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Postpartum Inpatient Management

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81. Heart Disease and Stroke Statistics

(Nationwide) Inpatient Sample, hospitalizations for acute ischemic stroke increased significantly for both males and females and for certain racial/ethnic groups among younger adults aged 18 to 54 years. From 1995 through 2011 to 2012, stroke hospitalization rates almost doubled for males aged 18 to 34 and 35 to 44 years, with a 41.5% increase among males aged 35 to 44 years from 2003 to 2004 through 2011 to 2012. In analyses using data from the Global Burden of Disease Study, ≈90% of the stroke risk (...) disease. Admissions for endocarditis related to injection drug use have risen in recent years in parallel with the opioid drug crisis. The prevalence of documented intravenous drug use among people admitted to a hospital because of endocarditis in the National (Nationwide) Inpatient Sample rose from 4.3% in 2008 to 10% in 2014. Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism), Chronic Venous Insufficiency, Pulmonary Hypertension (Chapter 22) Traditional atherosclerotic risk factors

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2019 American Heart Association

82. Lamotrigine

. We compared the risk of inpatient psychiatric admission within three months postpartum between women who used lamotrigine (N=55) versus lithium (N=59) during pregnancy. A logistic regression model was used 2017 18. Lamotrigine USE OF LAMOTRIGINE IN PREGNANCY 0344 892 0909 USE OF LAMOTRIGINE IN PREGNANCY (Date of issue: December 2014 , Version: 2 ) This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure (...) included if they had been on LTG-VPA combination therapy for at least 6 months. Patient demographics and information about epilepsy type, severity, and degree of medical intractability were obtained 2008 14. Pharmacokinetics, Safety and Tolerability of Repeat Dosing Lamotrigine in Healthy Chinese Subjects Pharmacokinetics, Safety and Tolerability of Repeat Dosing Lamotrigine in Healthy Chinese Subjects - Full Text View - Hide glossary Glossary Study record managers: refer

2018 Trip Latest and Greatest

83. Syphilis in pregnancy

inpatient management for higher risk groups (as above) o Supportive management relevant to symptoms (e.g. antipyretics, intravenous fluids, tocolysis) · If inpatient management not practical (e.g. in a remote setting) consider: o Outreach follow-up contact in the community (e.g. by phone, text or personal contact) o Fetal heart rate (FHR) auscultation or cardiotocography pre and post administration 31,50 Queensland Clinical Guideline: Syphilis in pregnancy Refer to online version, destroy printed copies (...) not address all elements of standard practice and accepts that individual clinicians are responsible for: · Providing care within the context of locally available resources, expertise, and scope of practice · Supporting consumer rights and informed decision making, including the right to decline intervention or ongoing management · Advising consumers of their choices in an environment that is culturally appropriate and which enables comfortable and confidential discussion. This includes the use

2019 Queensland Health

84. Placenta Accreta Spectrum

in the management of severe and refractory postpartum hemorrhage. Downsides are a risk of thrombosis and considerable cost. Two large case series that included some placenta accreta spectrum patients noted positive responses in 76–86% of cases. However, there were six thromboses in fewer than 200 patients (33, ). Thus, use in placenta accreta spectrum should be limited to posthysterectomy bleeding with failed standard therapy. Hypofibrinogenemia is the biomarker most predictive of severe postpartum hemorrhage (...) committee members and authors have submitted a conflict of interest disclosure statement related to this published product. Any potential conflicts have been considered and managed in accordance with ACOG’s Conflict of Interest Disclosure Policy. The ACOG policies can be found on For products jointly developed with other organizations, conflict of interest disclosures by representatives of the other organizations are addressed by those organizations. The American College of Obstetricians

2019 American College of Obstetricians and Gynecologists

85. Chronic Pelvic Pain

guidelines on chronic pelvic pain. Eur Urol, 2010. 57: 35. 5. Engeler, D.S., et al. The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development. Eur Urol, 2013. 64: 431. 6. McMahon, S.B., et al. Visceral pain. Br J Anaesth, 1995. 75: 132. 7. Shoskes, D.A., et al. Clinical phenotyping of patients with chronic prostatitis/chronic pelvic pain syndrome and correlation with symptom severity. Urology, 2009. 73: 538. 8. Magri (...) prostatitis/chronic pelvic pain syndrome: A MAPP: Research Network Neuroimaging Study. Neuroimage Clin, 2015. 8: 493. 66. Abrams, P., et al. A new classification is needed for pelvic pain syndromes--are existing terminologies of spurious diagnostic authority bad for patients? J Urol, 2006. 175: 1989. 67. Baranowski, A., et al., Urogenital Pain in Clinical Practice. 2008, New York. 68. Baranowski, A.P., et al. Urogenital pain--time to accept a new approach to phenotyping and, as a consequence, management

2019 European Association of Urology

86. Multiple Pregnancy Following Assisted Reproduction

embryo reduction may be considered to reduce the number of multiple births following IVF. The alarming rise in the multiple pregnancy rate resulting from the use of assisted reproductive technology (ART) has led to many publications highlighting the significant maternal, fetal and neonatal risks associated with these pregnancies. - Maternal complications include increased risk of pregnancy‐induced hypertension, gestational diabetes, peripartum haemorrhage, operative delivery, postpartum depression (...) . 15 Henderson, J , Hockley, C , Petrou, S , Goldacre, M , Davidson, L . Economic implications of multiple births: inpatient hospital costs in the first 5 years of life . Arch Dis Child Fetal Neonatal Ed 2004 ; 89 : F542 – 5 . 16 Ledger, WL , Anumba, D , Marlow, N , Thomas, CM , Wilson, EC ; Cost of Multiple Births Study Group (COMBS Group) . The costs to the NHS of multiple births after IVF treatment in the UK . BJOG 2006 ; 113 : 21 – 5 . 17 McKelvey, A , David, AL , Shenfield, F , Jauniaux, ER

2018 Royal College of Obstetricians and Gynaecologists

87. Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder

greater than $5,000 and any other relevant business or professional conflicts of interest. Because of their unique clinical or content expertise, individuals with potential conflicts may be retained. The Task Order Officer (TOO) and the EPC work to balance, manage, or mitigate any potential conflicts of interest identified. The list of Technical Experts who provided input to this report follows: Susan Borja, Ph.D.* Program Chief, Dimensional Measurement and Intervention Program, Traumatic Stress (...) of interest. However, the conclusions and synthesis of the scientific literature presented in this report do not necessarily represent the views of individual reviewers. Peer Reviewers must disclose any financial conflicts of interest greater than $5,000 and any other relevant business or professional conflicts of interest. Because of their unique clinical or content expertise, individuals with potential nonfinancial conflicts may be retained. The TOO and the EPC work to balance, manage, or mitigate any

2019 Effective Health Care Program (AHRQ)

88. Prevention and early intervention for adults with mild to moderate depression

, and Literature Reviews 17 Individual Studies of Programs and Services 23 Peer- and clinician-based interventions 41 Email and text-based interventions 46 Exercise-based interventions 49 5 Discussion 53 What policies, programs, or services have been effective at prevention and/or managing mild–moderate depression and anxiety in people aged 18 years and over? 53 6 Gaps in the evidence 57 7 Conclusions and recommendations 60 References 63 MILD-MODERATE DEPRESSION AND ANXIETY IN ADULTS | SAX INSTITUTE 5 Appendix (...) and programs identified in the Evidence Check on prevention and early intervention programs for people aged 18 years and over with mild–moderate depression and anxiety 83 MILD-MODERATE DEPRESSION AND ANXIETY IN ADULTS | SAX INSTITUTE 7 1 Executive summary Background The purpose of the report is to review and summarise the evidence base for the effectiveness of interventions that prevent or manage mild to moderate depression and anxiety in adults. The review makes judgements about the overall strength

2018 Sax Institute Evidence Check

89. The Irish Maternity Early Warning System (IMEWS) National Clinical Guideline

for this guideline is outlined in Appendix 7 . The NCEC NCG No. 4 IMEWS V2 should be reviewed by each hospital’s senior management team, in conjunction with the relevant local implementation leads and project groups, to appropriately plan implementation of the recommendations. This will ensure that the hospital care of pregnant and postpartum women is optimised . It is recommended that hospitals use quality improvement (QI) methodology when implementing the IMEWS. Such methods enhance stakeholder engagement (...) title and affiliation Professor Michael Turner (Chair) Lead, Clinical Programme Obstetrics & Gynaecology Dr Peter Boylan Chair, Institute of Obstetricians and Gynaecologists Ms Triona Cowman Director, Centre for Midwifery Education Ms Anna Deasy Clinical Risk Manager, Coombe Women and Infants University Hospital Ms Angela Dunne Midwifery Director, National Women and Infants Health Programme Ms Mary Flynn Assistant Director of Midwifery, Cork University Maternity Hospital Dr Jennifer Hogan Specialist

2019 HIQA Guidelines

90. Levels of Maternal Care

and ability to stabilize and transfer high-risk women and newborns. Examples of appropriate patients (not requirements) Term, singleton, vertex presentation Level I (Basic Care) Definition Care of uncomplicated pregnancies with the ability to detect, stabilize, and initiate management of unanticipated maternal–fetal or neonatal problems that occur during the antepartum, intrapartum, or postpartum period until patient can be transferred to a facility at which specialty maternal care is available (...) II health care providers plus continuous availability of adequate numbers of nursing leaders and RNs with competence in level III care criteria and ability to transfer and stabilize high-risk women and newborns who exceed level III care criteria, and with special training and experience in the management of women with complex maternal illnesses and obstetric complications. ob-gyn available onsite at all times. MFM with inpatient privileges available at all times, either onsite, by phone

2019 American College of Obstetricians and Gynecologists

91. Substance use disorders in pregnancy: clinical, ethical, and research imperatives of the opioid epidemic

on OUD in particular; to draft preliminary recommendations regarding screening, pain management, and medication-assisted therapy (MAT) for OUD during pregnancy; and to delineate research gaps. Epidemiology of opioid use in pregnancy Epidemiologic evidence that was presented at the workshop demonstrated that rates of substance use in pregnancy have increased significantly in the past decade and that rates of OUD in pregnant and postpartum women have increased in parallel: • One study reported (...) on epidemiology, prenatal screening, pain management, and treatment modalities of OUD in pregnancy, workshop participants were assigned to 1 of 3 breakout groups to discuss the following key issues in greater depth and to make preliminary recommendations: (1) screening and testing for substance use disorder, including OUD, in pregnancy; (2) pain management during the antepartum, intrapartum, and postpartum periods; and (3) management modalities for pregnant women with OUD. The following key findings emerged

2019 Society for Maternal-Fetal Medicine

92. Prevention and Control of Methecillin-Resistant Staphylcoccus Aureus (MRSA)

measures in the acute hospital setting 13 2.1.3 MRSA in the non-acute healthcare setting 20 2.1.4 MRSA in obstetrics and neonates 26 2.1.5 Community-associated MRSA 29 2.1.6 Eradication of MRSA carriage (decolonisation) 38 2.1.7 Antimicrobial stewardship in the prevention and control of MRSA 44 2.1.8 Occupational health aspects of MRSA 46 2.2 Management of MRSA 55 2.2.1 Treatment and prophylaxis 55 2.3 Surveillance 66 2.4 Evaluation and audit 68 3.0 Background and methodology 70 3.1 Economic impact (...) : Elements of a programme to prevent and control MRSA to promote safe quality care 7 Table 2: Key Components of Standard Precautions 22 Table 3: Practical guidance on antibiotic choices for the management of moderate CA-MRSA SSTI 33 Table 4: Definition of contacts of CA-MRSA index cases 36 Table 5: Risk Factors for MRSA in HCWs 50 Table 6: Treatment - practical guidance for MRSA infections in adults 57 Table 7: Estimation of the costs of HCAI in Ireland for 2011 extrapolated from national

2019 National Clinical Guidelines (Ireland)

93. Stroke, Diagnosis and Initial Treatment of Ischemic Stroke

that these are abnormal, do not delay head CT or IV Alteplase Unless emergently indicated, do not delay imaging/IV Alteplase to obtain EKG, CXR or place foley Patient presents with signs and symptoms of an acute stroke Manage hemorrhagic stroke Positive for hemorrhage Evaluate for TIA Negative for hemorrhage (resolved neurological de?cits) Symptom onset? Negative for hemorrhage (continuing neurological de?cits) Neurology consultation Within 4.5 hours > 4.5 hours or time of onset is unknown IV Alteplase (...) of Neurology/Fairview Health Services Ruth Marie Thomson, DO Vascular Neurology Park Nicollet Health Services Fadoua Kushner, PharmD Pharmacy University of Minnesota Physicians Christopher Streib, MD Vascular Neurology ICSI Staff Senka Hadzic, MPH Clinical Systems Improvement Facilitator Jodie Dvorkin, MD, MPH Project Manager/Health Care Consultant Algorithm (Acute Ischemic Stroke) 1 Evidence Grading 3 Foreword 4-6 Introduction 4 Endorsement of 2018 American Heart Association (AHA)/ American Stroke

2019 Institute for Clinical Systems Improvement

94. Recommendations for Prevention and Control of Influenza in Children, 2019–2020

of gestation and postpartum. Any licensed, recommended, and age-appropriate influenza vaccine may be used, although experience with the use of RIV4 in pregnant women is limited. LAIV is contraindicated during pregnancy. Data on the safety of influenza vaccination at any time during pregnancy continues to accumulate and support the safety of influenza immunization during pregnancy. In a 5-year retrospective cohort study from 2003 to 2008 with more than 10 000 women, influenza vaccination in the first (...) observational Vaccine Safety Datalink study conducted during the 2010–2011 and 2011–2012 seasons noted an association between receipt of IIV containing H1N1pdm09 and risk of spontaneous abortion when an H1N1pdm-09-containing vaccine had also been received the previous season. A follow-up study conducted by the same investigators with a larger population did not reveal this association and further supported the safety of influenza vaccine during pregnancy. Postpartum women who did not receive influenza

2019 American Academy of Pediatrics

95. Canadian immunization guide chapter on influenza and statement on seasonal influenza vaccine for 2017-2018

without neurological conditions, among the groups for whom influenza vaccination is particularly recommended. This replaces and includes the previous recommendation for people with conditions that compromise the management of respiratory secretions and are associated with an increased risk of aspiration. From the preliminary review, it was noted that the odds ratios for influenza complications in patients with neurologic conditions in comparison to those without ranged from 1.57 (pneumonia; 95% CI (...) group presented with seizures more frequently than those with neurologic and neurodevelopment conditions and a vaccine indication (41.7% vs. 26.4%; P = 0.006) and required ICU admission (20.9% vs. 11.8%; P = 0.02) and mechanical ventilation (14.8% vs. 4.5%; P 0%) against medically attended laboratory-confirmed influenza in the outpatient or inpatient setting. The author’s conclusions in this review may be subject to interpretation because of the restrictive inclusion criteria that were used

2017 CPG Infobase

96. Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

users can save articles, searches, and manage email alerts. All registration fields are required. I have read & acknowledge the . I have read & accept the terms of the . You currently have no recent searches Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Toggle navigation (...) Reference Manager Save my selection Regional Anesthesia and Pain Medicine: doi: 10.1097/AAP.0000000000000763 REGIONAL ANESTHESIA AND ACUTE PAIN: SPECIAL ARTICLE Free From the *Mayo Clinic, Rochester, MN; †Katholieke Universiteit, Leuven, Belgium; ‡Bielefeld Hospital, Bielefeld, Germany; §Massachusetts General Hospital, Boston, MA; and ∥Northwestern University, Chicago, IL. Accepted for publication January 21, 2018. Address correspondence to: Terese T. Horlocker, MD, Department of Anesthesiology

2018 American Society of Regional Anesthesia and Pain Medicine

97. Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices

of insur- ance coverage for inpatient LARC insertion has been an obstacle to immediate postpartum LARC initiation; how- ever, since 2013 increasing numbers of state Medicaid programs have begun covering this service (74). For additional information, including clinical guidance, see Committee Opinion No. 670, Immediate Postpartum Long-Acting Reversible Contraception and Practice Bulletin No. 186, Long-Acting Reversible Contraception: Implants and Intrauterine Devices. Postabortal Long-Acting Reversible (...) their IUD with 42 former non-IUD users found no difference in pregnancy rates or time to pregnancy between the groups (40). Intrauterine Devices May Be Inserted Without Difficulty in Most Adolescents and Nulliparous Women Intrauterine device insertion has not been shown to be more difficult in adolescents compared with older as management of irregular or abnormal uterine bleeding and treatment of dysmenorrhea (17). Coercive provision of LARC has been used as a means of fertility control in marginalized

2018 American College of Obstetricians and Gynecologists

98. Practice Guideline Recommendations Summary: Disease-modifying Therapies for Adults with Multiple Sclerosis

with people with MS who are taking a DMT and attempt to manage these AEs, as appropriate. Clinicians should discuss a medication switch with people with MS for whom these AEs negatively influence adherence. Switching: Recommendation 5 Rationale Persistent laboratory abnormalities, such as elevated liver enzymes and decreased white blood cell counts, may prompt a discussion about switching DMT (see table e-2,©2018 American Academy of Neurology Level B Clinicians should (...) , clinicians should promptly discuss switching to an alternate DMT, especially for people with MS using azathioprine, methotrexate, mycophenolate, cyclophosphamide, fingolimod, teriflunomide, alemtuzumab, or dimethyl fumarate. People with MS with serious infections potentially linked to their DMT should switch DMTs (does not pertain to PML management in people with MS using DMT). Switching: Recommendation 8 Rationale Neutralizing antibodies may be produced against natalizumab and have been associated

2018 American Academy of Neurology

99. Comprehensive Systematic Review Summary: Disease-modifying Therapies for Adults with Multiple Sclerosis

In addition, in many people with MS, progression of the disease ultimately leads to severe disability. e16 Early studies suggested that most individuals with relapsing-remitting MS (RRMS) make the transition to secondary progressive MS (SPMS) if observed for long enough intervals. e17 These statistics challenge clinicians to manage and control disease activity in the interest of helping persons with MS maintain a vibrant and meaningful life. The 2002 American Academy of Neurology (AAN) clinical practice (...) interferons in 244 individuals with RRMS in terms of the ARR. Massacesi et al e36 (Class II owing to less than 80% completion) and Etemadifar et al e37 (Class II owing to unclear allocation concealment, more than 2 primary outcomes) studies allowed any of the interferon beta preparations for MS disease management. Meta-analysis of data from these studies shows a rate ratio of 0.64 (95% CI, 0.44?0.92), favoring azathioprine. One of these Class II studies e37 also evaluated the proportion of individuals

2018 American Academy of Neurology

100. Optimizing Support for Breastfeeding as Part of Obstetric Practice

. Committee on Fetus and Newborn, Task Force on Sudden Infant Death Syndrome. Pediatrics 2016;138:e20161889. Postpartum pain management. ACOG Committee Opinion No. 742. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;132:e35–43. Howard C, Howard F, Lawrence R, Andresen E, DeBlieck E, Weitzman M. Office prenatal formula advertising and its effect on breast-feeding patterns. Obstet Gynecol 2000;95:296–303. U.S. Department of Agriculture. WIC and the retail price of infant formula (...) , or consequential damages, incurred in connection with this publication or reliance on the information presented. All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. Any potential conflicts have been considered and managed in accordance with ACOG’s Conflict of Interest Disclosure Policy. The ACOG policies can be found on For products jointly developed with other organizations, conflict of interest disclosures

2018 American College of Obstetricians and Gynecologists

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