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161. Pharmacologic and Nonpharmacologic Therapies in Adult Patients With Exacerbation of COPD

5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00013-I Prepared by: Mayo Clinic Evidence-based Practice Center Rochester, MN Investigators: Claudia C. Dobler, M.D., Ph.D. Allison S. Morrow, B.A. Magdoleen H. Farah, M.B.B.S. Bradley Beuschel, B.S.P.H. Abdul M. Majzoub, M.D. Michael E. Wilson, M.D. Bashar Hasan, M.D. Mohamed O. Seisa, M.D. Lubna Daraz, Ph.D. Larry J. Prokop, M.L.S. M. Hassan Murad, M.D., M.P.H. Zhen Wang, Ph.D. AHRQ Publication No. 19(20)-EHC024-EF October (...) questions about the optimal nutritional support for patients with ECOPD. 31, 32 Established treatments for ECOPD, such as antibiotics and systemic corticosteroids, may not be indicated in every single episode of an ECOPD. One uncertainty relates to the need for antibiotics in mild and moderately severe ECOPD, especially in an outpatient setting. 33 While antibiotics for treatment of severe ECOPD have been shown to be beneficial in some studies, the need for antibiotics in less severe forms of COPD

2019 Effective Health Care Program (AHRQ)

162. Brief psychological interventions for young people with common mental health conditions

. 2015;20(1):49-55. 34. Piet J, Hougaard, E., Hecksher, M. S. & Rosenberg, N. K. . A randomized pilot study of mindfulness- based cognitive therapy and group cognitive- behavioral therapy for young adults with social phobia. Scandinavian Journal of Psychology. 2010;51:403–410. 35. Walsh E, Eisenlohr-Moul T, Baer R. Brief mindfulness training reduces salivary IL-6 and TNF-alpha in young women with depressive symptomatology. J Consult Clin Psychol. 2016 Oct;84(10):887-97. 36. Baer RA. Mindfulness Training (...) as a Clinical Intervention: A Conceptual and Empirical Review. Clinical Psychology: Science and Practice. 2003;10(2):125-143. 37. Bohlmeijer E, Prenger R, Taal E, Cuijpers P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. J Psychosom Res. 2010 Jun;68(6):539-44. 38. Fjorback LO, Arendt M, Ornbol E, Fink P, Walach H. Mindfulness-based stress reduction and mindfulness-based cognitive therapy: a systematic review

2019 Orygen, The National Centre of Excellence in Youth Mental Health

163. Surveillance, Diagnosis and Management of Clostridium Difficile Infection in Ireland

Surveillance, Diagnosis and Management of Clostridium Difficile Infection in Ireland Surveillance, Diagnosis and Management of Clostridium difficile Infection in Ireland National Clinical Guideline No. 3 June 2014National Clinical Effectiveness Committee (NCEC) The National Clinical Effectiveness Committee (NCEC) was established as part of the Patient Safety First Initiative in September 2010. The NCECs mission is to provide a framework for national endorsement of clinical guidelines and audit (...) to optimise patient and service user care. The NCEC has a remit to establish and implement processes for the prioritisation and quality assurance of clinical guidelines and clinical audit so as to recommend them to the Minister for Health to become part of a suite of National Clinical Guidelines and National Clinical Audit. National Clinical Guidelines are “systematically developed statements, based on a thorough evaluation of the evidence, to assist practitioner and service users’ decisions about

2019 National Clinical Guidelines (Ireland)

164. Community-Acquired Pneumonia (CAP) in Adults

outcomes; furthermore, outpatient treatment included daily nursing visits and parenteral antibiotic therapy that is typically restricted to inpatient care. Rationale for the recommendation Our recommendation to use the PSI as an adjunct to clinical judgment to guide the initial site of treatment is based on consistent evidence of the effectiveness and safety of this approach. Using a safe and effective decision aid to increase outpatient treatment of patients with CAP has potential to decrease (...) to MRSA or P. aeruginosa ( see Recommendation 11) are uncommonly managed in the outpatient setting, these patients may require antibiotics that include coverage for these pathogens. Research needed in this area There is a need for head-to-head prospective RCTs of outpatient CAP treatment, comparing clinical outcomes, including treatment failure, need for subsequent visits, hospitalization, time to return to usual activities and adverse events. Furthermore, the prevalence of specific pathogens

2019 Infectious Diseases Society of America

165. Patients Hospitalized with Heart Failure: Risk Assessment, Management, and Clinical Trajectory

or by palliative care specialists may be FIGURE 1 Clinical Course of Heart Failure Improving towards target Improving towards target Not improved/ worsening Stalled Focus of Care Transition to Oral Therapies Admission Discharge First Follow-up Visit Clinical decompensation Discharge coordination Ongoing optimization of outpatient care Guideline-directed medical therapy Evaluation for long-term trajectory Early acute phase Late acute phase Optimization phase Early post- discharge phase Transition to chronic (...) Patients Hospitalized with Heart Failure: Risk Assessment, Management, and Clinical Trajectory EXPERT CONSENSUS DECISION PATHWAY 2019 ACC Expert Consensus Decision PathwayonRiskAssessment, Management, and Clinical Trajectory of Patients Hospitalized With Heart Failure A Report of the American College of Cardiology Solution Set Oversight Committee Writing Committee Steven M. Hollenberg, MD, FACC, Chair Lynne Warner Stevenson, MD, FACC, Vice Chair Tariq Ahmad, MD, MPH, FACC Vaibhav J. Amin, MD

2019 American College of Cardiology

166. Recommendations for Prevention and Control of Influenza in Children, 2019–2020

of outpatient clinic and emergency department visits for influenzalike illness, high influenza-related hospitalization rates, and high numbers of deaths. – Influenza A(H3N2) viruses predominated through February 2018; influenza B viruses predominated from March 2018 onward. Although hospitalization rates for children that season did not exceed those reported during the 2009 pandemic, they did surpass rates reported in previous high-severity A(H3N2)-predominant seasons. Excluding the 2009 pandemic, the 186 (...) season, replacing the LAIV3. The most commonly reported reactions in children are runny nose or nasal congestion, headache, decreased activity or lethargy, and sore throat. The safety of LAIV in people with a history of asthma, diabetes mellitus, or other high-risk medical conditions associated with an elevated risk of complications from influenza (see Contraindications and Precautions) has not been firmly established. In postlicensure surveillance of LAIV (including LAIV3 and LAIV4), the Vaccine

2019 American Academy of Pediatrics

167. What is the evidence on availability and integration of refugee and migrant health data in health information systems in the WHO European Region?

, was established at the WHO Regional Office for Europe in 2011 to support Member States to strengthen the health sector’s capacity to provide evidence-informed responses to the public health challenges for refugee and migrant health. The programme operates under the umbrella of the European health policy framework Health 2020 and provides support to Member States under four pillars: technical assistance; health information, research and training; policy development; and advocacy and communication (...) systems for the general population because this is also likely to improve the availability of data on refugee and migrant health; • integrate key data elements related to refugees and migrants (e.g. country of birth, nationality, length of stay, reason for migration) into existing data collection systems to facilitate stratified data analysis, identify at-risk subgroups and ensure cross-border comparability; • establish and/or strengthen a tailored, proactive approach to data collection for refugees

2019 WHO Health Evidence Network

168. What are the roles of intercultural mediators in health care and what is the evidence on their contributions and effectiveness in improving accessibility and quality of care for refugees and migrants in the WHO European Region?

and Health programme, formerly known as Public Health Aspects of Migrants in Europe (PHAME), was established in 2011 to support Member States of the WHO European Region to strengthen the health sector’s capacity to provide evidence-informed responses to the public health challenges of refugee and migrant health. The programme operates under the umbrella of the European health policy framework Health 2020. The programme provides support to Member States under four pillars: technical assistance; health (...) providers were found to be lacking. Policy considerations Based on the review findings, the following policy considerations to improve the equity of health services for refugees and migrants can be considered by Member States: • establish clear and coherent definitions of the roles and responsibilities of intercultural mediators working in the health sector; • establish professional guidelines, standards and quality assurance processes to support the recognition and full professionalization

2019 WHO Health Evidence Network

169. BTS/SIGN British Guideline on the Management of Asthma

establish whether or not the airflow obstruction reverses to normal with treatment. Evidence of a symptomatic response, ideally using objective measures of asthma control and lung function, should be sought at a follow-up visit. If there is significant reversibility or improvement in symptom scores, confirm the diagnosis of asthma and record the basis on which the diagnosis was made. Continue to treat as asthma, but aim to find the minimum effective dose of therapy. If the patient remains asymptomatic (...) development group 152 17.3 Acknowledgements 154 17.4 Consultation and peer review 154 Abbreviations 156 Annexes 158 References 1721 1 | Introduction 1 Introduction 1.1 The need for a guideline Asthma is a common condition which produces a significant workload for general practice, hospital outpatient clinics and inpatient services. It is clear that much of this morbidity relates to poor management, particularly around the use of preventative medicine. 1.1.1 Background In 1999 the British Thoracic Society

2019 British Thoracic Society

170. Multiplex polymerase chain reaction gastrointestinal pathogen panels for people with suspected gastroenteritis

of infectious intestinal disease. Clin Infect Dis. 2012;54(9):1275-86. 11. 11. Woodward DL, Clark CG, Caldeira RA, Ahmed R, Rodgers FG. Verotoxigenic Escherichia coli (VTEC): a major public health threat in Canada. Can J Infect Dis. 2002;13(5):321-30. 12. 12. Locking ME, Pollock KG, Allison LJ, Rae L, Hanson MF, Cowden JM. Escherichia coli O157 infection and secondary spread, Scotland, 1999-2008. Emerg Infect Dis. 2011;17(3):524-7. 13. 13. Farthing M, Salam MA, Lindberg G, Dite P, Khalif I, Salazar-Lindo E (...) of the infection. The majority of cases resolve within several days without the need for treatment 2 . As such, most cases are self-managed in the community. If severe or persistent symptoms occur, patients may require admission to hospital for observation and symptom management. SHTG Evidence Synthesis | 6 In a minority of cases, infectious pathogens can cause complications which lead to chronic illness or mortality. Infectious gastroenteritis caused by toxin-producing pathogens, such as Verotoxigenic E. coli

2019 SHTG Advice Statements

171. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America

( ). A randomized trial compared the safety of inpatient versus outpatient treatment of 49 patients with CURB-65 scores of less than 2 ( ) but had limited power to detect differences in patient outcomes; furthermore, outpatient treatment included daily nursing visits and parenteral antibiotic therapy that is typically restricted to inpatient care. Rationale for the recommendation Our recommendation to use the PSI as an adjunct to clinical judgment to guide the initial site of treatment is based on consistent (...) failure, need for subsequent visits, hospitalization, time to return to usual activities and adverse events. Furthermore, the prevalence of specific pathogens and their antimicrobial susceptibility patterns in outpatients with pneumonia should be monitored. Newer agents, including lefamulin and omadacycline, need further validation in the outpatient setting. Question 9: In the Inpatient Setting, Which Antibiotic Regimens Are Recommended for Empiric Treatment of CAP in Adults without Risk Factors

2019 American Thoracic Society

172. Neratinib (Nerlynx) - Breast cancer, breast neoplasms

. Neratinib was tolerated in rats for up to 6 months with a NOAEL of 10 mg/kg/day. In dogs, neratinib was tolerated for up to 9 months, and although findings related to faecal disturbance were found the NOAEL for dogs is suggested as 6 mg/kg/day. During examination of covalent binding to human serum albumin, neratinib was shown to bind through a, ß unsaturated amide binding to the e amino group of Lysine190 via a protein-enhanced Michael addition. This binding was species dependent and occurred in human (...) , no effects were detected in oestrous cycling or on mating and embryo survival. The NOAEL was determined to be 12 mg/kg/day. Based on exposure established in the rat 26 week general toxicity study, where a NOAEL of 10 mg/kg/day gave a safety margin of 29-fold based on exposure, the fertility NOAEL provides for a sufficient margin for expected human doses (>29-fold). A statement has been proposed to section 4.6 of the SmPC to reflect that no significant changes in fertility parameters in male and female

2018 European Medicines Agency - EPARs

173. Treatment of Depression in Children: A Systematic Review

to the Effective Health Care Program. Please visit the website (www.effectivehealthcare.ahrq.gov) to see draft research questions and reports or to join an e- mail list to learn about new program products and opportunities for input. If you have comments on this systematic review, they may be sent by mail to the Task Order Officer named below at: Agency for Healthcare Research and Quality, 5600 Fishers Lane, Rockville, MD 20857, or by email to epc@ahrq.hhs.gov. Gopal Khanna, M.B.A. Arlene Bierman, M.D., M.S (...) of pharmacotherapy versus control ... ES-12 Table D. Strength of evidence for benefits of fluoxetine + CBT versus placebo ES-16 Table E. Strength of evidence for benefits and harms of comparative effectiveness studies ES-18 Table F. Evidence map for interventions for childhood depression ES-20 Table 1. Current clinical practice guidelines for the treatment of child and adolescent DDs 2 Table 2. Nonpharmacological interventions used to treat child and adolescent depression 3 Table 3. Pharmacological agents used

2019 Effective Health Care Program (AHRQ)

174. Sodium zirconium cyclosilicate (Lokelma) - Hyperkalemia

of hospitalised patients, and the incidence ranges from 1 to 10%. There is no agreed definition of hyperkalaemia, since the raised level of potassium at which a treatment should be initiated has not been established. The European Resuscitation Council guidelines consider hyperkalaemia to be a serum potassium (S-K) level > 5.5 mmol/L, with mild elevations defined as 5.5 to 5.9 mmol/L, moderate as 6.0-6.4 mmol/L, and severe as = 6.5 mmol/L. The guidelines also note that extracellular potassium levels (...) the active substance, sodium zirconium cyclosilicate. The specifications have been established according to physico-chemical characteristics and properties of the crystalline active substance. The finished product is released to the market based on the above release specifications, through traditional final product release testing. The analytical methods used have been adequately described and appropriately validated in accordance with the ICH guidelines. Satisfactory information regarding the reference

2018 European Medicines Agency - EPARs

175. Bictegravir / emtricitabine / tenofovir alafenamide / fumarate (Biktarvy) - HIV Infections

inhibitor resistant IPC In-process control IQ inhibitory quotient IQ95 inhibitory quotient of 95% IR Infrared ISE Integrated Summary of Efficacy ISS Integrated Summary of Safety IV intravenous KF Karl Fischer titration LC-MS/MS liquid chromatography/tandem mass spectrometry LDH lactate dehydrogenase LDL low-density lipoprotein LLOQ lower limit of quantitation LOCF last observation carried forward LSM least-squares mean M = E missing = excluded M = F missing = failure MedDRA Medical Dictionary (...) coefficient of variation 3TC lamivudine ABC abacavir AE adverse event AIDS acquired immunodeficiency syndrome ALT alanine aminotransferase ANOVA analysis of variance anti-HBe antibody against hepatitis B e antigen anti-HBs antibody against hepatitis B surface antigen ART antiretroviral therapy ARV antiretroviral ATV atazanavir AUC area under the concentration versus time curve AUClast area under the concentration versus time curve from time zero to the last quantifiable concentration AUCtau area under

2018 European Medicines Agency - EPARs

176. Reducing Acute Care Length of Stay in Newfoundland & Labrador

& Labrador Centre for Applied Health Research, established in 1999, contributes to the effectiveness of the health and community services system of the province and the physical, social, and psychological well-being of the population. NLCAHR accomplishes this mandate by building capacity in applied health research, supporting high quality research, and fostering more effective use of research evidence by decision makers and policy makers in the province’s health system. About the Contextualized Health (...) interventions: ? based on the involvement of pharmacists; 3 ? involving the planning, coordination, and delivery of outpatient services; or ? requiring new infrastructure investments. Comparator(s) Standard or usual care. Outcome(s) Average Length of Stay (ALOS) is the primary outcome of interest for this project. ALOS is generally defined as the period of time that a patient remains in hospital for of a single episode of care, based on the number of nights the patient spent in hospital. A patient who

2018 Newfoundland and Labrador Centre for Health Information

177. Cardiac rehabilitation

be limited, and that evidence from the wider CHD literature and beyond would need to be considered. Highlighting the need for further research within CR has therefore assumed greater importance in this guideline.2 | Cardiac rehabilitation Figure 1: BACPR core components for cardiovascular disease prevention and rehabilitation 4 A U D I T A N D E VA L U AT I O N LONg -TEr m STr ATEg IES Psychosocial health Health behaviour change and education management medical r isk Lifestyle risk factor management (...) functioning in their community and through improved health behaviour, slow or reverse progression of disease” . 4 The term ‘cardiac rehabilitation’ is widely accepted to encompass the processes described in this definition, but is itself a dated and potentially misleading term. It was established at a time when patients were hospitalised for long periods after MI or cardiac surgery, advised to rest for several months, and in need of carefully monitored exercise-based rehabilitation to enable them

2017 SIGN

178. Agitation and Aggression in Long-Term Care Residents with Dementia

review of the literature. J Psychiatr Ment Health Nurs. 2014 Dec;21(10):879–88. 17. Brasure M, Jutkowitz E, Fuchs E, Nelson VA, Kane RA, Shippee T, et al. Nonpharmacologic Interventions for Agitation and Aggression in Dementia [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016. Available from: https://www.ncbi.nlm.nih.gov/books/NBK356163/ 18. Chang Y-S, Chu H, Yang C-Y, Tsai J-C, Chung M-H, Liao Y-M, et al. The efficacy of music therapy for people with dementia: A meta (...) -analysis of randomised controlled trials. J Clin Nurs. 2015 Dec;24(23–24):3425–40. 19. Disalvo D, Luckett T, Agar M, Bennett A, Davidson PM. Systems to identify potentially inappropriate prescribing in people with advanced dementia: a systematic review. BMC Geriatr. 2016 May 31;16:114. 20. Jutkowitz E, Brasure M, Fuchs E, Shippee T, Kane RA, Fink HA, et al. Care-Delivery Interventions to Manage Agitation and Aggression in Dementia Nursing Home and Assisted Living Residents: A Systematic Review and Meta

2018 Newfoundland and Labrador Centre for Health Information

179. The Lung Cancer Framework: Principles for Best Practice Lung Cancer Care in Australia

at multidisciplinary team meetings 34 ` Increased frequency of discussions regarding patient outcomes: associated with the use of PROMs. PROMs also assist patients and their doctors in developing a shared view of treatment goals, the status of the patient and the patient’s reason for visiting their doctor 25 ` An increase in referrals to psychosocial care: associated with the use of PROMs with patients affected by lung cancer 31 ` Enhanced and better-targeted information supplied to regional patients, especially (...) they are visiting Sydney, such as Sydney transport options. The Information Guide was drafted following a wide consultation process with patients and also their carer(s) to determine areas of need and what would best suit this need. Pilot testing was conducted with consumers prior to full implementation, and feedback was gathered and then actioned. Once completed, the Information Guide was distributed to a range of services located in regional centres in Dubbo and Coffs Harbour. 34 ` Cancer Council Australia’s

2018 Cancer Australia

180. Delivering best practice lung cancer care - a guide for health professionals

and patients to allow patient values and preferences to be considered when discussing treatment and care options. 28 ` Provide communication skills training for health professionals to help staff establish a rapport with patients and carers, and have more effective conversations about patients’ health, treatment and prognosis. 29 Question Prompt Lists 13,14 Decision aids 13 Delivering best practice lung cancer care 3 Principle 1: Patient-centred care To access the Lung Cancer Framework visit (...) an overview of the Lung Cancer Framework, which can be accessed at . References Delivering best practice lung cancer care 13 To access the Lung Cancer Framework visit canceraustralia.gov.au 1. McPherson CJ, Higginson IJ, Hearn J. Effective methods of giving information in cancer: a systematic literature review of randomized controlled trials. J Public Health Med. 2001;23(3):227-234. 2. Gysels M, Higginson IJ. Interactive technologies and videotapes for patient education in cancer care: systematic review

2018 Cancer Australia

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