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Fetal Heart Tracing

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182. Atrial Fibrillation

Atrial Fibrillation We use cookies to enhance your experience on our website. By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS | European Heart Journal | Oxford Academic Search Account Menu Menu Navbar Search Filter Mobile Microsite Search Term Close search filter search input Article Navigation Close mobile search (...) on: Bart Van Putte (The Netherlands) Search for other works by this author on: Panagiotis Vardas (Greece) Search for other works by this author on: ESC Scientific Document Group Search for other works by this author on: European Heart Journal , Volume 37, Issue 38, 7 October 2016, Pages 2893–2962, Published: 27 August 2016 A correction has been published: Citation Paulus Kirchhof, Stefano Benussi, Dipak Kotecha, Anders Ahlsson, Dan Atar, Barbara Casadei, Manuel Castella, Hans-Christoph Diener, Hein

2016 European Society of Cardiology

183. Ongentys (opicapone) - Parkinson?s disease

, the result of 4-O-methylation. BIA 9-1103 has been detected in mouse, rat and monkey samples, and BIA 9-1104 detected in trace amounts in mini-pig, rat and mouse samples, and so no unique human metabolites are present and all can be detected in at least one of the non-clinical species. Two have been examined with significance, BIA 9-1079 and BIA 9-1103. Opicapone was not considered to be an inducer of CYP450 enzymes, was a mild inhibitor of CYP1A2 and CYP3A4, a moderate inhibitor of CYP2B6

2016 European Medicines Agency - EPARs

186. Pelvic inflammatory disease

cyst rupture, torsion, or haemorrhage; and urinary tract infection) should also be considered. Women with suspected PID should ideally be managed in a genito-urinary medicine (GUM) clinic or other local specialist sexual health service. Empirical antibiotics should be started as soon as possible. Diagnostic investigations should be performed to confirm the diagnosis and to test for other STIs and other genital infections (ideally before starting antibiotics). Sexual contacts should be traced (...) primary healthcare professionals to: Recognize the clinical features of pelvic inflammatory disease (PID) promptly. Assess and examine a woman with suspected PID. Arrange investigations to confirm the diagnosis and to test for other sexually transmitted infections and genital infections. Prescribe appropriate treatment in the primary care setting. Ensure that sexual partners of women with PID are traced and managed appropriately. Refer to secondary care or other specialist services as required

2019 NICE Clinical Knowledge Summaries

187. Atrial fibrillation

Atrial fibrillation Atrial fibrillation - NICE CKS Share Atrial fibrillation: Summary Atrial fibrillation (AF) is an arrhythmia. It results from irregular, disorganized electrical activity in the atria, leading to an irregular ventricular rhythm. The ventricular rate of untreated AF often averages between 160–180 beats per minute (although this is typically slower in older people). The most common causes of AF are ischaemic heart disease, hypertension, valvular heart disease (...) , and hyperthyroidism. Complications of AF include: Stroke and thromboembolism. Heart failure. Tachycardia-induced cardiomyopathy and critical cardiac ischaemia. Reduced quality of life. AF should be suspected in people with an irregular pulse. If AF is present, an ECG will have no P-waves, a chaotic baseline, and an irregular ventricular rate. Management of AF includes: Admitting people who have severe symptoms or a serious complication. Identifying and managing any underlying causes. Treating the arrhythmia

2019 NICE Clinical Knowledge Summaries

188. Gonorrhoea

. Infertility. Infection of Mullerian, or Cowper glands. Possible complications of gonorrhoea in women include: Pelvic inflammatory disease — occurs in up to one-third of women with gonorrhoea. This can result in chronic pelvic pain, tubal infertility, or ectopic pregnancy. For more information, see the CKS topic on . Rarely, peritoneal spread including perihepatic abscesses may occur (Fitz-Hugh-Curtis syndrome). Gonorrhoea in pregnancy is associated with miscarriage, fetal loss and congenital infections (...) ) Treatment of Neisseria gonorrhoea e [ ], and the British Medical Journal (BMJ) best practice guide Gonorrhoea infection [ ]. The complexities of gonorrhoea management, especially contact tracing, can be challenging. As a result people should be referred promptly to specialists in genito-urinary medicine (GUM) for management [ ]. Treatment How should I treat a person with gonorrhoea in primary care? Treat gonorrhoea in primary care only if specialist services cannot be accessed within a reasonable time

2019 NICE Clinical Knowledge Summaries

189. Trifluridine/tipiracil hydrochloride (TAS102) (Lonsurf)

rather than blood cells in rat, monkey, and human blood. Following single oral administration of ([ 14 C]FTD)FTD:TPI or ([ 14 C]TPI)FTD:TPI to lactating rats, radioactivity was excreted into milk. Thus, women should be advised to avoid breastfeeding during treatment with FTD:TPI. TPI was not substantially metabolized in vitro in human hepatocytes, although the minor metabolite 6-hydroxymethyluracil (6-HMU) was detected in human plasma and urine at trace levels. 6-HMU was also detected in rat plasma (...) , urine, and feces following single oral administration of [ 14 C-TPI]FTD:TPI or 14 C-TPI, providing nonclinical exposure for this metabolite. In human hepatocytes, FTD was metabolized in vitro using human hepatocytes to FTY, uracil-5-carboxylic acid (5-CU), and 5-carboxy-2’-deoxyuridine (5- CdUrd), with FTY being the major metabolite. In keeping with this, trifluridine was metabolized to FTY in human plasma along with 5-CU and 5-CdUrd at low or trace levels. Following a single oral administration

2015 FDA - Drug Approval Package

190. Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews

School, University of Warwick, UK Professor Jane Norman Professor of Maternal and Fetal Health, University of Edinburgh, UK Professor John Powell Consultant Clinical Adviser, NICE, UK Professor James Raftery Professor of Health Technology Assessment, Wessex Institute, Faculty of Medicine, University of Southampton, UK Dr Rob Riemsma Reviews Manager, Kleijnen Systematic Reviews Ltd, UK Professor Helen Roberts Professorial Research Associate, University College London, UK Professor Helen Snooks (...) ,TGurung, KFreeman,SJohnson, N-B Kandala, A Grove, B Gurung, S Morrow and A Clarke* Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK *Corresponding author Background: Prophylactic aspirin has been considered to be bene?cial in reducing the risks of heart disease and cancer. However, potential bene?ts must be balanced against the possible harm from side effects, such as bleeding and gastrointestinal (GI) symptoms. It is particularly important to know the risk of side effects

2013 NIHR HTA programme

191. Umbilical Cord Prolapse

section should be performed with the aim of achieving birth within 30 minutes or less if the cord prolapse is associated with a suspicious or pathological fetal heart rate pattern but without compromising maternal safety. Category 2 caesarean birth can be considered for women in whom the fetal heart rate pattern is normal, but continuous assessment of the fetal heart trace is essential. If the cardiotocograph (CTG) becomes abnormal, re-categorisation to category 1 birth should immediately (...) of Obstetricians and Gynaecologists Category 2 caesarean birth can be considered for women in whom the fetal heart rate pattern is normal, but continuous assessment of the fetal heart trace is essential. If the cardiotocograph (CTG) becomes abnormal, re-categorisation to category 1 birth should immediately be considered. Discussion with the anaesthetist should take place to decide on the appropriate form of anaesthesia. Regional anaesthesia can be considered in consultation with an experienced anaesthetist

2014 Royal College of Obstetricians and Gynaecologists

193. Odomzo - sonidegib

(Ptc) in combination with either homozygous deletion of p53 or heterozygous deletion of hypermethylated in cancer (Hic). Ex vivo cell proliferation was inhibited with an IC 50 ranging from 6 to 9 nM (RD-2007-50807). Sonidegib also blocked Gli-1 expression in a human cell line from fetal mesenchymal origin with an IC50 of 12.7 nM (RD-2007-50858). The effect of sonidegib (batch NVP-SONIDEGIB-NX3) was also assessed in ex vivo cultures of skin punch biopsies taken from 17.5 day Ptc+/- LacZ mouse (...) nervous system (CNS), cardiovascular and respiratory systems has been investigated. Functional Observational Battery (FOB) was used to evaluate sonidegib effects on the central nervous system (CNS), in a study complying with GLP [Study Report 0770728]. No mortality was observed and no effect was reported regarding clinical signs, body weight variations and FOB. The effect of sonidegib on the cardiovascular system was evaluated in vitro [Study Reports 0718501] in heart samples and in transfected HEK293

2015 European Medicines Agency - EPARs

194. Kengrexal - cangrelor

therapy DES drug-eluting stent DRF dose range finding ECG electrocardiographic / electrocardiogram(s) EFD embryo fetal development F female FCA Freund’s complete adjuvant FFP fresh frozen plasma g gram GCP Good Clinical Practice GGT gamma glutamyltransferase GLDH glutamate dehydrogenase GLP Good Laboratory Practice GP glycoprotein GTN glyceryl trinitrate GUSTO Global Use of Strategies to Open Occluded Coronary Arteries h hour(s) H2 Histaminergic HDPE High Density Polyethylene HED human equivalent dose (...) levels (3, 12, and 48 µg/kg/min), indicated by slight reductions in fetal weights and increased incidence of unossified hind limb metatarsals. These effects were in the absence of any overt maternal toxicity. The high-dose group showed also an increased incidence of Assessment report EMA/137542/2015 Page 26/113 incomplete ossification of skull and sternebrae bone. Since no fetal NOAEL was determined in this study, no safety margin for fetal toxicity is determined. Cangrelor administered to rabbit

2015 European Medicines Agency - EPARs

196. Kolbam - cholic acid

suggesting both a vagally mediated and a direct effect on heart rate. The response was further diminished by ganglion blockade or decerebration (Joubert 1978). In feline isolated right ventricular papillary muscles low concentrations (3x10-9-3x10-7M) of CA induced a mild positive inotropic effect as well as an endocardial endothelium- dependent and ß-receptor mediated positive inotropic response. Higher concentrations of CA (>3x10- 7M ) or prolonged exposure to a single low concentration (3x10-8M) caused (...) extensive morphological damage to the endothelium (Colpaert et al. 1992). Two separate studies examined the influence of bile acids, including CA, on the actions of isoprenaline, adrenaline, noradrenaline and acetylcholine on the rat autonomic system on the heart in vivo and in vitro, using an isolated blood vessel preparation (Kadlubowski et al. 1984) and isolated rat intestine (Szkudlinski, 1984). Kadlubowski et al. reported that bile acids reduced the stimulating effect of isoprenaline, adrenaline

2015 European Medicines Agency - EPARs

197. Evotaz - atazanavir / cobicistat

interval, and prolongation of QRS complex) were only observed in an initial 2-week oral toxicity study and not in subsequent 2-week and 9-month oral toxicity studies performed in dogs. Cobicistat In the isolated heart of the rabbit, shortening of the monophasic action potential duration (MAPD) was also observed at = 1 µM. In addition, COBI was associated with a significant increase in coronary perfusion pressure (at =1.5 µM), decrease in ventricular function (at =1 µM; possibly secondary to interaction (...) mechanism, observed in rodents. In this mouse study, liver carcinomas were not present, and in rats, all the results were negative. All together, these results suggest that atazanavir will not increase the carcinogenic risk in humans. The nonclinical safety evaluation of ATV also demonstrated that this compound was generally well-tolerated. Cobicistat In an isolated heart of the rabbit safety pharmacology study, shortening of the monophasic action potential duration (MAPD) was also observed at =1 µM

2015 European Medicines Agency - EPARs

198. Genetics of Skin Cancer (PDQ®): Health Professional Version

cell leukemia; cutaneous T-cell lymphoma is often confined to the skin throughout its course. Overall, 10% of leukemias and lymphomas have prominent expression in the skin.[ ] Epidermal appendages are also found in the dermal compartment. These are derivatives of the epidermal keratinocytes, such as hair follicles, sweat glands, and the sebaceous glands associated with the hair follicles. These structures are generally formed in the first and second trimesters of fetal development. These can form (...) by BCNS.[ , , ] BCNS-associated ovarian fibromas are more likely to be bilateral and calcified than sporadic ovarian fibromas.[ ] Ameloblastomas, aggressive tumors of the odontogenic epithelium, have also been proposed as a diagnostic criterion for BCNS, but most groups do not include it at this time.[ ] Other associated benign neoplasms include gastric hamartomatous polyps,[ ] pulmonary cysts,[ ] cardiac fibromas,[ ] meningiomas,[ - ] craniopharyngiomas,[ ] fetal rhabdomyomas,[ ] leiomyomas

2018 PDQ - NCI's Comprehensive Cancer Database

199. Genetics of Breast and Gynecologic Cancers (PDQ®): Health Professional Version

, in which more than 16,000 women were randomly assigned to receive combined HRT or placebo, was halted early because health risks exceeded benefits.[ , ] Adverse outcomes prompting closure included significant increase in both total (245 vs. 185 cases) and invasive (199 vs. 150 cases) breast cancers (RR, 1.24; 95% CI, 1.02–1.5, P < . 001) and increased risks of coronary heart disease, stroke, and pulmonary embolism. Similar findings were seen in the estrogen-progestin arm of the prospective

2018 PDQ - NCI's Comprehensive Cancer Database

200. Angio-oedema and anaphylaxis

stopping treatment with an ACE inhibitor. Angio-oedema with an unidentifiable or unavoidable cause/trigger. For people awaiting specialist review who are at risk of anaphylaxis, seek specialist advice about prescribing an adrenaline auto-injector device to be used in the event of anaphylaxis before their hospital appointment. People at risk of anaphylaxis include people with co-existing asthma, chronic obstructive pulmonary disease, or heart disease, people who have experienced angio-oedema with trace (...) when blood glucose levels decrease to less than 3.5 mmol/L. For more information, see the sections on hypoglycaemia in the CKS topics on or . Pulmonary embolism — a condition in which one or more emboli, usually arising from a blood clot formed in the veins (or, rarely, in the right heart) are lodged in and obstruct the pulmonary arterial system. For more information, see the CKS topic on . Urticaria. For more information, see the CKS topic on . Vasovagal episode — transient loss of consciousness

2018 NICE Clinical Knowledge Summaries

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