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Myocardial Infarction Stabilization

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421. The British Society for Rheumatology biologic DMARD safety guidelines in inflammatory arthritis Full Text available with Trip Pro

failure Heart failure Cardiac failure Ischaemic heart disease Ischaemic heart disease Ischemic heart disease Myocardial infarct* Coronary artery bypass graft NSTEMI STEMI Acute coronary syndrome Respiratory disease Interstitial lung disease Fibrosis Pulmonary fibrosis Uveitis Uveitis Drug induced uveitis Demyelinating disease Demyelinat* Neuro* Optic neuritis Multiple sclerosis Diverticular disease Diverticul* Vaccinations Vaccin* Vaccine Pneumococcal vacc* Influenza vacc* Singles vacc* Hepattiis vac (...) Ischaemic heart disease Ischemic heart disease Myocardial infarct* Coronary artery bypass graft NSTEMI STEMI Acute coronary syndrome Respiratory disease Interstitial lung disease Fibrosis Pulmonary fibrosis Uveitis Uveitis Drug induced uveitis Demyelinating disease Demyelinat* Neuro* Optic neuritis Multiple sclerosis Diverticular disease Diverticul* Vaccinations Vaccin* Vaccine Pneumococcal vacc* Influenza vacc* Singles vacc* Hepattiis vac* Monitoring Monitor* Test* Connective tissue disease Drug

2018 British Society for Rheumatology

422. Routine investigation and monitoring of adult HIV-1-positive individuals (2019 interim update)

. Chow EP, Read TR, Chen MY et al. Routine CD4 cell count monitoring seldom contributes to clinical decision- making on antiretroviral therapy in virologically suppressed HIV-infected patients. HIV Med 2015; 16: 196–200. 6. Doyle A, Kegg S. Routine laboratory monitoring in the HIV out-patient setting – what does the full blood count add? HIV Med 2014; 15 (Suppl 3): 133–134. 7. Bruisten SM, Oudshoorn P, van Swieten P et al. Stability of HIV-1 RNA in blood during specimen handling and storage prior (...) to amplification by NASBA-QT. J Virol Methods 1997; 67: 199–207. 8. Vandamme AM, Van Laethem K, Schmit JC et al. Long-term stability of human immunodeficiency virus viral load and infectivity in whole blood. Eur J Clin Invest 1999; 29: 445–452. 9. Giordano M, Kelleher T, Colonno RJ et al. The effects of the Roche AMPLICOR HIV-1 MONITOR UltraSensitive Test versions 1.0 and 1.5 viral load assays and plasma collection tube type on determination of response to antiretroviral therapy and the inappropriateness

2019 British HIV Association

425. Management of Acute Atrial Fibrillation and Atrial Flutter in Non-Pregnant Hospitalized Adults

A2 Age =75 years 2 D Diabetes Mellitus 1 S2 Prior Stroke or TIA or thromboembolism 2 V Vascular disease (e.g. peripheral artery disease, myocardial infarction, aortic plaque) 1 A Age 65–74 years 1 Sc Sex category (i.e. female gender) 1 Table 3: When to consider a rhythm control strategy for atrial fibrillation/flutter • First occurrence of symptomatic AF/AFL • Occurrence or recurrence of AF due to reversible cause (e.g. hyperthyroidism, pulmonary embolism, postoperative state, pneumonia, acute (...) coronary syndrome/acute myocardial infarction ACS/AMI) • Hospital readmissions for AF/AFL or management of AF-related comorbidities • Atrial Tachyarrhythmia-related symptoms despite adequate rate control, or inability to achieve adequate rate control • Cardiomyopathy presumed to be secondary to tachycardia • Younger patients (age 120, consider a second bolus over 2 minutes Then start infusion at 5 mg/hr, titrate by 2.5 mg/hr every 30 minutes to HR, maximum dose 15 mg/hr [onset time 2-7 min] 120 to 360

2017 University of Michigan Health System

426. The Association of Coloproctology of Great Britain and Ireland Consensus Guidelines in Surgery for Inflammatory Bowel Disease Full Text available with Trip Pro

of IBD is highest in North America and Europe, with the highest prevalence of ulcerative colitis in Norway (505 per 100 000 population) and the USA (286 per 100 000) and of Crohn's disease in Germany (322 per 100 000) and Canada (319 per 100 000) . Although most recent studies concur that the incidence and prevalence of IBD has stabilized in most Western populations, there is a steady overall increase globally - . Incidence has been rising particularly in the newly industrialized countries of Africa

2018 Association of Coloproctology of Great Britain and Ireland

428. Developing and Sustaining Safe, Effective Staffing and Workload Practices

-Term Care (MOHLTC), and it was subsequently approved by the Joint Provincial Nursing Committee (JPNC). The resulting Healthy Work Environments Best Practice Guidelines Project was based on the need to stabilize and strengthen the nursing profession in Ontario, as identified by the JPNC and the Canadian Nursing Advisory Committee. Work on the project began in July 2003, when RNAO, with funding from the MOHLTC, began a partnership with Health Canada’s Office of Nursing Policy. At the time of writing (...) factors are related to its climate, culture, and values. They include organizational stability, communication practices and structures, labour management relations, and a culture of continuous learning and support. ? External socio-cultural factors influence how organizations and individuals operate. They include consumer trends, changing care preferences, changing roles in families, the diversity of the population and of providers, and changing demographics.BACKGROUND Developing and Sustaining Safe

2017 Registered Nurses' Association of Ontario

430. Coronary Artery Calcium Scoring

Coronary Artery Calcium Scoring The Cardiac Society of Australia and New Zealand Coronary Artery Calcium Scoring – Position Statement Coronary Artery Calcium Scoring (CAC) is a non-invasive quantitation of coronary artery calcification using computed tomography (CT). It is a marker of atherosclerotic plaque burden and an independent predictor of future myocardial infarction and mortality. CAC provides incremental risk information beyond traditional risk calculators (eg. Framingham Risk Score (...) therapy such as aspirin and statins. The evidence for pharmacotherapy is less robust in patients at intermediate levels of CAC 100-400, with modest benefit for aspirin use; though statins maybe reasonable if they are above 75th centile. Aspirin and statins are generally not recommended in patients with CAC 15% or annual increase of CAC >100 units are predictive of future myocardial infarction and mortality. Cost effectiveness of CAC based primary prevention recommendations There is currently no data

2017 Cardiac Society of Australia and New Zealand

432. CRACKCast E078 – Acute Coronary Syndromes Part B

things from last episode: – the patho of ACS and why serial ECGs are key. “The pathophysiology of an acute coronary event includes (1) endothelial damage through plaque disruption, irregular luminal lesions, and shear injury; (2) platelet aggregation; (3) thrombus formation causing partial or total lumen occlusion; (4) coronary artery vasospasm; and (5) reperfusion injury caused by oxygen free radicals, calcium, and neutrophils. In patients with non infarction ACS, spontaneous fibrinolysis (...) Remember someone can have a perfectly normal workup – and still be in the class of Unstable Angina – (i.e. No myocardial necrosis has occurred) Now let’s get back to our questions! 1) List Sgarbossa criteria for AMI in pre-existing LBBB (1) ST segment elevation of at least 1 mm that is concordant with the QRS complex; (2) ST segment depression of at least 1 mm in lead V1, V2, or V3; and (3) ST segment elevation of at least 5 mm that is discordant with the QRS complex. “These findings were assigned

2017 CandiEM

433. CRACKCast E078 – Acute Coronary Syndromes Part A

than 20 minutes (not the “I had chest pain while reading a book that lasted 5 minutes”) Can represent a possible harbinger of acute myocardial infarction Any ED patient with angina should be assumed to have UA until a thorough clinical evaluation proves otherwise. “UA can also be defined from a pathophysiologic perspective. Plaque rupture accompanied by thrombus formation and vasospasm illustrate the intracoronary events of UA . This is frequently characterized by an electrocardiographic (...) to myocardial necrosis “This [universal definition for myocardial infarction] requires a typical rise and fall of a cardiac biochemical marker, currently troponin, with either (a) clinical symptoms, (b) ECG changes(T wave changes, ST elevation or depression, pathologic Q waves), or [c] coronary artery abnormalities based on interventional evaluation.”; or (d) wall motion abnormalities on echocardiography. Five types Of infarction: Type 1: a true ACS event leading to coronary thrombosis and vasospasm Type 2

2017 CandiEM

436. WHO recommendation on tranexamic acid for the treatment of postpartum haemorrhage

of placenta: (one study; RR 0.95, 95% CI 0.87 to 1.04). ? Procedure-related complications: Moderate certainty evidence suggests there is probably little or no difference between groups for thromboembolic events (any maternal thromboembolic event: RR 0.88, 95% CI 0.54 to 1.43; deep venous thrombosis: two studies; RR 0.62 95% CI 0.20 to 1.88; pulmonary embolism RR 0.85, 95% CI 0.44 to 1.61; myocardial infarction: RR 0.66, 95% CI 0.11 to 3.97; stroke: RR 1.33, 95% CI 0.46 to 3.82). ? Neonatal adverse effects (...) quarter of all maternal deaths are associated with PPH, and in most low- income countries it is the main cause of maternal mortality. 3 6HYHUH33+LVJHQHUDOO\GHÀQHGDVDEORRGORVVRIPORUPR UHDIWHUELUWK Severe maternal health conditions, such as organ dysfunction or death, generally occur following substantial blood loss that compromises maternal haemodynamic stability. Uterine atony is the most common cause of PPH and a leading cause of maternal mortality worldwide. 3 Genital tract trauma (that is, vaginal

2017 World Health Organisation Guidelines

438. Association of British Clinical Diabetologists - Renal Association (ABCD-RA) Clinical Practice Guidelines for Management of Lipids in Adults with Diabetes Mellitus and Nephropathy and/or Chronic Kidney Disease

is inexpensive and will also identify a group of patients where lipid-lowering therapy is not indicated (e.g. malnourished patients with LDL cholesterol 4.9 mmol/L and/or a vascular event in the three months prior to study entry. Atorvastatin failed to demonstrate any reduction in the primary end point compared to placebo. The primary end point was a composite of cardiac death, fatal stroke, nonfatal myocardial infarction, or nonfatal stroke. In AURORA 2273 haemodialysis patients aged >50years were (...) as they are usually on multiple agents often including immunosuppression, antihypertensive therapy and antimicrobial prophylaxis. Lipid assessment should be performed once immunosuppressive drug dosing has been stabilised and the risk of acute rejection requiring corticosteroid therapy has fallen. This period of stability is likely to be achieved three months post transplantation at the earliest, although this will vary with individual patients. Evidence base for impact of lipid lowering CVD risk in renal

2017 Association of British Clinical Diabetologists

440. Prevention, Diagnosis & Management of infective endocarditis

Enterococcus species 88 4.2.2.5 HACEK microorganisms 91 4.2.2.6 Candida 92 4.2.2.7 Non-HACEK Gram-negative microorganisms 93 4.2.2.8 Other microorganisms 94 4.2.3 Empirical therapy 95 4.2.4 Outpatient parenteral antimicrobial therapy for infective endocarditis 99 5.0 SURGICAL INTERVENTION 100 5.1 Indications 100 5.2 Timing of surgery 102 5.2.1 Preventing systemic embolism 103 5.3 Sur gery in specific conditions 104 5.3.1 Cerebral infarction or haemorrhage 104 5.3.2 Right-sided endocarditis 105 5.3.3 (...) • Lung embolisation • Occurs in right-sided IE causing pneumonia or lung abscess • Abdominal embolisation • Splenic abscesses or infarcts Cardiac • Murmurs • Appearance of new

2017 Ministry of Health, Malaysia

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