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Fetal Heart Tracing

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301. The Apgar Score

(5). When a Category I (normal) or Category II (indeterminate) fetal heart rate tracing is associated with Apgar scores of 7 or higher at 5 minutes, a normal umbilical cord arterial blood pH (± 1 standard deviation), or both, it is not consistent with an acute hypoxic–ischemic event (6). Prediction of Outcome A 1-minute Apgar score of 0–3 does not predict any individual infant’s outcome. A 5-minute Apgar score of 0–3 correlates with neonatal mortality in large populations ( , ), but does (...) of resuscitation all can be recorded in the comments box. The Apgar score alone cannot be considered to be evidence of or a consequence of asphyxia. Many other factors, including nonreassuring fetal heart rate monitoring patterns and abnormalities in umbilical arterial blood gases, clinical cerebral function, neuroimaging studies, neonatal electroencephalography, placental pathology, hematologic studies, and multisystem organ dysfunction need to be considered in diagnosing an intrapartum hypoxic–ischemic event

2015 American College of Obstetricians and Gynecologists

302. Supraventricular Tachycardia: Guideline For the Management of Adult Patients With

ACCP 2012 (17) Atrial ?brillation ESC 2012 (18) 2010 (19) Device-based therapy ACC/AHA/HRS 2012 (20) Atrial ?brillation CCS 2014 (21) 2011 (22) Hypertrophic cardiomyopathy ACC/AHA 2011 (23) Secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease AHA/ACC 2011 (24) Adult congenital heart disease ACC/AHA 2008 (25)* Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC (...) Supraventricular Tachycardia: Guideline For the Management of Adult Patients With CLINICAL PRACTICE GUIDELINE 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society Writing Committee Members* Richard L. Page, MD, FACC, FAHA, FHRS, Chair José A. Joglar, MD, FACC, FAHA, FHRS, Vice Chair Mary A. Caldwell, RN

2015 American College of Cardiology

303. The Agenda for Familial Hypercholesterolemia Full Text available with Trip Pro

atherosclerotic coronary heart disease. Heterozygous FH has the highest prevalence of genetic defects that cause significant premature mortality (≈1:200 to 1:500 or higher in founder populations). The genetic basis of the disorder, impaired functioning of the low-density lipoprotein (LDL) receptor, was first recognized by Goldstein and Brown in their Nobel Prize–winning work. Studies of LDL receptor function have identified additional mechanisms for the pathogenesis of FH (defects in apolipoprotein [apo] B (...) and reviews of progress with regard to diagnosis and treatment. Patient perspectives are critical to optimizing care because patients have to live with fears concerning premature heart disease, implications of genetic diagnosis, and lifelong pharmacological care for a condition that has no symptoms before a coronary event. Genetic diagnosis and genotype/phenotype correlations have created questions related to diagnosis, particularly with regard to the meaning of heterozygosity and homozygosity

2015 American Heart Association

304. The Society of Invasive Cardiovascular Professionals New 2015 Educational Guidelines for Invasive Cardiovascular Technology Personnel in the Cardiovascular Catheterization Laboratory

. Pulmonary Diseases (COPD) 14. Arterial Diseases 15. Infectious Diseases 16. Tumors 17. Cerebrovascular Diseases 18. Renal Disease 19. Endocrine Disease D. Athlete’s Heart 1. Common Cardiovascular Cath Lab Findings E. Surgical Procedures 1. Coronary Bypass 2. Minimally Invasive Coronary Bypass 3. Surgical Valvular Repair/Replacement 4. Transcatheter Valvular Repair/Replacement 5. Heart Transplant 6. Cardiac Implantable Electronic Devices (pacemaker, defibrillator, cardiac resynchronization therapy (...) Risks & Complications D. Left Heart Catheterization Indications & Contraindications Risks & Complications E. The Evolving Role of Registered Cardiovascular Invasive Specialists (RCIS) I. Patient Ethics A. Patients’ Rights and Safety Informed Consent Patient Identification Confidentiality/HIPAA Patient Bill of Rights Patient Safety Methods B. Professionalism C. Communication & Hand-offs II. Anatomy and Physiology A. Normal Cardiovascular Anatomy and Physiology B. Flow Dynamics – Cardiac Cycle C

2015 Society for Cardiovascular Angiography and Interventions

305. AACE/ACE Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan

). Screening for asymptomatic coronary artery disease with various stress tests in patients with T2D has not been clearly demon- strated to improve cardiac outcomes and is there- fore not recommended (grade A; bEl 1). 3.Q13. how is obesity managed in patients with Diabetes? • r40. Obesity should be diagnosed according to body mass index (BMI) (grade b; bEl 2). Individuals with a BMI =30 kg/m 2 are classified as obese, and those with a BMI of 25 to 102 cm (40 in) for males and > 88 cm (35 in) for females (...) , which may improve glucose control while reducing risks of hypoglycemia (grade A; bEl 1) 3.Q6. how is hypoglycemia managed? • r21. Oral administration of rapidly absorbed glu- cose should be used to treat hypoglycemia (gen- erally defined as any blood glucose 10%) (grade D; bEl 4). • r39. Measurement of coronary artery calcification or coronary imaging may help assess whether a patient is a reasonable candidate for intensification of glycemic, lipid, and/or blood pressure control (grade b; bEl 2

2015 American Association of Clinical Endocrinologists

308. Electronic Cigarettes Full Text available with Trip Pro

. Most of the adverse health effects of smoking are caused by tobacco combustion products, but there are some health concerns that are related to nicotine per se. Many of these concerns are related to the ability of nicotine to release catecholamines, including hemodynamic effects (increase in heart rate, a transient increase in blood pressure, vasoconstriction of coronary and other vascular beds), adverse effects on lipids, and induction of insulin resistance. Nicotine has also been reported (...) -cigarettes. The results of these studies suggest that e-cigarettes can increase heart rate and blood pressure, as expected with systemic absorption in nicotine. The use of e-cigarettes for 7 minutes did not cause diastolic dysfunction, which was seen with conventional cigarette smoking. Another study found that e-cigarette use had no effect on flow velocity reserve of the left anterior descending coronary artery assessed by echocardiography, whereas cigarette smoking caused a decline in flow reserve (16

2014 American Heart Association

309. Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardiovascular Disease in Healthy General Populations of Young People (12?25 Years of Age) Full Text available with Trip Pro

, aortic stenosis), dilated cardiomyopathy, ruptured aortic aneurysm, premature atherosclerotic coronary artery disease, and arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D), as well as a variety of other congenital heart malformations. A small proportion of these deaths (2%–3%) are not associated with structural cardiac abnormalities at autopsy, including Wolff-Parkinson-White preexcitation, ion channelopathies, and sickle cell trait. Other causes not directly related to preexisting (...) life. The relative weakness of the history and physical examination for screening can also be traced to other factors. For example, with ion channelopathies and Wolff-Parkinson-White syndrome, only the ECG potentially defines the clinical phenotype, and the physical examination is unremarkable. For many of the structural cardiac diseases responsible for SD, symptoms, family history of heart disease, and loud pathological heart murmurs are infrequent findings. One potential exception is HCM

2014 American Heart Association

310. Safe Prevention of the Primary Cesarean Delivery

elements of the Category II tracing or provide reassurance of fetal well-being. Scalp stimulation to elicit a fetal heart rate acceleration is an easily employed tool when the cervix is dilated and can offer clinician reassurance that the fetus is not acidotic. Spontaneous or elicited heart rate accelerations are associated with a normal umbilical cord arterial pH (7.20 or greater) (54, ). Recurrent variable decelerations, thought to be a physiologic response to repetitive compression of the umbilical (...) . The most common indications for primary cesarean delivery include, in order of frequency, labor dystocia, abnormal or indeterminate (formerly, nonreassuring) fetal heart rate tracing, fetal malpresentation, multiple gestation, and suspected fetal macrosomia. Safe reduction of the rate of primary cesarean deliveries will require different approaches for each of these, as well as other, indications. For example, it may be necessary to revisit the definition of labor dystocia because recent data show

2014 American College of Obstetricians and Gynecologists

311. Routine newborn assessment

Cardiac o Pulses – brachial and femoral o Skin colour/perfusion o Heart rate o Heart rhythm o Heart sounds o Pulse oximetry (optional) • Variations in rate, rhythm or regularity • Murmurs • Poor colour/mottling ? Weak or absent pulses ? Positive pulse oximetry screen (if performed) Queensland Clinical Guideline: Routine newborn assessment Refer to online version, destroy printed copies after use Page 11 of 17 Table 4. Newborn examination continued Aspect Clinical assessment Indications for further (...) Routine 5-7 days & 6 weeks • Chart head circumference, length, weight on centile charts • Head shape, size • Scalp, fontanelles, sutures • Eye size, position structure • Nose, position, structure • Ear position, structure • Mouth, palate, teeth, gums tongue, frenulum • Jaw size • Size, shape, symmetry, movement • Breast tissue, nipples • Heart sounds, rate, pulses • Breath sounds, resp rate • Pulse oximetry (optional) • Ortolani and Barlow’s manoeuvres • Leg length, proportions, symmetry and digits

2014 Queensland Health

312. Specification, implementation and management of information technology (IT) systems in hospital transfusion laboratories

areas include patients with antibodies (ensure all codes match across data to be migrated) and patients with special requirements. The use of the NHS Tracing Services to match NHS numbers to patient records can assist in this data cleansing. 1.7.2 Duplicate Records A search for duplicate records should be carried out on the legacy system and duplicates resolved prior to data migration. 1.7.3 Implementation Strategy An implementation strategy is required to define how the new system will be brought (...) and good practice to meet their operational needs. 2.1 Stock Management It is a requirement of the Blood Safety and Quality Regulations (as amended) (BSQR 2005) and the EU Directive 2001/83/EC (EU 2001) that records are retained allowing tracing of all components and products from source to recipient or final fate and vice versa. The system should hold a local reference table of blood components and batch products in which label barcodes are associated with descriptions and internal codes. There must

2014 British Committee for Standards in Haematology

313. Routine newborn assessment

Cardiac o Pulses – brachial and femoral o Skin colour/perfusion o Heart rate o Heart rhythm o Heart sounds o Pulse oximetry (optional) • Variations in rate, rhythm or regularity • Murmurs • Poor colour/mottling ? Weak or absent pulses ? Positive pulse oximetry screen (if performed) Queensland Clinical Guideline: Routine newborn assessment Refer to online version, destroy printed copies after use Page 11 of 17 Table 4. Newborn examination continued Aspect Clinical assessment Indications for further (...) Routine 5-7 days & 6 weeks • Chart head circumference, length, weight on centile charts • Head shape, size • Scalp, fontanelles, sutures • Eye size, position structure • Nose, position, structure • Ear position, structure • Mouth, palate, teeth, gums tongue, frenulum • Jaw size • Size, shape, symmetry, movement • Breast tissue, nipples • Heart sounds, rate, pulses • Breath sounds, resp rate • Pulse oximetry (optional) • Ortolani and Barlow’s manoeuvres • Leg length, proportions, symmetry and digits

2014 Clinical Practice Guidelines Portal

314. Perinatal care at the threshold of viability

and neurodevelopmental outcomes among infants born at 22 to 25 weeks' gestation. JAMA. 2011; 306(21):2348-2358. 46. Crowther CA, McKinlay CJ, Middleton P, Harding J. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes. Cochrane Database of Systematic Reviews 2011, Issue 6. Art. No.: CD003935. DOI: 10.1002/14651858.CD003935.pub3. 47. Afors K, Chandraharan E. Use of continuous electronic fetal monitoring in a preterm fetus: clinical dilemmas (...) and recommendations for practice. Journal of Pregnancy. 2011; 2011:848794-848794. 48. Hofmeyr F, Groenewald C, Nel D, Myers M, Fifer W, Signore C, et al. Fetal heart rate patterns at 20 to 24 weeks gestation as recorded by fetal electrocardiography. The Journal of Maternal-Fetal & Neonatal Medicine. 2013; 27(7):714-8. 49. Roberts D, Kumar B, Tincello DG, Walkinshaw SA. Computerised antenatal fetal heart rate recordings between 24 and 28 weeks of gestation. BJOG: An International Journal Of Obstetrics

2014 Clinical Practice Guidelines Portal

317. Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions Full Text available with Trip Pro

(imatinib/sunitinib)Alkylating agents (cyclophosphamide/ifosfamide)Cisplatin Oxidative stressInhibition of Abl kinase mitochondrial dysfunctionVascular endothelial cell injuryHypomagnesia, coronary artery fibrosis CHF indicates congestive heart failure; and HERG, human ether-a-go-go related. The types of chemotherapy-induced cardiovascular alterations reported primarily, but not exclusively, in adults include the following: Acute cardiac rhythm abnormalities (arrhythmias including QT prolongation (...) survivors diagnosed in childhood or young adulthood who had received >35 Gy of cardiac radiation. All had evidence of radiation-induced cardiac damage, and 6 had at least 1 coronary artery with severe stenosis. Since these early studies, the incidence and risk factors of cardiovascular disease (CVD) have been studied intensely, as described in the present article. Indeed, cardiac-specific disease is the most common noncancer cause of death among long-term childhood cancer survivors

2013 American Heart Association

319. Cardiovascular Function and Treatment in ß-Thalassemia Major Full Text available with Trip Pro

relating to treatment of chronic myocardial siderosis but none relating to treatment of acute heart failure. The principles of diagnosis and treatment of cardiac iron loading in TM are directly relevant to other iron-overload conditions, including in particular Diamond-Blackfan anemia, sideroblastic anemia, and hereditary hemochromatosis. Heart failure is the most common cause of death in TM and primarily results from cardiac iron accumulation. The diagnosis of ventricular dysfunction in TM patients (...) by cardiac T2* magnetic resonance. Cardiac T2* <10 ms is the most important predictor of development of heart failure. Serum ferritin and liver iron concentration are not adequate surrogates for cardiac iron measurement. Assessment of cardiac function by noninvasive techniques can also be valuable clinically, but serial measurements to establish trends are usually required because interpretation of single absolute values is complicated by the abnormal cardiovascular hemodynamics in TM and measurement

2013 American Heart Association

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