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Emergency Medicine Treatment and Labor Act

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141. Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association

. Tweet , and Malissa J. Wood and On behalf of the American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; and Stroke Council Originally published 22 Feb 2018 Circulation. 2018;137:e523–e557 You are viewing the most recent version of this article. Previous versions: Abstract Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary (...) , MD, PhD, FAHA , and MD MDOn behalf of the American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; and Stroke Council Sharonne N. Hayes , Esther S.H. Kim , Jacqueline Saw , David Adlam , Cynthia Arslanian-Engoren , Katherine E. Economy , Santhi K. Ganesh , Rajiv Gulati , Mark E. Lindsay , Jennifer H. Mieres , Sahar Naderi , Svati Shah , David E. Thaler , Marysia S

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2018 American Heart Association

142. Elagolix for Treating Endometriosis

treatments, new therapies are needed. A new agent, elagolix (Orilissa™, AbbVie) was approved by the FDA for the management of moderate-to-severe pain associated with endometriosis on July 23, 2018. 16 Elagolix is a short-acting, oral, nonpeptide, GnRH antagonist that rapidly suppresses the pituitary- ovarian hormones and produces a dose-dependent suppression of ovarian estrogen production that varies from partial to full suppression depending on the frequency and dose given. 17,18 In contrast, GnRH (...) agonists act by initially stimulating the pituitary gland to release female hormones and can worsen symptoms of endometriosis during the first 10 to 14 days of treatment before persistent binding to the GnRH receptor leads to full suppression of ovarian hormones. By not producing the initial surge in LH and FSH associated with GnRH agonists, elagolix does not result in an initial increase in symptoms and the need to treat with hormonal contraceptives. Moreover, GnRH agonists must be administered

2018 California Technology Assessment Forum

143. Management of Strongyloidiasis

helminthiases, it needs additional diagnostic tools beyond microscopy and requires different treatment. In areas in which preventive anthelmintic chemotherapy with ivermectin has been used to control onchocerciasis or lymphatic filariasis, there has been a noticeable reduction in the prevalence of strongyloidiasis [ – ]. The WHO Essential Medicines Committee has included ivermectin in its list, including in combination with albendazole, for strongyloidiasis. Some 900 million people are now receiving (...) , because of the risk of hyperinfection—a potentially fatal complication. Reliable diagnosis of patients at risk is needed for accurate recognition and treatment before immunosuppressive therapy is initiated, or in patients with HTLV-I or human immunodeficiency virus (HIV) infection. If emergency immunosuppression is required in a patient who may have previously undiagnosed strongyloidiasis, and diagnostic tests are not rapidly available (very few hospitals can do same-day serology), presumptive

2018 World Gastroenterology Organisation

144. Perineal care

6.2.1 Types of repair 23 6.2.2 OASIS repair 24 7 Puerperal genital haematoma 25 7.1 Diagnosis of puerperal haematoma 25 7.2 Treatment of puerperal haematoma 26 8 Postpartum perineal care 27 8.1 Management of pain and bowel function 27 8.2 Antibiotics 27 8.3 Promoting perineal recovery 28 8.4 Follow up after perineal injury 29 8.5 Previous OASIS and decision making 30 8.5.1 Risk factors for recurrence of OASIS 31 9 Clinical measures not supported by evidence 31 10 Female genital mutilation (FGM) 32 (...) around 35 weeks gestation o One to two times per week o For around five minutes per session 39 4.2 Pelvic floor muscle training (PFMT) Table 10. Pelvic floor muscles training Aspect Consideration Risks and benefits · When commenced in early pregnancy, effective in reducing urinary incontinence in late pregnancy and first six months postpartum 40 · Greater positive effect if treatment closely supervised with adequate exercise regimen to strengthen muscles 40 · Effective treatment for existing urinary

2018 Queensland Health

145. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain

, with higher dosages and more frequent infusions associated with greater risks. Larger studies, evaluating a wider variety of conditions, are needed to better quantify efficacy, improve patient selection, refine the therapeutic dose range, determine the effectiveness of nonintravenous ketamine alternatives, and develop a greater understanding of the long-term risks of repeated treatments. From the * Departments of Anesthesiology & Critical Care Medicine, Neurology, and Physical Medicine & Rehabilitation (...) ramifications for pain medicine providers. Despite the recent surge in use in the context of mood disorders, there is a relative paucity of clinical data compared with its use as an anesthetic and analgesic agent, but the mood-enhancing effects appear to emerge in approximately 4 hours, after most of the drug has been cleared from circulation, and persist for up to 2 weeks, long after the acute analgesic effects dissipate. Similar to its use as an analgesic, a variety of routes of administration have been

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2018 American Society of Regional Anesthesia and Pain Medicine

146. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology

and the American Society for Microbiology J Michael Miller Microbiology Technical Services, LLC, Dunwoody, Georgia Correspondence: J. M. Miller, Microbiology Technical Services, LLC, PO Box 88212, Dunwoody, GA 30338 ( ). Search for other works by this author on: Matthew J Binnicker Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota Search for other works by this author on: Sheldon Campbell Yale University School of Medicine, New Haven (...) , Connecticut Search for other works by this author on: Karen C Carroll Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland Search for other works by this author on: Kimberle C Chapin Department of Pathology, Rhode Island Hospital, Providence Search for other works by this author on: Peter H Gilligan Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill Search for other works by this author on: Mark D Gonzalez Department of Pathology

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2018 Infectious Diseases Society of America

147. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency

in the interpretation of genetic test results because of the complexity of the CYP21A2 locus. Treatment of classic congenital adrenal hyperplasia 4.1 In growing individuals with classic congenital adrenal hyperplasia, we recommend maintenance therapy with hydrocortisone. (1|⊕⊕⊕○) 4.2 In growing individuals with congenital adrenal hyperplasia, we recommend against the use of oral hydrocortisone suspension and against the chronic use of long-acting potent glucocorticoids. (1|⊕⊕⊕○) 4.3 In the newborn and in early (...) infancy, we recommend using fludrocortisone and sodium chloride supplements to the treatment regimen. (1|⊕⊕⊕○) 4.4 In adults with classic congenital adrenal hyperplasia, we recommend using daily hydrocortisone and/or long-acting glucocorticoids plus mineralocorticoids, as clinically indicated. (1|⊕⊕⊕○) 4.5 In all individuals with classic congenital adrenal hyperplasia, we recommend monitoring for signs of glucocorticoid excess, as well as for signs of inadequate androgen normalization, to optimize

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2018 The Endocrine Society

148. CAEP FEI | Human Trafficking Awareness: A Learning Module

H, et al. Human Trafficking: A Guide to Identification and Approach for the Emergency Physician. Ann Emerg Med . 2016;68(4):501-508.e1. [ ] 5. Grace A, Lippert S, Collins K, et al. Educating health care professionals on human trafficking. Pediatr Emerg Care . 2014;30(12):856-861. [ ] 6. Chisolm-Straker M, Richardson L, Cossio T. Combating slavery in the 21st century: the role of emergency medicine. J Health Care Poor Underserved . 2012;23(3):980-987. [ ] 7. ACT Alberta. The Action Coalition (...) review assessing the need for awareness in emergency departments and the effectiveness of training modules on human trafficking was then completed. A one-hour lecture presented by ACT Alberta, a local organization that raises awareness and aids victims of human trafficking, was provided to medical students across all four years as a part of the Physicianship Longitudinal Themes course curriculum, a series of lectures and small group learning throughout all four years of the medical program covering

2018 CandiEM

149. Management of Pregnancy

complications and morbidity • Emphasize the use of patient-centered care (PCC) II. Background A. Description of Pregnancy Pregnancy is the reproductive time during which a developing fetus grows inside of the uterus. It is a time of dramatic change for a developing fetus and a woman’s body. Most pregnancies are uncomplicated and labor results in a normal vaginal birth with a healthy mother and baby. Rarely, complications arise, which have the potential to lead to lifelong implications. As the fetus (...) . Changes were most pronounced between 2009 and 2014.[ ] There are many possible drivers for the decrease in rates of reproduction in the past few decades and the increasing number of deliveries later in women’s lives, such as women’s increasing prioritization on education and establishing careers prior to having children and improved access to contraception and reproductive health services. 6 7 8 b. Pregnancy Complications Although there have been advances in medicine and medical technologies over

2018 VA/DoD Clinical Practice Guidelines

150. End-of-Life Care for People Experiencing Homelessness

for the Homeless Clinicians’ Network ADAPTING YOUR PRACTICE Recommendations for End-of-life Care for People Experiencing Homelessness 4 3. Recognize that both Western medicine and integrative, complementary, and alternative medicine (ICAM) are options in end-of-life care to ensure optimal comfort for some patients. 4. Employ a harm-reduction philosophy regarding addiction, placement (patients may choose to stay outside), and medication adherence (both mental health and medical treatment). 5. Providers should (...) and Healthcare Leadership A.T. Still University, School of Medicine in Arizona Mesa, AZ Melissa Sandoval, MD Medical Director Circle the City Phoenix, AZ Mary Tornabene, APN, CNP Family Nurse Practitioner Heartland Health Outreach Chicago, IL Lawanda Williams, MSW, LCSW-C Director of Housing Services Health Care for the Homeless Baltimore, MD Laura Kaplan-Weisman, MD Family Physician The Institute for Family Health Walton Family Practice Bronx, NYHealth Care for the Homeless Clinicians’ Network ADAPTING YOUR

2018 National Health Care for the Homeless Council

151. 2018 IDSA Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy

examining innovative models of care for this challenging group of patients that involve management of addiction in addition to treatment of infection are needed. The role of long-acting glycopeptides in this population needs to be explored. IV. Should elderly patients be allowed to be treated with OPAT at home? Recommendation Elderly patients should be allowed to be treated with OPAT at home (strong recommendation, low-quality evidence) . This recommendation assumes that potential challenges to OPAT (...) . It does not offer recommendations on the treatment of specific infections. The reader is referred to disease- or organism-specific guidelines for such support. Executive Summary Outpatient parenteral antimicrobial therapy (OPAT) is defined as the administration of parenteral antimicrobial therapy in at least 2 doses on different days without intervening hospitalization. Recommendations made in the updated guideline for the prescription and management of OPAT are summarized below. The panel followed

2018 Infectious Diseases Society of America

152. Fistulizing Crohn's Disease

on the sparse evidence, but also the suggestion of short-term benefits, the consensus group conditionally sug - gested that antibiotics may be useful as an initial management strategy to decrease drainage, to prevent abscess formation, and to act a bridge to a more definitive treatment strategy. Key evidence Evidence for anti-TNF therapies in fistulizing disease comes from 1 positive RCT with infliximab that was conducted specifically in this patient group. 39 But the majority of evidence is from sub- group (...) , 7 Mark Borgaonkar, MD, 8 Usha Chauhan, NP , 9 Brendan Halloran, MD, 10 Jennifer Jones, MD, 11 Erin Kennedy, MD, PhD, 12 Grigorios I. Leontiadis, MD, PhD, 6 Edward V . Loftus Jr, MD, 13 Jonathan Meddings, MD, 2 Paul Moayyedi, MB, PhD, 6 Sanjay Murthy, MD, 14 Sophie Plamondon, MD, 15 Greg Rosenfeld, MD, 16 David Schwartz, MD, 17 Cynthia H. Seow, MBBS (Hons), 18 and Chadwick Williams, MD 19 1 Division of Gastroenterology, Mount Sinai Hospital, T oronto, Ontario, Canada; 2 Department of Medicine

2018 Canadian Association of Gastroenterology

153. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency

at least one parent aids in the interpretation of genetic test results because of the complexity of the CYP21A2 locus. Treatment of classic congenital adrenal hyperplasia 4.1 In growing individuals with classic congenital adrenal hyperplasia, we recommend maintenance therapy with hydrocortisone. (1|⊕⊕⊕○) 4.2 In growing individuals with congenital adrenal hyperplasia, we recommend against the use of oral hydrocortisone suspension and against the chronic use of long-acting potent glucocorticoids. (1 (...) |⊕⊕⊕○) 4.3 In the newborn and in early infancy, we recommend using fludrocortisone and sodium chloride supplements to the treatment regimen. (1|⊕⊕⊕○) 4.4 In adults with classic congenital adrenal hyperplasia, we recommend using daily hydrocortisone and/or long-acting glucocorticoids plus mineralocorticoids, as clinically indicated. (1|⊕⊕⊕○) 4.5 In all individuals with classic congenital adrenal hyperplasia, we recommend monitoring for signs of glucocorticoid excess, as well as for signs of inadequate

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2018 Pediatric Endocrine Society

154. Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients

GA, MELANSON SE, AND LANGMAN LJ. AACC Academy Laboratory Medicine Practice Guideline:6 LABORATORY MEDICINE PRACTICE GUIDELINES cific. On the other hand, definitive or confirmatory testing (e.g. mass spectrometry- or chromatography-based) are able to iden- tify a specific drug and/or its associated metabolites. Outcomes included adherence, diversion, emergency de- partment visits, and others. The time period was from January 2000-February 2015 in outpatient, inpatient, and community settings (...) . A systematic literature search was performed using the inclusion and exclusion criteria shown in Table 2. The following databases were searched: PubMed, the Nation- al Library of Medicine; Cochrane Database of Systematic Reviews, which includes the full text of regularly updated systematic re- views of the effects of healthcare prepared by the Cochrane Col- laboration; the National Guideline Clearinghouse (an initiative of the Agency for Healthcare Research and Quality), a public resource for evidence

2018 Publication 4890876

155. A review of the evidence base for modelling the costs of overweight, obesity and diet-related illness for Scotland, and critical appraisal of the cost-effectiveness evidence base for population wide interventions to reduce overweight, obesity and diet-rel

regarding behaviour change over the longer term is a priority. These insights will be important to build into any future modelling studies conducted for Scotland or the rest of the UK, using information from other countries which have already introduced population level interventions. In terms of future research recommendations, we suggest the following: 1. The lack of recent data from Scotland on cost of illness associated with overweight and obesity, combined with changes in the treatment (...) is higher in Scotland than in England (65% v 63% and 29% v 27% respectively). Further, obesity prevalence rates have risen in both Scotland and England since 2006/7. Finally, medical and surgical treatment options for obesity and conditions related to obesity (e.g. diabetes, hypertension, cardiovascular disease) have increased over the last 10 years. Castle et al (2015) also noted the potential magnitude of the costs of lost productivity due to morbidity and mortality, and with these added to health

2017 Health Economics Research Unit

156. Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services

cStage Clinical stage CT Computed Tomography DBC Diagnosis Treatment Combination DC Day care 26 Required hospital capacity and criteria for rationalisation KCE Report 289 DGOS General Directorate of Care Provision (‘Direction Générale de l’Offre de Soins’) (France) DHMA Danish Health and Medicines Authority DPCA Dutch Pancreatic Cancer Audit DREES ‘Direction de la Recherche, des Etudes, de l’Evaluation et des Statistiques’ (France) DRG Diagnosis Related Group DUCA Dutch Upper GI Cancer Audit EBRT (...) of inpatient beds 204 Figure 48 – Average length of stay (all types of care) 205 Figure 49 – Average length of stay (acute care) 206 Figure 50 – Licenses for cancer treatment in 2010 207 Figure 51 – Volume of care activities to be transferred to licensed hospitals 208 Figure 52 – Evolution of the number of hospitals licensed to treat cancer (2003-2016) 209 Figure 53 – Average entropy index by type of hospital in France, 2002-2009 210 Figure 54 – Avoidable admissions for chronic ambulatory care sensitive

2017 Belgian Health Care Knowledge Centre

157. Governance models for hospital collaborations

in the hospital sector 8 1.2 COLLABORATION IN THE HEALTHCARE SECTOR 9 1.2.1 Types of strategic alliance 11 1.2.2 Collaboration and networks 12 1.2.3 Collaboration forms in the Belgian Hospital Act 14 1.3 GOVERNANCE OF COLLABORATION INITIATIVES 14 1.3.1 Governance mechanisms 14 1.3.2 Governance structure 15 1.4 SCOPE AND OBJECTIVES OF THIS REPORT 16 2 CURRENT BELGIAN LEGAL CONTEXT OF COLLABORATION BETWEEN HOSPITALS – A DESCRIPTIVE ANALYSIS 17 2.1 INTRODUCTION 17 2.2 DIFFERENT FORMS OF ACTUAL COLLABORATION (...) : New organisation 60 Figure 5 – SGEI Analysis Tree 109 LIST OF TABLES Table 1 – Health networks and systems 13 Table 2 – Synthesis of the facilitators and obstacles 57 Table 3 – Proposed collaboration models 61 KCE Report 277 Governance models for hospital collaborations 5 ? SCIENTIFIC REPORT 1 Article 67 of the coordinated Law of 10 July 2008 on hospitals and other healthcare institutions (hereinafter referred to as the ‘Hospital Act’) provides 1 INTRODUCTION There is an international trend

2017 Belgian Health Care Knowledge Centre

158. Use of Silver Diamine Fluoride for Dental Caries Management in Children and Adolescents, Including Those with Special Health Care Needs

in primary teeth with caries lesions. Does the application of SDF arrest cavitated caries lesions as effectively as other treatment modalities in primary teeth? Methods This guideline adheres to the National Academy of Medicine's guideline standards 4 and the recommendations of the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. 5 The guidance presented is based on an evaluation of the evidence presented in a 2016 systematic review published by Gao and colleagues. 1 Search strategy (...) fluoride in this guideline’s recommendation refers to 38 percent SDF, the only formula available in the United States. These rec- ommended practices are based upon the best available evidence to-date. However, the ultimate decisions regarding disease man- agement and specific treatment modalities are to be made by the dental professional and the patient or his/her representative, acknowledging individuals’ differences in disease propensity, lifestyle, and environment. The guideline provides

2017 American Academy of Pediatric Dentistry

160. Epilepsy in Pregnancy

with epilepsy (WWE), their families and healthcare professionals should be aware of the different types of epilepsy and their presentation to assess the specific risks to the mother and baby. What other conditions in pregnancy should be considered in the differential diagnosis of epileptic seizures? In pregnant women presenting with seizures in the second half of pregnancy which cannot be clearly attributed to epilepsy, immediate treatment should follow existing protocols for eclampsia management until (...) in labour in WWE and how can they be minimised? Pregnant WWE should be counselled that the risk of seizures in labour is low. Adequate analgesia and appropriate care in labour should be provided to minimise risk factors for seizures such as insomnia, stress and dehydration. Long-acting benzodiazepines such as clobazam can be considered if there is a very high risk of seizures in the peripartum period. AED intake should be continued during labour. If this cannot be tolerated orally, a parenteral

2016 Royal College of Obstetricians and Gynaecologists

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