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61. Acute pain management: scientific evidence (3rd Edition)

: Scientific Evidence xv CONTENTS 9. SPECIFIC CLINICAL SITUATIONS 237 9.1 Postoperative pain 237 9.1.1 Risks of acute postoperative neuropathic pain 237 9.1.2 Acute postamputation pain syndromes 238 9.1.3 Other postoperative pain syndromes 240 9.1.4 Day-stay or short-stay surgery 242 9.1.5 Cranial neurosurgery 245 9.2 Acute pain following spinal cord injury 247 9.3 Acute burn injury pain 249 9.3.1 Management of procedural pain 250 9.3.2 Non-pharmacological pain management 251 9.4 Acute back pain 252 9.5 (...) 9.7.3 Breakthrough pain 285 9.7.4 Postoperative and procedural pain 286 9.7.5 Acute cancer pain due to bone involvement 287 9.7.6 Other acute cancer pain syndromes 288 9.7.7 Interventional therapies for acute cancer pain 289 9.8 Acute pain management in intensive care 290 9.8.1 Pain assessment in the intensive care unit 291 9.8.2 Non-pharmacological measures 291 9.8.3 Pharmacological treatment 291 9.8.4 Guillain-Barre syndrome 292 9.8.5 Procedure-related pain 293 9.9 Acute pain management

2015 National Health and Medical Research Council

62. Measles

profile. It is contraindicated in children younger than 16 years of age, because of the risk of Reye's syndrome [ ]. Guidance from PHE states that people with suspected measles should be kept away from school or nursery for 4 days after the development of rash (the infectious period), and this can reasonably be extrapolated to adults. PHE also advise people with suspected measles to avoid contact with vulnerable people, even though most cases will not be confirmed as measles [ ]. CKS recommends people (...) , and conjunctivitis. These symptoms, in addition to the appearance of a characteristic maculopapular rash (with or without Koplik's spots), are highly suggestive of measles. Other infections that may be misdiagnosed as measles include: Parvovirus B19, the virus that causes fifth disease (slapped cheek syndrome). Streptococcal infection (for example scarlet fever). Herpes virus type 6 (roseola infantum). Rubella. Early meningococcal disease. If a diagnosis of measles is suspected, it is essential to notify

2018 NICE Clinical Knowledge Summaries

63. Feverish children - management

the effectiveness of paracetamol versus ibuprofen in the management of febrile children noted that 'distress' is not well defined in the literature, and parents' perception of distress is subjective and may vary considerably [ ]. The recommendation not to use aspirin as an antipyretic in children under 16 years of age is based on the fact that aspirin-containing preparations are contraindicated in this age-group due to an associated increased risk of Reye's syndrome. It may be initiated by a specialist (...) is uncomfortable or distressed. To stop antipyretic drug treatment once the child is comfortable. Not to routinely treat children with fever who are otherwise well. Not to use aspirin as an antipyretic. Not to use routine prophylactic antipyretic drugs to reduce or prevent recurrent febrile seizures. Advice on the use of antipyretic drug treatment should include: Using either paracetamol or ibuprofen initially, depending on any co-morbidities, drug cautions or contraindications, and parental preference

2018 NICE Clinical Knowledge Summaries

64. Management of fever in children

for prescribing antipyretics are as follows: • select the first-line medication based on contraindications, warnings and precautions for use; • use a single substance in monotherapy for the first 24 hours. There is no preventive treatment for febrile seizures. Prescribing aspirin (acetylsalicylic acid) is not recommended in case of fever in children, due to a very rare but potentially fatal risk of Reye’s syndrome. On its own, a poorly tolerated fever, despite proper treatment for at least 24 hours (...) with caution in case of suspected bacterial infection; - gastrointestinal adverse effects: rare but sometimes fatal cases of gastrointestinal bleeding and gastric or oesophageal ulcerations; - renal adverse effects: rare cases of acute renal failure; - effects on haemostasis: the reversible action of NSAIDs on blood platelets leads to a risk of prolonged bleeding time; - others: skin allergic reactions, severe skin conditions, meningeal syndromes, bronchospasms and hyperkalaemia have also been reported.

2016 HAS Guidelines

65. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications

by increased morbidity and mortality and is now the third or fourth most common life-threatening infection syndrome, after sepsis, pneumonia, and intra-abdominal abscess. Globally, in 2010, IE was associated with 1.58 million disability-adjusted life-years or years of healthy life lost as a result of death and nonfatal illness or impairment. Epidemiological surveys from France and the International Collaboration on Endocarditis have confirmed that the epidemiological profile of IE has changed substantially (...) that has embolized, or an intracardiac abscess specimen; or pathological lesions; vegetation or intracardiac abscess confirmed by histological examination showing active endocarditis Clinical criteria 2 Major criteria, 1 major criterion and 3 minor criteria, or 5 minor criteria Possible IE 1 Major criterion and 1 minor criterion, or 3 minor criteria Rejected Firm alternative diagnosis explaining evidence of IE; or resolution of IE syndrome with antibiotic therapy for ≤4 d; or no pathological evidence

2016 Infectious Diseases Society of America

66. Acne clinical guideline Full Text available with Trip Pro

, A. Hormonal profiles and prevalence of polycystic ovary syndrome in women with acne. J Dermatol . 1997 ; 24 : 223–229 | | , x 53 Lucky, A.W. Endocrine aspects of acne. Pediatr Clin North Am . 1983 ; 30 : 495–499 | , x 54 Lucky, A.W., McGuire, J., Rosenfield, R.L., Lucky, P.A., and Rich, B.H. Plasma androgens in women with acne vulgaris. J Invest Dermatol . 1983 ; 81 : 70–74 | | | , x 55 Abulnaja, K.O. Changes in the hormone and lipid profile of obese adolescent Saudi females with acne vulgaris. Braz J Med

2016 American Academy of Dermatology

67. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications

to be characterized by increased morbidity and mortality and is now the third or fourth most common life-threatening infection syndrome, after sepsis, pneumonia, and intra-abdominal abscess. Globally, in 2010, IE was associated with 1.58 million disability-adjusted life-years or years of healthy life lost as a result of death and nonfatal illness or impairment. Epidemiological surveys from France and the International Collaboration on Endocarditis have confirmed that the epidemiological profile of IE has changed (...) , a vegetation that has embolized, or an intracardiac abscess specimen; or pathological lesions; vegetation or intracardiac abscess confirmed by histological examination showing active endocarditis Clinical criteria 2 Major criteria, 1 major criterion and 3 minor criteria, or 5 minor criteria Possible IE 1 Major criterion and 1 minor criterion, or 3 minor criteria Rejected Firm alternative diagnosis explaining evidence of IE; or resolution of IE syndrome with antibiotic therapy for ≤4 d; or no pathological

2015 American Heart Association

68. Pediatric Pulmonary Hypertension Full Text available with Trip Pro

that a particular test or therapy is useful or effective. *Data available from clinical trials or registries about the usefulness/efficacy in different subpopulations, such as sex, age, history of diabetes, history of prior myocardial infarction, history of heart failure, and prior aspirin use. †For comparative effectiveness recommendations (Class I and IIa; Level of Evidence A and B only), studies that support the use of comparator verbs should involve direct comparisons of the treatments or strategies being (...) of Evidence B). 3. Members of families afflicted with HPAH who develop new cardiorespiratory symptoms should be evaluated immediately for PAH (Class I; Level of Evidence B). 4. Families of patients with genetic syndromes asso- ciated with PH should be educated about the symptoms of PH and should be counseled to seek evaluation of the affected child should symptoms arise (Class I; Level of Evidence B). Persistent PH of the Newborn 1. Inhaled nitric oxide (iNO) is indicated to reduce the need

2015 American Heart Association

69. Pediatric Pulmonary Hypertension: ATS/AHA Clinical Practice Guidelines

, history of diabetes, history of prior myocardial infarction, history of heart failure, and prior aspirin use. †For comparative effectiveness recommendations (Class I and IIa; Level of Evidence A and B only), studies that support the use of comparator verbs should involve direct comparisons of the treatments or strategies being evaluated. by guest on March 15, 2016 http://circ.ahajournals.org/ Downloaded from Abman et al Pediatric Pulmonary Hypertension 5 available evidence as Level B when data were (...) of Evidence B). 4. Families of patients with genetic syndromes asso- ciated with PH should be educated about the symptoms of PH and should be counseled to seek evaluation of the affected child should symptoms arise (Class I; Level of Evidence B). Persistent PH of the Newborn 1. Inhaled nitric oxide (iNO) is indicated to reduce the need for extracorporeal membrane oxygenation by guest on March 15, 2016 http://circ.ahajournals.org/ Downloaded from 6 Circulation November 24, 2015 (ECMO) support in term

2015 American Thoracic Society

70. Clinical practice guideline on Systemic Lupus Erythematosus

treatment with low-dose aspirin to reduce the risk of thrombosis. B In patients with SLE and antiphospholipid syndrome with venous thrombosis, we recommend anticoagulation with a target INR 2.0-3.0. C In patients with SLE and antiphospholipid syndrome with arterial thrombosis, we suggest anticoagulation with a target INR >3.0, or combining anticoagulants with INR 2.0-3.0 + low-dose aspirin. C In patients with SLE, antiphospholipid syndrome and thrombotic episodes, we suggest indefinite anticoagulation (...) in this situation. Prevention of obstetric complications in patients with antiphospholipid antibodies v We suggest that patients with obstetric antiphospholipid syndrome and a history of repeated early miscarriages (=10 weeks) should be treated with aspirin, with or without associated heparin. v We suggest that patients with obstetric antiphospholipid syndrome and a history of foetal death (>10 weeks) or severe preeclampsia with placental insufficiency should be treated with aspirin and heparin at prophylactic

2015 GuiaSalud

71. Acute Pain Management: Scientific Evidence

pain management 280 8.1.3 Acute rehabilitation after surgery, “fast-track” surgery and enhanced recovery after surgery 281 8.1.4 Risks of acute postoperative neuropathic pain 282 8.1.5 Acute postamputation pain syndromes 283 8.1.6 Other postoperative pain syndromes 285 8.1.7 Day-stay or short-stay surgery 288 8.1.8 Cranial neurosurgery 294 8.1.9 Spinal surgery 297 8.2 Acute pain following spinal cord injury 298 8.2.1 Treatment of acute neuropathic pain after spinal cord injury 299 8.2.2 Treatment (...) 8.7.3 Medicines for acute cancer pain 340 8.7.4 Breakthrough pain 342 8.7.5 Acute neuropathic cancer pain 342 8.7.6 Procedural pain in cancer patients 344 8.7.7 Acute pain due to bone cancer 344 8.7.8 Other acute cancer pain syndromes 348 8.7.9 Interventional therapies for acute cancer pain 349 8.8 Acute pain management in intensive care 351 8.8.1 Pain assessment in the intensive care unit 351 8.8.2 Management of pain, agitation and delirium 351 8.8.3 Nonpharmacological measures 352 8.8.4

2015 Clinical Practice Guidelines Portal

72. Clopidogrel/Acetylsalicylic acid Teva

, decrease in urinary concentration) could be induced after 40-83 weeks of treatment with 120-230 mg/kg/day. In mice, doses of 130-1270 mg/kg/day induced an overall severe deterioration of general condition, including hair loss, decreased litter size and a highly significantly shortening of survival time. ASA is stated to play a role in the Reye’s syndrome; therefore, ASA should not be given to children younger than 12 years old. Epithelal desquamation, hyperemia, local ulceration and/or gastric (...) 2.5. Clinical safety 30 2.6. Pharmacovigilance 33 2.7. Risk Management Plan 34 2.8. Product information 39 3. Benefit-Risk Balance 39 Benefit-risk balance 41 4. Recommendations 42 Medicinal product no longer authorised Assessment report EMA/502333/2014 Page 3/43 List of abbreviations AA Arachidonic acid ACE Angiotensin converting enzyme ACS Acute coronary syndrome ADP Adenosine diphosphate AE Adverse event Al(u) Aluminium ANOVA Analysis of variance ASA Acetylsalicylic acid AUC Area under the curve

2014 European Medicines Agency - EPARs

73. Guidelines for the treatment of malaria. Third edition

and can be given orally or as a suppository. Ibuprofen (5 mg/kg bw) has been used successfully as an alternative in the treatment of malaria and other childhood fevers, but, like aspirin and other non-steroidal anti-inflammatory drugs, it is no longer recommended because of the risks of gastrointestinal bleeding, renal impairment and Reye’s syndrome. 4 | Treatment of uncomplicated Plasmodium falciparum malaria 44 Guidelines for the treatment of malaria 3 RD EDITION4.7.3 | USE OF ANTI - EMETICS

2015 World Health Organisation Guidelines

74. Antithrombotics: indications and management

reported, although the mechanisms and incidence are disputed. 19 3.1.3 CONTRAINDICATIONS Contraindications to aspirin include: known allergy to the drug; use other than as an antiplatelet in children and adolescents under 16 years (risk of Reye’s syndrome); active peptic ulceration; history of recent gastrointestinal bleeding; history of recent intracranial bleeding; and bleeding disorders including haemophilia, von Willebrand’s disease, severe thrombocytopenia (eg platelets 1g/day); concomitant use (...) . The effectiveness of LMWH compared with UFH for the prevention of recurrent pregnancy loss in women with APA syndrome has not been established. B Prophylactic doses of heparin with or without low-dose aspirin may be considered in women with antiphospholipid antibodies and recurrent pregnancy failure or fetal death in whom no other cause is identified. 9 In practice, LMWH is favoured because of its safety profile and ease of patient use. 9 9 9 In identifying women who may benefit from antithrombotic therapy

2012 SIGN

75. RACIN in Patients With Advanced TIL-negative Solid Tumors

Cooperative Oncology Group (ECOG) clinical performance status: 0-1 for all patients, independently of the number of previous lines of therapy. Life expectancy of ≥ 12 weeks Patients with Glycose-6-Phosphate Dehydrogenase (G6PD) deficiency or any other hereditary coagulation disorder are excluded, as well as patients with clinical history of Reye syndrome Adequate serology defined by the following laboratory results obtained during pre-screening period (day-28 to day-14). Seronegative for HIV infection (...) ) (0.5-3 Gy) and aspirin (ASA). The study comprises 2 phases: The aim of Phase Ia, is to determine safety and tolerability of this combination therapy, as well as the maximum tolerated dose (MTD) or recommended phase Ib dose (RP1bD) of radiotherapy. Phase Ib aims to further explore safety and tolerability of this treatment in an expansion cohort. In Phase Ia, 4 distinct cohorts will receive combination therapy for 5 cycles (C0-C4) which includes: RT (0.5-3 Gy) every 2 weeks (Q2W), Cy (200 mg/m2) Q2W

2018 Clinical Trials

76. Management of Acute ST Segment Elevation Myocardial Infarction (STEMI) ? (3rd Edition)

the team of authors and reviewers for their time and valuable contribu- tions. I believe this CPG will be an invaluable document for healthcare providers involved in the management of STEMI and subsequently to im- prove health outcomes associated with this deadly condition. (Datuk Dr. Noor Hisham bin Abdullah) The Director General of Health, Ministry of Health Malaysia ST segment myocardial infarction (STEMI) is the most deadly among the clinical presentations of acute coro- nary syndrome (ACS). Unlike (...) operator. • If primary PCI cannot be performed, then fibrinolytic therapy should be administered with a DNT of less than 30 minutes. • Concomitant pharmacotherapy includes aspirin, clopidogrel (or prasugrel or ticagrelor), ß-blockers, ACE-Is/ARBs and statins. • Complications of STEMI include arrhythmias, left ventricular (L V) dysfunction and shock. • High-risk patients should have early coronary angiography with a view to revascularisation. The others should be risk stratified according

2014 Ministry of Health, Malaysia

77. Valvular Heart Disease: Guidelines For the Management of Patients With

. *Data available from clinical trials or registries about the usefulness/ef?cacy in different subpopulations, such as sex, age, history of diabetes mellitus, history of prior myocardial infarction, history of heart failure, and prior aspirin use. yFor comparative-effectiveness recommendations(Class I and IIa; Level of Evidence A and B only), studies that support the use of comparatorverbs should involve direct comparisons of the treatments or strategies being evaluated. JACC Vol. 63, No. 22, 2014

2014 American College of Cardiology

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

or TIA but is reasonable in patients with clinically apparent CAD, particularly an acute coronary syndrome or stent placement (Class IIb; Level of Evidence C ). New recommendation For patients with ischemic stroke or TIA and AF who are unable to take oral anticoagulants, aspirin alone is recommended ( Class I; Level of Evidence A ). The addition of clopidogrel to aspirin therapy, compared with aspirin therapy alone, might be reasonable (Class IIb; Level of Evidence B ). 1. Reworded from the 2011 (...) antibody syndrome, sickle cell disease, cerebral venous sinus thrombosis, and pregnancy. Special sections address use of antithrombotic and anticoagulation therapy after an intracranial hemorrhage and implementation of guidelines. Introduction Each year in the United States, >690 000 adults experience an ischemic stroke. The enormous morbidity of ischemic stroke is the result of interplay between the resulting neurological impairment, the emotional and social consequences of that impairment

2014 American Heart Association

79. Liver Transplantation, evaluation of the adult patient

, March 2014increasingly performed prior to LT. Bare metal stents are favored to avoid the need for dual antiplatelet therapy (clopidogrel plus aspirin rather than the latter alone), although the requirement for antiplatelet agents to pre- ventstentocclusionmay delayLT. 30 Ofnote,recentdata demonstrates superior outcomes in patients who have undergone cardiac stenting with single vessel disease compared to outcomes for patients with prior CABG for multivesseldisease. 30 The cardiac evaluation may also (...) , and HEPATOLOGY, Vol. 59, No. 3, 2014 MARTIN ET AL. 11592. To recommend specific, objective data elements to be collected for individual conditions for those conditions for which there was insufficient evidence for granting increased priority. The MESSAGE committee deliberations were pre- sented to an international panel of experts and the ?nal recommendations for each individual condition considered were formulated and formalized. Several important recommendations were made: 1. Budd-Chiari syndrome in its

2014 American Association for the Study of Liver Diseases

80. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease

implythattherecommendationisweak.Manyimportantclinicalquestionsaddressedintheguidelinesdonotlendthemselvestoclinicaltrials. Although randomized trials are unavailable, there may be a very clear clinical consensus that a particular test or therapy is useful or effective. *Data available from clinical trials or registries about the usefulness/ef?cacy in different subpopulations, such as sex, age, history of diabetes mellitus, history of prior myocardial infarction, history of heart failure, and prior aspirin use. yFor comparative-effectiveness recommendations(Class I and IIa; Level of Evidence A and B only), studies

2014 Society for Cardiovascular Angiography and Interventions

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