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Preoperative Guidelines for Medications Prior to Surgery

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181. Canadian stroke best practice recommendations: acute inpatient stroke care guidelines, update 2015

of these patients have pre-existing stroke risk factors including hypertension, diabetes, cardiac dis- ease and dyslipidemia. 16 These in-hospital strokes often occur following cardiac and orthopedic proced- ures, usually within seven days of surgery. These?ndingsonin-hospitalacutestrokeemphasize the need for all healthcare providers to be educated in symptom recognition, using guidelines and tools such astheHeartandStrokeFoundationofCanada’sFAST (Face, Arm, Speech, Time) approach. 17 Also, protocols for rapid (...) , including rehabilitation professionals; ? Access to 24/7 brain and neurovascular imaging and interventional neuroradiology expertise; ? Emergent neurovascular surgery access; ? Protocols in place for hyperacute and acute stroke management, and seamless transitions between stages of care (including pre-hospital, Emergency Department and inpatient care); ? Dysphagia screening protocols in place to assess all stroke patients without prolonged time delays prior to commencing oral nutrition and oral

2015 CPG Infobase

182. SIGN 50: A guideline developers' handbook

changes to published guidelines are agreed by GPAG rather than SIGN Council and slotted into the programme according to current capacity and workload. GPAG considers small change requests on a rolling basis and guidelines will be ‘refreshed’ if a proposal meets the following criteria: y new evidence substantially changes a small number of recommendations in the guideline (corresponding to no more than two related key questions) OR y a specific issue such as a new drug therapy or national issue (...) will be ‘refreshed’ if a proposal meets the following criteria: y new evidence substantially changes a small number of recommendations in the guideline (corresponding to no more than two related key questions) OR y a specific issue such as a new drug therapy or national issue such as a new government policy will give rise to a new key question AND y the nature of the update may not warrant assembling a multidisciplinary group. To allow SIGN to be reactive to the needs of healthcare professionals in NHSScotland

2015 SIGN

183. The Impact of Early Surgery and Maintenance of Antiplatelet Therapy on Intraoperative Bleeding and Major Adverse Cardiovascular Event After Percutaneous Coronary Intervention

Syndrome Drug-eluting Stent Aspirin Procedure: Non-cardiac surgery Detailed Description: Recent guidelines of the ACC/AHA suggest that elective non-cardiac surgery (NCS) should optimally be delayed one year after percutaneous coronary intervention (PCI) with drug-eluting stent (DES). Regarding the antiplatelet agents, dual antiplatelet therapy, or at least aspirin is recommended to be continued considering the relative risk of bleeding and stent thrombosis especially during the first 4 to 6 weeks after (...) PCI to surgery and durations of antiplatelet agent administration prior to surgery. To achieve this aim, we undertook a retrospective cohort study of the patients who underwent noncardiac surgery after PCI with DES. Study Design Go to Layout table for study information Study Type : Observational Actual Enrollment : 1582 participants Observational Model: Cohort Time Perspective: Retrospective Official Title: The Impact of Early Surgery and Maintenance of Antiplatelet Therapy on Intraoperative

2016 Clinical Trials

184. Gynaecologic Surgery in the Obese Patient

of obesity on gynaecologic surgery; and preoperative, intraoperative, and postoperative interventions to reduce risk. Evidence For this guideline, relevant studies were searched in the PubMed, EMBASE, Medline, and Cochrane databases. MeSH search terms included Gynecology, Obesity, Obesity/morbid, Overweight, Body mass index, Surgery, Laparoscopy, Laparotomy, Anesthesia, Intraoperative complications, Postoperative complications, Morbidity, and Mortality. Validation methods The content and recommendations (...) or wean smoking prior to gynaecologic surgery (strong, very low). 6 Surgical teams should identify patients with potential airway concerns (e.g. enlarged neck circumference) and consider referral to Anaesthesia for preoperative assessment (strong, very low). 7 Surgical teams should consider screening obese patients for obstructive sleep apnea (e.g., the STOP-BANG questionnaire) and make appropriate preoperative referral for those who screen positive (e.g., ≥5) (strong, very low). 8 Wherever possible

2019 Society of Obstetricians and Gynaecologists of Canada

185. Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) Reporting Standards for Type B Aortic Dissections

the International Registry of Acute Aortic Dissection (IRAD), 1,2 patients with acute type B dissection composed approximately 33% of all dissection patients enrolled in the registry across a 17- year period. Management of acute type B dissection has evolved over time and now includes medical, surgical, and endovascular therapies performed by several spe- cialties, including vascular surgery, cardiothoracic sur- gery, interventional radiology, and cardiology. With the recent blanket U.S. Food and Drug Adminis (...) ; Division of Vascular Surgery and Endovascular Therapy, University of Alabama at Birmingham, Birmingham, Alabama; Division of Vascular and Endovascular Surgery, St. Elizabeth's Medical Center, Brighton, Massachusetts; Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center at Houston, Houston, Texas; Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Cardiac Surgery, University of Michigan, Ann Arbor

2020 Society of Thoracic Surgeons

186. Morcellation During Gynaecologic Surgery: Its Uses, Complications, and Risks of Unsuspected Malignancy

the spread of malignant tissue (II-3). Recommendations 1 Each patient presenting with uterine leiomyoma should be assessed for the possible presence of malignancy, based on her risk factors and preoperative imaging, although the predictive value of preoperative assessment is limited (III-C). 2 If there is a high index of suspicion of a uterine sarcoma prior to surgery, attempts should be made to remove the uterus intact. Myomectomy in perimenopausal and postmenopausal women should be discouraged (III-C (...) morcellation in gynaecologic surgery. Outcomes Morcellation may be used in gynaecologic surgery to allow removal of large uterine specimens, thus providing women with a minimally invasive surgical option. Adverse oncologic outcomes of tissue morcellation should be mitigated through improved patient selection, preoperative investigations, and novel techniques that minimize tissue dispersion. Evidence Published literature was retrieved through searches of PubMed and Medline in the spring of 2014 using

2019 Society of Obstetricians and Gynaecologists of Canada

187. 2014 ESC Management of Antithrombotic Therapy in Atrial Fibrillation Patients Presenting With Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary or Valve Interventions

oral anticoagulants (NOACs, previously referred to as new or novel OACs 3 )for patients with AF and=1 stroke risk factor(s). Also, these guidelines strongly advocate a clinical practice shift so that the initial decision step now is the identi?cation of ‘truly low risk’ patients, essentially those aged,65 years without any stroke risk factor (both male and female), who do not need any antithrombotic therapy. 2 The ESC guidelines also recommend the use of the CHA 2 DS 2 -VASc score 4 for stroke risk (...) + antiplatelet therapy was increased. Thus, even when the high risk of bleeding with recom- mended triple therapy after MI or PCI in AF patients decreases over time, the risk remains elevated in comparison with less intense antithrombotic regimens. 29,54 Nonetheless, many unanswered questions remain resulting from the limitations of these types of registries, such as changes in the antithrombotic regimen over time, unknown duration of each type of antithrombotic drug, and unknown INR control (for those

2014 Heart Rhythm Society

188. HRS/ACC/AHA Expert Consensus Statement on the Use of Implantable Cardioverter-Defibrillator Therapy in Patients Who Are Not Included or Not Well Represented in Clinical Trials Full Text available with Trip Pro

guidelines that provide indications for ICD therapy. However, recommendations made in this document cannot account for all the nuances of clinical medicine and cannot replace careful clinical judgment for the care of an individual patient. This document is not meant to be a comprehensive guideline on a specific clinical subject. Recommendations are not given a Class recommendation; instead, phrases such as “is recommended,” “can be useful,” “can be considered,” and “is not recommended” are used (...) Capabilities “Secondary Prevention” “Primary Prevention” 2006 ACC/AHA/ESC Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death ICD therapy is recommended for secondary prevention of SCD in patients who survived VF or hemodynamically unstable VT, or VT with syncope and who have an LVEF ≤40%, who are receiving chronic optimal medical therapy, and who have a reasonable expectation of survival with good functional status for more than 1 year. An ICD

2014 American Heart Association

189. Early-Stage and Locally Advanced (non-metastatic) Non-Small-Cell Lung Cancer: ESMO Clinical Practice Guidelines

, predicted postoperative; VO 2 , oxygen consumption. Reprinted from [50], with permission from the European Respiratory Society. Annals of Oncology Clinical Practice Guidelines Volume 28 | Supplement 4 | August 2017 doi:10.1093/annonc/mdx222 | iv7optimise a patient’s condition prior to surgery is bene?cial, espe- cially for those with a poor preoperative condition [54]. Recommendations: • In non-metastatic NSCLC, the cardiopulmonary ?tness ofthe patient will determine the choice of treatment [III (...) with ongoing cardiac care Institute any needed new medical interventions (i.e. beta-blockers, anticoagulants or statins) Cardiac consulation with non-invasive cardiac testing treatments as per AHA/ACC guidelines No History Physical examination Baseline ECG Calculate RCRI *RCRI weighted factors [138]: ? High risk surgery (including lobectomy or pneumonectomy) ? Ischaemic heart disease (prior myocardial infarction, angina pectoris) ? Heart failure ? Insulin-dependent diabetes ? Previous stroke or TIA

2017 European Society for Medical Oncology

190. American Academy of Sleep Medicine Position Paper for the Use of a Home Sleep Apnea Test for the Diagnosis of OSA in Children

management. Certain pediatric populations are also at higher risk for residual OSA after surgery, including those with severe preoperative OSA. Lastly, untreated OSA in children is associated with significant medical, developmental, and psychosocial complications so accurate diagnostic testing is important for this population. – The gold standard for diagnosis of OSA in children is PSG. Diagnosis of OSA in children is based, in part, on the apneahypopnea index (AHI) identified by PSG that indicates (...) , Colorado; 5 Children's Hospital of Orange County, Orange, California; 6 University of Michigan Medical Center, Ann Arbor, Michigan; 7 University of Michigan, Ann Arbor, Michigan; 8 Seattle Children's Hospital, Seattle, Washington; 9 American Academy of Sleep Medicine, Darien, Illinois; 10 Saint Louis University, St. Louis, Missouri ABSTRACT Introduction: The purpose of this position paper is to establish the American Academy of Sleep Medicine's (AASM) position on the use of a home sleep apnea test

2017 American Academy of Sleep Medicine

191. Guideline for the perioperative management of people with inherited salt-wasting alkaloses (Gitelman?s syndrome and Bartter?s syndrome) undergoing non-urgent surgical procedures

full discussion of the risks and benefits, with the option of carefully monitored intravenous electrolyte replacement peri-operatively. 6. Recognising the morbidity and mortality associated with the rapid correction of electrolyte abnormalities, we suggest that pre-operative administration of intravenous potassium and magnesium should be avoided for patients undergoing elective or expedited surgery. 7. We recommend that clinical practice guidelines on the need for fasting prior to surgery (...) suggest that the use of invasive arterial monitoring for serial peri-operative blood sampling is considered in the most complex cases. *Key national guidance documents ? The NCEPOD classification of intervention (NCEPOD, 2004) ? The use of routine preoperative tests for elective surgery (National Institute of Health and Clinical Excellence, 2003) ? ACC/AHA Guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery (Circulation, 2014) ? ESC/ESA

2015 Royal College of Anaesthetists

192. Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis Full Text available with Trip Pro

mobile search navigation Article navigation 21 November 2015 Article Contents Article Navigation 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC) Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM) Gilbert Habib (Chairperson) (France) Corresponding authors: Gilbert Habib, Service de Cardiologie, C.H.U. De La (...) , a focus on healthcare-associated IE and identification of the optimal timing for surgery. However, several reasons justify the decision of the ESC to update the previous guidelines: the publication of new large series of IE, including the first randomized study regarding surgical therapy; important improvements in imaging procedures, particularly in the field of nuclear imaging; and discrepancies between previous guidelines. In addition, the need for a collaborative approach involving primary care

2015 European Society of Cardiology

193. 2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non?ST-Elevation Myocardial Infarction (Updating the 2007 Guideline and Replacing the 2011 Focused Update) Full Text available with Trip Pro

that increase the risk of bleeding (eg, warfarin, heparin, fibrinolytic therapy, or chronic use of nonsteroidal anti-inflammatory drugs). † The recommended maintenance dose of aspirin to be used with ticagrelor is 81 mg daily. Ticagrelor's benefits were observed irrespective of prior therapy with clopidogrel. When possible, discontinue ticagrelor at least 5 days before any surgery. Issues of patient compliance may be especially important. Consideration should be given to the potential and as yet (...) in high-risk situations (patients with diabetes or a history of prior MI), in which its effect appears to be greater and its use may be considered. Do not start prasugrel in patients likely to undergo urgent CABG. When possible, discontinue prasugrel at least 7 d before any surgery. Additional risk factors for bleeding include body weight <60 kg, propensity to bleed, and concomitant use of medications that increase the risk of bleeding (eg, warfarin, heparin, fibrinolytic therapy, or chronic use

2012 American Heart Association

194. Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness

investigator or researcher: Laurence Claes (KU Leuven and UAntwerp), Torsten Olbers (Active researcher in the area. PI for Nationwide program in Sweden in adolescent bariatric surgery, PI for RCT Sleeve vs Gastric bypass), Caroline Rudisill (Part of a Delphi process to reach consensus statements as part of 4 th World Congress on Interventional Therapies for Type 2 Diabetes. Previously was a co-investigator on National Institutes of Health Research health Services and Research Delivery programme (NIHR HS (...) on Interventional Therapies for Type 2 Diabetes in April 2019 where travel and hotel are paid and I will be giving a talk on Value for Money of Bariatric/Metabolic Surgery for Type 2 Diabetes: The International Evidence), Luc Van Gaal (Presentations about obesitas in general / especially pharmacotherapy), Inge Van Pottelbergh (Speaker scientific meeting GPs NOVO, speakers fee MSD. ASTRA-AMGEN J&J Sanofi – BMS) Presidency or accountable function within an institution, association, department or other entity

2019 Belgian Health Care Knowledge Centre

195. Surgery

Table of Contents Search this document Portable Compression to Prevent Venous Thromboembolism After Hip and Knee Surgery : The ActiveCare System March (...) 2016 Summary Venous thromboembolism (VTE) (clots that form in a vein) is a common, but largely preventable, complication after orthopedic surgery . Preventive drug therapy (with anticoagulants or antiplatelets) is usually administered to lower the risk of VTE after orthopedic surgery . While the risk of major bleeding in orthopedic surgery (...) is fairly low, this risk is increased by the use of preventive drug therapies. Portable compression systems may be used in addition to, or as an alternative 2016 9. Variations in diabetes remission rates after bariatric surgery in Spanish adults according to the use of different diagnostic criteria for diabetes. BACKGROUND: There are multiple criteria to define remission of type 2 diabetes (DM2) after bariatric surgery but there is not a specific one widely accepted. Our objectives were to compare

2018 Trip Latest and Greatest

196. Medical Comorbidities Are Independent Preoperative Risk Factors for Surgical Infection After Total Joint Arthroplasty. Full Text available with Trip Pro

Medical Comorbidities Are Independent Preoperative Risk Factors for Surgical Infection After Total Joint Arthroplasty. Surgical site infection (SSI) after total joint arthroplasty (TJA) is a major cause of morbidity. Multiple patient comorbidities have been identified as SSI risk factors including obesity, tobacco use, diabetes, immunosuppression, malnutrition, and coagulopathy. However, the independent effect of multiple individual patient factors on risk of subsequent periprosthetic infection (...) is unclear.The purposes of this study are (1) to collect data on several preestablished infection risk factors in addition to SSI-related data on a large TJA cohort; and (2) to use multivariate modeling on previously established patient risk factors to determine independent preoperative predictors of SSI.We reviewed records of patients undergoing TJA from January 1, 2010, to July 30, 2012. Confirmation of SSI followed published guidelines for superficial, deep, and periprosthetic. A total of 29 culture

2013 Clinical Orthopaedics and Related Research

197. CUA guideline: Vasectomy

and document adequate information and counsel- ling to patients may lead to litigation. The focus of this guideline is the management of men presenting for vasectomy. Specifically, the topics covered include: preoperative counselling, vasectomy efficacy and complications, technical aspects of vasectomy, post-vasec- tomy semen testing, and interpretation-communication of post-vasectomy semen results. By performing an extensive literature review, we have generated an evidence-based con- sensus (...) on the management of these men. The objective of this guideline is to help standardize the treatment of men presenting for vasectomy. 1. Preoperative counselling The procedure should be described during the initial con- sultation. Men must be informed about wound care and the potential for early complications: infection (0.2?1.5%), bleeding or hematoma (4?20%), and primary surgical fail- ure (0.2?5%). 1-5 Men should also be made aware of late complications: chronic scrotal pain (1?14%) and delayed vasectomy

2016 Canadian Urological Association

198. CCS/CHRS 2016 Implantable Cardioverter-Defibrillator (ICD) Guidelines Full Text available with Trip Pro

Published online: October 06, 2016 Accepted: September 26, 2016 ; Received: September 11, 2016 ; | ---- Figure 1 Aid in decision-making for primary prevention ICD. ICD, implantable cardioverter defibrillator; LVEF, left ventricular ejection fraction; MI, myocardial infarction; OMT, optimal medical therapy. ---- | ---- Figure 2 Aid in decision-making for secondary prevention ICD. ICD, implantable cardioverter defibrillator; MI, myocardial infarction; VF, ventricular fibrillation; VT, ventricular (...) implantation on the basis of comorbidities; (3) ICD implantation in patients listed for heart transplantation; (4) implantation of a single- vs dual-chamber ICD; (5) implantation of single- vs dual-coil ICD leads; (6) the role of subcutaneous ICDs; and (7) ICD implantation infection prevention strategies. We expect that this document, in combination with the companion article that addresses the implementation of these guidelines, will assist all medical professionals with the care of patients who have had

2016 Canadian Cardiovascular Society

199. 2016 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation Full Text available with Trip Pro

presentations of coronary artery disease; (2) real-life data with non-vitamin K antagonist oral anticoagulants; (3) the use of antidotes for the reversal of non-vitamin K antagonist oral anticoagulants; (4) digoxin as a rate control agent; (5) perioperative anticoagulation management; and (6) AF surgical therapy including the prevention and treatment of AF after cardiac surgery. The recommendations were developed with the same methodology used for the initial 2010 guidelines and the 2012 and 2014 Focused (...) effective doses of NOACs; and delaying nonurgent catheterization until there is clarity about coagulation status and renal function. If the risk of restenosis is relatively low, the option of a bare metal stent (BMS) rather than a second-generation drug-eluting stent (DES) should be considered. Concomitant AF and stable CAD The current CCS AF guidelines recommendations for patients with AF who are at low risk of SSE (age < 65 years, CHADS 2 score of 0) are no antithrombotic therapy

2016 Canadian Cardiovascular Society

200. Robot-assisted surgery in thoracic and visceral indications

IN THORACIC AND VISCERAL INDICATIONS Project ID: OTCA14 Robot-assisted surgery for thoracic and visceral surgery Version 1.4, 06.05.2019 EUnetHTA Joint Action 3 WP4 2 DOCUMENT HISTORY AND CONTRIBUTORS Version Date Description V1.0 31.01.19 First draft. V1.1 27.02.19 Input from co-author has been processed. V1.2 29.03.19 Input from dedicated reviewers has been processed. V1.3 30.04.19 Input from external experts and manufacturer(s) has been processed. V1.4 06.05.19 Input from medical editing has been (...) surgery Version 1.4, 06.05.2019 EUnetHTA Joint Action 3 WP4 5 APPENDIX 1: METHODS AND DESCRIPTION OF THE EVIDENCE USED 96 DESCRIPTION OF THE EVIDENCE USED 96 Guidelines for diagnosis and management 96 Evidence tables of individual studies included for clinical effectiveness and safety 97 Applicability tables 152 DOCUMENTATION OF THE SEARCH STRATEGIES 155 APPENDIX 2 : LIST OF ONGOING AND PLANNED STUDIES 172 List of ongoing and planned studies 172 APPENDIX 3: CHECKLIST FOR POTENTIAL ETHICAL

2019 EUnetHTA

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