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Substance Abuse rehabilitation

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141. Joint BAP NAPICU evidence-based consensus guidelines for the clinical management of acute disturbance: De-escalation and rapid tranquillisation

Collaborative Group (2003) conducted a post-hoc analysis for diagnosis (misusing substances vs psychosis) and found no difference in response to IM midazolam versus IM haloperidol plus IM promethazine. Scale (PANSS-EC; Kay et al., 1987; Kay and Sevy, 1990) at 30, 60, 90 and 120 minutes (Meehan et al., 2001). IM lorazepam was found to be more sedating than IM aripiprazole at 2 hours (Zimbroff, 2007) . Midazolam. A number of trials have demonstrated the efficacy of the parenteral formulation as a sole RT

2018 British Association for Psychopharmacology

142. Erectile Dysfunction

into sexual health should be a standard of care in any encounter in which conditions are discussed or interventions contemplated that may influence a man’s sexual life. Medical, sexual, and psychosocial history. The etiology of ED is often multifactorial. General medical history factors to consider when a man presents with ED are age, comorbid medical and psychological conditions, prior surgeries, medications, family history of vascular disease, and substance use. Common risk factors for ED include

2018 American Urological Association

143. Canadian stroke best practice recommendations: secondary prevention of stroke, sixth edition practice guidelines

A]. ii. Echocardiography should be considered in cases where a stroke mechanism has not been identified [Evidence Level C]. 1.3 Functional assessment i. Selected patients with transient ischemic attack or ischemic stroke should be assessed for neurological impairments and functional limitations when appropriate (e.g. cognitive evaluation, screening for depression, screening of fitness to drive, need for potential rehabilitation therapy, and assistance with activities of daily living), especially (...) for patients who are not admitted to hospital [Evidence Level B]. Refer to Rehabilitation Module for additional information (Hebert et al 2016). 22 ii. Patients found to have any neurological impairments and functional limitations should be referred to the appropriate rehabilitation specialist for in-depth assessment and management [Evidence Level C]. Note: These recommendations are applicable to stroke of ischemic and hemorrhagic origin unless otherwise stated. 2.0 Risk factor assessment i. Persons

2018 CPG Infobase

144. Treating Opioid Use Disorder During Pregnancy: Guideline Supplement

custody of a child is a major barrier to seeking treatment for pregnant people who use substances. 10,11 Trauma-informed Care Opioid use disorder has been associated with a high lifetime prevalence of trauma including physical and sexual abuse, and pregnancy is a period of particular vulnerability for individuals who have experienced trauma. 12,13 It is also noteworthy that women are at increased risk of intimate partner violence during pregnancy, particularly in the case of unintended pregnancies. 14 (...) Treating Opioid Use Disorder During Pregnancy: Guideline Supplement 1 Guideline Supplement Treatment of Opioid Use Disorder During2 THIS IS A BLANK PAGE3 A Guideline for the Clinical Management of Opioid Use Disorder—Pregnancy Supplement The BC Centre on Substance Use (BCCSU) is a provincially networked platform mandated to develop, imple- ment, and evaluate evidence-based approaches to substance use and addiction. The BCCSU’s focus is on three strategic areas including research and evaluation

2018 British Columbia Perinatal Health Program

146. Obesity Prevention and Management

supervised weight loss program for a minimum of six months (including monthly documentation of weight, dietary, exercise and lifestyle modifications at each visit) without achieving significant weight loss. The supervised weight loss program usually should have occurred within the past 2 years, although some insurance companies will include the past 4 years. Absolute contraindications to bariatric surgery include pregnancy, lactation, active substance abuse, end-stage cardiovascular disease, severe (...) for patients with severe obesity and making little/limited progress Registered dietitian for help with dietary modifications Endocrine specialist for adult patients with BMI > 30 whose excess weight may be due to an endocrine disorder. Physical Medicine and Rehabilitation for patients with arthritis, joint, or mobility concerns Social work and mental health for issues regarding personal resources and emotional concerns Surgeon for consideration of bariatric surgery (see requirements of patients, listed

2020 University of Michigan Health System

147. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary Full Text available with Trip Pro

. Population Risk 1276 2.4. Coexistence of Hypertension and Related Chronic Conditions 1276 3. Classification of BP 1276 3.1. Definition of High BP 1276 3.2. Lifetime Risk of Hypertension 1277 3.3. Prevalence of High BP 1277 4. Measurement of BP 1277 4.1. Accurate Measurement of BP in the Office 1277 4.2. Out-of-Office and Self-Monitoring of BP 1278 4.3. Masked and White Coat Hypertension 1278 5. Causes of Hypertension 1281 5.1. Secondary Forms of Hypertension 1281 5.1.1. Drugs and Other Substances

2017 American Heart Association

149. Recommendations for the Use of Mechanical Circulatory Support: Ambulatory and Community Patient Care: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

PVD Active substance abuse Impaired cognitive function Unmanaged psychiatric disorder Lack of social support CRT indicates cardiac resynchronization therapy; DT, destination therapy; NYHA, New York Heart Association; Vo 2 , oxygen consumption; and PVD, peripheral vascular disease. As of July 2014, 158 centers in the United States offer long-term MCS. Patients often live a substantial distance from the implanting center, necessitating active involvement of local first responders (emergency medical (...) Increasing diuretic requirement Symptomatic despite CRT Inotrope dependence Low peak V o 2 (<14–16) End-organ dysfunction attributable to low cardiac output 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 Musculoskeletal disease that impairs rehabilitation Active systemic infection or prolonged intubation Untreated malignancy Severe

2017 American Heart Association

151. Management of Concussion-mild Traumatic Brain Injury (mTBI)

of Injury. The Centers for Disease Control and Prevention (CDC) estimate that approximately 2.2 million emergency department visits and 50,000 deaths occur annually due to TBI.[2] In the 2014 CDC Report to Congress “Traumatic Brain Injury In the United States: Epidemiology and Rehabilitation,” according to data from the DoD, 235,046 Service Members (or 4.2% of the 5,603,720 who served in the Army, Air Force, Navy, and Marine Corps) were diagnosed with a TBI between 2000 and 2011.[2] Similarly (...) that are important and relevant to the management of mTBI, from which Work Group members were recruited. The specialties and clinical areas of interest included: blind rehabilitation, family medicine, occupational therapy (OT), language neurology, nursing, pharmacy, physical medicine and rehabilitation (PM&R), physical therapy (PT), polytrauma care, primary care, psychiatry, psychology, and speech-language pathology. The guideline development process for the 2016 CPG update consisted of the following steps: 1

2016 VA/DoD Clinical Practice Guidelines

152. Management of Chronic Pain in Survivors of Adult Cancers Full Text available with Trip Pro

should be assessed. Clinicians should clearly understand terminology such as tolerance, dependence, abuse, and addiction as it relates to the use of opioids and should incorporate universal precautions to minimize abuse, addiction, and adverse consequences. Additional information is available at and . INTRODUCTION Section: As a result of extraordinary advancements in diagnosis and treatment, approximately 14 million individuals with a history of cancer (excluding nonmelanomatous skin cancers (...) factors) and captures information about cancer treatment history and comorbid conditions, psychosocial and psychiatric history (including substance use), and prior treatments for the pain. The assessment should characterize the pain, clarify its cause, and make inferences about pathophysiology. A physical examination should accompany the history, and diagnostic testing should be performed when warranted. (Informal consensus; benefits outweigh harms; evidence quality: insufficient strength

2016 American Society of Clinical Oncology Guidelines

153. Management of Opioid Therapy (OT) for Chronic Pain

(acute and chronic) in the U.S., as well as the disability and morbidity associated with pain.[26] Government agencies, including the VA, DoD, and Substance Abuse and Mental Health Services Administration (SAMHSA), have also launched initiatives to improve the study and treatment of pain and adverse events associated with opioid analgesics such as OUD and overdose.[27] By August 2013, the VA deployed the Opioid Safety Initiative (OSI) requirements to all Veterans Integrated Service Networks (VISNs (...) ), assessment for opioid use disorder, and consideration for tapering when risks exceed benefits (see Recommendation 14). Strong for Reviewed, New- replaced 4. a) We recommend against long-term opioid therapy for pain in patients with untreated substance use disorder. b) For patients currently on long-term opioid therapy with evidence of untreated substance use disorder, we recommend close monitoring, including engagement in substance use disorder treatment, and discontinuation of opioid therapy for pain

2017 VA/DoD Clinical Practice Guidelines

154. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians

anti-inflammatory drugs or skeletal muscle relaxants (moderate-quality evidence). (Grade: strong recommendation) Recommendation 2: For patients with chronic low back pain, clinicians and patients should initially select nonpharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (moderate-quality evidence), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant (...) low back pain, radicular low back pain, or symptomatic spinal stenosis. The review evaluated pharmacologic (acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs], opioids, skeletal muscle relaxants [SMRs], benzodiazepines, antidepressants, antiseizure medications, and systemic corticosteroids) and nonpharmacologic (psychological therapies, multidisciplinary rehabilitation, spinal manipulation, acupuncture, massage, exercise and related therapies, and various physical modalities) treatments

2017 American College of Physicians

155. Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold

implications. Anesth Pain Med. 2014;4(5): e20990. 40. Burns JM, Boyer EW. Antitussives and substance abuse. Subst Abuse Rehabil. 2013;4:75-82. 41. Albrecht HH. Can big data analysis help speed up the clinical development of mucoactive drugs for symptomatic RTIs? Lung. 2016;194:31-34. 42. EcclesR,TurnerRB,DicpinigaitisPV.Treatmentofacutecoughdue to the common cold: multi-component, multi-symptom therapy is preferable tosingle-component,single-symptomtherapy—apro/con debate. Lung. 2016;194:15-20 (...) prescribed for pain and found in cough medicines) should not be combinedwithbenzodiazepinesorothercentralnervous depressants. 38 Prescribers are advised to stay abreast of FDA communications and warning statements. Both prescription and OTC products contain active ingredients that may be abused. For example, high doses of dextromethorphan can produce euphoria and dissociative effects. The ingestion of large doses of dextromethorphan (Robitussin) cough syrup is referred to as “robo-tripping.” 39 “Purple

2017 American College of Chest Physicians

156. Diagnosis and Treatment of Low Back Pain

or interdisciplinary rehabilitation program which should include at least one physical component and at least one other component of the biopsychosocial model (psychological, social, occupational) used in an explicitly coordinated manner. Weak for Reviewed, New-replaced *For additional information, please refer to Grading Recommendations. †For additional information, please refer to Recommendation Categorization and Appendix A. VA/DoD Clinical Practice Guideline for Diagnosis and Treatment of Low Back Pain (...) research questions on which to base an SR about the diagnosis and treatment of LBP. The group also identified a list of clinical specialties and areas of expertise that were important and relevant to the diagnosis and treatment of LBP, from which Work Group members were recruited. The specialties and clinical areas of interest included: chiropractic care, integrative medicine, neurology, nursing, pain medicine, pharmacy, physical medicine and rehabilitation, physical therapy, primary care, radiology

2017 VA/DoD Clinical Practice Guidelines

157. Pharmacological Treatment of Patients with Alcohol Use Disorder

. 2015; Substance Abuse and Mental Health Services Administra- tion 2014). Receipt of evidence-based care is even less common. For example, one study found that of the 11 million people in the United States with AUD, only 674,000 received psychopharmacolog- ical treatment (Mark et al. 2009). Furthermore, treatment availability and the type of treatment pro- vided can vary based on geography and, in the United States, insurance coverage (Hagedorn et al. 2016; Mark et al. 2015), including formulary (...) . . . . . . . . . . . . . . . . . . . . . . 7 Assessment and Determination of Treatment Goals . . . . . . . . . . . . . . . . 7 Statement 1: Assessment of Substance Use . . . . . . . . . . . . . . . . . . . . 7 Implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Balancing of Potential Benefits and Harms in Rating the Strength of the Guideline Statement . . . . . . . . . . . . 8 Quality Measurement Considerations . . . . . . . . . . . . . . . . . . . . . . . 9 Statement 2: Use of Quantitative

2017 American Psychiatric Association

158. Management of Posttraumatic Stress Disorder and Acute Stress Reaction

, in person, the event(s) as it occurred to others 3. Learning that the event(s) occurred to a close family member or close friend Note: In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental. 4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains, police officers repeatedly exposed to details of child abuse) Note: This does not apply to exposure through (...) for at least three days and up to a month is needed to meet disorder criteria. Criterion D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Criterion E. The disturbance is not attributable to the physiological effects of a substance (e.g., medication or alcohol) or another medical condition (e.g., mild traumatic brain injury) and is not better explained by brief psychotic disorder. *Reprinted with permission

2017 VA/DoD Clinical Practice Guidelines

160. The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: A 10-year update

. 1.5.2. Substance abuse 1.5.2. Substance abuse A structured rehabilitative program may be considered for patients with a recent (24-month) history of alcohol abuse if transplantation is being considered (Class IIb, Level of Evidence: C). Continuing approval without change. Patients who remain active substance abusers (including alcohol) should not receive heart transplantation (Class III, Level of Evidence: C). Continuing approval without change 1.5.3. Psychosocial evaluation 1.5.3. Psychosocial (...) for patients with potentially reversible or treatable comorbidities, such as cancer, obesity, renal failure, tobacco use, and pharmacologically irreversible pulmonary hypertension, with subsequent reevaluation to establish candidacy (Class IIb, Level of Evidence: C). 1.5. Tobacco use, substance abuse, and psychosocial evaluation in candidates 1.5. Tobacco use, substance abuse, and psychosocial evaluation in candidates 1.5.1. Tobacco use 1.5.1. Tobacco use Education on the importance of tobacco cessation

2016 International Society for Heart and Lung Transplantation

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