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Postpartum Inpatient Management

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161. 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

162. 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

163. 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

164. Cardiac Arrest in Pregnancy

arrest in pregnancy. Maternal mortality is defined as the death of a woman during pregnancy and up to 42 days after delivery or termination of pregnancy, provided that the cause of death is related to or aggravated by the pregnancy or its management. Recent data from the US Nationwide Inpatient Sample suggest that cardiac arrest occurs in 1:12 000 admissions for delivery. Globally, 800 maternal deaths occur daily. , Maternal mortality trends in the United States as reported by the Centers for Disease (...) appropriate training and preparation for such events despite their rarity. This scientific statement addresses all of the important factors related to maternal arrest, including maternal physiology as it relates to resuscitation, pre-event planning of the critically ill pregnant patient, risk stratification during pregnancy, management of the unstable pregnant patient, basic life support (BLS) in pregnancy, advanced cardiovascular life support (ACLS) in pregnancy, neonatal considerations, emergency

2015 American Heart Association

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

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 stroke in the previous 3 mo Symptoms suggest SAH (...) 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 modifications over the years. These exclusion criteria were developed

2015 American Academy of Neurology

166. 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

167. Chronic Pelvic Pain

3.2.7.11 Botulinum toxin A 21 3.2.7.12 Physical treatments 21 3.2.7.13 Surgical management 21 3.2.7.14 Psychological treatment 21 3.2.8 Conclusions and recommendations: treatment of PPS 22 3.3 Bladder pain syndrome 23 3.3.1 Introduction 23 3.3.2 Pathogenesis 23 3.3.3 Epidemiology 23 3.3.4 Association with other diseases 24 3.3.5 Diagnosis 24 3.3.6 Conclusions and recommendations: assessment and diagnosis BPS 25 3.3.7 Medical treatment 25 3.3.8 Intravesical treatment 26 3.3.9 Interventional treatments (...) Clinical examination 35 4.3.1 Investigations 35 4.4 Pain associated with well-defined conditions 35 4.4.1 Dysmenorrhoea 35 4.4.2 Infection 35 4.4.3 Endometriosis and adenomyosis 36 4.4.4 Gynaecological malignancy 36 4.4.5 Injuries related to childbirth 36 4.4.6 Pain associated with pelvic organ prolapse and prolapse surgery 36 4.5 Vaginal and vulvar pain syndromes 37 4.6 Managing chronic gynaecological pain in ill-defined conditions 37 4.7 Summary 37 4.7.1 Conclusions and recommendations

2015 European Association of Urology

168. 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

169. 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

170. 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

172. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack

on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Peripheral Vascular Disease Originally published 1 May 2014 Stroke. 2014;45:2160–2236 You are viewing the most recent version of this article. Previous versions: Abstract The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage (...) ASCVD should be otherwise managed according to the ACC/AHA 2013 guidelines, which include lifestyle modification, dietary recommendations, and medication recommendations (Class I; Level of Evidence A ). 1. Revised to be consistent with the 2013 ACC/AHA cholesterol guideline Glucose disorders After a TIA or ischemic stroke, all patients should probably be screened for DM with testing of fasting plasma glucose, HbA 1c , or an oral glucose tolerance test. Choice of test and timing should be guided

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2014 American Heart Association

173. Guidelines for the Prevention of Stroke in Women

to a primary author and a secondary reviewer. In this guideline, we focus on the risk factors unique to women, such as reproductive fac- tors, and those that are more common in women, including migraine with aura, obesity, metabolic syndrome, and atrial 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 (...) as well as a higher risk of rupture. 50 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 aneu- rysms. 51 There is also a difference in the distribution of aneu- rysm locations in women versus men, and this may convey a higher hemorrhagic risk, especially with greater prevalence of aneurysms at the posterior communicating artery. 52 Other

2014 Congress of Neurological Surgeons

174. Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack (Secondary Stroke Prevention)

, will experience a transient ischemic attack (TIA). 2 Although a TIA leaves no immediate impairment, affected individuals have a Abstract—The aim of this updated guideline is to provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack. The guideline is addressed to all clinicians who manage secondary prevention for these patients. Evidence-based recommendations are provided for control of risk factors (...) . These seemingly silent infarctions are associ- ated with typical risk factors for ischemic stroke, increased risk for future ischemic stroke, and unrecognized neurological signs in the absence of symptoms. Clinicians who diagnose silent infarction routinely ask whether this diagnosis war- rants implementation of secondary prevention measures. The writing committee, therefore, identified silent infarction as an important and emerging issue in secondary stroke prevention. Although data to guide management

2014 Congress of Neurological Surgeons

175. Preparing for Clinical Emergencies in Obstetrics and Gynecology

is challenging. At a minimum, it should involve an assessment of the potential or actual risks related to the practice setting or the patient population. For example, in the outpatient setting, are medications given or procedures performed that may result in anaphylaxis, airway compromise, or hemorrhage? In the inpatient setting, unit data or risk management data may reflect common and uncommon emergency situations that have occurred. The implementation of audit programs and multidisciplinary collaboration (...) implementation of a rapid response team may involve overcoming logistic, political, institutional, social, financial, or anthropologic barriers. Leadership from senior medical and nursing personnel is crucial (11). Emergency Drills and Simulation The principle that standardized care can result in safer care applies to emergency situations as well as to routine care. Periodic drills that follow a designated protocol for the management of common emergencies, such as fetal bradycardia or postpartum hemorrhage

2014 American College of Obstetricians and Gynecologists

176. Influenza Vaccination During Pregnancy

presented. Influenza Vaccination During Pregnancy ABSTRACT: Influenza vaccination is an essential element of prepregnancy, prenatal, and postpartum care because influenza can result in serious illness, including a higher chance of progressing to pneumonia, when it occurs during the antepartum or postpartum period. In addition to hospitalization, pregnant women with influenza are at increased risk of intensive care unit admission and adverse perinatal and neonatal outcomes. The Centers for Disease (...) after exposure to egg can receive any licensed and recommended influenza vaccine that is otherwise appropriate for their age and health status. In the case of allergic symptoms more serious than hives, the vaccine should be administered in an inpatient or outpatient medical setting (including, but not necessarily limited to hospitals, clinics, health departments, and physician offices). Patients with flu-like illness should be treated with antiviral medications presumptively regardless

2014 American College of Obstetricians and Gynecologists

177. Guidelines for the Prevention of Stroke in Women: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

, such as reproductive factors, and those that are more common in women, including migraine with aura, obesity, metabolic syndrome, and atrial 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 (...) 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 a difference in the distribution of aneurysm locations in women versus men, and this may convey a higher hemorrhagic risk, especially with greater prevalence of aneurysms at the posterior communicating artery. Other studies have suggested similar trigger factors for aneurysm rupture in men and women. There is also no convincing evidence

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2014 American Heart Association

178. March 2014 supplement to the 2013 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection

8. Phasing out stavudine: progress and challenges 9. Transition to new HIV treatment regimens – issues related to procurement and supply chain management 10. Transition to 2013 WHO antiretroviral therapy regimens for children – procurement and supply chain management issues 11. Community-based delivery of antiretroviral therapy Supplementary sections to Chapter 11 – Monitoring and evaluation 12. Surveillance of the toxicity of antiretroviral drugs during pregnancy and breastfeeding 13 (...) addresses operational aspects (how to do it) along the cascade of HIV-care related services. This includes testing, antiretroviral drugs for HIV prevention, linkage and enrolment into care, retention and adherence in general HIV care and treatment, management of comorbidities, when to start antiretroviral therapy and preferred ART regimens. The 2013 guidelines also provide, for the first time, recommendations on optimal service delivery and decision-making guidance for programme managers. Since

2014 World Health Organisation HIV Guidelines

179. 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 Clinical Practice Guidelines Portal

180. Whole of government obesity prevention interventions

of Public Health, University of Sydney. January 2013 © The Sax Institute 2013 This work is copyright. It may be reproduced in whole or in part for study training purposes subject to the inclusion of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above requires written permission from the copyright owners. Enquiries regarding this report may be directed to the: Manager Knowledge Exchange Program Sax Institute (...) of evidence are less relevant in defining the relative merit of specific interventions to prevent or manage obesity. Whilst studies with controlled experimental designs have strong internal validity, they provide only one piece of the jigsaw of evidence that is available to more completely define the potential public impact of an intervention. That is why we chose to utilise a composite measure based on the quality and quantity of evidence available around its effectiveness (which we defined as the “level

2013 Sax Institute Evidence Check

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