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41. Obstetric Management of Patients with Spinal Cord Injuries

an obstetrician with experience in caring for women with disabilities, maternal-fetal medicine subspecialists, anesthesiologists, spinal rehabilitation physicians, nurses, physiotherapists, occupational therapists, lactation consultants, pediatricians, and neonatologists . Common Complications Autonomic Dysreflexia Autonomic dysreflexia (sometimes called autonomic hyperreflexia) is the most serious medical complication that occurs in women with SCIs and is found in 85% of patients with lesions at or above T6 (...) management of a parturient with spinal cord injury and autonomic hyperreflexia. Anaesthesia 2003;58:823–4. Article Locations: Baker ER, Cardenas DD, Benedetti TJ. Risks associated with pregnancy in spinal cord-injured women. Obstet Gynecol 1992;80:425–8. Article Locations: Krassioukov A, Warburton DE, Teasell R, Eng JJ. A systematic review of the management of autonomic dysreflexia after spinal cord injury. Spinal Cord Injury Rehabilitation Evidence Research Team. Arch Phys Med Rehabil 2009;90:682–95

2020 American College of Obstetricians and Gynecologists

42. Screening and Management of Late and Long-term Consequences of Myeloma and its Treatment

, late effects, quality of life, haematopoietic stem cell transplantation, chemotherapy. Methodology These guidelines were developed using the following stages: • Review of key literature from 1 April 2006 to 31 March 2016 using the Cochrane database (search term: myeloma) and Medline: search terms used were [myeloma] + late effects, long term effects, frailty, geriatric assessment, infec- tion, infection prophylaxis, vaccination, nutrition, exercise, rehabilitation, employment, endocrine, disability (...) and male patients where appropriate, with specialist advice (Grade 2B). Neurological and eye complications Spinal cord or nerve root compression is the most common neurological complication of newly presenting or relapsing myeloma. Chemotherapy-induced peripheral neuropathy (CIPN) is the most common neurological complication in long-term survivors, and has both peripheral and central nervous system (processing) components (Boland et al, 2014a). Polyneuropathy may also be a feature of myeloma

2017 British Committee for Standards in Haematology

43. Guidelines for Psychological Practice With Older Adults

, family, geropsy- chology, health, industrial/organizational, neuropsychol- ogy, rehabilitation, and others. The 2008 APA Survey of Psychology Health Service Providers found that 4.2% of respondents viewed older adults as their primary focus and 39% reported that they provided some type of psy- chological services to older adults (APA, Center for Workforce Studies, 2008). Relatively few psychologists, however, have received formal training in the psychol- ogy of aging. Fewer than one third of APA (...) can negatively re- sult in health disparities. Guideline 13 of APA’s “Guide- lines for Psychological Practice With Lesbian, Gay, and Bisexual Clients” (APA, 2012c) discusses particular chal- lenges faced by older adults of this minority status. Aging presents special issues for individuals with developmental or acquired disabilities (e.g., mental retar- dation, autism, cerebral palsy, seizure disorders, spinal cord injury, traumatic brain injury) as well as physical impair- ments such as blindness

2014 American Psychological Association

44. 2016 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult

(Strong Recommendation; Low-Quality Evidence). 2. We recommend that vitamins, minerals, or supple- ments for symptoms of myalgia perceived to be statin- associated not be used (Strong Recommendation; Low-Quality Evidence). Anderson et al. 1277 2016 CCS Dyslipidemia GuidelinesPractical Approach The backbone of risk reduction involves a concerted effort to affect lifestyle choices. 121 We recognize that there is con- troversy when it comes to the use of treatment targets. The primary panel continues

2016 CPG Infobase

47. Stroke, Diagnosis and Initial Treatment of Ischemic Stroke

for EVT, it is reasonable to proceed with CTA if indicated in patients with suspected intracranial LVO before obtaining a serum creatinine concentration in patients without a history of renal impairment. (COR IIa; LOE B-NR) (New recommendation) Agree 10. In patients who are potential candidates for mechanical thrombectomy, imaging of the extracranial carotid and vertebral arteries, in addition to the intracranial circulation, is reasonable to provide useful information on patient eligibility (...) stratifications.) Agree Intracranial/intraspinal surgery within 3 mo 1. For patients with AIS and a history of intracranial/spinal surgery within the prior 3 mo, IV alteplase is potentially harmful. (Class III: Harm; LOE C-EO) Agree History of intracranial hemorrhage 1. IV alteplase administration in patients who have a history of intracranial hemorrhage is potentially harmful. (Class III: Harm; LOE C-EO) Agree Subarachnoid hemorrhage 1. IV alteplase is contraindicated in patients presenting with symptoms

2019 Institute for Clinical Systems Improvement

48. Guidelines on Chronic Coronary Syndromes Full Text available with Trip Pro

test 18 Invasive testing 19 3.1.6 Step 6: assess event risk 21 Definition of levels of risk 22 3.2 Lifestyle management 23 3.2.1 General management of patients with coronary artery disease 23 3.2.2 Lifestyle modification and control of risk factors 23 Smoking 23 Diet and alcohol 24 Weight management 24 Physical activity 24 Cardiac rehabilitation 24 Psychosocial factors 24 Environmental factors 25 Sexual activity 25

2019 European Society of Cardiology

49. Canadian Urological Association guideline for the diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction

The International Continence Society (ICS) defines “neurogenic lower urinary tract dys - function” (NLUTD) as “lower urinary tract dysfunction due to disturbance of the neurological control mechanism.” This broad definition is used to describe a multitude of conditions of varying severity. Common causes of NLUTD include: spinal cord injury (SCI), multiple sclerosis (MS), and myelomeningocele (MMC). Other causes of NLUTD include: Parkinson’s disease, cere- brovascular accidents, traumatic brain injury, brain (...) or spinal cord tumour, cauda equina syndrome, transverse myelitis, multisystem atrophy, pelvic nerve injury, and diabetes. It is well-described that neurological disorders can lead to urological complications, including: urinary incontinence, urinary tract infections (UTIs), urolithiasis, sepsis, ureteric obstruction, vesicoureteric reflux (VUR), and renal failure. 2 Due to the potential morbidity and even mortality, initial investigation, ongoing management, and surveillance is warranted

2019 Canadian Urological Association

50. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: an AUA/SUFU Guideline

be considered complicated OAB patients. These co-morbid conditions include neurologic diseases (i.e., stroke, multiple sclerosis, spinal cord injury), mobility deficits, medically complicated/uncontrolled diabetes, fecal motility disorders (fecal incontinence/ constipation), chronic pelvic pain, history of recurrent urinary tract infections (UTIs), gross hematuria, prior pelvic/vaginal surgeries (incontinence/prolapse surgeries), pelvic cancer (bladder, colon, cervix, uterus, prostate) and pelvic radiation

2019 American Urological Association

51. Sudden Hearing Loss Full Text available with Trip Pro

are the target population for the therapeutic interventions that make up the bulk of the guideline update. By focusing on opportunities for quality improvement, this guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients. Methods Consistent with the American Academy of Otolaryngology–Head and Neck Surgery Foundation’s “Clinical (...) presents with sudden hearing loss. (KAS 7) Clinicians should educate patients with sudden sensorineural hearing loss about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy. (KAS 13) Clinicians should counsel patients with sudden sensorineural hearing loss who have residual hearing loss and/or tinnitus about the possible benefits of audiologic rehabilitation and other supportive measures. These strong

2019 American Academy of Otolaryngology - Head and Neck Surgery

52. Integrated care for older people (?ICOPE)?: guidance for person-centred assessment and pathways in primary care

to prevent falls. 3 93 Generic care pathway Person-centered assessment and pathways in primary care Social care and support plan Remove barriers to social participation Environmental adaptation Community-level interventions to manage declines in intrinsic capacity Understand the older person's life, values, priorities and social context Integrated management of diseases Rehabilitation Palliative and end-of-life care Reinforce generic health and lifestyle advice or usual care FOR CONDITIONS ASSOCIATED (...) and support plan Remove barriers to social participation Environmental adaptation Community-level interventions to manage declines in intrinsic capacity Understand the older person's life, values, priorities and social context Integrated management of diseases Rehabilitation Palliative and end-of-life care Reinforce generic health and lifestyle advice or usual care FOR CONDITIONS ASSOCIATED WITH LOSS IN INTRINSIC CAPACITY No loss of intrinsic capacity YES YES NO NO NO YES SCREEN FOR LOSSES IN INTRINSIC

2019 World Health Organisation Guidelines

54. Diagnosis and Management of Acute Pulmonary Embolism Full Text available with Trip Pro

acute PE ( Figure ). CTEPH = Chronic thromboembolic pulmonary hypertension; CTPA = computed tomography pulmonary angiography; LMWH = low-molecular weight heparin; NOAC(s) = non-vitamin K antagonist oral anticoagulant(s); PE = pulmonary embolism; RV = right ventricular; VKA(s) = vitamin K antagonist(s); VTE = venous thromboembolism. 2.2.2 Changes in recommendations 2014–19 CTEPH = Chronic thromboembolic pulmonary hypertension; PE = pulmonary embolism. Coloured columns indicate classes (...) of recommendation (see Table for colour coding). CTEPH = Chronic thromboembolic pulmonary hypertension; PE = pulmonary embolism. Coloured columns indicate classes of recommendation (see Table for colour coding). 2.2.3 Main new recommendations 2019 CPET = cardiopulmonary exercise testing; CTEPH = Chronic thromboembolic pulmonary hypertension; CUS = compression ultrasonography; ECMO = extracorporeal membrane oxygenation; LMWH = low-molecular weight heparin; NOAC(s) = non-vitamin K antagonist oral anticoagulant(s

2019 European Society of Cardiology

55. Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients

study compar- ing three methods of hydrolysis (two enzymes, and 6 N HCl) with non-hydrolyzed recoveries on efficiency of tapentadol recovery demonstrated different yields for each method (23). The chemi- cal hydrolysis method was preferred over the enzymatic methods due to better compatibility with the associated liquid chromatog- raphy columns. As such, chromatography quality and consistency were superior to the enzymatic hydrolysis products. As suggested above, the efficiency of hydrolysis

2018 American Academy of Pain Medicine

56. Acute Pain Medicine in the United States: A Status Report Full Text available with Trip Pro

to empower patients and to address their wants , needs, and rights . These trends have relevance to the area of acute pain medicine (APM). The practice of APM involves the practice of medicine at multiple levels of inpatient healthcare, rehabilitation, and recovery of the patient at home. Specialists in APM diagnose variants of and conditions related to acute pain, offer medical, interventional, and complementary and integrative medicine therapies, and provide for primary and secondary prevention (...) and effective acute pain care at the patient-population level. For example, it is no longer sufficient to simply perform a nerve block or place an indwelling catheter: APM teams must consider how these interventions affect patient safety, rehabilitation, and disposition; the training of healthcare providers in multiple disciplines; the logistics of supply chain management and financing; and optimal healthcare delivery. Although acute pain management occurs in a variety of patient care settings (e.g

2015 American Academy of Pain Medicine

57. Society of Interventional Radiology Training Guidelines for Endovascular Stroke Treatment Full Text available with Trip Pro

gastrectomy. Obes Surg . 2014 ; 24 : 2021–2024 , x 55 Santok, G.D., Raheem, A.A., Kim, L.H. et al. Proctorship and mentoring: Its backbone and application in robotic surgery. Invest Clin Urol . 2016 ; 57 : S114–S120 ). Direct and indirect methods of supervised training are available for the interventionalist. Direct training would include hands-on participation in cases, whereas indirect training would include observing cases being performed. Ideally, supervised training would include robust, hands

2019 Society of Interventional Radiology

59. Early Management of Head Injury in Adults

Injury xii for Head CT Algorithm 4. Selection of Adults with Head Injury xiii for Imaging of the Cervical Spine Algorithm 5. Management of Adults Patient with xiv Mild Head Injury Requiring Urgent Surgery other than Cranial Surgery 1. INTRODUCTION 1 2. DEFINITION 3 3 CLASSIFICATION OF SEVERITY 5 4. DIFFERENTIAL DIAGNOSES 6 5. PRE-HOSPITAL CARE (PHC) 6 5.1 Assessment and General Treatment 6 5.2 Initial Management 7 5.3 Referral or Discharge at Primary Care Setting 9 5.4 Transportation 11 6. MANAGEMENT (...) guidelines to those involved in the early management of head injury in primary and secondary/tertiary care CLINICAL QUESTIONS Refer to Appendix 2 TARGET POPULATION Inclusion Criteria Adult patients presenting with head injury (18 years old and above) Exclusion Criteria The guidelines do not cover definitive management of head injury: • all surgeries pertaining to neurosurgery and post-operative care • rehabilitation • management of multisystem injuries TARGET GROUP/USERS This document is intended

2015 Ministry of Health, Malaysia

60. Management of Osteoporosis

on alendronate maintained or improved their lumbar spine and femoral neck BMD compared to BMD loss in the alfacalcidol group. 159 IV zolendronate produced a better gain in lumbar spine and femoral neck BMD compared to oral risedronate over 1 year. 157 Teriparatide led to a better gain in lumbar spine and femoral neck BMD compared to alendronate over 3 years. 153 Alendronate and risedronate reduced vertebral fractures in patients on glucocorticoid therapy. 141,155 In patients on glucocorticoids (...) weekly risedronate 164 and once monthly ibandronate 178 have been shown to increase BMD in the lumbar spine and femoral neck in men with osteoporosis (T-score -2.0). Alendronate treatment was shown to reduce radiographic vertebral fracture over 2 years. 160,165 Similarly, risedronate treatment resulted in a decrease of new vertebral fracture over 2 years. 166 A once yearly infusion of IV zoledronate has been shown to improve BMD similar to once weekly alendronate over 2 years. 167 Teriparatide (r-PTH

2015 Ministry of Health, Malaysia


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