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Myocardial Infarction Stabilization

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281. Management of Nonvariceal Upper Gastrointestinal Bleeding: Guideline Recommendations From the International Consensus Group

Downloaded from by Karen Karen Sparkes on 03/26/2020no effects on mortality (n = 3 studies; RR, 1.02 [CI, 0.68 to 1.54]) or myocardial infarction risk (n = 2 studies; RR, 0.96 [CI, 0.51 to 1.81]). No studies were found that assessed ASA in com- bination with other antiplatelet drugs, such as prasug- rel or ticagrelor. The evidence was downgraded for high or unclear risk of bias in the Chinese studies and for serious indirectness in all 4 trials (most patients did not have a history (...) therapy. Although various adverse events have been re- ported with PPI therapy (statement E5), the systematic review and meta-analysis conducted for this guideline found no increased risk for myocardial infarction in pa- tients receiving DAPT. On the basis of the evidence, the consensus group suggests PPI therapy to prevent rebleeding in most pa- tients who require single- or dual-antiplatelet therapy for a duration consistent with the ongoing need for an- tiplatelet therapy. StatementE5 In patients

2020 Canadian Association of Gastroenterology

282. Unhealthy Drug Use: Screening

use can cause many serious health effects that vary by drug type, administration mode, amount, and frequency of use, as well as pregnancy status. Opioid use can cause drowsiness, slowed breathing, constipation, coma, and fatal overdose. Stimulants such as cocaine can cause arrhythmias, myocardial infarction, seizures, and other complications. Marijuana use is associated with slowed reaction time; problems with balance, coordination, learning, and memory; and chronic cough and frequent respiratory (...) . Treatment Treatment of drug use disorders is based on the type of drug used, the severity of drug use, and the type of use disorder. Many drug use disorders are chronic, relapsing conditions, and many persons who start treatment do not complete treatment. Therefore, treatment must often be repeated to stabilize current drug use, reduce relapse, and achieve abstinence or other treatment goals. Some patients, such as those who are pregnant, nursing, or caring for ill or healthy neonates, may require

2020 U.S. Preventive Services Task Force

283. Position Statement on the Management of Cardiac Electrophysiology and Cardiac Implantable Electronic Devices in Australia During the COVID-19 Pandemic: A Living Document Version 2

in an intensive care unit. 5 In Influenza infection, cardiovascular complications include myocarditis, acute myocardial infarction (plaque rupture secondary to viral inflammation) and exacerbation of heart failure. Previous coronavirus infections have also been associated with cardiovascular complications. The risk of adverse outcomes and the severity of adverse outcomes are increased by pre-existing cardiovascular disease. SARS has previously been associated with hypotension, tachycardia, bradycardia, atrial (...) of patients admitted to ICU. 5 HRC COVID-19 9/4/2020, version 2 16 A separate single-centre retrospective analysis also from Wuhan demonstrates correlation between underlying cardiovascular disease (CVD) and myocardial injury with increased mortality and malignant arrhythmias. One third of the patients (35.3%) had previous CVD, and 52 (27.8%) patients experienced an acute myocardial injury. Troponin T (TnT) elevation likely represents myocardial injury from either myocarditis, infarction with plaque

2020 Cardiac Society of Australia and New Zealand

285. Recognition and Initial Management of Fulminant Myocarditis: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

time to the specific diagnosis of the cause of FM that may have a specific treatment. , AMI indicates acute myocardial infarction; EMB, endomyocardial biopsy; FM, fulminant myocarditis; LFT, liver function test; and VBG, venous blood gas. Once properly stabilized, regardless of pathogenesis, all patients with FM and contractile dysfunction benefit from evidence-based neurohormonal antagonist therapy. Heart failure therapy with neurohormonal antagonists and diuretics is the cornerstone of management (...) into account at least 2 of 3 CMR tissue characterization criteria for myocarditis (79% diagnostic accuracy ): (1) edema (as quantified by global or regional T2 enhancement), (2) scar or active inflammation (by LGE imaging, usually in a regional or global subepicardial distribution, although subendocardial infarct LGE has been observed ; ), or (3) evidence of myocardial hyperemia (by enhancement early after gadolinium). , The sensitivity may change with clinical severity, with the greatest sensitivity

2020 American Heart Association

286. Perioperative

undergoing noncardiac surgery. (Fleisher , 2014) Risk calculators may include the Revised Cardiac Risk Index, American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Myocardial Infarction and Cardiac Arrest (MICA), and American College of Surgeons NSQIP Surgical Risk Calculator. (Fleisher, 2014) Return to Index Table Return to Table of Contents Electrocardiogram Cardiac arrhythmias and conduction disturbances are common findings in the perioperative period. However, limited (...) including 371,594 patients with anemia found that Return to Index Table Return to Table of Contents Institute for Clinical Systems Improvement 18 Perioperative Sixth Edition /January 2020 anemia was associated with increased mortality, acute kidney injury, infection and increased incidence of red cell transfusion in anemic patients undergoing noncardiac or cardiac surgeries. In cardiac surgery, anemia was associated with increased risk for stroke but not myocardial infarction

2020 Institute for Clinical Systems Improvement

289. Venous Thromboembolism (VTE)

thrombocytopenia (for heparin or LMWH administration) Underlying liver disorder (INR > 1.5) Clinically unstable pulmonary embolus: • hypotension (systolic bp 220 mm Hg and/or diastolic BP > 120 mm Hg) Renal insufficiency (serum creatinine > 2.5 mg dL) Morbid obesity (BMI>40) Comorbidity that might increase the risk of home treatment (congestive heart failure, COPD, diabetes, cancer, recent myocardial infarction or stroke, altered mental status, age>70, or any other condition increasing risk to the patient (...) ]. Treatment Heparin Low molecular weight heparin (LMWH). LMWH is preferred for initial treatment over unfractionated heparin (UFH) or fondaparinux due to better safety and outcomes [IA]. Outpatient use of LMWH for DVT. LMWH is appropriate for most patients with DVT to use at home [IIA]. Some require initial brief hospital admission and stabilization. Clinically stable patients not at elevated risk due to comorbidities can be managed entirely as outpatients using LMWH. Unfractionated heparin. UFH

2020 University of Michigan Health System

290. Guidelines on Chronic Coronary Syndromes Full Text available with Trip Pro

tomography-based fractional flow reserve GEMINI- ACS A Study to Compare the Safety of Rivaroxaban Versus Acetylsalicylic Acid in Addition to Either Clopidogrel or Ticagrelor Therapy in Participants With Acute Coronary Syndrome GFR Glomerular filtration rate GLS Global longitudinal strain GOSPEL Global secondary prevention strategies to limit event recurrence after myocardial infarction HbA1c Glycated haemoglobin HF Heart failure ICA Invasive coronary angiography IMR Index of microcirculatory resistance (...) IMT Intima−media thickness IONA Impact Of Nicorandil in Angina iwFR Instantaneous wave-free ratio (instant flow reserve) LAD Left anterior descending LBBB Left bundle branch block LDL-C Low-density lipoprotein cholesterol LM Left main (coronary artery) LV Left ventricular LVEF Left ventricular ejection fraction MI Myocardial infarction MRA Mineralocorticoid receptor antagonist NOAC Non-vitamin K antagonist oral anticoagulant NT-proBNP N-terminal pro-B-type natriuretic peptide OAC Oral

2019 European Society of Cardiology

291. Heart Failure - Systolic Dysfunction

implantation an ICD include: • An ICD should not be implanted within one month following myocardial infarction or within three months following CABG (data from CABG Patch (1997) and DINAMIT (2004)). • Survival benefit is only realized after one year (MADIT II and SCD HeFT trials), so the patient’s life expectancy should be greater than a year. • Women meeting criteria for ICD placement should be referred to an electrophysiologist or cardiologist no differently than men. However, some question exists (...) . The agents were tested in different populations, spironolactone in patients with severe heart failure and eplerenone in patients with mild heart failure and in patients post- myocardial infarction. As aldosterone antagonists, both spironolactone and eplerenone are potassium sparing diuretics and can cause hyperkalemia, especially when administered concomitantly with angiotensin converting enzyme inhibitors or angiotensin receptor blockers. In the clinical trial of aldosterone antagonism in patients

2020 University of Michigan Health System

292. Assessment of tachycardia

function. Differentials Sinus tachycardia Acute atrial fibrillation Chronic atrial fibrillation Atrial flutter Atrial tachycardia AV nodal re-entrant tachycardia AV re-entry tachycardia/Wolff-Parkinson-White syndrome Multifocal atrial tachycardia Junctional ectopic tachycardia Monomorphic ventricular tachycardia with prior myocardial infarction Monomorphic ventricular tachycardia with non-ischaemic cardiomyopathy Ventricular fibrillation Polymorphic ventricular tachycardia with normal QT interval (...) , are characterised by depolarisation of the ventricle and retrograde atrial activation (if present), manifested by a retrograde P wave. Arrhythmias that originate from the ventricle may originate from the distal His-Purkinje system or ventricular myocardium. The site of origin within the ventricle further defines some arrhythmias within the ventricle. Examples include right ventricular out-flow tract ventricular tachycardia and bundle branch re-entry ventricular tachycardia. Haemodynamic stability

2018 BMJ Best Practice

293. Assessment of delirium

secondary to illness or trauma, may also contribute to delirium initiation. Inouye SK. Delirium in older persons. N Engl J Med. 2006 Mar 16;354(11):1157-65. Differentials Dementia Pain Stroke/cerebrovascular accident and transient ischaemic attack Myocardial infarction Acute systemic infection Hypoglycaemia Hyperglycaemia Hypoxia Hypercarbia Acute urinary obstruction Medication- or illicit drug-related Alcoholic ketoacidosis Hepatic (...) . 2006 May-Jun;6(3):303-8. Gupta N, de Jonghe J, Schieveld J, et al. Delirium phenomenology: what can we learn from the symptoms of delirium? J Psychosom Res. 2008 Sep;65(3):215-22. Meagher DJ, Leonard M, Donnelly S, et al. A longitudinal study of motor subtypes in delirium: frequency and stability during episodes. J Psychosom Res. 2012 Mar;72(3):236-41. http

2018 BMJ Best Practice

295. Effectiveness of interventions to reduce homelessness: a systematic review and meta?analysis Full Text available with Trip Pro

, once per week, 2) the intervention is described as standard or broker case management, or 3) where intensity was not described. Housing programs Housing programs for homeless people typically provide accommodation and include goals such as long term residential stability, improved life‐skills and greater self‐determination (20, 21). These programs are complex and may include various forms of support and services, such as case management, work therapy, treatment of mental illness and substance abuse (...) , there have been many evaluations of housing and treatment programs for homeless individuals and/or persons at risk of homelessness. Several reviews and meta‐analyses have also been published (12, 18, 20, 28‐31). Yet, a large share of the reviews are out of date, or do not focus on homelessness and residential stability as primary outcomes, or are not systematic reviews of effectiveness. Tabol and colleagues (2010) (12) aimed to determine how clearly the supported/supportive housing model is described

2018 Campbell Collaboration

296. Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness

mortality in the surgical group (4.5%) vs. the non- surgical group (8.5%). Pooled adjusted estimates from the non- randomized studies indicated and suggested that the surgical group had lower risk of all-cause mortality (OR 0.55, 95%CI: 0.46-0.65; 10 studies). Besides risk for CV-events (myocardial infarction: OR 0.71, 95%CI: 0.54-0.94; stroke: OR 0.66, 95%CI: 0.49-0.89; and their composite: OR 0.67, 95%CI: 0.54-0.83; 1 study), and risk of cancer (OR 0.74, 95%CI: 0.65-0.85; 2 studies) was also reduced (...) with adjusted data, bariatric surgery was associated with a significantly reduced risk of composite cardiovascular adverse events (OR 0.54, 95%CI: 0.41-0.70). Bariatric surgery was also associated with significant reduction in specific endpoints of myocardial infarction (OR 0.46 95%CI 0.30-0.69, 4 studies) and stroke (OR 0.49 95%CI: 0.32-0.75, 4 studies). ? The SR-MA by Sheng et al. 43 evaluated the LT-effect (1 RCT and 9 cohorts with FU time ranging from 5 to 15 years) of MBS in patients with type 2

2019 Belgian Health Care Knowledge Centre

297. Performance of the Belgian health system

– Indicators specifically on population aged 75+ 74 Table 21 – Indicators on end of life care for patients with terminal cancer 77 Table 22 – Indicators on mother and newborn care 81 KCE Report 313C Performance report 2019 5 LIST OF ABBREVIATIONS ABBREVIATION DEFINITION ADL Activities of daily living AMI Acute myocardial infarction BAPCOC Belgian Antibiotic Policy Coordination Committee BCR Belgian Cancer Registry CT Computed Tomography DDD Defined Daily Dose DTP Diphtheria - Tetanus - Pertussis EBP (...) . 15 The effectiveness of primary care is measured by avoidable hospital admissions for two chronic conditions, namely asthma and complication of diabetes. Effectiveness indicators for hospital acute care are 5-year relative survival rate for cancer (breast and colorectal cancer), case fatality within 30 days after admission for acute myocardial infarction (AMI) and ischemic stroke, and case fatality within 30 days after admission for surgery for colorectal cancer. 16 Performance report 2019 KCE

2019 Belgian Health Care Knowledge Centre

298. Iron Deficiency and Anaemia in Adults

is a 75-year-old gentleman with known chronic heart failure, aetiology ischaemic heart disease having had two previous myocardial infarctions. He has been well for some time (NYHA I) but has found he has been able to do less, with his wife taking on more in the home. His deteriorating symptoms include increasing shortness of breath and fatigue and he is now NYHA II/ III. He is unable to play nine holes of golf as he once did and is feeling isolated at home, unable to get out like previously and meet (...) >500 to 1000mg 250ml 15 minutes Note: For stability reasons, dilutions to concentrations less than 2mg iron/ml are not permissible. Ferinject must not be administered by the subcutaneous or intramuscular route. Minimum observation is required (pulse and blood pressure should be checked before and after infusion). Facilities for cardiorespiratory resuscitation and equipment for handling acute anaphylactic/anaphylactoid reactions should be available, including an injectable 1:1000 adrenaline solution

2018 Royal College of Nursing

299. Nitroglycerin

ration via nasogastric tube. In 4 groups of 5 horses each, saline (0.9% NaCl) solution or ET receptor antagonist (10(5)M 2006 2. Prehospital Nitroglycerin Safety in Inferior ST Elevation Myocardial Infarction. Patients with inferior ST elevation myocardial infarction (STEMI), associated with right ventricular infarction, are thought to be at higher risk of developing hypotension when administered nitroglycerin (NTG). However, current basic life support (BLS) protocols do not differentiate location (...) (or ) are indicated as first line agents in most other cases of III. Preparation Mix 50 mg in 250 ml D5W IV. Dosing: Acute Myocardial Ischemia or Infarction Bolus: 12.5 to 25 mcg 2015 16. Nitroglycerin Nitroglycerin Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies

2018 Trip Latest and Greatest

300. Ezetimibe

of major adverse cardiovascular events (including cardiac death, spontaneous myocardial infarction, unplanned 2017 2. Prevention of Stroke with the Addition of Ezetimibe to Statin Therapy in Patients With Acute Coronary Syndrome in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) 28972004 2017 12 26 2017 12 26 1524-4539 136 25 2017 Dec 19 Circulation Circulation Prevention of Stroke with the Addition of Ezetimibe to Statin Therapy in Patients With Acute Coronary (...) of cardiovascular events, but whether the addition of ezetimibe , a nonstatin drug that reduces intestinal cholesterol absorption (...) (40 mg) and ezetimibe (10 mg) (simvastatin- ezetimibe ) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization (≥30 days after randomization), or nonfatal stroke. The median follow-up was 6

2018 Trip Latest and Greatest

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