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McMurray Test

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221. Atrial Fibrillation

patients), or (iii) to short-term antiarrhyth- mic drug therapy limited to four weeks after cardioversion (261 patients). The trial tested the hypothesis that short-term therapy was non-inferior to long-term therapy. Patients were fol- lowed for six months by daily telemetric ECG recording for the primary outcome of persistent AF or death. The trial demon- strated that short-term therapy conveyed a slightly inferior—but still effective—antiarrhythmic action, estimated at 80% of the effect of long-term (...) and prevention of remodelling – ACEI/ARB/statin HHD No LVH LVH sotalol dronedarone dronedarone amiodarone amiodarone CHD HF Figure 4 Choice of antiarrhythmic drug according to underlying pathology. ESC Guidelines 2738 Downloaded from by guest on 02 April 2019Dronedarone has been associated with severe hepatotoxicity in a few instances. Hence, monitoring of liver function tests is advisable in patients on long-term dronedarone treatment

2012 European Society of Cardiology

222. Valvular Heart Disease

. . . . . . . . . . . . . . . . . . . . . . . . .2455 3.1.1. Clinical evaluation . . . . . . . . . . . . . . . . . . . . . .2455 3.1.2. Echocardiography . . . . . . . . . . . . . . . . . . . . . .2456 3.1.3. Other non-invasive investigations . . . . . . . . . . . .2456 Stress testing . . . . . . . . . . . . . . . . . . . . . .2456 Cardiac magnetic resonance . . . . . . . . . . . .2457 Computed tomography . . . . . . . . . . . . . . .2457 Fluoroscopy . . . . . . . . . . . . . . . . . . . . . . .2458 (...) . . . . . . . . . . . . . . . . . . . . . . . . .2460 4.4. Indications for surgery . . . . . . . . . . . . . . . . . . . . . .2461 4.5. Medical therapy. . . . . . . . . . . . . . . . . . . . . . . . . . .2462 4.6. Serial testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2463 4.7. Special patient populations . . . . . . . . . . . . . . . . . . .2463 5. Aortic stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2463 5.1. Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2463 5.2. Natural history

2012 European Society of Cardiology

223. Impact of Body Mass Index on the Accuracy of N-Terminal Pro-Brain Natriuretic Peptide and Brain Natriuretic Peptide for Predicting Outcomes in Patients With Chronic Heart Failure and Reduced Ejection Fraction: Insights From the PARADIGM-HF Study (Prospect Full Text available with Trip Pro

Medical Center, Charleston (M.R.Z.); Institut de Cardiologie de Montréal, Université de Montréal, Canada (J.L.R.); Department of Molecular and Clinical Medicine, University of Gothenburg, Sweden (K.S.); and Novartis Pharmaceuticals Corporation, East Hanover, NJ (M.L., V.C.S., M.F.P.). McMurray John J JJ From Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.L.C., A.S.D., S.D.S.); Department of Internal Medicine, University of Campinas, Campinas, Brazil (W.N.); British Heart (...) Fragments blood Predictive Value of Tests Prospective Studies Protease Inhibitors adverse effects therapeutic use Risk Assessment Risk Factors Stroke Volume drug effects Time Factors Treatment Outcome Ventricular Function, Left drug effects BNP NT-proBNP heart failure natriuretic peptides obesity prognosis 2016 11 30 6 0 2016 11 30 6 0 2018 8 28 6 0 ppublish 27895026 CIRCULATIONAHA.116.024976 10.1161/CIRCULATIONAHA.116.024976

2018 Circulation Controlled trial quality: uncertain

224. 3D-MRI combined with signal-to-noise ratio measurement can improve the diagnostic accuracy and sensitivity in evaluating meniscal healing status after meniscal repair. (Abstract)

, swelling, locking, or positive McMurray test; on MRI, grade III signal intensity at the site of repair. Finally, the SNR on 3D-MRI of the healed and the unhealed groups were compared.On second-look arthroscopy, 68 (90.7%) menisci were found to be completely healed. With the arthroscopic healing rate as the standard, the clinical healing rate was 69.3% (63 menisci) [sensitivity, 85.7%; specificity, 75.0%; accuracy, 76.0%; positive predictive value (PPV), 26.1%; negative predictive value (NPV), 98.1

2018 Knee Surgery, Sports Traumatology, Arthroscopy

225. Ketamine Versus Electroconvulsive Therapy in Depression

subjects of childbearing potential must have a negative urine pregnancy test at enrolment (Visit 1) and be willing to use a reliable method of birth control (i.e., double-barrier method, oral contraceptive, implant, dermal contraception, long-term injectable contraceptive, intrauterine device, or tubal ligation) during the study. Abstain from consuming grapefruit juice (a potent 3A4 cytochrome inhibitor) on the day of the ketamine infusions as it may slow down the elimination of ketamine. Be able (...) function tests AST and ALT three times the upper normal limit at screening. Uncorrected hypothyroidism or hyperthyroidism. Subjects needing a thyroid hormone supplement to treat hypothyroidism must have been on a stable dose of the medication for 30 days prior to enrolment (Visit 1). Clinically significant deviation from the reference range in clinical laboratory test results as judged by the investigator(s). Including: Sodium under 135 or over 145 mmol/L Potassium under 3.5 or over 5.0 mmol/L Chloride

2018 Clinical Trials

226. Home Modifications and Their Impact on Waged Care Substitution

of the key definitions and concepts underpinning waged home care substitution by home modifications, and then testing this by comparing outcome and process measures from cases—those with exposure to home modification and waged home care interventions. Thus we systematically search the literature to present both current work and then use this to refine and advance a person-environment fit theory relevant to waged home care substitution, collect cases to test it, and reflect on whether the theory (...) its real-life context, from which both generating and testing hypotheses become possible. The case study method was deemed an ideal supplementary methodology for this research because of its ability to describe and illustrate a complex situation. This report seeks to better understand the substitutive relationships that can develop surrounding care in the home, where health, available care support and degree of home modifications are all highly individualised and each come into play to varying

2014 Home Modification Information Clearinghouse

228. Clinical Practice Guideline on the Management of Anterior Cruciate Ligament Injuries

for or against the intervention. Moderate Moderate Evidence from two or more “Moderate” strength studies with consistent findings, or evidence from a single “High” quality study for recommending for or against the intervention. Limited Low Strength Evidence or Conflicting Evidence Evidence from two or more “Low” strength studies with consistent findings or evidence from a single study for recommending for or against the intervention or diagnostic test or the evidence is insufficient or conflicting and does (...) that the practitioner might perform surgical reconstruction because it reduces activity related disability and recurrent instability which may lead to additional injury. Strength of Recommendation: Limited Description: Evidence from two or more “Low” strength studies with consistent findings or evidence from a single study for recommending for or against the intervention or diagnostic test or the evidence is insufficient or conflicting and does not allow a recommendation for or against the intervention. ACL YOUNG

2014 American Academy of Orthopaedic Surgeons

229. Psychological, social and biological determinants of ill health (pSoBid)

and to the participants themselves. This study was funded by the Glasgow Centre for Population Health which is a partnership between NHS Greater Glasgow and Clyde, Glasgow City Council and the University of Glasgow, supported by the Scottish Government. Jennifer McLean July 2013 3Abbreviations and glossary AVLT Auditory Verbal Learning Test: assesses short-term auditory-verbal memory BMI Body mass index BP Blood pressure CHD Coronary heart disease cIMT Carotid intima-media thickness: a surrogate marker (...) from the most and least deprived communities of Glasgow. This study also illustrates the willingness of subjects to volunteer for a variety of investigations involving psychological, behavioural, sociological and medical questions and tests. The depth and range of the data collected and the analyses undertaken in this study yield important information concerning the relationships between health and socioeconomic status, inflammation, atherosclerosis, mental outlook, cognitive performance

2013 Glasgow Centre for Population Health

230. Global Strategy for Diagnosis, Management, and Prevention of COPD

on multiple scienti?c and clinical achievements in the 10yearssincethe2001GOLDreportwaspublished,thisrevised editionprovidesanewparadigmfortreatmentofstableCOPD. Thismajorrevisionbuildsonthestrengthsfromtheoriginalrec- ommendations and incorporates new knowledge to make three important new recommendations: 1. One of the strengths was the treatment objectives. These have stood the test of time, but are now organized into two groups: objectives that are directed toward immedi- ately relievingand reducingthe (...) , with the aim that future studies will test the value of this system. Summary of New Recommendations A summary of the new issues presented in this report follows: 1. Thisdocumenthasbeenconsiderablyshortenedinlength by limiting section 1 to the essential background data on COPD. Readers who wish to access more comprehensive information are referred to a variety of excellent text- books that have appeared in the last decade. 2. Section 2 includes information on diagnosis and assess- ment of COPD. The de

2015 European Respiratory Society

231. Management of Chronic Kidney Disease (CKD) in Primary Care

will inevitably and appropriately occur when clinicians take into account the needs of individual patients, available resources, and limitations unique to an institution or type of practice. Every health care professional making use of these guidelines is responsible for evaluating the appropriateness of applying them in the setting of any particular clinical situation. These guidelines are not intended to represent TRICARE policy. Further, inclusion of recommendations for specific testing and/or therapeutic

2014 VA/DoD Clinical Practice Guidelines

232. Prevention of stroke in nonvalvular atrial fibrillation

) relative to that with warfarin (0.86%/y). Practice recommendation. C4. Clinicians might offer apixaban to patients with NVAF and GI bleeding risk who require anticoagulant medication (Level C). Other factors affecting administration of new oral anticoagulants. INR monitoring is not required for dabigatran, rivaroxaban, and apixaban for maintaining anticoagulation within the therapeutic window. Liberation from frequent periodic INR testing may be attractive to patients unwilling or unable to submit (...) to frequent periodic testing. Practice recommendation. C5. Clinicians should offer dabigatran, rivaroxaban, or apixaban to patients unwilling or unable to submit to frequent periodic testing of INR levels (Level B). Patients with NVAF who are at risk for stroke and unsuitable candidates for warfarin treatment are candidates for alternative treatment with aspirin, but the results are poor in view of the substantially lower level of protection conferred by aspirin (22% RRR) relative to that by warfarin (RRR

2014 American Academy of Neurology

233. Non-ST-Elevation Acute Coronary Syndromes: Guideline For the Management of Patients With

4.4.4. Early Invasive and Ischemia-Guided Strategies: Recommendations ... e168 Comparison of Early Versus Delayed Angiography ... . e169 4.4.5. Subgroups: Early Invasive Strategy Versus Ischemia-Guided Strategy ... ... e169 4.4.6. Care Objectives ... e169 4.5. Risk Strati?cation Before Discharge for Patients With an Ischemia-Guided Strategy of NSTE-ACS: Recommendations . ... e170 4.5.1. Noninvasive Test Selection .. ... e170 4.5.2. Selection for Coronary Angiography.. ... e170 5.MYOCARDIAL (...) . ... e174 6.LATE HOSPITAL CARE, HOSPITAL DISCHARGE, AND POSTHOSPITAL DISCHARGE CARE . e175 6.1. General Principles (Cardioprotective Therapy and Symptom Management) ... e175 6.2. Medical Regimen and Use of Medications at Discharge: Recommendations .. e175 6.2.1. Late Hospital and Posthospital Oral Antiplatelet Therapy: Recommendations .. e175 6.2.2. Combined Oral Anticoagulant Therapy and Antiplatelet Therapy in Patients With NSTE-ACS . e177 6.2.3. Platelet Function and Genetic Phenotype Testing

2014 American College of Cardiology

234. Guidelines for the Prevention of Stroke in Women: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Full Text available with Trip Pro

bradycardia III/B ACE inhibitors, angiotensin receptor blockers, renin inhibitors Skeletal and cardiovascular abnormalities, renal dysgenesis, pulmonary hypoplasia III/C ACE indicates angiotensin-converting enzyme; and LFTs, liver function tests. Modified from Umans et al with permission from Elsevier, Copyright © 2009. α-Blockers, β-blockers, CCBs, hydralazine, and thiazide diuretics have been used in pregnancy; all transfer across the placenta. There are no data from large, well-controlled, randomized

2014 American Heart Association

235. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack Full Text available with Trip Pro

ASCVD should be otherwise managed according to the ACC/AHA 2013 guidelines, which include lifestyle modification, dietary recommendations, and medication recommendations (Class I; Level of Evidence A ). 1. Revised to be consistent with the 2013 ACC/AHA cholesterol guideline Glucose disorders After a TIA or ischemic stroke, all patients should probably be screened for DM with testing of fasting plasma glucose, HbA 1c , or an oral glucose tolerance test. Choice of test and timing should be guided (...) by clinical judgment and recognition that acute illness may temporarily perturb measures of plasma glucose. In general, HbA 1c may be more accurate than other screening tests in the immediate postevent period (Class IIa; Level of Evidence C ). New recommendation Obesity All patients with TIA or stroke should be screened for obesity with measurement of BMI (Class I; Level of Evidence C ). New recommendation Given the demonstrated beneficial effects of weight loss on cardiovascular risk factors

2014 American Heart Association

236. 2014 AHA/ACC Guideline for the Management of Patients With Non?ST-Elevation Acute Coronary Syndromes: Executive Summary

regulatory or payer decisions, the intent is to improve the quality of care and be aligned with the patient’s best interest. Evidence Review —Guideline writing committee (GWC) members are charged with reviewing the literature; weighing the strength and quality of evidence for or against particular tests, treatments, or procedures; and estimating expected health outcomes when data exist. In analyzing the data and developing CPGs, the GWC uses evidence-based methodologies developed by the Task Force. A key (...) : postcardiac arrest care AHA 2010 Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure NHLBI 2003 Statements Key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes and coronary artery disease ACC/AHA 2013 Practical clinical considerations in the interpretation of troponin elevations ACC 2012 Testing of low-risk patients presenting to the emergency department

2014 American Heart Association

237. 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes Full Text available with Trip Pro

of Early Versus Delayed Angiography e370 4.4.5. Subgroups: Early Invasive Strategy Versus Ischemia-Guided Strategy e371 4.4.6. Care Objectives e371 4.5. Risk Stratification Before Discharge for Patients With an Ischemia-Guided Strategy of NSTE-ACS: Recommendations e371 4.5.1. Noninvasive Test Selection e371 4.5.2. Selection for Coronary Angiography e372 Myocardial Revascularization e372 5.1. Percutaneous Coronary Intervention e372 5.1.1. PCI–General Considerations: Recommendation e372 5.1.2. PCI (...) Management) e376 6.2. Medical Regimen and Use of Medications at Discharge: Recommendations e376 6.2.1. Late Hospital and Posthospital Oral Antiplatelet Therapy: Recommendations e376 6.2.2. Combined Oral Anticoagulant Therapy and Antiplatelet Therapy in Patients With NSTE-ACS e378 6.2.3. Platelet Function and Genetic Phenotype Testing e379 6.3. Risk Reduction Strategies for Secondary Prevention e379 6.3.1. Cardiac Rehabilitation and Physical Activity: Recommendation e379 6.3.2. Patient Education

2014 American Heart Association

238. HRS/ACC/AHA Expert Consensus Statement on the Use of Implantable Cardioverter-Defibrillator Therapy in Patients Who Are Not Included or Not Well Represented in Clinical Trials Full Text available with Trip Pro

of mortality was 0.40 (95% CI: 0.27–0.59). In the Multicenter Automatic Defibrillator Trial (MADIT), 196 patients with prior myocardial infarction, EF ≤0.35, and inducible nonsuppressible ventricular arrhythmias at electrophysiologic testing were randomized to receive an ICD or medical therapy alone. After an average follow-up of 27 months, the ICD was associated with a significant reduction in mortality (HR: 0.46; 95% CI: 0.26–0.82; P =.009). In the Multicenter Automatic Defibrillator Trial II (MADIT-II

2014 American Heart Association

239. Guidelines for the Prevention of Stroke in Women

Table 1. Applying Classification of Recommendation and Level of Evidence A recommendation with Level of Evidence B or C does not imply that the recommendation is weak. Many important clinical questions addressed in the guidelines do not lend themselves to clinical trials. Although randomized trials are unavailable, there may be a very clear clinical consensus that a particular test or therapy is useful or effective. *Data available from clinical trials or registries about the usefulness/efficacy

2014 Congress of Neurological Surgeons

240. Guidelines for the Primary Prevention of Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

among individuals who have not previously experienced a stroke or transient ischemic attack. Evidence- based recommendations are included for the control of risk factors, interventional approaches to atherosclerotic disease of the cervicocephalic circulation, and antithrombotic treatments for preventing thrombotic and thromboembolic stroke. Further recommendations are provided for genetic and pharmacogenetic testing and for the prevention of stroke in a variety of other specific circumstances (...) for primary stroke prevention. 14,15 Some of the goals of such risk assessment tools are to identify people at elevated risk who might be unaware of their risk, to assess risk in the presence of >1 condition, to measure an individual’s risk that can be tracked and lowered by appropri- ate modifications, to estimate risk for selecting treatments or stratification in clinical trials, and to guide appropriate use of further diagnostic testing. Although stroke risk assessment tools exist, the complexi- ties

2014 American Heart Association

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