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Emergency Medicine Treatment and Labor Act

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261. Management of Stillbirth

micrograms every 6 hours in women with a stillbirth between 24 and 28 weeks of gestation and a previous uterine scar . Available evidence from randomized trials supports the use of vaginal misoprostol as a medical treatment to terminate nonviable pregnancies before 24 weeks of gestation . Further research is required to assess effectiveness and safety, optimal route of administration, and dose, especially in women between 24 weeks and 28 weeks of gestation in whom lower doses of misoprostol (200 (...) and inductions of labor for previable premature rupture of membranes are specifically excluded from the stillbirth statistics and are classified as terminations of pregnancy . The term stillbirth is preferred among parent groups, and more recent research efforts have begun using this term in place of fetal death. Therefore, in this document, the term stillbirth is used. Frequency of Occurrence In 2013, the stillbirth rate in the United States was 5.96 per 1,000 live births, a decrease from 6.61 in 2006

2020 American College of Obstetricians and Gynecologists

262. Tobacco and Nicotine Cessation During Pregnancy

prevention strategies, recognition of psychosocial challenges, and identification of social support systems in the third trimester and postpartum are helpful in decreasing recidivism . Pharmacotherapy The U.S. Preventive Services Task Force has concluded that current evidence is insufficient to assess the balance of benefits and harms of nicotine replacement products or other pharmaceuticals for tobacco cessation during pregnancy . Recent reviews have suggested nicotine replacement therapy is associated (...) in pregnancy did not demonstrate an increased risk of congenital anomalies, low birth weight, or preterm birth . Obstetrician-gynecologists and other obstetric care professionals should counsel women about the risks of smoking and the benefits of cessation and discuss the resources available to help with smoking cessation, which may include the use of varenicline and bupropion. If these medications are prescribed, familiarity with the risks, benefits, and updated FDA Drug Safety Communications is prudent

2020 American College of Obstetricians and Gynecologists

263. Safety guideline: neurological monitoring associated with obstetric neuraxial block

whopresent withacutemotororsensorylossafterdelivery require urgent review, particularly if there is associated headache (see Fig. 2). Hospitals should have local protocols to facilitate the re-admission of women postpartum to enable necessary investigation and treatment, whether they present to maternity services, the emergency department, or via other routes. There is potentially a broad differential diagnosis of abnormal neurology postpartum (Fig. 2). It is essential that hospitals have strategies (...) injuries involving the lower extremities: a practical approach. Anesthesia and Analgesia 2015;120:141–8. 30. Richards A, McLaren T, Paech MJ, Nathan EA, Beattie E, McDonnell N. Immediate postpartum neurological de?cits in the lower extremity: a prospective observational study. International Journal of Obstetric Anesthesia 2017; 31: 5–12. 31. Alerhand S, Wood S, Long B, Koyfman A. The time-sensitive challenge of diagnosing spinal epidural abscess in the emergency department. Internal Emergency Medicine

2020 Association of Anaesthetists of GB and Ireland

264. Overview of musculoskeletal pain

, sparse, and difficult to find. It typically occurs in older patients. In patients under the age of 60 years, underlying metabolic conditions associated with calcium pyrophosphate deposition, such as hyperparathyroidism or haemochromatosis, should be investigated. Most common entrapment neuropathy. Symptoms include numbness and/or tingling of the thumb and radial fingers, aching wrist, and clumsiness. Acute spinal cord trauma is a medical emergency that requires swift diagnosis and treatment (...) =bestpractice.com Most commonly results from motor vehicle accidents, gunshot or stab wounds, contact sports, or workplace accidents during heavy physical labour. The effects of the injury include paralysis, loss of sensation, and pain. The specific clinical presentation will depend on the nerve roots involved and the degree of injury to each root. A bursa is a sac containing a small amount of synovial fluid that lies between a tendon and either skin or bone to act as a friction buffer. In bursitis

2018 BMJ Best Practice

265. Management of opioid use disorders: a national clinical practice guideline

to transition from methadone to buprenorphine–naloxone if treatment is unsuccessful 22,23 • Higher risk of public safety harms if diverted 26,27 • Higher potential for adverse drugdrug interactions (e.g., antibiotics, antidepressants, antiretrovirals) 31 • Associated with QTc prolongation and increased risk of cardiac arrhythmia in patients prescribed higher doses, with pre-existing risk factors or taking other medication(s) that prolong QTc interval 22,23 • Can be more expensive if prescribed as daily (...) been eligible for coverage under Health Canada’s Non-Insured Health Benefits program for the treatment of opioid use disorder since November 2014, 64 although this indi- cation is considered off-label in Canada. It is the consensus of this committee that health care providers who wish to prescribe opi- oid agonist treatment based on slow-release oral morphine should hold a valid federal exemption under Section 56 of the Controlled Drugs and Substances Act to prescribe methadone as an indication

2018 CPG Infobase

266. Ekso exoskeleton for rehabilitation in people with neurological weakness or paralysis

exoskeleton was CE marked as a class IIa device in 2012 and this certification was renewed in 2016. The current version of Ekso has been developed from older versions that did not have the SmartAssist software, and these are also CE marked under the same certification. A search of the Medicines and Healthcare products Regulatory Agency (MHRA) website revealed that no manufacturer Field Safety Notices or Medical Device Alerts have been issued for this technology. Ekso exoskeleton for rehabilitation (...) place in therap apy y would be instead of, or in addition to, existing rehabilitation activities including physiotherapy, exercise, strength training, walking therapies with or without support, and functional electrical stimulation. The k ke ey points from the e y points from the evidence vidence summarised in this briefing are from 1 systematic review and 5 case series, involving a total of 41 patients in a rehabilitation setting. After using Ekso, these patients were able to walk without

2017 National Institute for Health and Clinical Excellence - Advice

267. SecurAcath for securing cerebrospinal fluid catheters

has also produced medical technologies guidance on this device for a different indication, SecurAcath for securing percutaneous catheters. © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 8The technology The technology SecurAcath (Interrad Medical) is a securement device that uses an anchor below the skin to hold cerebrospinal fluid (CSF) drainage catheters in place. It comprises a base and a cover: the base (...) the channel diameter changes. Typically, catheters used for CSF drainage are 6 or 8 Fr. SecurAcath can also be used to secure catheters for other purposes, such as for venous access. These indications are beyond the scope of this briefing. Innovations SecurAcath is designed to reduce the risk of accidentally moving the catheter. Accidental dislocation or removal of external CSF drainage may need emergency surgery to replace the catheter. SecurAcath can be lifted away to clean around the insertion site

2017 National Institute for Health and Clinical Excellence - Advice

268. Diagnosis and management of epilepsy in adults

and risks of further seizures and concerns about prolonged antiepileptic drug treatment. ? The rate of withdrawal of antiepileptic drugs should be slow, usually over a few months, and longer with barbiturates and benzodiazepines. One drug should be withdrawn at a time. 4.8 COMPLEMENTARY THERAPY Complementary therapy is increasingly popular with patients, who may use this in addition to conventional medication. 155, 156 The term covers a wide variety of treatments such as acupuncture, chiropractic (...) 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

2018 SIGN

269. Deployment of personnel to military operations: impact on mental health and social functioning Full Text available with Trip Pro

technology, medical technologies, and military tactics, have increased chances of survival among those who face military deployment ( ; ). 1.1.2 The evidence The nature of the issue makes it difficult to establish a causal link between deployment and mental health outcomes. For example randomised controlled trials where military personnel are explicitly randomly assigned to either face deployment to a combat zone or to not be deployed are not available. Instead we have found a large base of observational (...) special forces is a separate branch, whereas in the US each branch have their own special forces component. are all relevant. Both combat and non‐combat personnel face deployment to international missions and are thus relevant to the review. Deployed non‐combat personnel include personnel with transport/logistics functions, health and medical staff, information technology and communication staff, and general technical support personnel. As an example, the NATO mission to Afghanistan included

2018 Campbell Collaboration

270. Reducing unemployment benefit duration to increase job finding rates: a systematic review Full Text available with Trip Pro

entitlement has occurred in the course of usual decisions outside the researcher's control must have demonstrated pre‐treatment group equivalence via matching, statistical controls, or evidence of equivalence on key risk variables (e.g., labour market conditions) and participant characteristics. These factors are outlined in under the subheading of Confounding , and the methodological appropriateness of the included studies was assessed according to the risk of bias model outlined in . Studies (...) ‐ The International Monetary Fund ( ) AIECE ‐ Association of European Conjuncture Institutes ( ) ESRC ‐ Economic Social Research Council ( ) Copenhagen Economics ( ) Google Scholar ( ) Due to changes in access possibilities, Theses Canada was not searched after the 2011 update. 3.3.5 Hand searching Reference lists of included studies and reference lists of relevant reviews was searched. “The Journal of Labor Economics” and “Labour Economics” was searched for the years 2011‐2015 and the available issues of 2016 up

2018 Campbell Collaboration

271. Agricultural input subsidies for improving productivity, farm income, consumer welfare and wider growth in low? and lower?middle?income countries: a systematic review Full Text available with Trip Pro

potential due to liquidity and labour constraints, unfavourable geographical and environmental conditions and environmental degradation, which they link to a lack of technical innovation. They also point to government and market failures (the former involving policy that deters investors, resulting in too little investment, the latter failing to deliver credit and input services and overcome poverty traps) and unfavourable global market forces arising from OECD subsidies for their own agricultural (...) of vouchers to farm households that they are free to redeem in local markets. Agricultural inputs that can be subsidised include seeds, fertilisers, pesticides, herbicides, animal feed, drugs, machinery and fuel. Subsidies are most often only targeted at a few inputs and are in many cases limited to fertilisers or seeds. Subsidies usually cover only a small number of these inputs, for instance seed and fertiliser packs in Malawi or fertiliser subsidies in Indonesia, and may only target producers

2018 Campbell Collaboration

272. Effectiveness of interventions to reduce homelessness: a systematic review and meta?analysis Full Text available with Trip Pro

. Location of services (from all services delivered in office to all delivered in vivo) 7. Staffing ratios and composition (from individual caseloads to interdisciplinary teams with shared caseloads) Case management interventions can be categorized into the following five models: broker case management (BCM), standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI). See Table 3.1 in for an adapted overview of case (...) management models (14, 18). In this review, we have organized case management according to intensity: high versus low. The following is a description of the interventions included under high intensity case management: Assertive Community Treatment (ACT) is an example of intensive case management in which a high level of care is provided. The distinguishing features of ACT are described as follows: “case management provided by a multidisciplinary team of professionals, including psychiatrists, social

2018 Campbell Collaboration

273. School?based interventions for reducing disciplinary school exclusion: a systematic review Full Text available with Trip Pro

From school From all schools (in this case, the students must be offered alternative education) Indefinite. School Principal should recommend expulsion to the school board. Parents must be informed within 24 hours. All expulsions can be appealed at a tribunal. Possessing or using a weapon, physical assault on another person that causes bodily harm requiring treatment by a medical practitioner, sexual assault, trafficking in weapons, trafficking in illegal drugs, robbery, drinking alcohol. 0.02 (...) are considered long‐term. School Principal. Parents must be informed within 24 hours. All suspensions can be appealed to the school board. Threat to inflict serious bodily harm on another person, possessing alcohol or illegal drugs, being under the influence of alcohol, swearing at a teacher or at another person in a position of authority, committing an act of vandalism that causes extensive damage to school property, or bullying. 2.76% of enrolled students (N= 2,014,407). Academic Year 2013‐2014 5 Expulsion

2018 Campbell Collaboration

274. Performance of the Belgian health system

Evidence-based practice EC European Commission ECHI European Community Health Indicators ECHIM European Community Health Indicators Monitoring EFPIA European Federation of Pharmaceutical Industries and Associations EPS Permanent Sample ER Emergency Room EU European Union EU – SILC European Union Statistics on Income and Living Conditions FOBT Faecal Occult Blood Test FOD – SPF Federal Public Service FRKVA – CFQAI Federal council for quality of nursing activities FTE Full Time Equivalent GDP Gross (...) infarction (AMI) or ischaemic stroke The 30-day AMI case-fatality rate reflects the processes of care, such as timely transport of patients and effective medical interventions. Case-fatality after AMI decreased in Belgium between 2000 and 2014, mirroring the trend observed in other European countries. 24 Part of this reduction can probably be attributed to better treatment, particularly in the acute phase of myocardial infarction. Mortality results are lower in Flanders than in the two other regions

2019 Belgian Health Care Knowledge Centre

275. Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness

investigator or researcher: Laurence Claes (KU Leuven and UAntwerp), Torsten Olbers (Active researcher in the area. PI for Nationwide program in Sweden in adolescent bariatric surgery, PI for RCT Sleeve vs Gastric bypass), Caroline Rudisill (Part of a Delphi process to reach consensus statements as part of 4 th World Congress on Interventional Therapies for Type 2 Diabetes. Previously was a co-investigator on National Institutes of Health Research health Services and Research Delivery programme (NIHR HS (...) & RD), Cost-effectiveness of different levels of uptake of bariatric surgery in a large population. Cohort study and Markov model, October 2013 –September 2015. This resulted in a number of publications), Henri Steyaert (A prospective observational cohort study collecting coordinated clinical, epidemiological and behavioural data in adolescent morbid obese patients who underwent surgical treatment, ULB - VUB), Luc Van Gaal (PI (Belgium) of several farmaco studies in obesitas), Inge Pottelbergh (PI

2019 Belgian Health Care Knowledge Centre

276. Iron Deficiency and Anaemia in Adults

or intolerances may lead to a diet that does not contain sufficient iron-rich foods. Medicines A comprehensive list of all medicines being taken is vital. Many people will mention over the counter, homeopathic and/or herbal remedies alongside any medications that are regularly prescribed by a clinician. There can be contraindications and a comprehensive list will allow identification of any type of medicine that might cause gastrointestinal bleeding (bleeding from the stomach and intestines (...) obstetric review to investigate the origin of the blood loss and decide further treatment. Contraindications and precautions for IV iron therapy • First trimester of pregnancy. • Previous hypersensitivity to IV iron. • Anaemia not attributable to iron deficiency. • Iron overload. • Acute infection/inflammation. • Clinical or biomedical evidence of liver damage. • Asthma. Case study Mrs Hill had an uncomplicated pregnancy other than nausea and had Hb of 107 g/l at 28 weeks gestation. She went

2018 Royal College of Nursing

277. What are the methods for improving mental or physical health after a transition from unemployment to employment in those with a long term condition or disability?

2018 support and access to interventions, that will help the individual before they get too far removed from the workplace. A CFE Research report states that health and social care interventions generally have a positive effect on employment for those with mental health problems, but no evidence currently exists in this area for physical conditions (11). Anti-depressant medication, cognitive behavioural therapy and combinations of treatments were all found to improve employment outcomes (...) ). There is evidence that some medical and psychological treatments for anxiety and depression can improve worker’s symptoms and quality of life, but there is as yet only limited evidence of their positive impact on work outcomes (14). Supported employment Supported employment is an approach to vocational rehabilitation that involves trying to place clients in competitive jobs without any extended preparation. The IPS model is a form of supported employment for people with severe and persistent mental illness

2018 Public Health England - Evidence Briefings

278. Briefing paper 54: the public health implications of rising debt

Briefing paper 54: the public health implications of rising debt BRIEFING PAPER 54 October 2018 www.gcph.co.uk • Unsecure personal debt, including; credit cards, overdrafts and short-term loans, is at its highest level in the UK since before the 2008 economic recession; with the level projected to rise higher still in the coming years. • The high level of unsecure personal debt is related to the economy, labour market conditions, government policy and the re-emergence of irresponsible lending (...) , Lea SE. Student attitudes to student debt. Journal of Economic Psychology 1995;16(4):663-679. 47. Lea SE, Webley P, Levine RM. The economic psychology of consumer debt. Journal of Economic Psychology 1993;14(1):85-119.22 48. Jenkins R, Fitch C, Hurlston M, W alker F . Recession, debt and mental health: challenges and solutions. Mental Health in Family Medicine 2009;6(2):85-90. 49. Druss BG, Marcus SC, Olfson M, Pincus HA. The most expensive medical conditions in America. Health Affairs 2002;21(4

2019 Glasgow Centre for Population Health

279. Vestronidase alfa (Mepsevii) - Mucopolysaccharidosis VII

Adverse event BE Bioequivalence BOT-2 Bruininks-Oseretsky Test of Motor Proficiency CGI Clinical Global Impression CIM6PR Cation-independent mannose 6-phosphate receptor CL Clearance Cmax Maximum concentration CMC Chemistry, Manufacturing, and Controls CS Chondroitin sulfate DART Developmental and reproductive toxicology DMP Drug Monitoring Program DS Dermatan sulfate eIND Emergency Investigational New Drug [application] EMA European Medicines Agency ER Exposure response ERT Enzyme replacement therapy (...) Questionnaire MR Mannose receptor ODD Orphan Drug Designation PD Pharmacodynamics(s) PedsQL Pediatric Quality of Life Multidimensional Fatigue Scale PGI-C Physician Global Impression-Change PIND Pre-Investigational New Drug [application] PIP Paediatric Investigational Plan PK Pharmacokinetic(s) QOW Every other week rh-GUS Recombinant human GUS rm-GUS Recombinant mouse GUS SAE Serious adverse event SOC System Organ Class t1/2 Half-life TEAE Treatment-emergent adverse event uGAG Urinary glycosaminoglycan ULN

2018 European Medicines Agency - EPARs

280. Management of Cardiovascular Diseases during Pregnancy Full Text available with Trip Pro

3.6.2 Assessing foetal wellbeing 3178 3.7 Interventions in the mother during pregnancy 3178 3.7.1 Percutaneous therapy 3178 3.7.2 Cardiac surgery with cardiopulmonary bypass 3178 3.8 Timing and mode of delivery: risk for mother and child 3179 3.8.1 Timing of delivery 3179 3.8.2 Labour induction 3179 3.8.3 Vaginal or caesarean delivery 3179 3.8.4 Delivery in anticoagulated women (not including mechanical valve; see section 5) 3179 3.8.5 Urgent delivery on therapeutic anticoagulation 3179 3.8.6 (...) Haemodynamic monitoring during delivery 3180 3.8.7 Anaesthesia/analgesia 3180 3.8.8 Labour 3180 3.8.9 Perimortem caesarean section 3180 3.8.10 Post-partum care 3180 3.8.11 Breastfeeding 3180 3.9 Infective endocarditis 3180 3.9.1 Prophylaxis 3180 3.9.2 Diagnosis and risk assessment 3180 3.9.3 Treatment 3180 3.10 Methods of contraception and termination of pregnancy, and in vitro fertilization 3181 3.10.1 Methods of contraception 3181 3.10.2 Sterilization 3181 3.10.3 Methods of termination of pregnancy 3181

2018 European Society of Cardiology

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