cultural determinants of health. Indigenous SEWB is ?rmly established as a national strategic priority. 8 Beyond Blue (...) to risk (i.e. understanding risk and mental health promotion, and developing tailored early intervention and prevention strategies); and 4) establishing improved engagement, screening, management and referral pathways. The latter is critically important: 80% of adolescents (10–24 years) from 114 primary healthcare services were not screened for social and emotional wellbeing concerns. Of those screened, no further action was taken for 14% of all clients for whom concerns were identified

2018 Sax Institute Evidence Check

96. Bioresorbable Stents in cardiovascular indications (coronary artery disease)

hospitalisation or outpatient visits [7]. Therefore, revascularisation should ideally prolong life expectancy, reduce symptoms and future revascularisations, and increase health-related quality of life. Safety: Adverse events (AEs) • vascular access site complication • procedure-related contrast-induced nephropathy Bioresorbable stents for cardiovascular indications Version 1.4, 28 January 2019 EUnetHTA Joint Action 3 WP4 19 SAEs • late/very late (after =1 year) ScT and/or stent thrombosis and its (...) (studies) Quality Comments Risk with DES or other revascularisation strategies Risk with DESolve ® Scaffold System Effectiveness All-cause mortality — — — — — Outcome not reported Cardiac mortality — — — — — Outcome not reported MI — — — — — Outcome not reported Safety Periprocedural mortality — — — 345 ??? ? very low 5 No events of periprocedural mortality occurred in three single-arm observational studies of the DESolve ® Scaffold System Periprocedural MI — — — 345 ??? ? very low e One periprocedural

2019 EUnetHTA

97. The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs)

consumption correlates with in- creased antibiotic resistance, with countries that have moderate to high consumption of antibiotics also having high levels of AMR. However, a causal link between antibiotic consumption and re- sistance is difficult to establish. (A0002) At the patient level, there is a clear link between antibiotic dose and duration and the emergence of antibiotic resistance. There is also evidence that patients who have been treated frequently with antibiotics are at greater risk (...) not generally recommend the use of antibiotics in acute sinusitis, it is unclear what the aim of CRP testing, on its own or as part of a clinical prediction rule, would be even if a suitable threshold could be established. In pharyngitis/tonsillitis, treatment with antibiotics is generally only recommended in those with group A streptococcal (GAS) infection (5% to 30% of those presenting with sore throat). A cut-point of 35 mg/L CRP may be useful in discriminating bacterial from non-bacterial pharyngitis

2019 EUnetHTA

98. Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia

, x 41 Maclean, D., Harris, M., Drake, T. et al. Factors predicting a good symptomatic outcome after prostate artery embolisation (PAE). Cardiovasc Intervent Radiol . 2018 ; 41 : 1152–1159 , x 42 Rampoldi, A., Barbosa, F., Secco, S. et al. Prostatic artery embolization as an alternative to indwelling bladder catheterization to manage benign prostatic hyperplasia in poor surgical candidates. Cardiovasc Intervent Radiol . 2017 ; 40 : 530–536 , x 43 Salem, R., Hairston, J., Hohlastos, E. et al (...) techniques. Cardiovasc Intervent Radiol . 2017 ; 40 : 366–374 , x 40 Kurbatov, D., Russo, G.I., Lepetukhin, A. et al. Prostatic artery embolization for prostate volume greater than 80 cm3: results from a single-center prospective study. Urology . 2014 ; 84 : 400–404 , x 41 Maclean, D., Harris, M., Drake, T. et al. Factors predicting a good symptomatic outcome after prostate artery embolisation (PAE). Cardiovasc Intervent Radiol . 2018 ; 41 : 1152–1159 , x 43 Salem, R., Hairston, J., Hohlastos, E. et al

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2019 Society of Interventional Radiology

99. WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents

the University of Wisconsin-Madison Pain and Policies Studies Group was an observer at the first scoping meeting. He was then appointed to the GDG as a member. 2 Eric Krakauer first joined the guideline development process as a member of the WHO Steering Com - mittee, and following his departure from WHO joined the GDG as a member.7 ACKNOWLEDGEMENTS Systematic Review team members: Ethan M Balk (Lead), Gaelen P Adam, Mengyang Di, Hannah J Kimmel, Matthew Olean, Jessica K Roydhouse, Bryant Smith, Andrew R (...) This recommendation applies to people who already have painful bone metastases; it does not apply to people whose bone metastases are not painful. The GDG acknowledged that other established practices exist for treatment of cancer pain, but evidence of efficacy is limited. Regarding such practices, the clinician may consider an individual trial of therapy and cease the medicine if no improvement in pain occurs. Ideally, eligible patients should be enrolled in a clinical trial wherever pos- sible to expand

2019 World Health Organisation Guidelines

100. Day-case surgery

if their child becomes unwell before the day of surgery. This can prevent late cancellations, avoiding the wasteoftheatreresourcesandunnecessarytripstohospital with a child who is not ?t for the procedure and may be an infectionrisk. Pre-anaesthetic assessment is also an opportunity to establish who has parental responsibility and to ensure that appropriate consent procedures are followed. Written consent for the procedure may already have been obtained in the outpatient setting, but a discussion regarding (...) members of a working party established by the Association of Anaesthetists of Great Britain and Ireland and the British Association of Day Surgery (BADS). It has been seen and approvedbytheAssociationofAnaesthetist’sBoardofDirectorsandtheCouncilofBADS.Ithasbeenendorsedbythe Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) and the Royal College of Anaesthetists (RCoA). Twitter:@drcrbailey Re-use of this article is permitted in accordance with the Creative Commons Deed

2019 Association of Anaesthetists of GB and Ireland

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