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201. Intermediate care including reablement

). Page 3 of 28This guideline is the basis of QS173. Ov Overview erview This guideline covers referral and assessment for intermediate care and how to deliver the service. Intermediate care is a multidisciplinary service that helps people to be as independent as possible. It provides support and rehabilitation to people at risk of hospital admission or who have been in hospital. It aims to ensure people transfer from hospital to the community in a timely way and to prevent unnecessary admissions (...) intermediate care teams. These might include: regular team meetings to share feedback and review progress shared notes opportunities for team members to express their views and concerns. 1.2.6 Ensure that the intermediate care team has a clear route of referral to and engagement with commonly used services, for example: general practice podiatry pharmacy mental health and dementia services specialist and longer-term rehabilitation services housing services voluntary, community and faith services specialist

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

202. Management of Valvular Heart Disease (Full text)

navigation 21 September 2017 Article Contents Article Navigation 2017 ESC/EACTS Guidelines for the management of valvular heart disease Helmut Baumgartner Corresponding authors: Helmut Baumgartner, Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Albert Schweitzer Campus 1, Building A1, 48149 Muenster, Germany. Tel: +49 251 834 6110, Fax: +49 251 834 6109, E-mail: . Volkmar Falk, Department of Cardiothoracic and Vascular Surgery (...) , Germany. Tel: +49 251 834 6110, Fax: +49 251 834 6109, E-mail: . Volkmar Falk, Department of Cardiothoracic and Vascular Surgery, German Heart Center, Augustenburger Platz 1, D-133353 Berlin, Germany and Department of Cardiovascular Surgery, Charite Berlin, Charite platz 1, D-10117 Berlin, Germany. Tel: +49 30 4593 2000, Fax: +49 30 4593 2100, E-mail: . Search for other works by this author on: Jeroen J Bax Search for other works by this author on: Michele De Bonis Search for other works

2017 European Society of Cardiology PubMed abstract

203. Diagnosis and Treatment of Peripheral Arterial Diseases (Full text)

, demonstrated that DAPT vs. aspirin reduced silent cerebral micro-emboli by 37% after 7 days. No life-threatening intracranial or major bleeding was observed, but the sample size was small. For these reasons, DAPT may be considered within 24 h of a minor ischaemic stroke or transient ischaemic attack (TIA) and may be continued for 1 month in patients treated conservatively. DAPT is recommended in patients undergoing CAS. Two small RCTs comparing aspirin alone with DAPT for CAS were terminated prematurely (...) for Endarterectomy SAPT Single antiplatelet therapy SBP Systolic blood pressure SFA Superficial femoral artery SPACE Stent Protected Angioplasty versus Carotid Endarterectomy STAR Stent Placement in Patients With Atherosclerotic Renal Artery Stenosis and Impaired Renal Function TAMARIS Efficacy and Safety of XRP0038/NV1FGF in Critical Limb Ischaemia Patients With Skin Lesions TAVI Transcatheter aortic valve implantation TBI Toe-brachial index TcPO 2 Transcutaneous oxygen pressure TIA Transient ischaemic attack

2017 European Society of Cardiology PubMed abstract

204. BSR guideline Management of Adults with Primary Sjögren's Syndrome (Full text)

to replace tear film oil layer Punctal plugging—punctal or intracanalicular plugs (ophthalmology only) Nutritional tear substitutes Secretagogues Autologous or allogeneic serum eye drops (available via specialist commissioned centres only) Oral pilocarpine max 5 mg 4× per day (start with 2.5 mg od and build up) Permanent punctal occlusion via cautery of all four puncta Pilocarpine 4% (3 drops = 5 mg) for those who are unable to swallow (palliative care pathway [ ]) Periorbital botulinum toxin (...) commissioned centres only) Oral pilocarpine max 5 mg 4× per day (start with 2.5 mg od and build up) Permanent punctal occlusion via cautery of all four puncta Pilocarpine 4% (3 drops = 5 mg) for those who are unable to swallow (palliative care pathway [ ]) Periorbital botulinum toxin for significant blepharospasm Bandage contact lenses Amniotic membrane overlay or corneal grafting for significant corneal ulceration and corneal melt or perforation Based upon the DEWS workshop and the Meibomian Gland

2017 British Society for Rheumatology PubMed abstract

205. WHO Guidelines on Integrated Care for Older People (ICOPE)

in the demographics of populations around the world: the proportion of older people in general populations has increased substantially within a relatively short period of time. Numerous underlying physiological changes occur with increasing age, and for older people the risks of developing chronic disease and care dependency increase. By the age of 60 years, the major burden of disability and death arises from age-related losses in hearing, seeing and moving, and conditions such as dementia, heart disease, stroke (...) over 60 years of age is expected to increase over threefold, from 46 million in 2015 to 147 million in 2050 (1). With increasing age, numerous underlying physiological changes occur, and the risks for older people developing chronic disease and care dependency increase. The major population burdens of disability and death in people over 60 arise from age-related losses in hearing, seeing and moving, and conditions such as dementia, heart disease, stroke, chronic respiratory disorder, diabetes

2017 World Health Organisation Guidelines

206. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock (Full text)

, and killing as many as one in four (and often more) ( ). Similar to polytrauma, acute myocardial infarction, or stroke, early identification and appropriate management in the initial hours after sepsis develops improves outcomes. The recommendations in this document are intended to provide guidance for the clinician caring for adult patients with sepsis or septic shock . Recommendations from these guidelines cannot replace the clinician’s decision-making capability when presented with a patient’s unique (...) (the Italian Association of Anesthesia and Intensive Care). Dr. Nishida participates in The Japanese Society of Intensive Care Medicine (vice chairman of the executive boards), the Japanese Guidelines for the Management of Sepsis and Septic Shock 2016 (chairman), The Japanese Guidelines for Nutrition Support Therapy in the Adult and Pediatric Critically Ill Patients (board), The Japanese Guidelines for the Management of Acute Kidney Injury 2016 (board), The Expert Consensus of the Early Rehabilitation

2016 European Respiratory Society PubMed abstract

207. Shoulder Pain - Atraumatic

still provides an excellent method to assess repair integrity, as well as potential complications following surgery and during rehabilitation. The ability to perform provocative maneuvers can further demonstrate abnormalities that other forms of imaging would be incapable of performing. Nuclear Medicine Nuclear medicine studies are not routinely used in the evaluation of pain after rotator cuff repair. Variant 8: Atraumatic shoulder pain. Neurogenic pain (excluding plexopathy). Initial imaging

2018 American College of Radiology

208. Delirium in Adult Cancer Patients: ESMO Clinical Practice Guidelines

Continued Table 1. Continued Indirectriskfactorsfordelirium Otherstatusorpredisposingcomorbidities[5,39] Visual impairment Urinary retention or use of urinary catheter Constipation Alcohol or drug abuse, or withdrawal (including nicotine) CNS diseases or trauma; history of stroke or transient ischaemia Liver failure Renal failure End-stage cardiac disease End-stage lung disease Endocrinopathy CNS, central nervous system; NSAID, non-steroidal anti-in?ammatory drug; SIADH, syndrome of inappropriate (...) IdiSNA, Pamplona; 10 ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain; 11 Division of Thoracic Oncology, Cardio-Thoracic Department, University Hospital of Pisa, Pisa, Italy; 12 Department of Pharmacy, The Ottawa Hospital, Ottawa, Canada; 13 Department of Health Sciences, Hull York Medical School, University of York, York; 14 Bradford District Care NHS Foundation Trust, Bradford, UK; 15 Department of Rehabilitation, Aged Care Unit, Ancelle

2018 European Society for Medical Oncology

209. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

. One of these drugs is dipyridamole, which acts in vivo to modify several biochemical pathways involved in platelet aggregation and thrombus formation. The extended release (ER) forms of dipyridamole (200 mg ER) and ASA (25 mg) are often used in combination for the management of cerebral vascular disease including secondary prevention of stroke and transient ischemic attacks (TIAs). Dipyridamole inhibits PDE-3 and PDE-5. By inhibiting cAMP and cGMP PDEs, cAMP and cGMP levels increase, which results (...) in this patient population. Low-dose ASA, when used for secondary prophylaxis, has been shown to reduce the risk of stroke and myocardial infarction in the range of 25% to 30%. Furthermore, the discontinuation of ASA for secondary prophylaxis is associated with significant risk. The lowest effective ASA daily dose for the prevention of TIA and ischemic stroke is 50 mg. For men at high risk of cardiovascular disease, the recommended dose increases to 75 mg. The routine long-term use of doses greater than 75

2018 American Society of Regional Anesthesia and Pain Medicine

210. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain (Full text)

injury. A second RCT that included individuals with both CRPS types I and II reported a 14-point difference on the short-form McGill Pain Questionnaire between the ketamine (up to 100 mg over 4 hours for 10 consecutive weekdays) and placebo infusion groups at 9- to 12-week follow-up ( ). In individuals with nociceptive pain, the results have been mixed. Among patients with ischemic pain attributed to severe peripheral vascular disease, 1 RCT reported a 19% difference in pain relief between (...) no significant changes in cardiac output, stroke volume, systemic vascular resistance, and other cardiovascular parameters. However, in critically ill patients, there appears to be a negative inotropic effect as demonstrated in a 1980 study. Reviews have noted that ketamine has both a negative inotropic effect and simultaneous indirect sympathetic nervous system stimulation, which is due to systemic release of catecholamines, vagal nerve inhibition, inhibition of norepinephrine reuptake at peripheral nerves

2018 American Society of Regional Anesthesia and Pain Medicine PubMed abstract

211. Optimization of Heart Failure Treatment

Atherosclerotic Cardiovascular Risk in Adults (96). Also see the nonstatin treatment of dyslipidemia clinical pathways (97) Peripheral Vascular Disease Moderate None Treat according to current AHA/ACC vascular guidelines (98) Cerebrovascular Disease Moderate Weak Treat according to current AHA stroke guidelines (99) Noncardiovascular Obesity Moderate (inverse association) Weak Further data needed Chronic Lung Disease Strong Weak Optimize therapy, consider pulmonary consultation Diabetes Mellitus Strong (...) doses or maximally tolerated doses, patients with chronic HFrEF should be evaluated on a regularly scheduled basis. For most patients, a reasonableintervalisevery3to6months,althoughmany may require more frequent follow-up to monitor clinical stability and revisit opportunities for further GDMT titration. Cardiac rehabilitation is bene?cial and remains underutilized. High-risk features (conveniently summarized in the acronym “INEEDHELP” in Figure 4 and Table 6)should trigger consideration

2017 American College of Cardiology

212. Clinical practice guidelines for the care of girls and women with Turner syndrome: proceedings from the 2016 Cincinnati International Turner Syndrome Meeting (Full text)

recommend a formal audiometric evaluation every 5 years regardless of the initial age at diagnosis, initial hearing threshold levels, karyotype and/or presence of a mid-frequency sensorineural hearing loss, to assure early and adequate technical and other rehabilitative measures (⨁⨁◯◯). R 6.2. We recommend aggressive treatment of middle-ear disease and otitis media (OM) with antibiotics and placement of myringotomy tubes as indicated (⨁⨁◯◯). R 6.3. We recommend screening for hypothyroidism at diagnosis

2016 European Society of Human Reproduction and Embryology PubMed abstract

213. Assessment scales for disorders of consciousness: evidence-based recommendations for clinical practice and research

validity (including criterion validity), and/or prognostic validity data on a second-generation DOC behavioral assessment scale; (2) examined a cohort, case con- trol, or case series sample made up of persons with DOC resulting from traumatic brain injury, stroke, and/or other non- traumatic brain injury etiology with most age greater than or equalto18years;and(3)assessedthesampleineitheranacute care or a rehabilitation setting. Articles were excluded if peer review was not conducted, original data (...) . Inmostcasesauthorsarepermittedtoposttheirversionofthe article(e.g. inWordorTexform)totheirpersonalwebsiteor institutionalrepository. Authorsrequiringfurtherinformation regardingElsevier’sarchivingandmanuscriptpoliciesare encouragedtovisit:'s personal copy SPECIAL ARTICLE A Practice Parameter of the American Congress of Rehabilitation Medicine Assessment Scales for Disorders of Consciousness: Evidence- Based Recommendations for Clinical Practice and Research Report of the American Congress of Rehabilitation

2010 American Academy of Neurology

214. Reporting Standards for Carotid Artery Angioplasty and Stent Placement

Definition (49) Medical Coronary artery disease (angina, myocardial infarctionsix mo, congestive heart failure), hypertension (180/110 mm Hg), severe peripheral vascular disease, chronic obstructive pul-monary disease, age older than 70 years, severely obese Neurological Neurological deficit within 24 h, general cerebral ischemia, recent cerebrovascular accident (seven d), frequent transient ischemic attacks Angiographic Contralateral internal carotid artery occlusion, siphon stenosis, plaquethree cm (...) (30% to 99% symptomatic stenosis) have been re- ported(27,28).Theoverallrateofperi- operative stroke and death (1.1%) was 6.5%.Fivebaselinevariableswerepre- dictive of statistically significant in- creasedsurgicalrisk:hemisphericver- sus retinal transient ischemic attack as the qualifying event, left-sided proce- dure, contralateral carotid occlusion, ipsilateral ischemic lesion on CT scan, and irregular or ulcerated ipsilateral plaque.Theincidenceofperioperative wound complications was 9.3

2009 Society of Interventional Radiology

215. Reporting Standards for Angioplasty and Stent-assisted Angioplasty for Intracranial Atherosclerosis

- cranial stenosis,” “stroke,” “transient ischemic attacks,” “TIA,” or “cerebral stenosis,” were used in conjunction with procedural terms, including “in- tracranial stent,” “intracranial angio- plasty,” “intracranial stent-assisted angioplasty,” “thrombolysis,” “inter- vention,” “endovascular revascular- ization,” and “endovascular treat- ment.” English and non-English language articles published between January 1, 1997, and December 31, 2007, are in- cluded. To identify further published, unpublished (...) at qualifying event, no. (%) Type and dose of diuretic treatment at time of medical treatment failure, no. (%) Schumacher et al  S453 Volume 20 Number 7Seitherofthesescalesshouldhavebeen trained, tested, and certified in their use to assure their correct application (12–14). Patient Selection According to Under- lyingPathophysiologyofBrainIschemia SecondarytoIntracranialAtherosclerosis Transient ischemic attacks or isch- emic stroke secondary to intracranial cerebral atherosclerosis are caused by 4

2009 Society of Interventional Radiology

216. Level of Care for Musculoskeletal Surgery

distress - Obstructive sleep apnea - Liver disease – cirrhosis - Vascular • Cardiovascular disease o myocardial infarction (MI) within six (6) months of intended surgery o angina pectoris with severe functional limitation o cardiac arrhythmia o implantable cardiac device (defibrillator, pacemaker) Copyright © 2018. AIM Specialty Health. All Rights Reserved. Level of Care for Musculoskeletal Surgery and Procedures 7 • Cerebrovascular disease o recent stroke or transient ischemic attack (TIA (...) Copyright © 2018. AIM Specialty Health. All Rights Reserved. Level of Care for Musculoskeletal Surgery and Procedures 13 • Cardiovascular disease o myocardial infarction (MI) within six (6) months of intended surgery o angina pectoris with severe functional limitation o cardiac arrhythmia o implantable cardiac device (defibrillator, pacemaker) • Cerebrovascular disease o recent stroke or transient ischemic attack (TIA) - Uncontrolled preoperative pain - Prior complication of anesthesia - Prior

2018 AIM Specialty Health

217. AIM Clinical Appropriateness Guidelines for Arterial Ultrasound

attack (CVA) and transient ischemic attack (TIA) do not apply specifically to either anterior or posterior circulation ? For the purposes of this guideline, severity of vascular stenosis is defined as follows: ? Mild disease: 1.40) ? Duplex imaging is appropriate for patients with claudication who have normal, borderline, or inconclusive physiological testing (ABI> 0.90) ? Patients with resting ischemic pain ? Patients with evidence of atheroembolic disease of the lower extremities (ischemic (...) transcranial Doppler studies in addition to Duplex imaging. Transcranial Doppler studies are not subject to preauthorization and are therefore not addressed in this document ? For the purposes of this guideline symptoms are defined as follows: ? Anterior symptoms (carotid vascular territory) include unilateral motor or sensory deficit, speech impairment, or amaurosis fugax ? Posterior symptoms (vertebrobasilar territory) include vertigo, ataxia, diplopia, dysphagia, dysarthria ? The terms cerebrovascular

2018 AIM Specialty Health

218. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions

Recommendation B Clinicians should administer appropriate physical impair- ment assessments of body structure and function, at least at baseline and at discharge or 1 other follow-up point, for all patients with meniscus tears to support standardization for quality improve- ment in clinical care and research, including the modi?ed stroke test for effusion assessment, assessment of knee active range of motion, maximum voluntary isometric or isokinetic quadriceps strength test- ing, forced hyperextension (...) , maximum passive knee ?exion, McMurray’s maneuver, and palpation for joint-line tenderness. D Clinicians may administer the appropriate physical impair- ment assessments of body structure and function, at least at baseline and at discharge or 1 other follow-up point, for all patients with articular cartilage lesions to support standardization for quality improvement in clinical care and research, including the modi?ed stroke test for effusion assessment, assessment of knee active range of motion

2018 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

219. Alcoholic Liver Disease

that warrant questioning the diagnosis of hepatic encephalopathy or AWS. For example, seizures, focal neuro- logical defi cits, severe headache, and encephalopathy refractory to all measures should point towards an alternate cause for altered consciousness such as stroke, subdural hematoma, drug overdose, meningitis, and fungal infections of the central nerv- ous system. A drug screen is recommended and in selected patients imaging of the head and cerebral spinal fl uid studies may be required ( 53 (...) - ume) ( 7 ). Economic costs due to AUD (249 billion USD per year) are increasing. An estimated 88,000 people (~62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the fourth leading preventable cause of death in the United States ( 8 ). Apart from ALD, accidents or violence are other com- mon causes of death among adult people abusing alcohol. In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths in the United States (31% of overall driving

2018 American College of Gastroenterology

220. Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association

of cases occur without any prior recognized heart disease; half occur without any prodromal symptoms. Despite robust systems of care for patients with trauma and rapidly evolving systems of care for patients with ST-segment–elevation myocardial infarction (STEMI) and stroke, the majority of communities do not achieve optimal survival after OHCA because of large discrepancies in resuscitation-related processes of care. As a result, survival to hospital discharge varies significantly both across (...) in neurocritical care specialty units by neurointensivists improves outcomes in patients with traumatic brain injury, , intracerebral hemorrhage, cerebrovascular accident, and subarachnoid hemorrhage. How this specialty could be integrated into the continuum of care delivery for survivors of OHCA represents in important area of future inquiry. Implementation and Operationalizing Operationalizing the comprehensive components of an optimal resuscitation system of care may face challenges at each level

2018 American Heart Association


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