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Emergency Medicine Treatment and Labor Act

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101. Diagnosis, staging and treatment of patients with Gestational Trophoblastic Disease

therapy with etoposide and cisplatin. Such patients may also benefit fr om substitution of EMA/CO with EP/EMA (Etoposide and cisplatin plus etoposide, methotrexate, actinomycin D) (Grade C). 2.4.4.1 For women with low-risk GTN undergoing first-line chemotherapy, the first ± second course of chemotherapy should be administered as an in-patient at a centre with medical oncology, gynaecological services and interventional radiology (Grade C). 2.4.5.1 Monitoring during treatment low-risk: Patients should (...) and Advisory Centre will have the potential to identify the volume of patients with GTD in the country, which should inform costs. 1.3 Objectives of the National Clinical Guideline The overall objectives of the National Clinical Guideline No. 13 ‘Diagnosis, staging and treatment of patients with GTD’ are: • To improve the quality of clinical care, • To prevent variation in practice, • To address areas of clinical care with new and emerging evidence, • Based on the best research evidence in conjunction

2015 Health Service Executive (Ireland) - Clinical Guidelines

102. National Clinical Guideline for the Diagnosis, Staging and Treatment of Prostate Cancer

-related healthcare costs out of a total of €619 million. Drug expenditure accounted for a further €127 million, while primary, outpatient and emergency care were estimated at €32 million, €30 million and €13 million, respectively (Luengo-Fernandez et al., 2013). 1.3 Objectives of the National Clinical Guideline The overall objectives of the National Clinical Guideline No. 8 ‘Diagnosis, staging and treatment of patients with prostate cancer’ are: • To improve the quality of clinical care, • T o pr (...) will require diagnostic tests (radiology, pathology) and depending on the treatment plan may require surgery, chemotherapy and radiation therapy. A proportion of patients may also require palliative care. A recent population-based cost analysis (Luengo-Fernandez et al., 2013) illustrated the economic burden of cancer on the European Union (EU). In 2009, cancer is estimated to have cost the EU €126 billion, with healthcare costs accounting for €51 billion (40%). Prostate cancer is estimated to have cost

2015 Health Service Executive (Ireland) - Clinical Guidelines

103. Diagnosis, Staging and Treatment of Patients with Gestational Trophoblastic Disease

therapy with etoposide and cisplatin. Such patients may also benefit fr om substitution of EMA/CO with EP/EMA (Etoposide and cisplatin plus etoposide, methotrexate, actinomycin D) (Grade C). 2.4.4.1 For women with low-risk GTN undergoing first-line chemotherapy, the first ± second course of chemotherapy should be administered as an in-patient at a centre with medical oncology, gynaecological services and interventional radiology (Grade C). 2.4.5.1 Monitoring during treatment low-risk: Patients should (...) and Advisory Centre will have the potential to identify the volume of patients with GTD in the country, which should inform costs. 1.3 Objectives of the National Clinical Guideline The overall objectives of the National Clinical Guideline No. 13 ‘Diagnosis, staging and treatment of patients with GTD’ are: • To improve the quality of clinical care, • To prevent variation in practice, • To address areas of clinical care with new and emerging evidence, • Based on the best research evidence in conjunction

2015 National Clinical Guidelines (Ireland)

104. Treatment of Fecal Incontinence

included “fecal incontinence” anD [“fecal oR anal oR stool”], anD [“physical therapy oR rehabilitation oR biofeedback”], anD [“sphincteroplasty” oR “implants” oR “bowel sphincter” oR “artificial sphincter” oR “ra- diofrequency” oR “sacral nerve stimulation” oR “inject- able”]. Directed searches of the embedded references from The American Society of Colon and Rectal Surgeons’ Clinical Practice Guideline for the Treatment of Fecal Incontinence Ian M. Paquette, M.D.• Madhulika G. Varma, M.D.• Andreas M (...) are based on patients’ subjective experience of fi, and none correlate well with objective parameters and/or coping mechanisms. t here is also no perfect cor- relation between any of the instruments and prediction of outcomes for various management options. n evertheless, the use of these instruments is recom- mended because a validated measure of severity is help- ful in selecting patients for therapies and for measuring response to treatment over time. Patients with more severe symptoms or for whom

2015 American Society of Colon and Rectal Surgeons

105. A cost-effectiveness analysis of maternal genotyping to guide treatment for postpartum pain and avert infant adverse events

not received genetic screening information prior to commencing post-partum codeine therapy. 6 2 Methods This work includes a series of studies culminating in a CEA performed by decision analysis. The initial study involved a medical record review to establish the prevalence of use of various analgesics in the postnatal ward at St. Michael’s hospital in Toronto. This was the site of a clinical study where the proposed intervention of CYP2D6 screening to guide analgesic treatment was conducted. Within (...) quality of life (HRQoL) before and after drug therapy. A patient tracking sheet was used for patients to self-report medication use and infant medical status or adverse event after discharge. Patients were also asked to complete a health service use and cost diary to record health services use throughout the duration of drug therapy and for the duration of any adverse event and its resolution. 10 Figure 2.1: Study procedures 6 weeks prior to delivery 2 weeks prior to delivery 1 day after delivery

2015 SickKids Reports

106. 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

107. 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

108. 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

109. 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

110. 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

111. 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

112. 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

113. 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

114. 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

115. 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

116. 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

117. 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

118. 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

119. 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

120. 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

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