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Postpartum Office Visit

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141. Sepsis Management

Antepartum (%) Postpartum (%) Genital tract 20.2 37.2 Urinary tract 33.6 11.7 Wound 0.0 14.3 Respiratory 9.0 3.5 Other 7.5 9.5 Unknown 29.9 23.8 Source: Severe Maternal Sepsis in the UK, 2011-2012: A National Case-Control Study Table 7 Organisms isolated in severe maternal sepsis Organism Antepartum Postpartum E. Coli 24.6 19.1 Group A Streptococcus 1.5 13.0 Group B Streptococcus 9.7 7.4 Other Streptococcus 4.5 6.5 Staphylococcus 1.5 9.1 Mixed organisms 3.7 6.1 Other 9.0 5.6 Unknown 3.7 0.4 No laboratory (...) . It is recommended that the least physiologically deranging method of achieving adequate control be used. Patients need to be carefully examined to ensure that drainable foci have been identified. Infected collections, devitalised tissue, lines and devices will act as a persistent source of sepsis until removed as antimicrobials have limited penetration. Source control is also a time-dependent phenomenon in patients with severe sepsis/septic shock with a recommendation of a 12 hour window post stabilisation

2019 National Clinical Guidelines (Ireland)

142. BTS/SIGN British Guideline on the Management of Asthma

that these equality aims are addressed in every guideline. This methodology is set out in the current version of SIGN 50, our guideline manual, which can be found at www.sign.ac.uk/sign-50.html. The EQIA assessment of the manual can be seen at www.sign.ac.uk/assets/sign50eqia.pdf. The full report in paper form and/or alternative format is available on request from the Healthcare Improvement Scotland Equality and Diversity Officer. Every care is taken to ensure that this publication is correct in every detail (...) of inhaled corticosteroids) • assess the patient’s status with a validated symptom questionnaire, ideally corroborated by lung function tests (FEV 1 at clinic visits or by domiciliary serial peak flows to capture times with/without symptoms) • with a good symptomatic and objective response to treatment, confirm the diagnosis of asthma and record the basis on which the diagnosis was made • if the response is poor or equivocal, check inhaler technique and adherence, arrange further tests and consider

2019 British Thoracic Society

143. Management of Stroke in Neonates and Children Full Text available with Trip Pro

is by age: Stroke occurring from 28 weeks’ gestation to 28 postnatal days of life is broadly classified as perinatal stroke, and stroke occurring after 28 days to 18 years of age is classified as childhood stroke. Within perinatal stroke, mode of presentation distinguishes 2 varieties. Acute perinatal stroke occurs in newborn infants at or near birth and typically presents shortly after onset with focal seizures or encephalopathy. Presumed perinatal stroke refers to chronic infarcts, diagnosed (...) centers, and pediatric tertiary care hospitals should be encouraged. Knowledge Gaps Safety and efficacy data for hyperacute stroke therapies in children are lacking. Children treated with such therapies should be enrolled in existing registries, for example, the Swiss NeuroPediatric Stroke Registry and the International Pediatric Stroke Study Registry. There is no evidence to guide how young or how small a child may safely undergo thrombectomy. Analyses directly comparing post-AIS neurological

2019 American Heart Association

144. Heart Disease and Stroke Statistics Full Text available with Trip Pro

. Circulation. 2019;139:e56–e528. doi: 10.1161/CIR.0000000000000659. The expert peer review of AHA-commissioned documents (eg, scientific statements, clinical practice guidelines, systematic reviews) is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit . Select the “Guidelines & Statements” drop-down menu, then click “Publication Development.” Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution (...) they use them, the cost of these services, and how the costs are paid NHANES—disease and risk factor prevalence and nutrition statistics NHIS—disease and risk factor prevalence NAMCS—physician office visits National Home and Hospice Care Survey—staff, services, and patients of home health and hospice agencies NHAMCS—hospital outpatient and ED visits NIS of the Agency for Healthcare Research and Quality—hospital inpatient discharges, procedures, and charges United States Renal Data System—kidney disease

2019 American Heart Association

145. What quantitative and qualitative methods have been developed to measure the implementation of a life-course approach in public health policies at the national level?

(HEN) is an information service for public health decision-makers in the WHO European Region, in action since 2003 and initiated and coordinated by the WHO Regional Office for Europe under the umbrella of the WHO European Health Information Initiative (a multipartner network coordinating all health information activities in the WHO European Region). HEN supports public health decision-makers to use the best available evidence in their own decision-making and aims to ensure links between evidence (...) The Evidence for health and well-being in context project was initiated at the WHO Regional Office for Europe in response to Members States' consideration of Health 2020, the European policy framework for health and well-being. Health 2020 includes a number of promising values- based health concepts that are difficult to measure and report on. In response to this challenge, the WHO Regional Office for Europe convened an expert group to investigate ways of enhancing Health 2020 monitoring and reporting

2019 WHO Health Evidence Network

146. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV

Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV UPDATED RECOMMENDATIONS ON FIRST-LINE AND SECOND-LINE ANTIRETROVIRAL REGIMENS AND POST-EXPOSURE PROPHYLAXIS AND RECOMMENDATIONS ON EARLY INFANT DIAGNOSIS OF HIV SUPPLEMENT TO THE 2016 CONSOLIDATED GUIDELINES ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION DECEMBER 2018 INTERIM GUIDELINES HIV TREATMENTUPDATED (...) RECOMMENDATIONS ON FIRST-LINE AND SECOND-LINE ANTIRETROVIRAL REGIMENS AND POST-EXPOSURE PROPHYLAXIS AND RECOMMENDATIONS ON EARLY INFANT DIAGNOSIS OF HIV: INTERIM GUIDELINES SUPPLEMENT TO THE 2016 CONSOLIDATED GUIDELINES ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION DECEMBER 2018WHO/CDS/HIV/18.51 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution- NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https

2019 World Health Organisation HIV Guidelines

147. Medical management of abortion

retrieval and synthesis 10 2.5 Use of the frameworks for decision-making 11 2.6 Document preparation, revision and peer review 11 3. Recommendations, rationale and evidence summary 12 3.1 Guiding principles 14 3.2 Incomplete abortion 16 3.3 Intrauterine fetal demise 20 3.4 Induced abortion 24 3.5 Post-abortion contraception 31 4. General implementation considerations 38 5. Dissemination and adaptation 44 6. Guideline impact evaluation and future updates 44 References 46 Annex 1: WHO staff and external (...) and policy guidance for health systems, second edition. Geneva: World Health Organization; 2012 (http://apps.who.int/iris/bitstream/ handle/10665/70914/9789241548434_eng.pdf).vi Executive summaryvii Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies), incomplete abortion and intrauterine fetal demise, as well as post-abortion contraception. Medical management of abortion generally involves

2019 World Health Organisation Guidelines

148. Interpregnancy Care

, with devastating consequences for women and children ( ). Screening for symptoms with a validated instrument, such as the Patient Health Questionnaire-9 or the Edinburgh Postnatal Depression Scale, is recommended by the U.S. Preventive Services Task Force ( ) and by all major medical organizations that care for women and infants (65, , ). The American Academy of Pediatrics recommends postpartum depression screening at the time of well-child visits at 1, 2, 4, and 6 months of age (67). Although screening alone (...) ( ), such as reproductive life planning, screening for depression, vaccination, managing diabetes or hypertension if needed, education about future health, assisting the patient to develop a postpartum care team, and making plans for long-term medical care (Box 1). Timing of visits should consider any changes in insurance coverage anticipated after delivery. What Are the Clinical Components of Interpregnancy Care? Breastfeeding and Maternal Health Health care providers should routinely provide anticipatory guidance

2019 American College of Obstetricians and Gynecologists

149. Ethical Considerations for the Care of Patients With Obesity

to address any identified bias to help ensure that it does not interfere with the delivery of respectful clinical care for patients with obesity. Box 1 includes questions for self-reflection to help obstetrician–gynecologists identify implicit bias. Patient-Centered Counseling to Address Obesity Obstetrician–gynecologists may find it difficult during a typical office visit to initiate a dialogue about weight, healthy diet, and lifestyle, especially when other problems must be addressed or if the patient (...) “as is” without any warranty of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented. All ACOG

2019 American College of Obstetricians and Gynecologists

150. Prepregnancy Counseling

of accuracy, reliability, or otherwise, either express or implied. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented. All ACOG committee members (...) a body mass index (BMI) in the normal range before attempting pregnancy, because abnormal high or low BMI is associated with infertility and maternal and fetal pregnancy complications. Introduction Obstetrician–gynecologists have a prime opportunity to improve maternal and fetal outcomes through prepregnancy counseling. Like a well-woman visit, the prepregnancy visit (when the patient presents to discuss a potential future pregnancy) provides an excellent opportunity to counsel patients about

2019 American College of Obstetricians and Gynecologists

151. Sharing a Sleep Surface with an Infant in the First Year of Life: A Rapid Review

guidelines lacking a description of their methodology (3) Quality assessment of relevant guidelines (4) Guidelines (4) Strong guideline (1) Appendix C: Literature Search Flowchart Adapted from: healthevidence.org Keeping Track of Search Results: A Flowchart. [Retrieved January 13, 2010] Setting not similar to Canada (2) 33 Appendix D: Data Extraction Table NICE. (2014). Addendum to Clinical Guideline 37, Postnatal Care: Routine postnatal care of women and their babies. General Information and Quality (...) reported in the included studies. Alcohol and drug use were included in the original recommendations in the Postnatal Care guideline (2006) and there was very limited evidence in this area included in the evidence review. It was considered inappropriate to exclude these factors from the updated recommendations. o Recommendation on the use of medication of drugs making one sleep more heavily was considered. No evidence had been identified in relation to co-sleeping and legal drug use. • Preterm infants

2019 Peel Health Library

152. Standard care

for non-commercial purposes, as long as you attribute Queensland Clinical Guidelines, Queensland Health and abide by the licence terms. You may not alter or adapt the work in any way. To view a copy of this licence, visit https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en For further information, contact Queensland Clinical Guidelines, RBWH Post Office, Herston Qld 4029, email Guidelines@health.qld.gov.au, phone (07) 3131 6777. For permissions beyond the scope of this licence, contact (...) or group of midwives in collaboration with medical officers where there are identifiable risk factors Private obstetric care 30,58 · Care is provided by a privately practicing obstetrician with intrapartum and postnatal care supported by hospital midwives GP obstetrician care 30,58 · Care is provided by a GP obstetrician with intrapartum and postnatal care supported by hospital midwives Shared care 30,58 · Care provided by community based obstetrician or GP and/or midwife in collaboration with hospital

2019 Queensland Health

153. Syphilis in pregnancy

purposes, as long as you attribute Queensland Clinical Guidelines, Queensland Health and abide by the licence terms. You may not alter or adapt the work in any way. To view a copy of this licence, visit https://creativecommons.org/licenses/by-nc-nd/4.0/deed.en For further information, contact Queensland Clinical Guidelines, RBWH Post Office, Herston Qld 4029, email Guidelines@health.qld.gov.au, phone (07) 3131 6777. For permissions beyond the scope of this licence, contact: Intellectual Property (...) Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Queensland Clinical Guideline: Syphilis in pregnancy Refer to online version, destroy printed copies after use Page 3 of 31 Flow Chart: Antenatal care IM: intramuscular injection, MSM: Men who have sex with men, PCR: Polymerase Chain Reaction QSSS: Queensland Syphilis Surveillance Service, STI: sexually transmitted infection, 4 weeks before birth · Indicated following risk assessment

2019 Queensland Health

154. 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza Full Text available with Trip Pro

in severe illness and death, particularly among very young children, older adults, pregnant and postpartum women within 2 weeks of delivery, people with neurologic disorders, and people with certain chronic medical conditions including chronic pulmonary, cardiac, and metabolic disease, and those who are immunocompromised [2–8]. During 2010–2018, seasonal influenza epidemics were associated with an estimated 4.3–23 million medical visits, 140 000–960 000 hospitalizations, and 12000–79 000 respiratory (...) . Hayden, Scott A. Harper, Jon Mark Hirshon, Michael G. Ison, B. Lynn Johnston, Shandra L. Knight, Allison McGeer, Laura E. Riley, Cameron R. Wolfe, Paul E. Alexander, and Andrew T. Pavia For full document, including tables and references, please visit the . Abstract These clinical practice guidelines are an update of the guidelines published by the Infectious Diseases Society of America (IDSA) in 2009, prior to the 2009 H1N1 influenza pandemic. This document addresses new information regarding

2019 Infectious Diseases Society of America

155. Neonatal seizures

. In essence, you are free to copy and communicate the work in its current form for non-commercial purposes, as long as you attribute Queensland Clinical Guidelines, Queensland Health and abide by the licence terms. You may not alter or adapt the work in any way. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en For further information, contact Queensland Clinical Guidelines, RBWH Post Office, Herston Qld 4029, email Guidelines@health.qld.gov.au, phone (07 (...) ) 3131 6777. For permissions beyond the scope of this licence, contact: Intellectual Property Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Queensland Clinical Guideline: Neonatal seizures Refer to online version, destroy printed copies after use Page 3 of 32 Flow Chart: Assessment and management Baby with suspected seizure activity Observe and monitor: • Seizure activity • Temperature, heart rate, respiratory rate & effort, BP, O

2019 Queensland Health

156. Intrapartum fetal surveillance

. In essence, you are free to copy and communicate the work in its current form for non-commercial purposes, as long as you attribute Queensland Clinical Guidelines, Queensland Health and abide by the licence terms. You may not alter or adapt the work in any way. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/3.0/au/deed.en For further information contact Queensland Clinical Guidelines, RBWH Post Office, Herston Qld 4029, email Guidelines@health.qld.gov.au, phone (07 (...) ) 3131 6777. For permissions beyond the scope of this licence contact: Intellectual Property Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Queensland Clinical Guideline: Intrapartum fetal surveillance Refer to online version, destroy printed copies after use Page 3 of 30 Flow Chart: Mode of fetal heart rate monitoring Abbreviations: APH Antepartum Haemorrhage; BMI Body Mass Index; CTG Cardiotocograph; FBS Fetal blood sample; FGR

2019 Queensland Health

157. Standards for Studies of Neurological Prognostication in Comatose Survivors of Cardiac Arrest: A Scientific Statement From the American Heart Association

; To provide insights into the clinical elements currently used in neurological prognostication studies of comatose adult and pediatric survivors of cardiac arrest to improve their relevance to clinical practice; and To provide suggestions to improve the scientific quality of neurological prognostication studies in comatose adult and pediatric survivors of cardiac arrest. Why Is Neurological Prognostication Important? Determining prognosis after successful resuscitation is a central component of post (...) As the brain is subjected to global hypoxia/ischemia with cardiac arrest, the injury pattern manifested is not homogeneous and is determined by the selectively vulnerable neuron subpopulations. The clinical spectrum of post–cardiac arrest neurological disorders correlates well with the selective vulnerability of the cortex, arousal systems, thalamus, cerebellum, and brainstem to global hypoxia/ischemia. During the immediate postresuscitation period, coma and varying manifestations of disorders

2019 American Heart Association

158. Practice Advisory: Management of Pregnant and Reproductive-Aged Women during a Measles Outbreak

, infants under 12 months of age, and immunocompromised individuals at increased risk. During prenatal visits, discuss the importance of vaccination, especially measles, with your patients and encourage them to vaccinate their children. Most women start the decision-making process about vaccinations for their children before or during pregnancy. This is especially important for first-time parents who tend to be more vaccine hesitant 10 . A randomized control trial showed that prenatal or postnatal (...) manner, and measles exposure is suspected in a non-immune pregnant woman, the patient should receive measles immunoglobulin (IGIV). While most women have immunity to measles due to prior MMR vaccination, given risks associated with measles in pregnancy, possible infection or exposure to measles should be carefully and expediently investigated 2 . Obstetrician-gynecologists should follow local health department guidance for testing (see algorithm in reference 7 ). Postpartum MMR vaccine should

2019 American College of Obstetricians and Gynecologists

159. Child Abuse, Elder Abuse, and Intimate Partner Violence

of reporting. Some injured children are unable to provide a history due to age, development, and/or fear. In a multivariate analysis of the stated reason for the visit, one of the best predictors of child physical abuse was injury inconsistent with the history, such as a vague or minor explanation for a significant injury (e.g., bumped head on car seat when a large hematoma is seen). Another good predictor is the patient was referred to the clinician for suspected child abuse. 6 Other overall impressions

2019 American College of Surgeons

160. Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

of patients with PE will develop persistent symptoms, including chest pain and dyspnea, functional limitation, and exercise intolerance, which some have called the post-PE syndrome. Several observational analyses and subanalyses of randomized trials have demonstrated elevated PA pressures (PAPs) among patients with PE treated with anticoagulation at 6 to 28 months of follow-up. , In a prospective observational study of 254 patients with PE, 29% had residual perfusion defects on a lung scan after a median (...) that include dyspnea on exertion and functional limitation after an incident PE. Similarly, a minority of patients demonstrate persistent clinical signs of their incident PE months to years after diagnosis, including persistent lung perfusion defects and abnormal echocardiographic findings without frank pulmonary hypertension. It is uncertain whether systemic thrombolysis or interventional approaches to acute PE are associated with a decreased incidence of the post-PE syndrome. The relative contributions

2019 American Heart Association

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