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181. Cardiac arrhythmias in coronary heart disease

of trials in adults with or at high risk of CVD, no clear effect from omega-3 fatty acids was reported on composite cardiovascular outcomes (RR 0.96, 95% CI 0.90 to 1.03), total mortality (RR 0.95, 95% CI 0.86 to 1.04), non-vascular mortality (RR 0.97, 95% CI 0.84 to 1.11), coronary events (RR 0.86, 95% CI, 0.67 to 1.11) or revascularisation (RR 0.95, 95% CI 0.89 to 1.00). There was also no evidence of benefit for cerebrovascular events (RR 1.03, 95% CI 0.92 to 1.16) or arrhythmia (RR 0.99, 95% CI 0.85 (...) of ischaemic VT induced at electrophysiological study, sudden death and out-of-hospital collapse. R Revascularisation should be considered in patients who have had sustained VT or VF. 9 Patients with previous sustained VT/VF should undergo assessment for inducible ischaemia by stress testing or myocardial perfusion imaging followed, if appropriate, by coronary arteriography and revascularisation. These patients should all be considered for implantable cardioverter defibrillator therapy. 5.2.2 IMPLANTABLE

2018 SIGN

182. AAWC Pressure Ulcer Guidelines

2007) or severe chronic or terminal disease (Fowler et al.2008) b. Diabetes, with Hb A1c > 6.5 to document blood glucose control (Fowler et al.2008; Amer. Diabetes Assn. 2009) c. Cardiovascular disease or condition including cardiovascular accident (CVA) leading to altered sensation or ability to move (Fowler et al.2008; De Laat et al 2007; IHI 2007) d. Gastrointestinal, genitourinary, renal, endocrine or pulmonary disease or condition (IHI 2007) e. Peripheral vascular disease/condition: assess (...) 2008) 6. Conduct a pain assessment using an age-appropriate validated pain scale (Chang et al., 1998; Flock, 2003; Gardner et al., 2001; Heyneman et al., 2008) 7. Repeat above assessments regularly at same intervals as pressure ulcer risk assessment based on patient risk and institutional guidelines or on any change in patient condition. (Konishi et al 2008) G. DIAGNOSTIC TESTS 1. Use appropriate vascular laboratory consult as needed to assess tissue perfusion if limited vascular perfusion

2011 Association for the Advancement of Wound Care

183. Complex regional pain syndrome in adults. UK guidelines for diagnosis, referral and management in primary and secondary care 2018 (2nd edition)

management. It may also be appropriate instead to refer cases of confirmed CRPS to specialist rehabilitation or vocational rehabilitation services if: ? CRPS presents in the context of another existing disabling condition (eg stroke or severe multiple trauma) ? specialist facilities, equipment or adaptations are required or need review ? the patient needs specialist vocational rehabilitation or support to return to work (this service is sometimes also provided by pain management services) ? litigation (...) of the painful limb. 87 Management ED physicians should provide reassurance that enhanced symptoms are common after injury but usually resolve. Appropriate analgesia should be prescribed as per standard ED practice. The aim is to minimise pain and support physical rehabilitation. Where not contraindicated, advice should be given to touch/stroke the skin of the painful parts and to gently use the limb, even where this appears counterintuitive to the patient (see Appendix 5: Desensitisation). Patients

2018 British Society of Rehabilitation Medicine

184. Practice Guideline Update Systematic Review Summary: Disorders of Consciousness

Practice Guideline Update Systematic Review Summary: Disorders of Consciousness 1 Practice guideline update: Disorders of consciousness Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research Joseph T. Giacino, PhD 1 ; Douglas I. Katz, MD 2 ; Nicholas D. Schiff, MD 3 ; John Whyte, MD, PhD 4 (...) ; Eric J. Ashman, MD 5 ; Stephen Ashwal, MD 6 ; Richard Barbano, MD, PhD 7 ; Flora M. Hammond, MD 8 ; Steven Laureys, MD, PhD 9 ; Geoffrey S. F. Ling, MD 10 ; Risa Nakase- Richardson, PhD 11 ; Ronald T. Seel, PhD 12 ; Stuart Yablon, MD 13 ; Thomas S. D. Getchius 14 ; Gary S. Gronseth, MD 15 ; Melissa J. Armstrong, MD, MSc 16 1. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School; Department of Psychiatry, Massachusetts General Hospital

2018 American Academy of Neurology

185. Perioperative Pathways: Enhanced Recovery After Surgery

preparation with an alcohol-based agent unless contraindicated ( ). Chlorhexidine-alcohol is an appropriate choice. Skin antiseptics should be used in accordance with their manufacturer’s instructions. Scrub time (gentle, repeated back-and-forth strokes) for chlorhexidine-alcohol preparations should last for 2 minutes for moist sites (inguinal fold and vulva) and 30 seconds for dry sites (abdomen), and allowed to dry for 3 minutes ( ). However, if using povidone-iodine scrubs for abdominal preparation (...) , controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection. Dis Colon Rectum 2003;46:851–9. Anderson AD, McNaught CE, MacFie J, Tring I, Barker P, Mitchell CJ. Randomized clinical trial of multimodal optimization and standard perioperative surgical care. Br J Surg 2003;90:1497–504. Serclova Z, Dytrych P, Marvan J, Nova K, Hankeova Z, Ryska O, et al. Fast-track in open intestinal surgery

2018 American College of Obstetricians and Gynecologists

186. Canadian Cardiovascular Harmonized National Guidelines Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care

, Ont.; Department of Medicine and Libin Cardiovascular Institute (Lau), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O’Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart (...) , Calgary, Alta.; Li Ka Shing Knowledge Institute (Leiter), St. Michael’s Hospital, University of Toronto, Toronto, Ont.; Heart and Stroke Foundation (Lindsay), Ottawa, Ont.; Ottawa Heart Institute (Liu), University of Ottawa, Ottawa, Ont.; Insitut de Cardiologie de Montreal (O’Meara), Universite de Montreal, Montreal, Que.; Division of Cardiology, Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Departments of Medicine, Community

2018 CPG Infobase

187. The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea Guideline

program and have no contraindications or active cardiovascular disease, we suggest an evaluation for potential antiobesity pharmacotherapy (conditional recommendation, very low certainty in the estimated effects). REMARKS. “Active cardiovascular disease” refers to a myocardial infarction or cerebrovascular accident within the past 6 months, uncontrolled hypertension, life- threatening arrhythmias, or decompensated congestive heart failure. Question 7: Should Bariatric Surgery Be Recommended (Rather (...) . The questions were then discussed, modi?ed, and approved by the fullguidelinepanel.Outcomesthatmightbe affected by each of the interventions were numericallyrated(from1to7)accordingto theirimportance.Theevidencewasassessed only for outcomes whose average rating fell into the “important” or “critical” categories. The primary outcomes evaluated were quality of life, mortality, weight loss, change in OSA severity, resolution of OSA, cardiovascular events or stroke, major and minor adverse events, daytime

2018 American Thoracic Society

188. Stable Coronary Artery Disease (2nd Edition)

PDE5 Phosphodiesterase Type 5 Inhibitor PET Positron Emission Tomography PTP Pre-test Probability PUFA Polyunsaturated Fatty Acid SCAD Stable Coronary Artery Disease SCD Sudden Cardiac Death SFA Saturated Fatty Acid SLE Systemic Lupus Erythematosus SPECT Single-Photon Emission Computed Tomography STEMI ST Elevation Myocardial Infarction TIA Transient Ischemic Attack TFA Trans Fatty Acid TMR Transmyocardial Revascularization UA Unstable Angina Rationale: Coronary Artery Disease (CAD) covers a wide (...) Tomography STEMI ST Elevation Myocardial Infarction TIA Transient Ischemic Attack TFA Trans Fatty Acid TMR Transmyocardial Revascularization UA Unstable Angina ABBREVIATIONS Rationale: Coronary Artery Disease (CAD) covers a wide spectrum from asymptomatic individuals to patients with stable CAD, Acute Coronary Syndromes (ACS) and Sudden Cardiac Death (SCD). This Clinical Practice Guidelines (CPG) on Stable CAD is directed at individuals: • with stable chest pain or other symptoms (e.g. dyspnea) which

2018 Ministry of Health, Malaysia

189. Are the ACC/AHA Guidelines on the Treatment of Blood Cholesterol a Game Changer? A Perspective From the Canadian Cardiovascular Society Dyslipidemia Panel

assessment, randomized trials of these approaches will need to be completed. Risk Assessment Is Important Much of the controversy of the new American guidelines relates to the development of the new pooled cohort equations for risk assessment. Although it is derived from several cohorts, including people of various ages, ethnicities, and geographic distribution and appropriately measures risk of hard cardiovascular end points including myocardial infarction and stroke, concern has been raised that it has (...) of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet . 2012 ; 380 : 581–590 | | | | | | 8 European Association for Cardiovascular Prevention and Rehabilitation, Reiner, Z., Catapano, A.L. et al. ESC/EAS guidelines for the management of dyslipidaemias: the task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J . 2011 ; 32 : 1769–1818 | | | | 9 Tobe, S.W., Stone, J.A., Brouwers

2014 Canadian Cardiovascular Society

190. Cardiovascular Disease: Secondary Prevention

with atorvastatin, for secondary prevention. Previously, rosuvastatin was non-formulary and was a second-line option for secondary prevention. Annual LDL monitoring is no longer required. Annual LDL monitoring was recommended for all patients on a statin. Non-fasting lipid panel is now the preferred cholesterol test. Fasting lipoprotein panel or direct LDL cholesterol were the preferred cholesterol tests. Updated blood pressure targets: • 50%. • Cerebrovascular disease, such as transient ischemic attack (...) , ischemic stroke, and carotid artery stenosis > 50%. • Peripheral artery disease, such as claudication. • Aortic atherosclerotic disease, such as abdominal aortic aneurysm and descending thoracic aneurysm. Primary prevention refers to the effort to prevent or delay the onset of ASCVD. Secondary prevention refers to the effort to treat known, clinically significant ASCVD, and to prevent or delay the onset of disease manifestations. Target Population The target population for secondary prevention of ASCVD

2018 Kaiser Permanente Clinical Guidelines

191. Cardiovascular Disease: Primary Prevention

the preferred cholesterol tests. Updated blood pressure targets: • 190 mg/dL, or diabetes. • Aspirin not recommended for patients with 190 mg/dL. • Statins not recommended for patients with 50%. • Cerebrovascular disease, such as transient ischemic attack, ischemic stroke, and carotid artery stenosis > 50%. • Peripheral artery disease, such as claudication. • Aortic atherosclerotic disease, such as abdominal aortic aneurysm and descending thoracic aneurysm. Primary prevention refers to the effort to prevent (...) participants based on an elevated LDL-C level, a diabetes diagnosis, or at least one CVD risk factor. The pooled results of the trials showed that the use of low- or moderate-dose statins was associated with a reduced risk of all- cause mortality (RR 0.86; 95% CI, 0.80–0.93), cardiovascular mortality (RR, 0.69; 95% CI, 0.54–0.88), ischemic stroke (RR 0.71; 95% CI, 0.62–0.82), heart attack (RR 0.64; 95% CI, 0.57–0.71), and a composite cardiovascular outcome (RR 0.70; 95% CI, 0.63–0.78).The relative risk

2018 Kaiser Permanente Clinical Guidelines

192. Oral Health Care for the Pregnant Adolescent

significant morbidity (e.g., hemorrhagic stroke) or mortality. 17 The diet of the pregnant adolescent can affect the health of the child. A healthy diet is necessary to provide adequate amounts of nutrients to the mother-to-be and the unborn child. Recommended dietary allowances during pregnancy and lactation are tabulated as absolute figures rather than additions to the basic allowances. 18 Nutrients of particular importance include folate (folic acid), calcium, magnesium, zinc, and vitamins K, C, B-6 (...) affected more than posterior teeth. 45 These findings are exacerbated by poor plaque control and mouth breathing. 46 From a periodontal perspective, the effects of hormonal levels on the gingival status of pregnant women may be accompanied by increased levels of progesterone and estrogen which contribute to increased vascularity, permeability, and possible tissue edema. 47,48 Evidence shows a relationship of periodontal disease and gestational AMERICAN ACADEMY OF PEDIATRIC DENTISTRY RECOMMENDATIONS

2016 American Academy of Pediatric Dentistry

193. Professional Practice Guidelines for Integrating the Role of Work and Career Into Psychological Practice

, Herbig, Dragano and Angerer (2013) concluded that long-term unemployment, defined as having been out of work for more than one year, is both a cause and effect of physical and mental illness. They found that long-term unemployed individuals were twice as likely to have a mental illness, had higher risks of heart attack and stroke, and had higher mortality rates than employed individuals. Interestingly, most of the current research examining long-term unemployment is being completed with samples (...) of rehabilitation psychology (Szymanski, 2000). This becomes a particular concern for individuals with disabling conditions as the U.S. Bureau of Labor Statistics (2015) reported that, in 2014, Guidelines for Integrating the Role of Work and Career Into Professional Psychology Practice only 17.1 percent of persons with a disability were employed as compared to 64.6 percent for persons without a disability. Across all educational attainment groups, unemployment rates were higher for persons with a disability

2015 American Psychological Association

194. Back Pain

with Chronic Conditions workshops X X Physical therapy X X Yoga X X Tai chi X X Relaxation therapy (meditation, progressive muscle relaxation, biofeedback, guided visualization) X X Acupuncture X X Spinal manipulation (chiropractic) X X Massage X X NSAIDs X X Duloxetine X X Physical Medicine & Rehabilitation/Spine Care Clinic (where available) X Psychotherapy (cognitive behavioral therapy for pain, mindfulness- based stress reduction) Note: Self-referral for physical therapy, acupuncture, or spinal (...) ; advise patients to check with Member Services to determine their individual coverage and benefits. • Massage: There is some evidence of moderate improvement in both pain and function with massage. • Physical Medicine & Rehabilitation (PMR): Consider referral to PMR, which develops detailed treatment plans to enable individual patients to carry out their rehabilitation, including exercise and self-care. PMR can also provide a second opinion for patients with suboptimal response to a conservative

2017 Kaiser Permanente Clinical Guidelines

195. Neck pain: revision 2017.

, and when reported were minor, transient, and of short duration. For manual therapy or exercise, the only consistently reported problem was a mild transient exacerbation of symptoms. For manipulation, rare but serious adverse events such as stroke or serious neurological deficits were not reported in any of the trials. Serious but rare adverse events for manipulation are known to occur. One study reported mild adverse events equal in treatment and placebo groups, including tiredness, nausea, headache (...) need more intensive rehabilitation and an early pain education program. ( Grade of Recommendation: F ) Chronic For patients with chronic neck pain with movement coordination impairments (including WAD): Clinicians may provide the following: Patient education and advice focusing on assurance, encouragement, prognosis, and pain management Mobilization combined with an individualized, progressive submaximal exercise program including cervicothoracic strengthening, endurance, flexibility

2017 National Guideline Clearinghouse (partial archive)

196. Final recommendation statement: adolescent idiopathic scoliosis: screening.

less television). The USPSTF again acknowledges the subjective nature and the difficulty of assessing potential harms: for example, how bad is a "mild" stroke? The third domain is cost—not just monetary cost, but opportunity cost, in particular the amount of time a provider spends to provide the service, the amount of time the patient spends to partake of it, and the benefits that might derive from alternative uses of the time or money for patients, clinicians, or systems. Consideration (...) on Scoliosis Orthopaedic and Rehabilitation Treatment. The type of evidence supporting the recommendations is not specifically stated. Benefits of Early Detection and Intervention or Treatment The U.S. Preventive Services Task Force (USPSTF) found no direct evidence regarding the effect of screening for adolescent idiopathic scoliosis on patient-centered health outcomes. The USPSTF found inadequate evidence on the treatment of idiopathic scoliosis (Cobb angle <50° at diagnosis) in adolescents with exercise

2018 National Guideline Clearinghouse (partial archive)

197. Guideline for the management of knee and hip osteoarthritis

controlled trial RR relative risk SES socioeconomic status SMD standardised mean difference SNRI serotonin and norepinephrine reuptake inhibitor TEAE treatment-emergent adverse event TENS transcutaneous electrical nerve stimulation TGA Therapeutic Goods Administration TNF-alpha tumour necrosis factor alpha TrkA tyrosine kinase receptor TRPV1 Transient Receptor Potential Vanilloid 1 VAS Visual Analog Scale WHO World Health Organization WOMAC Western Ontario and McMaster Universities Osteoarthritis Indexv (...) Director, Medibank Private Ltd Associate Professor Marie Pirotta, general practitioner; Department of General Practice, University of Melbourne, Victoria Dr Michael Ponsford, rehabilitation medicine specialist, Epworth Hospital, Victoria Associate Professor Morton Rawlin, general practitioner, Macedon Medical Centre, Victoria Dr Xia Wang, epidemiologist, University of Sydney, New South Wales Dr Samuel Whittle, Senior consultant rheumatologist, Queen Elizabeth Hospital, Woodville South, South Australia

2018 Clinical Practice Guidelines Portal

198. Prostate Cancer

and 3D vascular sonography as a method for diagnosis and staging of prostate cancer. Eur Urol, 2003. 44: 21. 267. de Rooij, M., et al. Accuracy of Magnetic Resonance Imaging for Local Staging of Prostate Cancer: A Diagnostic Meta-analysis. Eur Urol, 2016. 70: 233. 268. Jager, G.J., et al. Local staging of prostate cancer with endorectal MR imaging: correlation with histopathology. AJR Am J Roentgenol, 1996. 166: 845. 269. Cornud, F., et al. Extraprostatic spread of clinically localized prostate

2018 European Association of Urology

199. ESC/ESH Management of Arterial Hypertension Full Text available with Trip Pro

–creatinine ratio (30–300 mg/g; 3.4–34 mg/mmol) (preferentially on morning spot urine) Moderate CKD with eGFR >30–59 mL/min/1.73 m 2 (BSA) or severe CKD eGFR <30 mL/min/1.73 m 2 b Ankle−brachial index <0.9 Advanced retinopathy: haemorrhages or exudates, papilloedema Established CV or renal disease Cerebrovascular disease: ischaemic stroke, cerebral haemorrhage, TIA CAD: myocardial infarction, angina, myocardial revascularization Presence of atheromatous plaque on imaging Heart failure, including HFpEF (...) (30–300 mg/g; 3.4–34 mg/mmol) (preferentially on morning spot urine) Moderate CKD with eGFR >30–59 mL/min/1.73 m 2 (BSA) or severe CKD eGFR <30 mL/min/1.73 m 2 b Ankle−brachial index <0.9 Advanced retinopathy: haemorrhages or exudates, papilloedema Established CV or renal disease Cerebrovascular disease: ischaemic stroke, cerebral haemorrhage, TIA CAD: myocardial infarction, angina, myocardial revascularization Presence of atheromatous plaque on imaging Heart failure, including HFpEF Peripheral

2018 European Society of Cardiology

200. Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU Full Text available with Trip Pro

, Delirium , Immobility ( mobilization /rehabilitation), and Sleep (disruption). Each section created Population, Intervention, Comparison, and Outcome, and nonactionable, descriptive questions based on perceived clinical relevance. The guideline group then voted their ranking, and patients prioritized their importance. For each Population, Intervention, Comparison, and Outcome question, sections searched the best available evidence, determined its quality, and formulated recommendations as “strong (...) ,” “conditional,” or “good” practice statements based on Grading of Recommendations Assessment, Development and Evaluation principles. In addition, evidence gaps and clinical caveats were explicitly identified. Results: The Pain , Agitation/ Sedation , Delirium , Immobility ( mobilization /rehabilitation), and Sleep (disruption) panel issued 37 recommendations (three strong and 34 conditional), two good practice statements, and 32 ungraded, nonactionable statements. Three questions from the patient-centered

2018 Society of Critical Care Medicine

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