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Emergency Medicine Treatment and Labor Act

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101. European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults Full Text available with Trip Pro

of rhPTH will improve QoL and reduce the risk of complications. In January 2015, the American Food and Drug Administration approved the use of rhPTH(1–84) (Natpara) as a supplement to conventional treatment (FDA 2015: ). The drug is only available through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) and carries a ‘black box warning’ that bone cancer (osteosarcoma) has been observed in rat studies with rhPTH. It is unknown whether long-term therapy also may cause (...) with an increased prevalence in HypoPT. list drugs, conditions and diseases which may interfere with calcium homeostasis. If a patient is diagnosed with one of the diseases or initiates treatment with one of the drugs, this may necessitate changes in the medical treatment of HypoPT in order to maintain normocalcaemia. Table 3 Symptoms patients should be informed to allow for early detection of hypo- or hypercalcaemia. Organ System Hypocalcaemia Hypercalcaemia CNS Depression Weakness Irritability Headache

2015 European Society of Endocrinology

102. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection

Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. Geneva: World Health Organization; 2013. These guidelines will be updated in 2015. CHAPTER 7: SECOND-LINE ANTIVIRAL THERAPIES FOR THE MANAGEMENT OF TREATMENT FAILURE • In persons with confirmed or suspected antiviral resistance (i.e. history of prior exposure or primary non-response) to lamivudine, entecavir, adefovir or telbivudine, a switch to tenofovir (...) below which HBV DNA concentrations are indicative of “inactive” disease, or the threshold above which treatment should be initiated (28). HBV DNA concentrations are also used for optimal monitoring of response to antiviral therapy, and a rise may indicate the emergence of resistant variants. WHO standards are now available for expression of HBV DNA concentrations (31,32). Serum HBV DNA levels should be expressed in IU/mL to ensure comparability; values given as copies/mL can be converted to IU/mL

2015 World Health Organisation Guidelines

103. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection

Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. Geneva: World Health Organization; 2013. These guidelines will be updated in 2015. CHAPTER 7: SECOND-LINE ANTIVIRAL THERAPIES FOR THE MANAGEMENT OF TREATMENT FAILURE • In persons with confirmed or suspected antiviral resistance (i.e. history of prior exposure or primary non-response) to lamivudine, entecavir, adefovir or telbivudine, a switch to tenofovir (...) below which HBV DNA concentrations are indicative of “inactive” disease, or the threshold above which treatment should be initiated (28). HBV DNA concentrations are also used for optimal monitoring of response to antiviral therapy, and a rise may indicate the emergence of resistant variants. WHO standards are now available for expression of HBV DNA concentrations (31,32). Serum HBV DNA levels should be expressed in IU/mL to ensure comparability; values given as copies/mL can be converted to IU/mL

2015 World Health Organisation HIV Guidelines

104. The emergency department and “access” to care

for those without the ability to obtain primary health care. Its role as the latter is not however due to the much-touted Emergency Medical Treatment and Labor Act (EMTALA) rather than a failing healthcare infrastructure. EMTALA was established in 1986 to ensure that any individual seeking care within an emergency department of a hospital that accepts Medicare payments would receive screening for and stabilization of any identified emergent condition regardless of ability to pay. Within its mandates (...) The emergency department and “access” to care The emergency department and "access" to care The emergency department and “access” to care | | March 28, 2017 427 Shares The redefinition of a potentially functioning medical system in which each individual is able to utilize financially non-prohibitive care into a disjointed balkanized realm of income-based insurance tribes is aided by the protean definitions of the political buzzword “access.” Access to medical care does not entail the ability

2017 KevinMD blog

105. Management of the Third Stage of Labor (Diagnosis)

of Obstetrical Emergencies . 3rd ed. Bristol, UK: Clinical Press; 1999. 196-201. Sleep J. Physiology and management of the third stage of labour. Bennett VR, Brown LK, eds. Myles' Textbook for Midwives . 12th ed. London, UK: Churchill Livingstone; 1993. 216-29. Dupont C, Ducloy-Bouthors AS, Huissoud C. [Clinical and pharmacological procedures for the prevention of postpartum haemorrhage in the third stage of labor.]. J Gynecol Obstet Biol Reprod (Paris) . 2014 Nov 6. 43(10):966-997. . Prendiville WJ (...) uterotonic agents. [ ] Carbetocin is not available in the United States. has shown early promise in the treatment of PPH. Additionally, its low cost, pill form, and heat stability make it a potentially excellent agent for prophylaxis in the third stage of labor. Unfortunately, randomized trials have shown it to be inferior to injectable uterotonics and to not be significantly more effective than placebo. [ ] Adverse effects, such as shivering and fever, are common; in regimens using higher doses, nausea

2014 eMedicine.com

106. Preterm Labor (Diagnosis)

disease. Magnesium sulfate should not be used in conjunction with select medications, such as calcium channel blockers, or when myasthenia gravis or neuromuscular disorders exist. In addition, the US Food and Drug Administration (FDA) has warned against extended magnesium sulfate injections in pregnancy. In 2013, the FDA issued a safety alert advising against the off-label administration of magnesium sulfate injections to pregnant women for more than 5-7 days as a means of stopping preterm labor (...) of material, effort, and money in perinatal medical technology, neonatal mortality rates for newborns born in the United States (5 per 1,000 babies) may rank as low as 32 nd among the 33 industrialized nations, superior only to Latvia. [ ] Successful reduction of perinatal morbidity and mortality associated with prematurity may require the implementation of effective risk identification and behavioral modification programs for the prevention of preterm labor; these in turn require both an improved

2014 eMedicine.com

107. Management of the Third Stage of Labor (Overview)

of Obstetrical Emergencies . 3rd ed. Bristol, UK: Clinical Press; 1999. 196-201. Sleep J. Physiology and management of the third stage of labour. Bennett VR, Brown LK, eds. Myles' Textbook for Midwives . 12th ed. London, UK: Churchill Livingstone; 1993. 216-29. Dupont C, Ducloy-Bouthors AS, Huissoud C. [Clinical and pharmacological procedures for the prevention of postpartum haemorrhage in the third stage of labor.]. J Gynecol Obstet Biol Reprod (Paris) . 2014 Nov 6. 43(10):966-997. . Prendiville WJ (...) uterotonic agents. [ ] Carbetocin is not available in the United States. has shown early promise in the treatment of PPH. Additionally, its low cost, pill form, and heat stability make it a potentially excellent agent for prophylaxis in the third stage of labor. Unfortunately, randomized trials have shown it to be inferior to injectable uterotonics and to not be significantly more effective than placebo. [ ] Adverse effects, such as shivering and fever, are common; in regimens using higher doses, nausea

2014 eMedicine.com

108. Preterm Labor (Overview)

disease. Magnesium sulfate should not be used in conjunction with select medications, such as calcium channel blockers, or when myasthenia gravis or neuromuscular disorders exist. In addition, the US Food and Drug Administration (FDA) has warned against extended magnesium sulfate injections in pregnancy. In 2013, the FDA issued a safety alert advising against the off-label administration of magnesium sulfate injections to pregnant women for more than 5-7 days as a means of stopping preterm labor (...) of material, effort, and money in perinatal medical technology, neonatal mortality rates for newborns born in the United States (5 per 1,000 babies) may rank as low as 32 nd among the 33 industrialized nations, superior only to Latvia. [ ] Successful reduction of perinatal morbidity and mortality associated with prematurity may require the implementation of effective risk identification and behavioral modification programs for the prevention of preterm labor; these in turn require both an improved

2014 eMedicine.com

109. Preterm Labor (Follow-up)

disease. Magnesium sulfate should not be used in conjunction with select medications, such as calcium channel blockers, or when myasthenia gravis or neuromuscular disorders exist. In addition, the US Food and Drug Administration (FDA) has warned against extended magnesium sulfate injections in pregnancy. In 2013, the FDA issued a safety alert advising against the off-label administration of magnesium sulfate injections to pregnant women for more than 5-7 days as a means of stopping preterm labor (...) of material, effort, and money in perinatal medical technology, neonatal mortality rates for newborns born in the United States (5 per 1,000 babies) may rank as low as 32 nd among the 33 industrialized nations, superior only to Latvia. [ ] Successful reduction of perinatal morbidity and mortality associated with prematurity may require the implementation of effective risk identification and behavioral modification programs for the prevention of preterm labor; these in turn require both an improved

2014 eMedicine.com

110. Management of the Third Stage of Labor (Follow-up)

of Obstetrical Emergencies . 3rd ed. Bristol, UK: Clinical Press; 1999. 196-201. Sleep J. Physiology and management of the third stage of labour. Bennett VR, Brown LK, eds. Myles' Textbook for Midwives . 12th ed. London, UK: Churchill Livingstone; 1993. 216-29. Dupont C, Ducloy-Bouthors AS, Huissoud C. [Clinical and pharmacological procedures for the prevention of postpartum haemorrhage in the third stage of labor.]. J Gynecol Obstet Biol Reprod (Paris) . 2014 Nov 6. 43(10):966-997. . Prendiville WJ (...) uterotonic agents. [ ] Carbetocin is not available in the United States. has shown early promise in the treatment of PPH. Additionally, its low cost, pill form, and heat stability make it a potentially excellent agent for prophylaxis in the third stage of labor. Unfortunately, randomized trials have shown it to be inferior to injectable uterotonics and to not be significantly more effective than placebo. [ ] Adverse effects, such as shivering and fever, are common; in regimens using higher doses, nausea

2014 eMedicine.com

111. Labor and Delivery, Normal Delivery of the Newborn

Director, Boston University School of Medicine; Director, Antenatal Testing Unit, Boston Medical Center Jodi F Abbott, MD is a member of the following medical societies: , , , , Disclosure: Nothing to disclose. Specialty Editor Board Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Nothing to disclose. Chief Editor Christine Isaacs, MD Associate Professor, Department of Obstetrics (...) and Gynecology, Division Head, General Obstetrics and Gynecology, Medical Director of Midwifery Services, Virginia Commonwealth University School of Medicine Christine Isaacs, MD is a member of the following medical societies: Disclosure: Nothing to disclose. Additional Contributors Luis M Lovato, MD Associate Clinical Professor, University of California, Los Angeles, David Geffen School of Medicine; Director of Critical Care, Department of Emergency Medicine, Olive View-UCLA Medical Center Luis M Lovato, MD

2014 eMedicine.com

112. Observation Care: Ethical and Legal Considerations for the Emergency Physician. (Abstract)

Labor Act) implications of the existing observation rule for EPs and offers practical solutions for EPs faced with counseling patients on the meaning and ramifications of the observation rule.We conclude that while we believe it does not violate the intent of the Emergency Medical Treatment and Active Labor Act to respond to patient questions about their admission status, the observation rules challenge the ethical principles of transparency related to the physician-patient relationship and justice (...) Observation Care: Ethical and Legal Considerations for the Emergency Physician. The Medicare observation rules remain controversial despite Centers for Medicare and Medicaid Services revisions and the new 2-midnight rule. The increased financial risks for patients and heightened awareness of the rule have placed emergency physicians (EPs) at the center of the controversy.This article reviews the primary ethical and legal (particularly with respect to the Emergency Medical Treatment and Active

2016 Journal of Emergency Medicine

113. On the Threshold of Safety: A Qualitative Exploration of Nurses' Perceptions of Factors Involved in Safe Staffing Levels in Emergency Departments. (Abstract)

On the Threshold of Safety: A Qualitative Exploration of Nurses' Perceptions of Factors Involved in Safe Staffing Levels in Emergency Departments. The emergency department is a unique practice environment in that the Emergency Medical Treatment and Active Labor Act (EMTALA), which mandates a medical screening examination for all presenting patients, effectively precludes any sort of patient volume control; staffing needs are therefore fluid and unpredictable. The purpose of this study (...) is to explore emergency nurses' perceptions of factors involved in safe staffing levels and to identify factors that negatively and positively influence staffing levels and might lend themselves to more effective interventions and evaluations.We used a qualitative exploratory design with focus group data from a sample of 26 emergency nurses. Themes were identified using a constructivist perspective and an inductive approach to content analysis.Five themes were identified: (1) unsafe environment of care, (2

2016 Journal of Emergency Nursing

114. Occupational therapy for people with Parkinson's disease

or embryonic cells transplanted into the basal ganglia, because these cells have the capacity to develop into all cells found in the human body. Much more research is needed if scientists are to understand how stem cells work and how they can be used to produce a viable treatment for Parkinson’s. Gene therapy is a new approach to treating medical conditions, in essence using genes as drugs. It works by introducing normal genes into the cells of people with certain disorders to overcome the effects (...) concludes that ‘there is inadequate evidence to evaluate the effect of occupational therapy for people with Parkinson’s disease’ (Dixon et al 2009). Nevertheless, emergent evidence and anecdotal clinical experience suggest that many functional and psychosocial issues that persist despite good medical management of Parkinson’s appear to be responsive to a condition- specifi c rehabilitative approach, such as the client- centred form of occupational therapy detailed in these Best Practice Guidelines

2010 Publication 1554

115. Treatment and recommendations for homeless people with Opioid Use Disorders

the plan of care; implement strategies to minimize risk of diversion/ misuse (random drug tests, alternate day dosing, prescription monitoring program, directly observed therapy). Balance overall benefits of continuing MAT with potential harms. FOLLOW-UP ? Determine frequency of follow-up based on stability of the patient and his/her living situation and risk of diversion/ misuse/ abuse of medications used for treatment of opioid use disorders or other substances. ? At each visit, assess for behaviors (...) overdoses, exacerbated by their limited access to medication-assisted treatment and to overdose prevention therapy (HCH Clinicians’ Network 2006 Oct & 2009 Feb). A five-year study of 28,033 homeless people who had received treatment from the Boston Health Care for the Homeless Program between 2003 and 2008 found that drug overdose had replaced HIV as the leading cause of death among homeless adults in Boston and was responsible for one-third of fatalities of those between the ages of 25 and 44. Opioid

2014 National Health Care for the Homeless Council

116. Clinical Practice guideline on the diagnosis and treatment of hyponatraemia

with diuretic therapy, but these results need to be con?rmed in a separate cohort before this par- ametercanberecommendedforroutineuseclinically[107]. Diagnosticdif?cultywithdiuretics Thediagnosticdif?culty we face with diuretics is that patients on these medications may have increased, normal or decreased extracellular and circulating volume and can have increased or decreased urine sodium concentration, depend- ing on the timing of the most recent tablet, irrespective of their underlying volume status (...) using the same technique used for the previous measurement and that no administrative errors in sample handlinghaveoccurred(notgraded). 7.3.1.2. If possible, stop ?uids, medications and other factorsthatcancontributetoorprovokehypo- natraemia(notgraded). 7.3.1.3. Werecommendstartingpromptdiagnosticas- sessment (1D). 7.3.1.4. We recommend cause-speci?c treatment (1D). 7.3.1.5. If the acute decrease in serum sodium concen- tration exceeds 10mmol/l, we suggest a single i.v. infusion of 150 ml 3

2014 European Renal Best Practice

117. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations

Adolescents from key populations 24 4 HEALTH SECTOR INVERVENTIONS 26 4.1 Prevention 26 4.1.1 Comprehensive condom and lubricant programming 26 4.1.2 Harm reduction for people who inject drugs 29 4.1.3 Behavioural interventions 40 4.1.4 Prevention of transmission in health-care settings 43 4.1.5 ARV-related prevention 44 4.1.6 Voluntary medical male circumcision for HIV prevention 48 4.2 HIV testing and counselling 50 4.3 Linkage and enrolment in care 54 4.4 HIV treatment and care 55 4.4.1 Antiretroviral (...) , Development and Evaluation HBV hepatitis B virus HCV hepatitis C virus HIV human immunodeficiency virus HIVST HIV self-testing HPV human papillomavirus HTC HIV testing and counselling IPT isoniazid preventive treatment LPV/r lopinavir/ritonavir M&E monitoring and evaluation MAT medically assisted treatment MMT methadone maintenance treatment NNRTI non-nucleoside reverse transcriptase inhibitor NSP needle and syringe programme OST opioid substitution therapy PEP post-exposure prophylaxis PEPFAR United

2014 World Health Organisation HIV Guidelines

118. Treatment and Recommendations for Homeless Patients with Chlamydial or Gonococcal Infections

the newly recommended combination therapy for gonococcal infections also includes the recommended treatment regimen for chlamydial infections, due to the high right of co-occurrence of these infections. Perhaps most importantly, the recommended regimens of single-dose, directly observed therapies for both gonococcal and chlamydial infections eliminate or greatly reduce concerns about medication compliance among persons experiencing homelessness. However, the updated treatment guidelines for gonococcal (...) of the U.S. Department of Health and Human Services or the National Health Care for the Homeless Council, Inc. ADAPTING YOUR PRACTICE Treatment & Recommendations for Homeless Patients with Chlamydial/Gonococcal Infections 4 PREFACE Clinicians practicing in Health Care for the Homeless (HCH) projects 1 and others who provide primary care to people who are homeless or at risk of homelessness routinely adapt their medical practice to foster better outcomes for these patients. Standard clinical practice

2013 National Health Care for the Homeless Council

119. Evaluation and Treatment of Minors. Full Text available with Trip Pro

Evaluation and Treatment of Minors. Many patients under the age of majority present to emergency departments (EDs) without parents or guardians. This may create concern in regard to evaluation of these patients without formal consent to treat. The Emergency Medical Treatment and Labor Act mandates that all patients presenting to EDs receive a medical screening examination and does not exclude these minors. Standards for who can provide consent for a patient vary from state to state and address (...) important issues such as consent by parent surrogates, as well as adolescent emancipation, reproductive health, mental health, and substance use. This document addresses current federal and state legal implications of providing emergency care to minors, as well as guidance in obtaining consent, maintaining confidentiality, and addressing refusal of care.Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

2017 Annals of Emergency Medicine

120. Shivering Treatment After Cesarean Delivery: Meperidine vs. Dexmedetomidine

, 2018 See Sponsor: Centre hospitalier de l'Université de Montréal (CHUM) Information provided by (Responsible Party): Centre hospitalier de l'Université de Montréal (CHUM) Study Details Study Description Go to Brief Summary: Comparing two treatments for shivering after cesarean delivery for labor dystocia under epidural anesthesia. Condition or disease Intervention/treatment Phase Cesarean Section Complications Drug: Dexmedetomidine Injection Drug: Meperidine Injection Phase 3 Detailed Description (...) of the study drug Secondary outcome: Response rate, incidence of nausea, vomiting, hypotension, bradycardia, maternal satisfaction and a cost-benefit analysis. The hypothesis is that dexmedetomidine will act faster, will have a superior response rate with less adverse effects. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 80 participants Allocation: Randomized Intervention Model: Parallel Assignment Intervention Model Description

2017 Clinical Trials

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