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4061. Management of stable angina

to prevent new vascular events 17 4.4 Medication concordance 18 5 Interventional cardiology and cardiac surgery 19 5.1 Coronary artery anatomy and definitions 19 5.2 Percutaneous coronary intervention 19 5.3 Coronary artery bypass grafting 21 5.4 Choice of revascularisation technique 23 5.5 Postintervention drug therapy 26 5.6 Postintervention rehabilitation 28 5.7 Managing restenosis 28 5.8 Managing refractory angina 28 6 Stable angina and non-cardiac surgery 30 6.1 Assessment prior to surgery 30 6.2 (...) blockers to beta blockers Minor update 4.2.2 Adding nitrates, nicorandil or ivabradine to other antianginal drugs Updated 4.3.1 Antiplatelet therapy Updated 4.4 Medication concordance New 5.2 Percutaneous coronary intervention Updated 5.2.1 Percutaneous coronary intervention versus medical therapy New 5.2.2 Type of stent New Management of stable angina| 3 5.3.1 Coronary artery bypass grafting versus medical therapy New 5.3.2 On-pump versus off-pump coronary artery bypass grafting Updated 5.3.3 Choice

2018 SIGN

4062. Management of lung cancer

by licensed medicines within the marketing authorisation. Such use should be supported by appropriate evidence and experience. 8 “Prescribing medicines outside the conditions of their marketing authorisation alters (and probably increases) the prescribers’ professional responsibility and potential liability” . 8 1 • Introduction4 | Management of lung cancer The General Medical Council (GMC) recommends that when prescribing a medicine off-label, doctors should: y be satisfied that such use would better (...) the effects of the medicine. Non-medical prescribers should ensure that they are familiar with the legislative framework and their own professional prescribing standards. Prior to any prescribing, the licensing status of a medication should be checked in the the summary of product characteristics (SPC). 9 The prescriber must be competent, operate within the professional code of ethics of their statutory bodies and the prescribing practices of their employers. 10 1.3.2 AddITIoNAL AdVICE To NHSSC o TLANd FR

2014 SIGN

4063. Cardiac rehabilitation

5.3 Physical activity and reducing sedentary behaviour 10 5.4 Diet 12 5.5 Long-term maintenance of behaviour change 14 6 Psychosocial health 15 6.1 Introduction 15 6.2 Models of psychological care 15 6.3 Measurement of psychological well-being 16 6.4 Psychological therapies and interventions 16 7 Vocational rehabilitation 19 7.1 Introduction 19 7.2 Interventions 19 Cardiac rehabilitation Contents8 Medical risk management 20 8.1 Introduction 20 8.2 Prescribing practices 20 8.3 Medication (...) for this guideline at www.sign.ac.uk 1.3.2 HEALTH TECHNOLOGY ASSESSMENT ADVICE FOR NHSSCOTLAND Specialist teams within Healthcare Improvement Scotland issue a range of advice that focuses on the safe and effective use of medicines and technologies in NHSScotland. The Scottish Medicines Consortium (SMC) provides advice to NHS boards and their Area Drug and Therapeutics Committees about the status of all newly-licensed medicines and new indications for established products. NHSScotland should take account

2017 SIGN

4064. Prepregnancy counseling

intervalsbetweenpregnanciesmaybehelpfultoreducefuturecomplications.Assessmentoftheneedforsexuallytransmittedinfec- tionscreeningshouldbeperformedatthetimeofprepregnancycounseling.Womenwhopresentforprepregnancycounselingshould be offered screening for the same genetic conditions as recommended for pregnant women. All patients should be routinely asked about their use of alcohol, nicotine products, and drugs, including prescription opioids and other medications used for nonmedical reasons. Screening for intimate partner violence should occur during prepregnancy counseling. Female prepregnancy folic acid (...) of alcohol, nicotine products, and drugs, including prescrip- tion opioids and other medications used for nonmedical reasons. Screening for intimate partner violence should occur dur- ing prepregnancy counseling. Femaleprepregnancyfolicacidsupplementationshouldbe encouragedtoreducetheriskofneuraltubedefects(NTDs). Patients should be screened regarding their diet and vitamin supplements to con?rm they are meeting recom- mended daily allowances for calcium, iron, vitamin A, vitamin B 12 , vitamin B

2019 Society for Assisted Reproductive Technology

4065. Gynecologic Care for Adolescents and Young Women With Eating Disorders

and affect psy- chologic and physical health, a multidisciplinary approach is imperative. c Although obstetrician–gynecologists are not expected to treat eating disorders, they should be familiar with the criteria that warrant immediate hospitalization for medical stabilization. c Weight restoration is the best treatment for low bone mineral density (BMD) caused by disor- dered eating. VOL. 131, NO. 6, JUNE 2018 OBSTETRICS & GYNECOLOGY e205c Further research is needed to define best practices, including (...) concern about body weight or shape 4. Not explained by medical or mental disorders Anorexia nervosa 1. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight defined as weight that is less than minimally normal or, for children and adolescents, less than that minimally expected 2. Intense fear of gaining weight or becoming fat, or persistent behavior

2018 American College of Obstetricians and Gynecologists

4066. Children and young people exposed prenatally to alcohol

for the assessment and diagnosis of children and young people affected by PAE. It includes evidence-based recommendations on measurement of alcohol consumption in pregnancy and consensus-based recommendations on: y identification of children at risk of FASD y criteria for diagnosis and use of FASD as a descriptor y medical assessment y physical examination y sentinel features y neurodevelopmental assessment y the multidisciplinary assessment team y special considerations in the neurodevelopmental assessment y (...) The need for guidance 1 1.2 Remit of the document 3 1.3 Definitions and terminology 3 1.4 Origin of this guidance 8 1.5 Statement of intent 9 2 Identification of children at risk of FASD 10 2.1 Maternal alcohol history 10 3 Identification and assessment of children and young people affected by prenatal alcohol exposure 15 3.1 Diagnostic criteria 15 3.2 Medical assessment 17 3.3 Sentinel facial features 18 3.4 Neurodevelopmental assessment 19 3.5 Special considerations in the assessment of infants

2019 SIGN

4067. British guideline on the management of asthma

in pregnancy 126 12.1 Natural history and management of stable asthma 126 12.2 Management of acute asthma in pregnancy 127 12.3 Drug therapy in pregnancy 128 12.4 Management during labour 131 12.5 Drug therapy for breastfeeding mothers 132 13 Occupational asthma 133 13.1 Incidence 133 13.2 At-risk populations 133 13.3 Diagnosis 133 13.4 Management of occupational asthma 136 14 Organisation and delivery of care 138 14.1 Care pathways 138 14.2 Educating clinicians 138 14.3 Asthma clinics 139 14.4 (...) and experience. 4 “Prescribing medicines outside the conditions of their marketing authorisation alters (and probably increases) the prescribers’ professional responsibility and potential liability.” 4 The General Medical Council (GMC) recommends that when prescribing a medicine ‘off label’, doctors should: • be satisfied that there is no suitably licensed medicine that will meet the patient’s need • be satisfied that there is sufficient evidence or experience of using the medicine to show its safety

2019 SIGN

4068. A guideline developer's handbook

in this context includes diagnostic tests, risk factors, risk exposure or treatments with medical devices or drugs) must be specified clearly and precisely. The only exception is in drug therapy where drug classes should be used in preference to specific agents unless there is a clear reason for focusing on a named agent. The decision on comparisons may include placebo/no treatment, and comparison with other therapies. It should be borne in mind that, where there is an existing treatment, comparison (...) criteria should be drawn up and saved as part of the record of the review. This will provide guidance at a later stage when studies are being selected for review. Inclusion criteria will include definition of the topic and may include such factors as duration of therapy, drug dosage, and frequency of treatment. Other factors include any geographic or language limits, the types of trials that will be accepted, and date range to be covered. Any equality groups that are expected to have specific needs

2019 SIGN

4069. Cardiac arrhythmias in coronary heart disease

choices available. It is advised, however, that significant departures from the national guideline or any local guidelines derived from it should be documented in the patient’s medical records at the time the relevant decision is taken. 1.3.1 INFLUENCE OF FINANCIAL AND OTHER INTERESTS It has been recognised that financial interests in, or close working relationships with, pharmaceutical companies may have an influence on the interpretation of evidence from clinical studies. It is not possible (...) for medicinal use in humans. Generally ‘off-label’ prescribing of medicines becomes necessary if the clinical need cannot be met by licensed medicines within the marketing authorisation. Such use should be supported by appropriate evidence and experience. 8 “Prescribing medicines outside the conditions of their marketing authorisation alters (and probably increases) the prescribers’ professional responsibility and potential liability. ” 8 The General Medical Council (GMC) recommends that when prescribing

2018 SIGN

4070. Evaluation of Abnormal Liver Chemistries

of concomitant steatosis or viral hepatitis ( 59 ). Drug and supplement-induced liver injury Prescribed and over-the-counter medications, as well as non- prescribed complimentary alternative medicines or dietary sup- plements, represent a common source for acute and chronic liver injury. Identifi cation of an off ending agent is challenging and requires a comprehensive query of the patient, his or her family, and careful review of available medical and pharmacy records and laboratory data ( 22 ). Nearly all (...) fails to elucidate a diagnosis, to stage a condition, or when multiple diagnoses are possible. Am J Gastroenterol 2017; 112:18–35; doi: 10.1038/ajg.2016.517; published online 20 December 2016 1 Division of Gastroenterology/Hepatology, Department of Medicine, Stanford University School of Medicine , Palo Alto , California , USA ; 2 Digestive Health Institute, University Hospitals Cleveland Medical Center and Division of Gastroenterology and Liver Disease, Department of Medicine, Case Western Reserve

2017 American College of Gastroenterology

4071. Management of Infants Born to Mothers with COVID-19

Management of Infants Born to Mothers with COVID-19 INITIAL GUIDANCE: Management of Infants Born to Mothers with COVID-19 Date of Document: April 2, 2020 Karen M. Puopolo, M.D. Ph.D., Mark L. Hudak, M.D., David W. Kimberlin, M.D., James Cummings, M.D. American Academy of Pediatrics Committee on Fetus and Newborn, Section on Neonatal Perinatal Medicine, and Committee on Infectious Diseases ABSTRACT COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, has led to an unprecedented (...) with COVID-19 disease requires either direct physical contact or close ( 60 years of age and those with comorbid conditions should not provide care if possible. • Infants with negative SARS-CoV-2 molecular testing should optimally be discharged to the care of a designated healthy (non-infected) caregiver. If the mother is in the same household, she should maintain a distance of at least 6 feet for as much of the time as possible, and when in closer proximity to the neonate should use a mask and hand

2020 American Academy of Pediatrics

4072. Catheterisation Indwelling catheters in adults ? Urethral and Suprapubic

6.5.4 Observation and management of catheter drainage 40 6.5.5 Stabilising of the urethral catheter 41 6.5.6 Clamping or not 42 6.6 Changes of urine due to food and medication 43 6.7 Constipation 43 6.8 Suprapubic catheter change 44 6.9 Removal of urethral and suprapubic catheters 45 6.10 Potential problems during and following catheter removal 45 7. Catheter complications 46 7.1 Catheter Associated Urinary Tract Infection (CAUTI) 46 7.2 Epididymitis 48 7.3 Catheter blockage 48 7.4 Catheter (...) procedure 69 Appendix C Female urethral catheterisation – insertion procedure 72 Appendix D Insertion of a suprapubic balloon catheter 73 Appendix E Patient information about common problems with indwelling catheter equipment 74 Appendix F Observation of the urinary drainage 75 Appendix G Possible colour and odour changes in urine due to food or medication 76 Appendix H Preparation and procedure for changing a suprapubic catheter 77 Appendix I Flow chart on Indwelling urethral catheter removal 85

2012 European Association of Urology Nurses

4073. Transrectal Ultrasound Guided Biopsy of the Prostate

document. These guidelines should be used within the context of local policies and existing protocols. It is acknowledged that throughout Europe nurses in different countries have different levels of involvement; some undertake the procedure independently whilst others assist medical colleagues. Additionally, it is acknowledged that there is wide variation in nursing titles: for the purpose of this document the term ‘specialist nurse’ will be used. Distribution This text is made available to all (...) reference list 40 11. References 42 12. About the authors 496 Transrectal Ultrasound Guided Biopsy of the Prostate – March 20117 Transrectal Ultrasound Guided Biopsy of the Prostate – March 2011 1. Methodology, disclosures 1.1 Guidelines working group The guidelines working group consisted of a multi-professional group of specialist nurses and a medical colleague. Information about the authors can be found on page 49. 1.2 Literature search The information offered in this guideline was obtained through

2011 European Association of Urology Nurses

4074. Catheterisation Urethral Intermittent in adults

procedure intermittent self catheterisation - 78 female and male Appendix H Help devices 80 Appendix I Voiding diary for intermittent catheterisation patients 84 Appendix J Changes in urine due to food and medication 85 Appendix K Medical travel document for patients 86 16. About the authors 88 17. References 907 Catheterisation: Urethral intermittent in adults – March 2013 1. Role of the nurse in different countries The EAUN is a professional organisation of European nurses who specialise in urological (...) products from other companies not listed in the guideline. 2.3 Rating system The recommendations provided in these documents are based on a rating system modified from that produced by the Oxford Centre for Evidence-based Medicine (OCBM) in 2011. All group members participated in the critical assessment of the scientific papers identified. Whenever possible, the Guidelines Working Group have graded treatment recommendations using a three-grade recommendation system (A-C) and inserted levels of evidence

2013 European Association of Urology Nurses

4075. EAUN Guidelines Manual

of bladder training versus any other conservative therapy or no treatment on patient related and biometric outcomes and adverse events? In men and women with urinary incontinence, does physical exercise improve patient outcomes regarding either urinary symptoms, leakage or quality of life, compared to no physical exercise ? Underlined are the main concepts represented in the PICO questions above. Concepts are the different ideas which make up each unique search topic. Most topics can be broken down (...) of the guidelines group on educational grants 8. Time line management (overview of the various projects) 9. Assistance with reference management (coordinate literature searches, and liaise with research specialist) 10. Interact with other organisations: e.g., guidelines producers, national associations, members, journals, and companies 8 11. Attend meetings 12. Liaise with guideline groups 13. Contribute to the editing of guideline documents, liaise with medical writers 14. Maintain standardised format

2013 European Association of Urology Nurses

4076. Continent Urinary Diversion

-operative Information 26 6.2.5.2 Post-operative teaching 27 6.3 Post-operative care 29 6.3.1 Stents / catheters 29 6.3.2 Fluid balance 30 6.3.3 Nutrition 30 6.3.4 Post-operative wound management 31 6.3.5 Post-operative pain management 32 6.3.6 Post-operative physical activity 32 6.3.7 Post-operative fatigue 32 6.3.8 Post-operative observation of pouch/neobladder 33 6.3.9 Changes in urine 33 6.3.10 Role of carers 34 6.3.10.1 Catheterisation management by carers 34 6.3.10.2 Procedure for discharge 35 6.4 (...) Discharge care 36 6.4.1 Patient diary 36 6.4.2 Reimbursement of appliances 37 6.4.3 Information about possible complications 37 6.5 Proactive and preventive care 38 6.5.1 Travelling with a pouch/neobladder 38 6.5.2 Medic alert bracelet, ‘Can’t Wait’ card, disability card 38 6.5.3 Insurance/travel 38 6.5.4 Treatment for UTIs, fluid intake and effect of food and medication on urine 39 6.5.5 Urine testing from a continent urinary diversion 40 6.5.5.1 Glucose levels in patients with diabetes 41 6.5.5.2

2010 European Association of Urology Nurses

4077. Intravesical instillation with mitomycin C or bacillus Calmette-Guérin in non-muscle invasive bladder cancer

of treatment with MMC/BCG with those of other chemotherapy neoadjuvant medication, thermo chemotherapy, and electromotive drug approach. 2.3 Search results The initial search was done in August 2013 by Yuhong (Cathy) Yuan, Research Associate at McMaster University, Hamilton, Ontario, Canada, and repeated in December 2014, which resulted in: It was a policy decision to restrict the search in the way described, although the Group was aware that more complex strategies were possible, and would be encouraged (...) . Intravesical instillation is drug administration into the urinary bladder via a catheter. This procedure allows drug delivery to the urothelium with reduced systemic side effects compared with oral or parental drug delivery. [5] The procedure is also referred to as bladder instillation, intravesical treatment, intravesical therapy. These guidelines use the term intravesical instillation. 3.2 Intravesical chemotherapy Intravesical chemotherapy aims to eradicate any surviving cancer cells in the bladder

2015 European Association of Urology Nurses

4078. Male external catheters in adults

as in women. The prevalence of UI ranges from 1 to 39%, depending on how UI is defined and which population has been included in the study. [2] Clear risk factors have not been scientifically documented, but several medical correlates have been reported. Established risk factors predisposing men to UI include increasing age, presence of lower urinary tract symptoms, urinary tract infections (UTIs), functional and cognitive impairment, diabetes, neurological disorders, and prostatectomy. [2] Containment (...) . Databases • Pubmed • Cinahl • Cochrane Search terms • Male external catheters • Condom catheters • Urinary sheaths • External urinary catheter In July 2015 an additional search was performed by Susanne Vahr, Nurse Specialist, Denmark. Databases • Embase • Cinahl • Cochrane Search terms • Male external catheters • Condom catheters • Urinary sheaths • External urinary catheter • Complications9 Male external catheters in adults – March 2016 As a result of the lack of medical subject headings, (MeSH

2016 European Association of Urology Nurses

4079. Guidelines for Protecting the Front Line: COVID 19 Day-to-Day Questions

not be in an area of the pharmacy that has access to medications and should be equipped with alcohol-based hand sanitizer, tissues and a lined waste container available in this space, as well as a phone if possible. Keep alcohol-based hand sanitizer at each patient contact point in the pharmacy Consider implementing the use of transparent physical barriers (e.g., plexiglass, acrylic, plastic sheeting) to separate the dispensary from the rest of the pharmacy. Some additional suggestions can be found . Place (...) association/organizations. What do I tell patients who ask about wearing a mask? The Public Health Agency of Canada has recommended that Canadians consider wearing a non-medical mask (e.g., a ) in situations where physical distancing is difficult to maintain. When worn properly, a person wearing a non-medical mask or face covering can reduce the spread of their own infectious respiratory droplets. However, such masks have not been proven to protect the wearer and should still be used in conjunction

2020 Covid-19 Ad hoc guidelines

4080. Management of hepatitis C

treated with combination drug therapy (pegylated interferon alfa and ribavirin) with sustained viral response (SVR) rates in 50-80% of patients. Although there are existing guidelines for the selection of patients for treatment 4-7 there are no national guidelines for screening, testing, diagnosis, service configuration, care during treatment or post-treatment follow up in adults or children. 1.1.1 UPDATING THE EVIDENCE This guideline updates SIGN 92: Management of hepatitis C to reflect the most (...) by appropriate evidence and experience. 8 “Prescribing medicines outside the conditions of their marketing authorisation alters (and probably increases) the prescribers’ professional responsibility and potential liability” . 8| 3 Management of hepatitis C The General Medical Council (GMC) recommends that when prescribing a medicine off-label, doctors should: y be satisfied that such use would better serve the patient’s needs than an authorised alternative (if one exists) y be satisfied

2013 SIGN

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