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Substance Abuse rehabilitation

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81. Frailty in Older Adults - Early Identification and Management

for Seniors Clinical Care Management Guideline: 48/6 Model of Care, available at the BC Patient Safety and Quality Council website at: Key Recommendations See . Early identification and management of patients with frailty or vulnerable to frailty provides an opportunity to suggest appropriate preventive and rehabilitative actions (e.g. exercise program, review of diet and nutrition, medication review) to be taken to slow, prevent, or even reverse decline associated with frailty. Use a diligent case (...) meta-analysis found that frailty was associated with increased risk for several negative health outcomes, which are listed in Figure 2. 13 Figure 2: Increased risk of negative outcomes associated with frailty 13 Early identification of patients with frailty or vulnerable to frailty provides an opportunity to suggest appropriate preventive and rehabilitative actions (e.g. exercise program, review of diet and nutrition, medication review) to be taken to slow, prevent, or even reverse decline

2017 Clinical Practice Guidelines and Protocols in British Columbia

82. Recommendations for the Delivery of Psychosocial Oncology Services in Ontario

with getting on with living; adjusting to new normal • Loss of dignity or meaning in one’s life • Addiction (e.g., alcohol, nicotine, other substances of abuse) Social • Coping and adjustment to altered social roles due to illness • Communication with healthcare providers • Family conflicts and sense of isolation from family members • Relationship disruptions • Discussion of illness with partner and family • Impact of cancer on children • Difficulty in decision-making • Dealing with stigma • Domestic abuse (...) , practical, nutritional and rehabilitative challenges associated with cancer, patients and families continue to face significant barriers in finding and accessing these services in Ontario. Across the province there are marked variations in the delivery and availability of PSO services. Patients often do not know how or where to find help, while healthcare providers struggle to connect them with appropriate supports. Confusion about what PSO is and a lack of a cohesive identity and understanding about

2018 Cancer Care Ontario

83. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain Full Text available with Trip Pro

, with higher dosages and more frequent infusions associated with greater risks. Larger studies, evaluating a wider variety of conditions, are needed to better quantify efficacy, improve patient selection, refine the therapeutic dose range, determine the effectiveness of nonintravenous ketamine alternatives, and develop a greater understanding of the long-term risks of repeated treatments. From the * Departments of Anesthesiology & Critical Care Medicine, Neurology, and Physical Medicine & Rehabilitation (...) presented to nor approved by either the American Society of Anesthesiologists Board of Directors or House of Delegates, it is not an official or approved statement or policy of the Society. Variances from the recommendations contained in the document may be acceptable based on the judgment of the responsible anesthesiologist. S.P.C. is funded in part by a Congressional Grant from the Center for Rehabilitation Sciences Research, Uniformed Services University of the Health Sciences, Bethesda, MD (SAP

2018 American Society of Regional Anesthesia and Pain Medicine

84. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management Full Text available with Trip Pro

differ from those for ketamine used to treat chronic conditions, with the exception of the use of ketamine in active substance abusers (Grade C relative contraindication for chronic pain, not a contraindication for acute pain) and poorly controlled cardiovascular disease (Grade B relative contraindication for chronic pain, Grade C for acute pain). These differences were attributed to the more urgent nature of treating acute pain, and for substance abuse, the fact that in most cases the drug of abuse (...) of Anesthesiology, University of Toronto, Toronto, Ontario, Canada; †† Procare Pain Solutions and Department of Anesthesiology, Michigan State University College of Human Medicine, Grand Rapids, MI; ‡‡ Departments of Anesthesiology and Psychiatry, Mayo College of Medicine, Rochester, MN; and §§ Departments of Anesthesiology and Critical Care Medicine, Neurology, and Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, and Uniformed Services University of the Health Sciences, Bethesda, MD

2018 American Society of Regional Anesthesia and Pain Medicine

86. Level of Care for Musculoskeletal Surgery

) - Uncontrolled preoperative pain - Prior complication of anesthesia - Prior postoperative complication • Ileus • Urinary retention • Psychiatric/cognitive o Ongoing substance abuse o Cognitive impairment • Social o Patient resides outside of a reasonable distance (30-minute drive) of an emergency medical facility o No responsible/reliable adult (caregiver) living with, or staying with the patient who is available to care for them for at least 23 hours after surgery. o Patient does not agree to surgery (...) postoperative complication • Ileus • Urinary retention • Psychiatric/cognitive o Ongoing substance abuse o Cognitive impairment • Social o Patient resides outside of a reasonable distance (30-minute drive) of an emergency medical facility o No responsible/reliable adult (caregiver) living with, or staying with the patient who is available to care for them for at least 23 hours after surgery. o Patient does not agree to surgery outside the inpatient hospital setting or is expected to be noncompliant

2018 AIM Specialty Health

87. Alcoholic Liver Disease

- sideration 18. Patients too sick to complete rehabilitation therapy may be considered for transplantation via exception pathway dependent on individual center policy and the patient’s pro? le. These patients can complete rehabilitation therapy after transplantation 19. Transplant recipients should be screened at each visit for use of alcohol and other substances especially tobacco and cannabis. Among recidivists, alcohol use should be quanti? ed to identify harmful use 20. Immunosuppression should (...) and titration is critical for optimal outcomes. Given the side eff ects of benzodiazepines in patients with advanced liver disease and the potential for abuse in an addictive population, other drugs such as baclofen, cloni- dine, gabapentin, and topiramate have been proposed to treat AWS in patients with ALD including alcoholic cirrhosis. How- ever, the effi cacy and safety of these substances in patients with AH is unknown and therefore prospective studies are required. A promising approach is to use

2018 American College of Gastroenterology

88. Clinical Guideline on the Treatment of Carpal Tunnel Syndrome

in the wrist and hand due to shape and size, infectious diseases, and substance abuse. These are all common exclusion criteria in CTS treatment studies and hence these potential risks have not been clearly assessed. 9 Persons involved in manual labor in some occupations have a greater incidence and severity of the symptoms. 7 The relationship between work, co-morbidities and personal factors require good physician judgment, experience with medical evidence and knowledge of the vast occupational literature (...) postoperatively after routine carpal tunnel surgery (Grade B, Level II). We make no recommendation for or against the use of postoperative rehabilitation. (Inconclusive, Level II). Recommendation 9 We suggest physicians use one or more of the following instruments when assessing patients’ responses to CTS treatment for research: • Boston Carpal Tunnel Questionnaire (disease-specific) • DASH – Disabilities of the arm, shoulder, and hand (region-specific; upper limb) • MHQ – Michigan Hand Outcomes Questionnaire

2008 Congress of Neurological Surgeons

89. Primary & Secondary Prevention of CVD

Rahman Secretary: Expert Panel Members (in alphabetical order): Consultant Cardiologist Subang Jaya Medical Centre, Selangor Consultant Cardiologist Institut Jantung Negara, KL Consultant Physician (Specialist in Cardiovascular Medicine), An-Nur Specialist Hospital Dr Anwar Suhaimi Rehabilitation Physician University Malaya Medical Centre Dr Chai Koh Meow Principal Assistant Director Traditional and Complementary Medicine Division, Ministry of Health Malaysia Dr Feisul Idzwan Mustapha Public Health (...) Sdn Bhd Dr Omar Mihat Deputy Director Non-Communicable Disease Control Division, Ministry of Health Dr Sia Koon Ket Senior Consultant Physician and Head, Department of Medicine Hospital Tuanku Fauziah, Kangar Dr Liew Huong Bang Consultant Cardiologist Kota Kinabalu Hospital Prof Dr Lydia Abdul Latif Department Of Rehabilitation Medicine Faculty of Medicine, University of Malaya Dr Wan Mohd Wan Bebakar Visiting Consultant Endocrinologist Universiti Sains Malaysia A/Prof Dr Pauline Lai Department

2017 Ministry of Health, Malaysia

90. Simplified guideline for prescribing medical cannabinoids in primary care

The risks of rare events, such as can- nabinoid hyperemesis syndrome (cyclic vomiting) and amotivational syndrome, are still being defined. 22,23 Cannabis use disorder (CUD), replacing previous can- nabis abuse and cannabis dependence, might be as common as appearing in one-fifth of regular cannabis users. 6 Risk of CUD is higher in those who use more frequently, are male, and begin at a younger age. 6,24 However, in another study of those meeting criteria for having CUD, 67% remitted (no longer met (...) use in Canada, 2012. Health Rep 2015;26(4):10-5. 2. Schauer GL, King BA, Bunnell RE, Promoff G, McAfee TA. Toking, vaping, and eat- ing for health or fun: marijuana use patterns in adults, U.S., 2014. Am J Prev Med 2016;50(1):1-8. Epub 2015 Aug 12. 3. Park JY, Wu LT. Prevalence, reasons, perceived effects, and correlates of medical marijuana use: a review. Drug Alcohol Depend 2017;177:1-13. Epub 2017 May 16. 4. Fischer B, Ialomiteanu AR, Aeby S, Rudzinski K, Kurdyak P, Rehm J. Substance use

2018 CPG Infobase

91. Neuro-urology

Urodynamics 14 3C.7.1 Introduction 14 3C.7.2 Urodynamic tests 15 3C.7.3 Specialist uro-neurophysiological tests 16 3C.7.4 Recommendations for urodynamics and uro-neurophysiology 16 3C.7.5 Typical manifestations of neuro-urological disorders 16 3C.8 Renal function 16 3D DISEASE MANAGEMENT 17 3D.1 Introduction 17 3D.2 Non-invasive conservative treatment 17 3D.2.1 Assisted bladder emptying - Credé manoeuvre, Valsalva manoeuvre, triggered reflex voiding 17 3D.2.2 Lower urinary tract rehabilitation 17 3D.2.2.1 (...) Bladder rehabilitation including electrical stimulation 17 3D.2.3 Drug treatment 18 3D.2.3.1 Drugs for treatment of storage neuro-urological symptoms 18 3D.2.3.2 Drugs for voiding neuro-urological symptoms 19 3D.2.4 Recommendations for drug treatments 19 3D.2.5 Minimal invasive treatment 19 3D.2.5.1 Catheterisation 19 3D.2.5.2 Intravesical drug treatment 20 3D.2.5.3 Intravesical electrostimulation 20 3D.2.5.4 Botulinum toxin injections in the bladder 20 3D.2.5.5 Bladder neck and urethral procedures 20

2015 European Association of Urology

92. Urological Infections

it is difficult to exclude obstruction by the sloughed papillae as the cause of the nephropathy. The risk of chronic renal disease and renal insufficiency caused by pyelonephritis is low. Underlying lesions including vesicoureteral reflux, analgesic abuse, nephrolithiasis and obstruction of the urinary tract have to be observed. However, acute bacterial infection, including pyelonephritis, can dramatically influence the progression of a chronic renal disease and vice versa chronic renal failure can alter

2015 European Association of Urology

93. Guidelines on Acute Pain Management

patients. 2.7.4 Aboriginal and Torres Strait Islander People. 2.7.5 Maor i . 2.7.6 Other ethnic groups and non-English speaking people. 2.7.7 Patients with obstructive sleep apnoea. 2.7.8 Patients with concurrent hepatic or renal disease. 2.7.9 Opioid-tolerant patients. 2.7.10 Patients with a substance abuse disorder. 2.7.11 Patients with cognitive behavioural and/or sensory impairments. 3. EDUCATION 3.1 Education regarding acute pain management should be part of the medical undergraduate core (...) , its role in recovery and rehabilitation, and options available (pharmacological and non- pharmacological), is an essential component of an acute pain management consultation. 3.3.2 Availability of appropriate reading material will enhance patient and carer understanding and expectations of available pharmacological and non-pharmacological therapies. 4. ASSESSMENT OF ANALGESIC EFFICACY AND ADVERSE EFFECTS 4.1 Tailoring of treatment regimens to the individual patient requires that regular

2013 Australian and New Zealand College of Anaesthetists

95. Educational and Psychological Interventions to Improve Outcomes for Recipients of Implantable Cardioverter Defibrillators and Their Families Full Text available with Trip Pro

patients. Furthermore, phantom shocks, that is, the patient-perceived experience of an ICD shock in the absence of an actual shock, may be observed more commonly in those with past ICD storms or a history of depression, anxiety, or substance abuse, which suggests the complexity of these relationships. QOL Summary In summary, ICD patients can expect generally desirable QOL provided they are not exposed to excessive, unnecessary, or repeated ICD shocks. Most ICD patients derive other benefits in addition (...) what is known about adult and pediatric patient and family responses to the ICD; educational and informational needs; factors associated with various responses; and educational, psychological, and rehabilitative interventions to promote adjustment to the ICD and prevent or reduce adverse psychological responses. The statement concludes with evidence-based recommendations for the multidisciplinary practice team, describes important gaps in the knowledge base, and identifies future directions

2012 American Heart Association

96. Recommendations for the Use of Mechanical Circulatory Support: Device Strategies and Patient Selection Full Text available with Trip Pro

· kg −1 · min −1 ) Contraindications Absolute Irreversible hepatic disease Irreversible renal disease Irreversible neurological disease Medical nonadherence Severe psychosocial limitations Relative Age >80 y for DT Obesity or malnutrition MS disease that impairs rehabilitation Active systemic infection or prolonged intubation Untreated malignancy Severe PVD Active substance abuse Impaired cognitive function Unmanaged psychiatric disorder Lack of social support HF indicates heart failure; DT

2012 American Heart Association

97. Treatment and recommendations for homeless people with Chronic Non-Malignant Pain

. Centrality of Pain Scale – Christina Nicolaidis, MD, MPH, Oregon Health Science University, Portland, Oregon D. Mental Health and Substance Abuse Screening Tools E. Action Plan, Valley Homeless Health Care Program (VHHP), San Jose, California F. Chronic Pain Recovery Program, Central City Concern, Portland, Oregon G. Pain Medications: Frequently Asked Questions, SFDPH H. Drug formulary, Albuquerque Health Care for the Homeless (HCH) I. Non-opioid Medications for Management of Chronic Pain, Albuquerque (...) as provider and staff resources and experience, weigh benefits and costs of using standardized screening tools. ? Use urine drug tests (UDT) as an additional tool in initial assessment for substance use disorders and in the ongoing evaluation of patient outcomes. Use UDT and pill counts carefully and strategically to monitor treatment adherence and to minimize diversion, misuse, and abuse for patients on COT. Use a Universal Precautions approach to initial and ongoing assessment of all patients

2011 National Health Care for the Homeless Council

98. Geriatric Trauma Management

for Depression Screening for Alcohol and Substance Abuse Assessing Baseline and Current Functional Status in Ambulatory Patients Assessing Gait and Mobility Impairment and Fall Risk in Ambulatory Patients Frailty Score: Operational Definition Frailty Score Screening for Nutritional Risk Bibliography 21 References 27 Expert Panel 28 2Background and Introduction Traumatic injury in the geriatric population is increasing in prevalence and is associated with higher mortality and complication rates compared (...) consult or by adding personnel with geriatric expertise to the multidisciplinary trauma team. See Appendix 2. z Establish past history of elderly- specific comorbidities, including:  Pulmonary disease  Chronic renal failure  Chronic anemia  Depression  Baseline cognitive impairment  Baseline functional impairment  Baseline frailty scores  Baseline nutritional status  Alcohol, tobacco, drug abuse or dependence (benzodiazepines, oxycodone)  Thyroid dysfunction  Glucose intolerance  Decubitus

2013 American College of Surgeons

99. Assessment and management of psychiatric disorders in individuals with multiple sclerosis

in MS from Pfizer, Merck-Serono, and Genentech; on fingolimod from Novartis; and on dextromethorphan and quinidine from Avanir; has received research support from the National Multiple Sclerosis Society (NMSS), the Center for Mental Health Services, and the Substance Abuse and Mental Health Services Administration; and has stock in Merck, Schering-Plough, and SmithKline. A. Feinstein has received travel funding from Merck-Serono, Teva, and Bayer; is serving as a member of an editorial advisory board (...) editor, associate editor, or member of an editorial advisory board for Journal of Rehabilitation Research & Development ; and has received financial or material research support or compensation from Novartis and the NMSS. D. Mohr has received research support from the NIH. S. Patten is a member of the editorial board of the Canadian Journal of Psychiatry , and has received research support from the Government of Alberta's Collaborative Research Grant Initiative, the Canadian Institutes for Health

2014 American Academy of Neurology

100. 2013 ISHLT Guidelines for Mechanical Circulatory Support

. Level of evidence: C. Class IIa: 1. Previous tobacco use should not preclude emergent pump implantation as a potential BTT. However, patients should not be made active on the transplant waiting list until 6 months of nicotine abstinence has been proven. Level of evidence: C. Recommendations for alcohol and substance abuse: 64 Class IIb: 1. The patient should be abstinent for a period of time as determined a priori by the program in order to be considered for MCS therapy. Level of evidence: C. Class (...) III: 1. Active substance abusers (including alcohol) should not receive MCS therapy. Level of evidence: C. Recommendations for caregiver burden: 65–68 Class I: 1. Caregiver burden should be assessed prior to MCS implantation to assure that support will be available. Agreement on behalf of the patient is not suf?cient. Level of evidence: C. Class IIb: 1. Signi?cant caregiver burden or lack of any caregiver is a relative contraindication to the patient’s MCS implanta- tion. Level of evidence: C

2013 International Society for Heart and Lung Transplantation


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