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Postpartum Inpatient Management

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121. Evidence-based guidelines for treating bipolar disorder

after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use (...) alongside NICE 2014 Bipolar Disorder: Assessment and Management (NICE2014) (https:// www.nice.org.uk/guidance/cg185), the recommendations from which are in places compared with our own. The quality of the evidence base Evidence categories (I to IV) traditionally imply a hierarchy from the best evidence, based on high-quality randomized trials, to the weakest, based on opinion/clinical impression (Shekelle et al., 1999). This approach explicitly downgrades non-experimental descriptive studies

2016 British Association for Psychopharmacology

122. Birth after Previous Caesarean Birth

is 72–75%. What factors determine the individualised likelihood of VBAC success? Women with one or more previous vaginal births should be informed that previous vaginal delivery, particularly previous VBAC, is the single best predictor of successful VBAC and is associated with a planned VBAC success rate of 85–90%. Previous vaginal delivery is also independently associated with a reduced risk of uterine rupture. Intrapartum management of planned VBAC What delivery setting is appropriate (...) incision in women undergoing ERCS. [New 2015] All women undergoing ERCS should receive thromboprophylaxis according to existing RCOG guidelines. [New 2015] Early recognition of placenta praevia, adopting a multidisciplinary approach and informed consent are important considerations in the management of women with placenta praevia and previous caesarean delivery. [New 2015] How should women in special circumstances be cared for? Clinicians should be aware that there is uncertainty about the safety

2015 Royal College of Obstetricians and Gynaecologists

123. Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death We use cookies to enhance your experience on our website. By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death | European Heart Journal | Oxford Academic Search Account Menu Menu Navbar Search Filter Mobile Microsite Search Term Close (...) search filter search input Article Navigation Close mobile search navigation Article navigation 1 November 2015 Article Contents Article Navigation 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital

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2015 European Society of Cardiology

124. Evidence-based Guidelines for Treating Bipolar Disorder

after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use (...) alongside NICE 2014 Bipolar Disorder: Assessment and Management (NICE2014) (https:// www.nice.org.uk/guidance/cg185), the recommendations from which are in places compared with our own. The quality of the evidence base Evidence categories (I to IV) traditionally imply a hierarchy from the best evidence, based on high-quality randomized trials, to the weakest, based on opinion/clinical impression (Shekelle et al., 1999). This approach explicitly downgrades non-experimental descriptive studies

2016 British Association for Psychopharmacology

125. Yoga for the Treatment of Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, Depression, and Substance Abuse

with postpartum depression, 28 and one study for women from the community with MDD or dysthymia. 29 The remaining RCT included adult patients with MDD from an inpatient hospital ward. 30 The yoga intervention took the form of gentle vinyasa flow yoga (60 min, 16 classes for eight weeks and home practice (30 min, one time per week using a DVD) for women with postpartum depression. 28 Vinyasa flow yoga involved a sequence of four categories of poses/techniques: I. breathing and centering techniques, II, Warm-up (...) pre and post-treatment. Mitchell et al. 18 also assessed outcomes at one- month follow-up. Based on the study by Mitchell et al., 18 additional outcome data such as PTSD screening, awareness and attentiveness, psychological flexibility, alcohol risk behaviours, substance use and dependence and symptom perception and management, was reported in two related follow-up studies 19,20 . Clinical effectiveness of yoga for adults with GAD Two systematic reviews were identified in the literature

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

126. Provision of interventional radiology services

image processing software. IR units should have established links and access to day-case facilities. Many IR procedures can be performed as a day-case episode and IR offers an opportunity to deliver more cost-effective care when day-case and outpatient facilities are used appropriately. Interventional radiologists have specialist knowledge and experience of managing patients undergoing interventional procedures. To ensure the highest quality of inpatient care, interventional radiologists should (...) is the provision of one staff member experienced with the procedures and equipment as scrubbed assistant, with sedation and monitoring provided by a separate member of staff. Interventional radiologists play an increasingly clinical role and job plans should incorporate all aspects of activity, including the requirements to provide outpatient clinics and inpatient clinical support. Patients expect the procedure and their treatment to be explained by the clinician carrying them out. Interventional radiologists

2014 Royal College of Radiologists

127. Best Practice Guidelines for Mental Health Disorders in the Perinatal Period

the Perinatal Period . . . . . . . . 44 Table 9: Common Treatments for Bipolar Disorder in the Perinatal Period . . . . . . . . . . . . . . . . 48 Table 10: Guidelines for the Treatment of Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . 50 Table 11: Guidelines for the Prevention/Management of Psychotic Disorders & Postpartum Psychosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Table 12: General Responses to Identified Suicide (...) but risks and impacts can be successfully managed. Medications play a significant role in management but adding a psychosocial intervention can improve treatment outcomes, particularly during the depression phase of bipolar. See Section 5.3 for discussion of Treatment and Self-Management. Recommendations for bipolar disorder Promote early identification and treatment of bipolar disorder in perinatal women by enquiring about risk factors (personal or family history of bipolar disorder and/or postpartum

2014 British Columbia Perinatal Health Program

128. What are the recommended clinical assessment and screening tests during pregnancy?

. INTRODUCTION 1.1. Background Each year, more than 125 000 births are registered in Belgium. 1 An early, adequate and continuous prenatal care with timely identification and management of risk factors is fundamental for a good pregnancy outcome. To avoid consequences of malpractice, inappropriate use of resources and inequality between patients, prenatal care should be based on the best scientific evidence. In 2004, the KCE had published a clinical guideline for antenatal care (KCE Report 6). 2 However (...) , since 2004, the health professionals who are involved in the management of pregnant women face new scientific evidence and emerging issues (e.g. lower threshold for the diagnosis of gestational diabetes 3 or new screening tests for preeclampsia risk). Furthermore, it appears that some laboratory tests that were not recommended in 2004 continue to be broadly prescribed in Belgium. 4 This observation can indicate a possible overuse of the screening tests with a risk of misallocation of resources

2015 Belgian Health Care Knowledge Centre

129. BladderScan BVI 9400 3D portable ultrasound scanner for measuring bladder volume

volume in people with chronic neurological conditions such as cerebral palsy or spinal dysraphism. Bladder care is an important aspect of management in the postpartum period. Postpartum voiding dysfunction occurs in a significant number of women after giving birth. Standard bladder scanners may measure uterine debris as bladder volume. The NeuralHarmonics technology within the BladderScan BVI 9400 potentially allows more accurate non-invasive bladder volume measurement in women who have recently (...) of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 16 of 26Kuppusamy S, Gillatt D (2011) Managing patients with acute urinary retention. Practitioner 255: 21–3 Marciano A, Capitanucci M, Mariani S et al. (2013) Accuracy of BladderScan BVI9400 compared to transurethral catheterization in evaluating bladder volume in children. Neurourology and Urodynamics 32: S43–4 Mulder FEM, Schoffelmeer MA, Hakvoort RA et al. (2012) Risk factors for postpartum urinary retention

2016 National Institute for Health and Clinical Excellence - Advice

130. Suicide during the perinatal period

represents the leading cause of maternal mortality in developed nations (Oates, 2003), principally as more physiological causes of maternal death, such as haemorrhage, obstetric embolisms, and pre-eclampsia/eclampsia, have become rarer with the routine health screening and care that pregnant women in developed nations now receive (Palladino et al, 2011). Around one-quarter (24%) to just under one-half (49%) of UK women referred to psychiatric services for postpartum depression have a history (...) information on all UK residents aged 10 or older who have been in receipt of psychiatric care (e.g., outpatient, day, inpatient, or crisis home treatment) in the 12 months preceding a death by suicide or homicide perpetration. Inquiry data is collected in 3 stages: Data on all suspected suicides in the UK (e.g., deaths recorded as either a suicide or an open verdict following a coroner’s inquest) are collected from the national registries in England and Wales, Scotland, and Northern Ireland; Psychiatric

2016 The Mental Elf

131. Task Force 6: Pediatric Cardiology Fellowship Training in Adult Congenital Heart Disease

1 clinic per week, although more may be necessary. • Experience a range of diagnostic and therapeutic methods used in the care of adults with CHD, including direct experience in echocardiography, magnetic resonance imaging, computed tomography, diagnostic catheterization, and exercise testing. • Participate in the perioperative evaluation of adults with CHD for both cardiac and noncardiac procedures and observe operative repairs. • Participate in outpatient evaluation and inpatient management (...) of pregnancy in women with CHD. • Participate in inpatient and outpatient management of adults with CHD and heart failure and/or pulmonary arteriolar hypertension. Participate in medical management of these patients, as well as exposure to discussion/ implementation of mechanical circulatory support and transplant as options for treatment. • Participate in the diagnosis and management of the arrhythmic complications seen in adults with CHD, both medical therapy and interventional options. • For those

2015 American Heart Association

132. Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

-related exclusion criteria for alteplase that are considered standard of care and are listed in the AHA/ASA acute stroke management guidelines ( ). Table 4. Inclusion and Exclusion Characteristics of Patients With Ischemic Stroke Who Could Be Treated With Intravenous rtPA Within 3 Hours From Symptom Onset Inclusion criteria Diagnosis of ischemic stroke causing measurable neurological deficit Onset of symptoms <3 h before treatment begins Age ≥18 y Exclusion criteria Significant head trauma or prior (...) Koennecke et al, 2001 Berlin, Germany Single academic center 504 13 32 8 20 40 Azzimondi et al, 1997 Bologna, Italy Single teaching hospital 204 NR 40 12 31 9 7 NIHSS indicates National Institutes of Health Stroke Scale; and NR, not reported. The current exclusion criteria listed in the AHA/ASA 2013 acute stroke management guidelines remain based largely on the criteria listed in the pivotal National Institute of Neurological Disorders and Stroke (NINDS) alteplase trial published in 1996, with a few

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2015 American Heart Association

133. 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

2015 American College of Obstetricians and Gynecologists

134. How and why do psychotherapies improve social support?

people and Outcomes were reported on social support. Depression could be either defined according to diagnostic interview or based on a cut-off score on a self-report measure. They excluded studies in which the effects of two or more psychotherapies were compared to each other and studies of inpatients and adolescents. Comorbid general medical or psychiatric disorders were not used as an exclusion criterion. As one might expect from the Cuijpers’ “stable”, the meta-analysis carried out was both (...) robust and of the highest quality (Hedge’s g, Cohen’s d, a test of homogeneity of effect sizes, several sensitivity analyses, subgroup analyses, Publication bias, and more). Results The authors identified 11 studies that reported on data from >1,500 patients with depression, comparing treatment with psychotherapy to care-as-usual or waiting list controls. The majority of studies assessed the participants’ perceptions of social support (7 studies out of the 11 studies: 3 on postpartum depression; 4

2016 The Mental Elf

135. Consolidated guidelines on HIV testing services

QUALITY ASSURANCE OF HIV TESTING 115 8.1 Assuring the quality of HIV testing results 116 8.2 Regulations for in vitro diagnostics 120 8.3 Quality management systems, irrespective of the testing setting 121 8.4 Quality improvement for HIV testing 131v 9 HIV TESTING IN THE CONTEXT OF SURVEILLANCE 133 9.1 Overview 134 9.2 Populations selected for biological surveillance 135 9.3 Returning HIV test results to participants in biological surveillance 137 9.4 Approaches for HIV testing in the context (...) ), postpartum (through breastfeeding) or via parenteral exposure (2). Eclipse period: the period between HIV infection and detection of virological markers, such as HIV RNA/DNA or HIV p24 antigen (1). External quality assessment (EQA): inter-laboratory comparison to determine if the HIV testing service can provide correct test results and diagnosis. Generalized epidemic: HIV is firmly established in the general population. Although subpopulations at high risk may contribute disproportionately to the spread

2015 World Health Organisation HIV Guidelines

136. Evaluation of Patients With Suspected Acute Pulmonary Embolism: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians

and recent guidelines. The target audience for this paper is all clinicians; the target patient population is all adults, both inpatient and outpatient, suspected of having acute PE. Best Practice Advice 1: Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Best Practice Advice 2: Clinicians should not obtain d -dimer measurements or imaging studies in patients with a low pretest probability of PE and who meet all (...) agglutination assays can only rule out PE in patients with low pretest probability ( ). For the purposes of these guidelines, we will assume that highly sensitive d -dimer assays are being used. Computed tomography (CT) has become the predominant imaging modality used for the diagnosis of PE. Although the use of CT for the evaluation of patients with suspected PE is increasing in the inpatient, outpatient, and ED settings ( ), no evidence indicates that this increased use has led to improved patient

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2015 American College of Physicians

137. Systematic review of the cost-effectiveness of influenza immunization programs: A Canadian perspective

, Management and Evaluation, University of Toronto Gabrielle van der Velde, PhD Toronto Health Economics and Technology Assessment (THETA) Collaborative Reviewers: Bryna Warshawsky, MDCM, CCFP, FRCP, MHSc Public Health Ontario, and Department of Epidemiology and Biostatistics, Western University Wanrudee Isaranuwatchai, PhD St. Michael’s Hospital, Cancer Care Ontario, and the Institute of Health Policy, Management, and Evaluation University of Toronto ACKNOWLEDGEMENTS This work is based on the MSc (...) Economic Evaluations 31 1.7.5 Alternate Methods of Summarizing Data: Best-evidence Synthesis 32 iv 1.8 Rationale for this Study 33 1.8.1 Research Objectives 34 2 METHODS 35 2.1 Systematic Literature Search 35 2.1.1 Database Search Strategies 35 2.1.2 Databases Searched 35 2.1.3 Data Collection 38 2.1.4 Data Extraction and Management 38 2.1.5 Selection Criteria 40 2.1.6 Quality Appraisal 41 2.1.7 Literature Synthesis 43 2.1.8 Currency and Inflation 43 2.2 Policy Document Search 43 3 RESULTS 45 3.1

2015 SickKids Reports

138. Guidelines for the prevention of stroke in women

fibrillation (AF). Topics that are not covered in detail include management of diabetes mellitus and cholesterol, because there are no recommendations for these risk factors that are specific to women. We therefore direct readers to the most recent primary and secondary prevention guidelines for specific detailed recommendations. , Table 1. Applying Classification of Recommendation and Level of Evidence Table 2. Definition of Classes and Levels of Evidence Used in AHA/ASA Recommendations Class I Conditions (...) to Cerebral Aneurysms There has been significant debate about the potential cause of the increased risk of SAH in women. Autopsy and angiographic studies have documented a higher prevalence of cerebral aneurysms in women, as well as a higher risk of rupture. These findings are in agreement with results of a recent study from the Nationwide Inpatient Sample, which claimed that more than twice as many women as men were discharged with both ruptured and unruptured cerebral aneurysms. There is also

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2014 American Academy of Neurology

139. Pharmacologic Therapy for Pulmonary Arterial Hypertension in Adults

. We suggest continuous IV treprostinil to improve 6MWD (Grade CB) . 56-57. We suggest continuous subcutaneous treprosti- nil to improve 6MWD (Grade CB) and improve cardiopulmonary hemodynamics. For treatment naive P AH patients in WHO FC IV who are unable or do not desire to manage parenteral prostanoid therapy, we advise treatment with an inhaled prostanoid in combination with an ETRA. More specifi cally in these patients: 58-59. We suggest bosentan to improve 6MWD (Grade 2B) and cardiopulmonary (...) AH, we suggest avoiding nones- sential surgery, and when surgery is necessary we suggest care at a pulmonary hypertension center, using a multidisciplinary approach including the pulmo- nary hypertension team, the surgical service, and cardiovascular anesthesiology with careful moni- toring and management of clinical status, oxygenation and hemodynamics postoperatively (Grade CB) . I n tr od uctio n Pulmonary arterial hypertension (PAH) remains a highly morbid disease with high mortality. Despite

2014 American College of Chest Physicians

140. Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium

for thromboprophylaxis 13 Table 8. Other pharmaceutical agents 14 Table 9. Antenatal prophylaxis 15 Table 10. Prophylaxis postpartum by assessment of risk 16 Table 11. Management of LMWH, UFH and neuraxial blockade 17 Table 12. Antenatal and postnatal management of specific patient groups 18 Table 13. Preparation for discharge 19 Queensland Clinical Guideline: VTE prophylaxis in pregnancy and the puerperium Refer to online version, destroy printed copies after use Page 7 of 25 1 Introduction Pulmonary embolism (PE (...) clinicians about VTE risk assessment • Document VTE risk assessment of the pregnant woman in the health record o Develop a written plan of care to manage identified risks o Document completion of the inpatient risk assessment on the National Inpatient Medication Chart • Measure and document observations consistent with the clinical situation and at a minimum, the Australian Commission on Safety and Quality in Health Care requirements 19 • Consider use of Queensland Maternity Early Warning Tools to detect

2014 Queensland Health

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