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101. Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes: A Population-Based Cohort Study Assessing Sex Disparities. (Full text)

Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes: A Population-Based Cohort Study Assessing Sex Disparities. With recent changes in UK clinical practice for diabetes care, contemporary estimates of sex disparities in cardiovascular risk and risk factor management are needed.In this retrospective cohort study, using the Clinical Practice Research Datalink linked to hospital and death records for people in England, we identified 79,985 patients with incident T2DM between 2006 (...) -2013 matched to 386,547 patients without diabetes. Sex-stratified Cox models were used to assess cardiovascular risk.Compared to women without T2DM, women with T2DM had a higher cardiovascular event risk (adjusted HR 1.20 [95% CI 1.12-1.28]) with similar corresponding data in men (HR 1.12 [1.06-1.19]) leading to a non-significant higher relative risk in women (risk ratio 1.07 [0.98-1.17]). However, some important sex differences in the management of risk factors were observed. Compared to men

2019 Circulation PubMed abstract

102. Do risk assessment tools help manage and reduce risk of violence and reoffending? A systematic review. (Full text)

Do risk assessment tools help manage and reduce risk of violence and reoffending? A systematic review. Although it is widely believed that risk assessment tools can help manage risk of violence and offending, it is unclear what evidence exists to support this view. As such, we conducted a systematic review and narrative synthesis. To identify studies, we searched 13 databases, reviewed reference lists, and contacted experts. Through this review, we identified 73 published and unpublished (...) studies (N = 31,551 psychiatric patients and offenders, N = 10,002 professionals) that examined either professionals' risk management efforts following the use of a tool, or rates of violence or offending following the implementation of a tool. These studies included a variety of populations (e.g., adults, adolescents), tools, and study designs. The primary findings were as follows: (a) despite some promising findings, professionals do not consistently adhere to tools or apply them to guide their risk

2019 Law and human behavior PubMed abstract

103. Reducing the Risk of Preterm Birth by Ambulatory Risk Factor Management. (Full text)

Reducing the Risk of Preterm Birth by Ambulatory Risk Factor Management. The preterm birth rate in Germany has remained unchanged at 8-9% since 2009. Preterm birth is the most common cause of neonatal morbidity and mortality. In the absence of a causal treatment, it is important to lower the risk of preterm birth by preventive measures in prenatal outpatient care.This review is based on pertinent publications from the years 2000-2019 that were retrieved by a selective search in PubMed.The (...) clinical risk factors for preterm birth-known mainly from retrospective cohort studies-include previous preterm birth (adjusted odds ratio [aOR]: 3.6), multiple pregnancy (relative risk [RR]: 7.7), nicotine consumption (aOR: 1.7), and a short uterine cervix, i.e., <25 mm in the second trimester (aOR: 6.9). In women with a short cervix, vaginally administered progesterone significantly lowers the preterm birth rate (22.5% vs. 14.1% for birth before 33 weeks of gestation, RR: 0.62; 95% confidence

2019 Deutsches Arzteblatt international PubMed abstract

104. Valproate medicines and serious harms in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme (Full text)

Valproate medicines and serious harms in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme Valproate medicines and serious harms in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Valproate medicines and serious harms (...) in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme Ongoing patient survey data suggest that more effort is needed by clinicians to achieve full and timely compliance with the valproate Pregnancy Prevention Programme and meet the goal to rapidly reduce and eventually eliminate the harms of valproate in pregnancy in view of its serious teratogenicity. We have updated the Annual Risk Acknowledgement

2019 MHRA Drug Safety Update PubMed abstract

105. For the management of Gout in UK Primary Care: is nurse-led management more effective than GP-led management?

For the management of Gout in UK Primary Care: is nurse-led management more effective than GP-led management? Getting Evidence in Clinical Practice: General Practice Nurse Evidence Based Practice (CAT group) Date: Nov 2018 CAT Lead: Andrew Finney, Rachel Viggars and Charlotte Harper Date: CAT completed: Nov 2018 Email: a.finney@keele.ac.uk Date: CAT to be reviewed: Nov 2021 Clinical bottom line Nurse-led gout care has been shown to be efficacious and cost-effective when compared with usual care (...) (GP-led). The findings of the key literature illustrate the benefits of educating and engaging patients in gout management and reaffirm the importance of a treat-to-target urate-lowering treatment strategy to improve patient- centred outcomes. Why is this important? People commonly think of gout as a ‘rich man’s disease’ caused by dietary excess and overconsumption of alcohol, evoking images of people like King Henry VIII (Richardson et al, 2016). This negative perception of the condition

2018 Home Modification Information Clearinghouse

106. Barbituates in the Management of Alcohol Withdrawal Syndrome

in Nashville, Tennessee ( ), the other in the ED of Denver Health Medical Center ( ). In the former study, use of a phenobarbital protocol for management of alcohol withdrawal was associated with a decrease in mean ICU length of stay of 2 days (95% CI -3.0 to -0.9 days) and decreased need for mechanical ventilation (relative risk of 0.07, 95% CI 0.01 to 0.53). In the latter study, phenobarbital had no effect on ICU admission rates (the primary outcome, but use of phenobarbital alone resulted (...) Barbituates in the Management of Alcohol Withdrawal Syndrome Barbituates in the Management of Alcohol Withdrawal Syndrome | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Our Team Sections Education Alumni Research ECRC Journal Club Events Jermyn Lectures Open Search Vignette You’re slogging through another morning shift in the Behavioral Health pod. Your overnight colleague signed you out a rock garden, including a patient

2020 Washington University Emergency Medicine Journal Club

107. Locoregional Management of In-Transit Metastasis in Melanoma

and provides the guideline recommendations only. For key evidence associated with each recommendation, see Section 2. GUIDELINE OBJECTIVES To provide guidance on appropriate management of satellite and in-transit metastases from melanoma. TARGET POPULATION These recommendations apply to adult patients diagnosed with satellite lesions or in- transit metastases (ITM) from melanoma with or without lymph node metastases. Patients with regional lymph node or distant metastasis were not included. INTENDED USERS (...) /moderate/maximal) of ITM. As such, while balancing adverse effects, local availability, and patient preference, systemic therapy should always be an option. Guideline 8-10 Section 2: Guideline Recommendations – February 18, 2020 Page 5 Locoregional Management of In-Transit Metastasis in Melanoma Section 2: Guideline – Recommendations and Key Evidence GUIDELINE OBJECTIVES To provide guidance on appropriate management of satellite and in-transit metastases from melanoma. TARGET POPULATION

2020 Cancer Care Ontario

108. Classification and Management of Endometrial Hyperplasia

to epidemiologic risk factors related to estrogen exposure, intermenstrual bleeding and postmenopausal bleeding are associated with increased risk of endometrial hyperplasia. Endometrial sampling should be carried out as per published algorithms with particular attention to women 40 years or older or with a body mass index of 30 kg/m 2 or greater (moderate). 2 Since the majority of cases of endometrial hyperplasia without atypia are successfully managed medically, hysterectomy is not considered first-line (...) Classification and Management of Endometrial Hyperplasia Guideline No. 390-Classification and Management of Endometrial Hyperplasia - Journal of Obstetrics and Gynaecology Canada Email/Username: Password: Remember me Search Terms Search within Search Volume 41, Issue 12, Pages 1789–1800 Guideline No. 390-Classification and Management of Endometrial Hyperplasia x Marie-Hélène Auclair , MDCM Montréal QC x Paul J. Yong , MD Vancouver, BC x Shannon Salvador , MD Montreal, QC x Jackie Thurston , MD

2020 Society of Obstetricians and Gynaecologists of Canada

109. Nerve Blocks for Management of Pain Following Hip Fracture

, internal medicine, geriatrics, anesthesia, and orthopedic surgery. These co-management models significantly reduce hospital length of stay, surgical delays, complication rates, and mortality ( , , ). Two of the complications reduced by this model are oligoanalgesia and delirium. Older Adult Oligoanalgesia – A Risk for Delirium Approximately 10% of patients over age 65 experience delirium during an episode of emergency department care. Pre-operative cognitive impairment and inadequate analgesia are both (...) Nerve Blocks for Management of Pain Following Hip Fracture Nerve Blocks for Management of Pain Following Hip Fracture | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Our Team Sections Education Alumni Research ECRC Journal Club Events Jermyn Lectures Open Search Vignette You’re moonlighting in an austere emergency department, and the night has been relatively benign except for your poor 79-year-old severely demented patient who

2020 Washington University Emergency Medicine Journal Club

110. Biopsy bleeding management

: Gel foam n=11 Coil n=1 N/A ? Control of bleeding ? Renal function *N = patients unless otherwise specified. Tx = transplanted kidney ______________________________________________________________________________________________________________________________________________________________________ Renal Biopsy – Bleeding management July-2018 Page 11 of 18 Table 2. Risk of bias- Other studies Study ID N Study type Quality Comments Ishikawa et al (2009)(13) 317 Retrospective observational Very low (...) Biopsy bleeding management ________________________________________________________________________________________________________________________ Renal Biopsy – Bleeding management July-2018 Page 1 of 18 8. BIOPSY BLEEDING MANAGEMENT Date written: April 2018 Author: David Voss, Solomon Menahem, Karine Manera, Paul Champion de Crespigny, Talia Gutman, Pamela Lopez-Vargas, John Saunders, Emily See, Jeffrey Wong, Rob MacGinley GUIDELINES a. We suggest that moderate to severe bleeding, indicated

2020 KHA-CARI Guidelines

111. Tuberculosis among First Nations, Inuit and Métis children and youth in Canada: Beyond medical management

Tuberculosis among First Nations, Inuit and Métis children and youth in Canada: Beyond medical management First Nations, Inuit and Métis people in Canada continue to be disproportionately affected by tuberculosis (TB), a disparity rooted primarily in factors such as poverty, crowded and inadequate housing, food insecurity, and inequitable health care access. Historical TB control practices in Canada have contributed to stigma and discrimination toward those with the disease, as well (...) , improve the quality and uptake of services for treatment and prevention in families and communities at risk. They can also advocate for sustainable, community-driven TB elimination strategies that incorporate First Nations, Inuit and Métis principles of wellness, healing and self-determination.   Key words: First Nations, Inuit, Métis, Indigenous, child health, tuberculosis, LTBI, social determinants

2020 Canadian Paediatric Society

112. Are healthy weight management interventions effective before, during and after pregnancy?

and phone call) can help pregnant women control GWG by providing guidance, reminders and educational materials (52). What is the evidence for effective healthy weight management interventions before, during and after pregnancy? KLS Evidence Briefing 2 nd October 2019 Preconception care A Cochrane review in 2015 found no randomised controlled trials that evaluated the effectiveness of preconception health programs and interventions for improving pregnancy outcomes for women who are overweight or obese (...) interventions before, during and after pregnancy? KLS Evidence Briefing 2 nd October 2019 References 1. Denison F, Aedla N, Keag O, Hor K, Reynolds R, Milne A, et al. 2018. Care of Women with Obesity in Pregnancy. Green-top Guideline No. 72. [Available: https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.15386]. 2. National Institute for Health and Care Excellence (NICE) 2010. Weight management before, during and after pregnancy : guidance (PH27). [Available: https://www.nice.org.uk/guidance

2020 Public Health England - Evidence Briefings

113. Managing diabetes during the COVID-19 pandemic

PWD best self-manage their condition in the context of the COVID-19 pandemic? How can routine care of PWD be managed given the disruption in healthcare and other services? What is the evidence on the management of PWD presenting with COVID-19? CURRENT EVIDENCE Reducing the risk of COVID-19 in PWD PWD are advised to follow general guidance on risk reduction, including social distancing and hand washing. There is little advice specific to PWD. A (not systematic) emphasises the importance of good (...) : routine appointments where diabetes is stable and well-managed; face-to-face structured group education courses; flash glucose monitoring start sessions; where the risk of attending an appointment is greater than the benefits; and where deferring appointments will not compromise clinical care. Some specific guidance is available regarding the management of diabetic foot clinics during the pandemic. suggests that access to outpatient and inpatient MDT foot services are essential, that access continues

2020 Oxford COVID-19 Evidence Service

114. Managing clinical trials during Coronavirus (COVID-19)

) away from other people Wash your hands as soon as you get home You can spread the virus even if you don’t have symptoms. Guidance Managing clinical trials during Coronavirus (COVID-19) How investigators and sponsors should manage clinical trials during COVID-19 Published 19 March 2020 Last updated 24 March 2020 — From: Contents This guidance advises those involved in clinical trials on specific issues which may arise as a result of COVID-19, and what they are required to do. We have separate (...) Managing clinical trials during Coronavirus (COVID-19) Managing clinical trials during Coronavirus (COVID-19) - GOV.UK Tell us whether you accept cookies We use about how you use GOV.UK. We use this information to make the website work as well as possible and improve government services. Accept all cookies You’ve accepted all cookies. You can at any time. Hide Search Stay at home Only go outside for food, health reasons or work (where this absolutely cannot be done from home) Stay 2 metres (6ft

2020 Covid-19 Ad hoc papers

115. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)

2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed. Methods We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched (...) in the general population, but there is limited guidance on the acute management of critically ill patients with severe illness due to COVID-19. Guideline Scope This guideline provides recommendations to support hospital clinicians managing critically ill adults with COVID-19 in the intensive care unit (ICU). The target users of this guideline are frontline clinicians, allied health professionals, and policymakers involved in the care of patients with COVID-19 in the ICU. The guideline applies to both high

2020 Covid-19 Ad hoc guidelines

116. COVID-19: Rapidly managing pneumonia in older people during a pandemic

COVID-19: Rapidly managing pneumonia in older people during a pandemic Rapidly managing pneumonia in older people during a pandemic - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. Navigate this website Rapidly managing pneumonia in older people during a pandemic Carl Heneghan, Jeff Aronson, Kamal Mahtani Rationale The current has highlighted the risk faced by older adults, who are more susceptible to complications, including (...) risk). Score 3 or 4: high risk (more than 10% mortality risk). that anyone with a score of 2 should be admitted to hospital. NICE’s approach, however, doesn’t account for the high risk in very elderly people. The mortality rate from COVID-19 approaches 15% at age 80 (Figure 1). Source data: (accessed 13 March 2020) Current NICE guidance requires starting antibiotic treatment as soon as possible after establishing a diagnosis of community-acquired pneumonia, and certainly within 4 hours

2020 Oxford COVID-19 Evidence Service

117. Operational considerations for case management of COVID-19 in health facility and community

. For clinical care, six major interventions must be put into place immediately, and then scaled up according to epidemiologic scenarios (see Table 3). Operational considerations for case management of COVID-19 in health facility and community: interim guidance 2 The document is organized to guide key actions by transmission scenario to enable timely surge of clinical operations. Scenario and strategic priorities Table 1. Key recommendations based on case severity and risk factors, irrespective (...) Operational considerations for case management of COVID-19 in health facility and community 1 Operational considerations for case management of COVID-19 in health facility and community Interim guidance 19 March 2020 Background This document is intended for health ministers, health system administrators, and other decision-makers. It is meant to guide the care of COVID-19 patients as the response capacity of health systems is challenged; to ensure that COVID-19 patients can access life-saving

2020 WHO Coronavirus disease (COVID-19) Pandemic

118. Managing Fever in adults with possible or confirmed COVID-19 in Primary Care

Managing Fever in adults with possible or confirmed COVID-19 in Primary Care Managing Fever in adults with possible or confirmed COVID-19 in Primary Care - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. Navigate this website Managing Fever in adults with possible or confirmed COVID-19 in Primary Care Sophie Park, Jon Brassey, Carl Heneghan and Kamal Mahtani 19th March 2020 Verdict the current evidence does not support routine (...) demands during fever (Carey 2010, Launey 2011). Antipyretic medication in critically unwell patients with a limited cardiopulmonary reserve may reduce the risk of haemodynamic instability and hypoxic tissue damage (Kiekkas 2013). Medications for fever Paracetamol Most paracetamol studies report lower body temperature, however, reductions are modest. Before administering, check when paracetamol last administered and cumulative paracetamol dose over previous 24 hours ; body-weight under 50 kg ; chronic

2020 Oxford COVID-19 Evidence Service

119. Critical Care Preparation and Management in the COVID-19 Pandemic

Critical Care Preparation and Management in the COVID-19 Pandemic Critical care — ICM Anaesthesia COVID-19 Open Menu Close Menu . Intubation should be performed by a skilled operator wearing appropriate PPE for an aerosol-generating procedure . Development of MERIT (see above) with appropriate portable equipment, PPE and protocols is advised. Sedation Follow established protocols for sedating critically ill patients with hypnotic infusions. For patients ventilated on an anaesthetic machine, low (...) dose (MAC 0.2-0.5) inhalational anaesthesia may be used to maintain sedation with a volatile agent in a low-flow (circle) system. Ventilation Ensure use of an antimicrobial filter within the circuit or placed on the expiratory limb or ventilator exhaust. Note that filters represent an airflow obstruction risk when saturated and routine exchange is advised. Use in-line suction catheters where possible. Avoid inadvertent ventilator circuit disconnections by ensuring all connections are 'tight

2020 ICM Anaesthesia COVID-19

120. COVID-19 Airway Management Principles (Full text)

) and 6(c) may be useful as a stand-alone resource. The full paper is likely to be of greater value as a reference when planning local services. Some references refer to English or UK governmental sites for up to date advice. Those practicing in other countries should be aware that advice in their country may differ and is regularly updated, so they should also refer to their own national guidance. COVID-19: the need for airway interventions and risks to airway managers Severe acute respiratory (...) procedures undertaken during management of cardiac arrest are likely to expose the rescuer to a risk of viral transmission. The RC(UK) guidance states that “The minimum PPE requirements to assess a patient, start chest compressions and establish monitoring of the cardiac arrest rhythm are an FFP3 facemask, eye protection, plastic apron, and gloves.” Avoid listening or feeling for breathing by placing your ear and cheek close to the patient’s mouth. In the presence of a trained airway manager early

2020 ICM Anaesthesia COVID-19 PubMed abstract

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