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161. U.S. Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of nontuberculous mycobacteria in individuals with cystic fibrosis Full Text available with Trip Pro

in rates of skin test reactivity to NTM antigens in US population-based testing studies, potentially indicating increasing exposure to NTM (see below). Furthermore, the relative frequency of M. abscessus detection in NTM-positive samples from individuals with CF has increased remarkably over time both in the USA and in Europe, , , , , , suggesting real changes in NTM acquisition rates (rather than increased sampling). Possible reasons for the potential increased frequency of NTM-positive cultures (...) in the same household for more than 10 years, have unique strains, , suggesting a lack of person-to-person transmission. However, a case report from the University of Washington described a possible outbreak of M. a. massiliense in five patients with potential transmission occurring during synchronous clinic visits. Recently, whole genome sequencing and antimicrobial susceptibility testing performed on 168 consecutive isolates of M. abscessus from 31 patients attending an adult CF centre in the UK

2016 Cystic Fibrosis Foundation

162. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for Comprehensive Medical Care of Patients with Obesity

prospective or case-controlled trials; MRI = magnetic resonance imaging; MUFA = monoun- saturated fatty acid; NAFLD = nonalcoholic fatty liver disease; NASH = nonalcoholic steatohepatitis; NES = night eating syndrome; NHANES = National Health and Nutrition Examination Surveys; NHLBI = National Heart, Lung, and Blood Institute; NHS = Nurses’ Health Study; NICE = National Institute for Health and Care Excellence; OA = osteoarthritis; OGTT = oral glucose tolerance test; OR = odds ratio; OSA = obstructive

2016 American Association of Clinical Endocrinologists

163. Delirium, Dementia, and Depression in Older Adults: Assessment and Care, Second Edition

, PhD Candidate Associate Professor Laurentian University Sudbury, Ontario Jessica Po Ying Lok, RN, BScN, MN Clinical Educator, Nursing and Personal Support VHA Home HealthCare Toronto, Ontario Shirley Marr, RN, BScN, MHEd, MHScN, CNCC(C) Clinical Nurse Educator, ICU William Osler Health System Toronto, Ontario Leah Masin, RN Staff Nurse Southlake Regional Health Center Newmarket, Ontario Elizabeth McMurray, RN, BScN Professional Practice Consultant Lead for a review group from St. Joseph’s Health

2016 Registered Nurses' Association of Ontario

164. Reasanz - serelaxin

times are used. Where 0-t is shown as t this denotes the AUC under a dosing interval Area under the serum concentration-time curve from time zero to infinity. For extrapolation to infinity Clast / ?z is used, where Clast is the estimated concentration at the last sample time point above LLOQ from linear regression of the terminal elimination phase Bacterial endotoxins test BNP B-type natriuretic peptide BP Blood Pressure bpm beats per minute BUN Blood urea nitrogen C48hr The observed serum (...) control Iso-Asp Isoaspartate, isoaspartic acid IU International units IV Intravenous(ly) JVP Jugular venous pulse kDA kilo Dalton K-M Kaplan-Meier LFT Liver function test LGR7 Leucine-rich repeat-containing G-protein-coupled receptor 7 LLOQ Lower limit of quantification LO Low volume light obscuration LOD Limit of detection LoQ List of questions LOS Length of Stay LVEF Left ventricular ejection fraction M Methionine MAA Marketing authorisation application MAP Mean arterial pressure MAPK Mitogen

2014 European Medicines Agency - EPARs

165. Classification of Anemias

, sulfacetamide, sulfamethoxazole, sulfanilamide & sulfapyridine. Drug induced Hemolytic anemia: ACEI, acetaminophen, ASA/NSAIDs, cephalosporins, chlorpromazine, chlorpropamide, diclofenac, hydrochlorothiazide, interferon a2a&2b , isoniazid, levodopa, levofloxacin, mefenamic acid, methadone, methyldopa, penicillins, probenecid, procainamide, quinine, quinidine, ribavirin, rifampin, sulfonamides, & tetracycline. (Direct antiglobulin test-DAT or Coomb’s test is used to detect cause of hemolytic anemia) Drug (...) agent ESRD=end-stage renal dx FeSO4=ferrous sulfate Hct=hematocrit HD-CKD=dialysis-CKD HF=heart failure Hgb=hemoglobin HRQL=health-related QOL ITT=intention to treat LFT=liver function tests LVMI=left ventricular mass index LVVI=left ventricular volume index LVCVI=left ventricular cavity volume index MCV=Mean corpuscular volume MI=myocardial infarction ND-CKD=non-dialysis CKD OL=open label pt=patient QALY=quality-adjusted life year QOL=quality of life RCT=randomized control trial RDW=Red cell

2014 RxFiles

166. Systematic review of needs for medical devices for ageing populations

, including tests used during the course of the study. In many cases, there may be a range of options of devices for a specific indication. The clinical application of the information from these studies in a real-world context may not always be clear, and a specific comment on the comparative safety and effectiveness of the alternative devices was not possible. Although the list of topics was based on the top five causes of losses of DALYs for older people in the Western Pacific Region, regionality has (...) be shifts in research priorities to accommodate the aged population, such as towards minimally invasive technologies or home and self-care devices (3). New medical devices are frequently developed and tested in high-resource settings, and hence their applicability to low- or medium-resource settings needs to be considered. The factors involved in setting priority health care areas and identifying the medical devices needed to address them are many and complex. The focus of this project is to identify

2015 Publication 80

168. Task Force 7: Pediatric Cardiology Fellowship Training in Pulmonary Hypertension, Advanced Heart Failure, and Transplantation

in patients with PH with and with- out congenital heart disease. • Identify the common presenting signs and symptoms of right and left heart failure. • Indications, risks, and benefits of techniques commonly used to evaluate patients with PH, including electrocardi- ography, echocardiography, cardiac magnetic resonance imaging, cardiac computed tomography, ventilation, and perfusion lung scans • Indications, risks, and benefits of cardiac catheterization and vasodilator testing 2.2.2.3. Classification (...) • Understand the World Health Organization Classification of PH. 2.2.2.4. Genetics • Understand patterns of heritable PAH. • Understand genetic tests relevant to heritable PH. 2.2.2.5. Treatment • Cardiovascular pharmacology. Understand the indi- cations, mechanisms of action, appropriate routes of administration, and adverse effects of the following med- ications used to treat PAH and understand the potential drug–drug interactions between the specific PAH thera- pies and other medications used to treat

2015 American Heart Association

170. Treatment of Hypertension in Patients With Coronary Artery Disease Full Text available with Trip Pro

receive moderate-intensity statin therapy such as simvastatin 20 to 40 mg/d, atorvastatin 10 to 20 mg/d, or rosuvastatin 5 to 10 mg/d to decrease LDL cholesterol by 30% to 50%. According to the guideline, nonstatin therapies do not provide acceptable CVD risk reduction benefits compared with their potential for adverse effects in the routine prevention of CVD. 1.1.5. Diabetes Mellitus Type 2 diabetes mellitus is defined as a fasting plasma glucose ≥126 mg/dL, a 2-hour oral glucose tolerance test value

2015 American Heart Association

171. American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis

is recommended beyond 6 months of therapy. Adapted from ref. 6. † Listed alphabetically. ‡ The panel indicated that patients with comorbidities, abnormal laboratory results, and/or multiple therapies may require more frequent laboratory testing than what is generally recommended laboratory monitoring for disease-modifying antirheumatic drugs in the table. § See ref. 6 for baseline monitoring recommendations. ACR RA Treatment Recommendations 13Figure 6. Tuberculosis (TB) screening algorithm for biologics (...) or tofacitinib (endorsed and modified from the 2012 American College of Rheumatology RA treatment recommendations). The Voting Panel reviewed and endorsed the 2012 TB screening algorithm with 1 change, that tofacitinib should be included alongside biologics. * 5 anergy panel testing is not recommended. ** 5 interferon-gamma release assay (IGRA) is preferred if patient has a history of BCG vaccination. †5 risk factors for TB exposure are definedbasedonapublicationfromthe US Centers for Disease Control

2015 American College of Rheumatology

172. Heart Failure Management in Skilled Nursing Facilities Full Text available with Trip Pro

to avoidable hospitalizations include lack of on-site primary care clinicians, lack of timely laboratory testing, lack of integration of HF assessment and interventions into nursing care, and large resident to clinical staff ratios. , , , Given the paucity of outcome data for HF patients in SNFs, further studies that provide longitudinal data regarding the range of patient experiences after hospital discharge to a SNF are needed. Comprehensive SNF HF Care Clinical Diagnosis of HF Comprehensive SNF HF care (...) begins with accurate identification of residents diagnosed with HF. The clinical diagnosis of HF may largely rely on data from care before SNF admission. Residents without an HF diagnosis who develop pulmonary congestion or volume overload should have a physical examination, chest radiograph, and blood chemistry tests to confirm congestion and volume overload within the SNF setting if possible. Results from laboratory tests may take 24 hours or longer to return in SNFs; thus, appropriate clinical

2015 American Heart Association

173. Basic Concepts and Potential Applications of Genetics and Genomics for Cardiovascular and Stroke Clinicians Full Text available with Trip Pro

format, that can ascertain the genotypes of up to millions of polymorphisms in a person’s genomic DNA sample in a single experiment. This is the technique used by commercial DNA testing services. Such services extract genomic DNA from the cells in a person’s saliva sample and then apply the DNA to a genotyping chip to determine the genotypes of a large number of SNPs and CNVs distributed across the genome. One disadvantage of this methodology is that it can ascertain the genotypes of only

2015 American Heart Association

174. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence Full Text available with Trip Pro

further research. Throughout, we emphasize that this document is not a comprehensive review of the literature but rather a focus on the major new trials that have led to recent guideline changes in the area of primary prevention of CVD in type 2 diabetes mellitus. New Diagnostic Criteria for Diabetes Mellitus and Prediabetes In 2010, the ADA included A 1c for the first time among the tests recommended for the diagnosis of diabetes mellitus. This recommendation has also been adopted by the European (...) Association for the Study of Diabetes, the World Health Organization, and other professional groups in the United States. Clinical practice recommendations from the ADA now state that an A 1c value of ≥6.5% or previous criteria for fasting glucose (≥126 mg/dL) or 2-hour glucose (≥200 mg/dL) can be used for the diagnosis of diabetes mellitus ( ). In 2010, the ADA also added A 1c to the tests used to identify people with prediabetes, who are at increased risk for type 2 diabetes mellitus. Thus, along

2015 American Heart Association

175. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

information. Also, this Table 1. Applying Classification of Recommendations 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 (...) be associated with coagulopathy Physical examination Vital signs A general physical examination focusing on the head, heart, lungs, abdomen, and extremities A focused neurological examination A structured examination such as the National Institutes of Health Stroke Scale can be completed in minutes and provides a quantification that allows easy communication of the severity of the event to other caregivers. GCS score is similarly well known and easily computed. Serum and urine tests Complete blood count

2015 Congress of Neurological Surgeons

176. Guidelines for the management of spontaneous intracerebral hemorrhage Full Text available with Trip Pro

such as the National Institutes of Health Stroke Scale can be completed in minutes and provides a quantification that allows easy communication of the severity of the event to other caregivers. GCS score is similarly well known and easily computed. Serum and urine tests Complete blood count, electrolytes, blood urea nitrogen and creatinine, and glucose Higher serum glucose is associated with worse outcome , Prothrombin time (with INR) and an activated partial thromboplastin time Warfarin-related hemorrhages (...) are associated with an increased hematoma volume, greater risk of expansion, and increased morbidity and mortality , Cardiac-specific troponin Elevated troponin levels are associated with worse outcome , Toxicology screen to detect cocaine and other sympathomimetic drugs of abuse Cocaine and other sympathomimetic drugs are associated with ICH Urinalysis and urine culture, as well as a pregnancy test in a woman of childbearing age Other routine tests Neuroimaging CT or MRI; consider contrast-enhanced

2015 American Academy of Neurology

177. Scientific rationale for the inclusion and exclusion criteria for intravenous alteplase in acute ischemic stroke

or PT >15 s Current use of direct thrombin inhibitors or direct factor Xa inhibitors with elevated sensitive laboratory tests (eg, aPTT, INR, platelet count, ECT, TT, or appropriate factor Xa activity assays) Blood glucose concentration <50 mg/dL (2.7 mmol/L) CT demonstrates multilobar infarction (hypodensity >1/3 cerebral hemisphere) Relative exclusion criteria Recent experience suggests that under some circumstances, with careful consideration and weighting of risk to benefit, patients may receive (...) with intravenous rtPA can be initiated before availability of coagulation test results but should be discontinued if INR is >1.7 or PT is abnormally elevated by local laboratory standards. In patients without a history of thrombocytopenia, treatment with intravenous rtPA can be initiated before availability of platelet count but should be discontinued if platelet count is <100 000/mm 3 aPTT indicates activated partial thromboplastin time; AVM, arteriovenous malformation; CT, computed tomography; ECT, ecarin

2015 American Academy of Neurology

178. Physical Activity and Exercise During Pregnancy and the Postpartum Period

loss counseling revisited. JAMA 2003;289:1747–50. [ ] [ ] Alexander SC, Cox ME, Boling Turer CL, Lyna P, Ostbye T, Tulsky JA, et al. Do the five A’s work when physicians counsel about weight loss? Fam Med 2011;43:179–84. [ ] [ ] McMurray RG, Mottola MF, Wolfe LA, Artal R, Millar L, Pivarnik JM. Recent advances in understanding maternal and fetal responses to exercise. Med Sci Sports Exerc 1993;25:1305–21. [ ] Persinger R, Foster C, Gibson M, Fater DC, Porcari JP. Consistency of the talk test (...) to exercise have been reported in pregnant women, the use of ratings of perceived exertion may be a more effective means to monitor exercise intensity during pregnancy than heart-rate parameters ( ). For moderate-intensity exercise, ratings of perceived exertion should be 13–14 (somewhat hard) on the 6–20 Borg scale of perceived exertion (Table 1). Using the “talk test” is another way to measure exertion. As long as a woman can carry on a conversation while exercising, she is likely not overexerting

2015 American College of Obstetricians and Gynecologists

179. Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus Full Text available with Trip Pro

research is needed to determine sex differences in the biological, social, and cultural factors that lead to worse cardiovascular outcomes for many minority populations with DM. CHD and heart failure in women Most contemporary recommendations for the prevention, diagnostic testing, and medical and surgical treatments of CHD in women are extrapolated from studies conducted predominantly in middle-aged men. Underrepresentation of women in trials of cardiovascular clinical procedures and therapies (...) first in the Framingham Heart Study in which heart failure risk was 2-fold higher in men ( P <0.05) and 5-fold higher in women with DM ( P <0.01) compared with the respective nondiabetic population. There was no statistical test for effect modification by sex in this analysis. In a more recent report, despite no difference in hospitalization among women with DM compared with men, the association between the diagnosis of heart failure and that of DM had a characteristic horseshoe shape over a 70-year

2015 American Heart Association

180. Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke Full Text available with Trip Pro

of normal Current use of anticoagulant with INR >1.7 or PT >15 s Current use of direct thrombin inhibitors or direct factor Xa inhibitors with elevated sensitive laboratory tests (eg, aPTT, INR, platelet count, ECT, TT, or appropriate factor Xa activity assays) Blood glucose concentration <50 mg/dL (2.7 mmol/L) CT demonstrates multilobar infarction (hypodensity >1/3 cerebral hemisphere) Relative exclusion criteria Recent experience suggests that under some circumstances, with careful consideration (...) without recent use of OACs or heparin, treatment with intravenous rtPA can be initiated before availability of coagulation test results but should be discontinued if INR is >1.7 or PT is abnormally elevated by local laboratory standards. In patients without a history of thrombocytopenia, treatment with intravenous rtPA can be initiated before availability of platelet count but should be discontinued if platelet count is <100 000/mm 3 aPTT indicates activated partial thromboplastin time; AVM

2015 American Heart Association

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