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Emergency Medicine Treatment and Labor Act

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121. 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

122. 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

123. 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

124. 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

125. 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

126. Andrew Weil, the Coors Foundation, and Americans for Prosperity, or: “Integrative medicine” isn’t just for hippy dippy lefties anymore

Foundation is well known for promoting integrative medicine. Mr. Jackson said as much himself in his email, and the touts its projects with the (run, of course, by Andrew Weil), the , and the . For instance, the : The health insurance industry, and its practice of not reimbursing doctors who prescribe CAM-type treatments, creates a massive bottleneck that prevents promising integrative treatments from entering the medical mainstream. The Adolph Coors Foundation has awarded a gift to the Center (...) of "integrating" alternative medicine quackery with real medicine. He's nationally and internationally regarded as a pioneering expert in "complementary and alternative medicine" (CAM). Indeed, arguably no human being has done more in his lifetime and career to seemingly legitimize the specialty of "integrative medicine." He's even started an integrative medicine residency and managed to spearhead a , although the latter does not use the usual accrediting organization used by most other established medical

2015 Respectful Insolence

127. Medical imaging

in pharmaceutical clinical trials [ ] Medical imaging has become a major tool in clinical trials since it enables rapid diagnosis with visualization and quantitative assessment. A typical goes through multiple phases and can take up to eight years. or outcomes are used to determine whether the therapy is safe and effective. Once a patient reaches the endpoint, he or she is generally excluded from further experimental interaction. Trials that rely solely on are very costly as they have long durations and tend (...) to expand, including studies, , , and assessing the effects of disruption agents on cancer tumors. Nuclear medicine [ ] Main article: Nuclear medicine encompasses both diagnostic imaging and treatment of disease, and may also be referred to as molecular medicine or molecular imaging & therapeutics. Nuclear medicine uses certain properties of isotopes and the energetic particles emitted from radioactive material to diagnose or treat various pathology. Different from the typical concept of anatomic

2012 Wikipedia

128. Medical transcription

care to ensure that the impositions on MT autonomy are not so onerous as to outweigh its benefits. Medical transcription is still the primary mechanism for a physician to clearly communicate with other healthcare providers who access the patient record, to advise them on the state of the patient's health and past/current treatment, and to assure continuity of care. More recently, following Federal and State Disability Act changes, a written report (IME) became a requirement for documentation (...) notes that were added in the patient's file for interpretation by the primary physician responsible for the treatment. Ultimately, this mess of handwritten notes and typed reports were consolidated into a single patient file and physically stored along with thousands of other patient records in a wall of filing cabinets in the medical records department. Whenever the need arose to review the records of a specific patient, the patient's file would be retrieved from the filing cabinet and delivered

2012 Wikipedia

129. Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version

and capacity for normal tissue repair. Hormonal milieu. Function of organs not affected by cancer treatment. Socioeconomic status. Health habits. Resources to Support Survivor Care Risk-based screening The need for long-term follow-up for childhood cancer survivors is supported by the American Society of Pediatric Hematology/Oncology, the International Society of Pediatric Oncology, the American Academy of Pediatrics, the Children’s Oncology Group (COG), and the Institute of Medicine. A risk-based medical (...) Late Effects of Treatment for Childhood Cancer (PDQ®): Health Professional Version Late Effects of Treatment for Childhood Cancer (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf Warning: The NCBI web site requires JavaScript to function. Search database Search term Search NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. PDQ Cancer Information

2016 PDQ - NCI's Comprehensive Cancer Database

130. EMTALA and Patients With Psychiatric Emergencies: A Review of Relevant Case Law. (Abstract)

EMTALA and Patients With Psychiatric Emergencies: A Review of Relevant Case Law. Emergency department (ED) care for patients with psychiatric complaints has become increasingly challenging given recent nationwide declines in available inpatient psychiatric beds. This creates pressure to manage psychiatric patients in the ED or as outpatients and may place providers and institutions at risk for liability under the Emergency Medical Treatment and Labor Act (EMTALA). We describe the patient (...) screening examination and did not detect an emergency medical condition that required stabilization.Lawsuits involving alleged EMTALA violations in the care of ED patients with psychiatric complaints are uncommon and rarely successful.Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

2014 Annals of Emergency Medicine

131. Pheochromocytoma and Paraganglioma Treatment (PDQ®): Health Professional Version

of cyclophosphamide, vincristine, and dacarbazine (the Averbuch protocol).[ ] Results of this regimen in 18 patients after 22 years of follow-up demonstrated a complete response rate of 11%, a partial response rate of 44%, a biochemical response rate of 72%, and a median survival of 3.3 years.[ ][ ] Several other chemotherapy regimens have been used in small numbers of patients, but the overall results were disappointing.[ , ] Targeted therapy Novel targeted therapies are emerging as potential treatment (...) disease. Surgery Treatment for recurrent disease involves appropriate medical management (i.e., alpha-adrenergic blockade) followed by complete surgical resection, when possible. Palliative Therapy Palliation of symptoms, including those related to catecholamine excess and local mass effect, is the primary focus of treatment for disease that is not resectable. The following are options for patients with local-regional or metastatic disease who are not considered candidates for surgical resection

2015 PDQ - NCI's Comprehensive Cancer Database

132. The “go to the ER” mentality of American medicine

doctors or secretaries. People who need to be admitted are sent in “just to get checked before they go upstairs.” Or sometimes, so the physician on duty can do the negotiation with the hospitalist, rather than having the primary care physician do so. Why is the ED the default? In 1986 Reagan championed and Congress passed EMTALA, the Emergency Medical Treatment and Active Labor Act, which says you can’t turn anyone away for reasons of non-payment. Another well-intentioned bit of government meddling (...) with more and more complex and multi-varied duties in the emergency departments of the 21st century. I’m not a medical economist. I do have some thoughts on the well-intentioned but deeply flawed Affordable Care Act. However, I won’t go there right now. What I do want to address is the “go directly to the ER” mentality of modern American medicine. Call your physician. If it’s after hours, the recording for any physician or practice of any sort in America will have a message: “If this is an emergency

2016 KevinMD blog

133. Mad Libs for medicine. Do you think you can use these?

these with the nurses, and give the shift a little levity. Pain medication. You see, doctor, my pain specialist is in (foreign city). Before he left, he gave me a (duration of time) supply of (narcotic), and said if I had any problems I should go to the (health care facility). It turns out that my cousin’s (type of pet) got into my pills and (bodily function) all over half of them and ate the rest. If I could just get a (unit of weight or volume) of (drug that begins with D), I’ll be fine until my doctor comes back (...) . This time he says the pain is (erotic but not profane word), and feels as if he may (normal bodily function). His (government official) has the same thing and was (spa treatment) last week and then hospitalized. This patient insists that only IV (insect) serum will reverse the symptoms. Also a dose of (pain med that starts with D). Satisfaction scores. Dear (medical provider title): A review of your patient satisfaction scores reveals that you need to spend more time doing (type of massage) on your

2015 KevinMD blog

134. Case studies at Denver Health: 'patient dumping' in the emergency department despite EMTALA, the law that banned it. Full Text available with Trip Pro

Case studies at Denver Health: 'patient dumping' in the emergency department despite EMTALA, the law that banned it. The Emergency Medical Treatment and Labor Act was enacted in 1986 to prevent hospitals from turning away patients with emergency medical conditions, often because they were uninsured--a practice commonly known as "patient dumping." Twenty-five years later, Denver Health--a large, urban, safety-net hospital--continues to experience instances in which people with emergency (...) conditions, many of whom are uninsured, end up in the safety-net setting after having been denied care or receiving incomplete care elsewhere. We present five case studies and discuss potential limitations in the oversight and enforcement of the 1986 law. We advocate for a more effective system for reporting and acting on potential violations, as well as clearer standards governing compliance with the law.

2012 Health affairs

135. Treatment and recommendations for homeless people with Chronic Non-Malignant Pain

with these patients to develop a plan of care. The practice adaptations recommended in this document are based on a comprehensive review of published reports and consensus opinion of clinicians with expertise in homeless health care, treatment of chronic pain, and addiction medicine. These recommendations are intended to be consistent with the standard clinical guidelines listed below. Their purpose is to facilitate adherence to these standards in the care of impoverished, displaced persons with multiple medical (...) indicated. FOLLOW-UP ? Determine frequency of follow-up based on stability of the patient and his/her living situation and risk of misuse. For patients with comorbid behavioral health issues who are receiving COT, more frequent visits with random urine drug tests may be necessary. In general, opioid prescriptions should be of shorter duration (1 month or less) to help reduce risk of diversion/ overdose/ loss of medications. ? At each visit, assess for behaviors outside the treatment plan, including

2011 National Health Care for the Homeless Council

136. Diagnosis and Treatment Malaria in Pregnancy

promptly while obtaining IV artesunate). The UK guidelines explain expert consultation is required before the artesunate will be issued. 1 Severe malaria in pregnancy provides an urgent and pressing reason for artesunate to be issued (although this is not in the current guidelines). 1 IV clindamycin is a very slow-acting antimalarial and it is unlikely to add any additional value to IV artesunate, which is the fastest acting of all antimalarial drugs. In endemic countries, the treatment course when (...) of the infant to malaria. P. falciparum causes greater morbidity (maternal and fetal, principally low birth weight and anaemia) and mortality than non-falciparum infections 5,7–10 but there is mounting evidence that P. vivax is not as benign as had been previously thought. 12–14 Response to antimalarial treatment is multifactorial but is associated with the degree of prior immunity acquired from repeated exposures in childhood and the background level of drug resistance. The higher the transmission

2010 Royal College of Obstetricians and Gynaecologists

137. Late Effects of Treatment for Childhood Cancer

, the Children’s Oncology Group (COG), and the Institute of Medicine. A risk-based medical follow-up is recommended, which includes a systematic plan for lifelong screening, surveillance, and prevention that incorporates risk estimates based on the following:[ ] Previous cancer. Cancer therapy. Genetic predisposition. Lifestyle behaviors. Comorbid conditions. Sex. Part of long-term follow-up is also focused on appropriate screening of educational and vocational progress. Specific treatments for childhood (...) for medical late effects, the impact of health behaviors on cancer-related health risks is also emphasized. Health-promoting behaviors are stressed for survivors of childhood cancer. Targeted educational efforts appear to be worthwhile in the following areas:[ ] Abstinence from smoking, excess alcohol use, and illicit drug use to reduce the risk of organ toxicity and, potentially, subsequent neoplasms. Healthy dietary practices and active lifestyle to reduce treatment-related metabolic and cardiovascular

2012 PDQ - NCI's Comprehensive Cancer Database

138. Drug rehabilitation Full Text available with Trip Pro

or family-based recovery support systems. Whatever the methodology, patient motivation is an important factor in treatment success. For individuals addicted to prescription drugs, treatments tend to be similar to those who are addicted to drugs affecting the same brain systems. Medication like and can be used to treat addiction to prescription opiates, and behavioral therapies can be used to treat addiction to prescription stimulants, benzodiazepines, and other drugs. Types of behavioral therapy include (...) their jobs, avoid crime and violence, and reduce their exposure to HIV and by stopping or reducing injection drug use and drug-related high risk . is a long-acting with few side effects. It is usually prescribed in medical conditions. Naltrexone blocks the euphoric effects of alcohol and opiates. Naltrexone cuts relapse risk during the first 3 months by about 36%. However, it is far less effective in helping patients maintain abstinence or retaining them in the drug-treatment system (retention rates

2012 Wikipedia

139. Drug abuse

-help organizations in which members support each other not to use alcohol. are significantly impaired in people suffering from due to the effects of alcohol on the brain, especially the area of the brain. It has been suggested that training adjunctive to inpatient treatment of alcohol dependence is probably efficacious, including managing the social environment. Medication [ ] A number of medications have been approved for the treatment of substance abuse. These include replacement therapies (...) such as and as well as antagonist medications like and in either short acting, or the newer long acting form. Several other medications, often ones originally used in other contexts, have also been shown to be effective including and . Methadone and are sometimes used to treat opiate addiction. These drugs are used as substitutes for other opioids and still cause withdrawal symptoms. Antipsychotic medications have not been found to be useful. Acamprostate is a glutamatergic NMDA antagonist, which helps

2012 Wikipedia

140. [Enzalutamide-a novel androgen receptor inhibitor that provides treatment options for patients with castration-resistant prostate cancer]. (Abstract)

[Enzalutamide-a novel androgen receptor inhibitor that provides treatment options for patients with castration-resistant prostate cancer]. The recent emergence of new hormonal or chemotherapeutic drugs has resulted in a paradigm shift in the treatment of castration-resistant prostate cancer(CRPC). Enzalutamide is a rationally designed, orally administered androgen receptor(AR)inhibitor. It inhibits multiple points in the androgen receptor signalling pathway, which is considered an important (...) free survival[rPFS], time to the first skeletal related event[SRE])as well as objective response outcomes(i.e. PSA, soft tissue, and quality of life[QOL]). On the basis of the AFFIRM results, Astellas and Medivation filed a new drug application with the United States Food and Drug Administration and the European Medicines Agency in 2012, and obtained their approval. Another phaseI/II enzalutamide trial was conducted in both chemotherapy-naïve patients and post-chemotherapy pa- tients

2014 Gan to kagaku ryoho. Cancer & chemotherapy

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