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221. Evaluation of the child with microcephaly

a genetic disorder was suspected or diagnosed, with the most frequent findings being neuronal migrational disorders or callosal malformations. In the children with postnatal onset microcephaly, 100% showed abnormalities, with hydranencephaly and infarction being most common. The second study classified MRI abnormalities into 4 groups: congenital cytomegalovirus (CMV) infection (n = 6), cerebral malformations/myelination disorders (n = 16), unclassifiable pathologic findings (n = 8), and normal (n = 3 (...) but is estimated to be 1%. Children with severe microcephaly (head circumference <−3 SD) are more likely (∼80%) to have imaging abnormalities and more severe developmental impairments than those with milder microcephaly (−2 to −3 SD; ∼40%). Coexistent conditions include epilepsy (∼40%), cerebral palsy (∼20%), mental retardation (∼50%), and ophthalmologic disorders (∼20% to ∼50%). Recommendations: Neuroimaging may be considered useful in identifying structural causes in the evaluation of the child

2009 American Academy of Neurology

222. Botulinum neurotoxin for the treatment of movement disorders

York, NY; Wake Forest University School of Medicine (A. Brashear), Winston-Salem, NC; Department of Neurology (C.C.), Rush University Medical Center, Chicago, IL; Department of Neurology (R.D.), University of Kansas, Kansas City; The National Institute of Neurological Disorders and Stroke (M.H., B.K., C.L.L.), Bethesda, MD; Department of Neurology (J.J.), Baylor College of Medicine, Houston, TX; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg (...) and Stroke (M.H., B.K., C.L.L.), Bethesda, MD; Department of Neurology (J.J.), Baylor College of Medicine, Houston, TX; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg, Germany; and Stanford University (Y.S.), CA. A. Brashear From the Department of Neurology (D.M.S.), Mount Sinai Medical Center, New York; Department of Otolaryngology (A. Blitzer), St. Lukes-Roosevelt Medical Center, New York, NY; Wake Forest University School of Medicine (A. Brashear

2008 American Academy of Neurology

223. Clinical Guideline on the Treatment of Carpal Tunnel Syndrome

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 (...) Center Drive 2130 Taubman Health Care Center Ann Arbor, MI 48109-0340 Plastic and Reconstructive Surgery Peter C Amadio, MD Mayo Clinic 200 1st St S W Rochester, MN 55902-3008 Orthopaedic Hand Surgeon Michael Andary, MD Michigan State University B401 W Fee Hall (PMR) East Lansing, MI 48824-1316 Physical Medicine and Rehabilitation Neurology Richard W. Barth, MD 2021 K St Ste 400 Washington, DC 20006-1003 AAOS Board of Councilors Orthopaedic Hand Surgeon Kent Maupin, MD 1111 Leffingwell NE Ste 200

2008 Congress of Neurological Surgeons

224. Treatment of cerebellar motor dysfunction and ataxia

ataxia type 2, 4-aminopyridine 15 mg/d probably reduces ataxia attack frequency over 3 months (1 Class I study). For patients with ataxia of mixed etiology, riluzole probably improves ataxia signs at 8 weeks (1 Class I study). For patients with Friedreich ataxia or spinocerebellar ataxia (SCA), riluzole probably improves ataxia signs at 12 months (1 Class I study). For patients with SCA type 3, valproic acid 1,200 mg/d possibly improves ataxia at 12 weeks. For patients with spinocerebellar (...) inpatient rehabilitation probably improves ataxia and function (1 Class I study); transcranial magnetic stimulation possibly improves cerebellar motor signs at 21 days (1 Class II study). For patients with multiple sclerosis–associated ataxia, the addition of pressure splints possibly has no additional benefit compared with neuromuscular rehabilitation alone (1 Class II study). Data are insufficient to support or refute use of stochastic whole-body vibration therapy (1 Class III study). Glossary AAN

2018 American Academy of Neurology

225. Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association (Full text)

, MD, PhD, FAHA , and MD MDOn behalf of the American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; and Stroke Council Sharonne N. Hayes , Esther S.H. Kim , Jacqueline Saw , David Adlam , Cynthia Arslanian-Engoren , Katherine E. Economy , Santhi K. Ganesh , Rajiv Gulati , Mark E. Lindsay , Jennifer H. Mieres , Sahar Naderi , Svati Shah , David E. Thaler , Marysia S (...) . Tweet , and Malissa J. Wood and On behalf of the American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; and Stroke Council Originally published 22 Feb 2018 Circulation. 2018;137:e523–e557 You are viewing the most recent version of this article. Previous versions: Abstract Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary

2018 American Heart Association PubMed abstract

226. Classification of Cough as a Symptom in Adults and Management Algorithms

%) Multiple causes (67%) High risk of bias; no harms reported Irwin et al 19 / 2006 USA Prospective; no exclusions; > 8 wk; no validated tool 24 Mean, 8.6 7.4 y Unexplained (46%) Extrapulmonary (33%) PNDS PNDSþ GERD GERD GERDþ ACEI Intrapulmonary (21%) Asthma Asthmaþ GERD GERDþ PNDS Bronchiolitis Industrial bronchitis High risk of bias; no harms reported Lai et al 20 / 2013 China Prospective; Currentsmokers excluded;$8wk; Novalidatedtool 704 Median, 12 m Range, 2-696 m CVA (32.6%) UACS (18.6%) Multiple (...) causes (8%) NAEB (17.2%) AC (13.2%) GERD (4.6%) Unexplained (8.4%) Others (5.4%) High risk of bias; no harms reported Yuetal 21 /2011 China Prospective; currentsmokers excluded;$8wk; novalidatedtool 109 Median, 6 m Range, 2-480 m CVA (41.3%) UACS (24.8%) NAEB (6.4%) GERD (6.4%) Combined causes: UACSþ CVA UACSþ GERD GERDþ CVA GERDþ NAEB UACSþ CVAþ GERD Other (5.5%) Unexplained (2.7%) Highriskofbias; noharms reported Lee et al 22 / 2007 South Korea Prospective;no exclusions; $4wk;validated

2018 American College of Chest Physicians

227. Hoarseness (Dysphonia) (Full text)

, Ninth Revision , the most commonly used by physicians were acute laryngitis, nonspecific dysphonia, benign vocal fold lesions (eg, cysts, polyps, nodules), and chronic laryngitis. The true point prevalence of dysphonia-related conditions is likely higher, as most patients with voice changes are not “treatment seeking,” particularly if the dysphonia is transient and related to an upper respiratory infection. An earlier study surveyed randomly selected non–treatment seeking adults in Iowa and Utah (...) are common among older adults and significantly affect their QOL. , Vocal fold atrophy with resulting dysphonia is common among older individuals and is frequently undiagnosed by primary care providers. , Neurologic conditions are also more common among older individuals (eg, Parkinson’s disease, stroke) and can cause voice changes. , - The differential diagnosis of pediatric patients is unique and depends on the age of the child. Premature infants are especially at risk for dysphonia. , Dysphonia

2018 American Academy of Otolaryngology - Head and Neck Surgery PubMed abstract

228. Primary & Secondary Prevention of CVD

: antiplatelet monotherapy indefinitely. o Following a stroke or TIA, antiplatelet monotherapy indefinitely. • Anticoagulant therapy: ? Anticoagulation with either warfarin or the newer oral anticoagulants (NOACs) for the prevention of stroke is indicated in individuals with: o Atrial fibrillation o Left ventricular (LV) thrombus demonstrated by echocardiogram and an established stroke or transient ischaemic attack (TIA). Adherence • Full adherence to therapy proven to reduce CVD (aspirin, BP and cholesterol (...) o Individuals with multiple CV risk factors or very high levels of a single CV risk factor – Section 4 o Individuals who are at high risk for a CV event – Section 5 & 6 ? Secondary prevention strategies directed at individuals who: o Have established CVD. • CVD includes: ? Coronary heart disease (CHD) ? Cerebrovascular accident (CVA) ? Peripheral artery disease (PAD) ? Asymptomatic individuals with: o “Silent” myocardial ischemia (MI) detected by non-invasive testing. o Significant atheromatous

2017 Ministry of Health, Malaysia

229. AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol

or other arterial revascularization, stroke, transient ischemic attack (TIA), or peripheral artery disease (PAD) including aortic aneurysm, all of atherosclerotic origin. ASCVD indicates atherosclerotic cardiovascular disease; CHD, coronary heart disease; CVD, cardiovascular disease; ERC, Evidence Review Committee; LDL-C, low-density lipoprotein cholesterol; MI, myocardial infarction; NNH, number needed to harm; NNT number needed to treat; and RCT, randomized controlled trial. 1.2. Organization (...) Figure 1. Secondary Prevention in Patients With Clinical ASCVD Colors correspond to Class of Recommendation in Table 2. Clinical ASCVD consists of ACS, those with history of MI, stable or unstable angina or coronary other arterial revascularization, stroke, transient ischemic attack (TIA), or peripheral artery disease (PAD) including aortic aneurysm, all of atherosclerotic origin Very high-risk includes a history of multiple major ASCVD events or 1 major ASCVD event and multiple high-risk conditions

2018 American College of Cardiology

230. Guidelines for the management of acute coronary syndromes

-310. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002; 324: 71-86. Mehta SR, Yusuf S, Peters RJ, et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 2001; 358: 527-533. Steinhubl SR, Berger PB, Mann JT, et al. Early and sustained dual oral antiplatelet therapy (...) . Circulation 1994; 90: 2280-2284. Madsen JK, Grande P, Saunamaki K, et al. Danish multicenter randomized study of invasive versus conservative treatment in patients with inducible ischemia after thrombolysis in acute myocardial infarction (DANAMI). DANish trial in Acute Myocardial Infarction. Circulation 1997; 96: 748-755. Caracciolo EA, Davis KB, Sopko G, et al. Comparison of surgical and medical group survival in patients with left main coronary artery disease. Long-term CASS experience. Circulation 1995

2006 MJA Clinical Guidelines

231. Physical activity for people with cardiovascular disease: recommendations of the National Heart Foundation of Australia (Full text)

of myocardial infarction compared with their active counterparts. While recent health promotion campaigns have passionately promoted physical activity for the general population, definitive national recommendations for those people with heart, stroke or vascular disease have not been available. To fill this void, the National Heart Foundation of Australia, in consultation with key stakeholders, has produced the following physical activity recommendations for people with CVD. More detailed information (...) ] A ). (see for NHMRC classifications.) Reduction in symptoms Exercise training reduces recurrent anginal symptoms, lessens breathlessness associated with heart failure and stroke, and reduces severity of claudication pain with walking in patients with PVD (LOE I, GOR A). Enhanced quality of life Exercise rehabilitation is associated with small but consistently favourable changes in self-reported quality-of-life domains among survivors of myocardial infarction, people with heart failure and PVD (LOE II

2006 MJA Clinical Guidelines PubMed abstract

232. National data elements for the clinical management of acute coronary syndromes (Full text)

condition. RS NC Date of the most recent stroke The date of the most recent documented stroke or cerebrovascular accident. Domain: D/O = Diagnosis/Outcome, CP = Clinical Process, RS = Risk Stratification. Dataset: C = Core, NC = Non-core. Data elements for acute coronary syndromes (ACS) (continued) Presentation and triage Domain Dataset Element Description D/O NC Time of onset of ACS symptoms The time of the onset of cardiac ischaemic symptoms that prompted the patient to seek medical attention related (...) stratification and treatment of ACS that a person has or has undergone before presentation: angina for more than past 2 weeks, angina only in the past 2 weeks, chronic lung disease, heart failure, hypertension, ischaemic: non-haemorrhagic cerebral infarction, haemorrhagic: intracerebral haemorrhage, peripheral artery disease, aortic aneurysm, renal artery stenosis, sleep apnoea, not stated, inadequately described. RS C Clinical evidence status Indicator of the status of evidence for a pre-existing clinical

2005 MJA Clinical Guidelines PubMed abstract

233. Neuro-urology

lesions and diseases Neurological Disease Frequency in General Population Type and Frequency of Neuro- Urological Symptoms Cerebrovascular accident (Strokes) 450 cases/100,000/yr (Europe) [21] (10% of cardiovascular mortality) Nocturia - OAB - UUI - DO (other patterns less frequent) [22]. 57-83% of neuro-urological symptoms at 1 month post stroke, 80% of spontaneous recovery at 6 months [23]. Persistence of UI correlates with poor prognosis [24]. Dementias: Alzheimer’s disease (80%), Vascular (10 (...) 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

2015 European Association of Urology

234. Urological Infections

immunosuppression* - Connective tissue diseases* - Prematurity, new-born N Nephropathic disease, with risk of more severe outcome - Relevant renal insufficiency* - Polycystic nephropathy U Urological RF , with risk of more severe outcome, which can be resolved during therapy - Ureteral obstruction (i.e. stone, stricture) - Transient short-term urinary tract catheter - Asymptomatic Bacteriuria** - Controlled neurogenic bladder dysfunction - Urological surgery C Permanent urinary Catheter and non-resolvable (...) . coli of 38°C), or costovertebral angle tenderness, and it can occur in the absence of symptoms of cystitis [79]. Pregnant women with acute pyelonephritis need special attention, because this kind of infection may have not only an adverse effect on the mother with anaemia, renal and respiratory insufficiency, but also on the unborn with more frequent preterm labour and preterm birth [80]. Most men with febrile UTI have a concomitant infection of the prostate as measured by transient increases of PSA

2015 European Association of Urology

235. Prostate Cancer

clinical impact is, as yet undetermined, given the slight net benefit for clinical decision-making [60].22 PROSTATE CANCER - UPDATE MARCH 2015 5.2.2.5 PCA3 marker PCA3 is a prostate-specific, non-coding mRNA biomarker that is detectable in urine sediments obtained after three strokes of prostatic massage during DRE. The Progensa urine test for PCA3 is now commercially available. PCA3 is superior to total and percent-free PSA for detection of PCa in men with elevated PSA as it shows significant

2015 European Association of Urology

236. ST-Elevation Myocardial Infarction: Guideline For the Management of

. Hyperglycemia .e112 10. Risk Assessment After STEMI .e113 10.1. Use of Noninvasive Testing for Ischemia Before Discharge: Recommendations . .e113 10.2. Assessment of LV Function: Recommendation .e114 10.3. Assessment of Risk for SCD: Recommendation .e114 11. Posthospitalization Plan of Care .e114 11.1. Posthospitalization Plan of Care: Recommendations .e114 11.1.1. The Plan of Care for Patients With STEMI .e114 11.1.2. Smoking Cessation .e116 11.1.3. Cardiac Rehabilitation .e116 11.1.4. Systems of Care (...) therapy. CABG indicates coronary artery bypass graft; DIDO, door-in–door-out; FMC, ?rst medical contact; LOE, Level of Evidence; MI, myocardial infarction; PCI, percutaneous coronary intervention; and STEMI, ST-elevation myocardial infarction. e86 O’Gara et al. JACC Vol. 61, No. 4, 2013 2013 ACCF/AHA STEMI Guideline: Full Text January 29, 2013:e78–140tutional quality improvement efforts, broader initiatives at a systems level are required to reduce total ischemic time, the principal determinant

2012 American College of Cardiology

237. Evolution of Critical Care Cardiology: Transformation of the Cardiovascular Intensive Care Unit and the Emerging Need for New Medical Staffing and Training Models (Full text)

requiring critical care. Evolution of the CICU Early History of Critical Care Cardiology In the early 1960s, after the successful implementation of open- and then closed-chest defibrillation and the introduction of the first continuous electrocardiographic monitoring, the first coronary care units (CCUs) were formed with the premise that rapid identification and termination of peri-infarction arrhythmias could dramatically alter the natural history of acute myocardial infarction (MI). , The earliest (...) procedures within the Duke University Coronary Care Unit from 1989 to 2006. Data from Katz et al. STEMI indicates ST-segment–elevation myocardial infarction; NSTEMI, non–ST-segment–elevation myocardial infarction; PCI, percutaneous coronary intervention; and PA, pulmonary artery. Figure 2. Evolution of the cardiac intensive care unit. Advances in technology, medical care, critical care unit organization, and changes in the patient population have contributed to evolution of the contemporary cardiac

2012 American Heart Association PubMed abstract

238. Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management (Full text)

achievement, language (expressive and receptive), gross motor function, oral and speech motor control functions, and attention (executive control). Methods of vital organ support during infant heart surgery, including CPB and DHCA, may result in cerebral macroemboli and microemboli to the central nervous system , or a period of global cerebral ischemia and thereby contribute to observed DDs. These central nervous system events may contribute to the presence of acute arterial ischemic strokes or cerebral (...) Gerdes , J. William Gaynor , Kathleen A. Mussatto , Karen Uzark , Caren S. Goldberg , Walter H. JohnsonJr , Jennifer Li , Sabrina E. Smith , David C. Bellinger , and William T. Mahle and on behalf of the American Heart Association Congenital Heart Defects Committee of the Council on Cardiovascular Disease in the Young, Council on Cardiovascular Nursing, and Stroke Council Originally published 30 Jul 2012 Circulation. 2012;126:1143–1172 You are viewing the most recent version of this article. Previous

2012 American Heart Association PubMed abstract

239. Educational and Psychological Interventions to Improve Outcomes for Recipients of Implantable Cardioverter Defibrillators and Their Families (Full text)

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 (...) isolation, transient depression, being shocked, fear of and anxiety associated with being shocked, problems associated with activity restrictions, and trying to live a normal life in the midst of dealing with a chronic heart condition. The inability to participate in full-contact organized sports was particularly burdensome to those who had genetically determined diseases that put them at increased risk for SCA. Stefanelli et al reported that 3 of 27 pediatric patients who had received repeated shocks

2012 American Heart Association PubMed abstract

240. Recommendations for the Use of Mechanical Circulatory Support: Device Strategies and Patient Selection (Full text)

ischemia. , Withdrawal of Nondurable MCS Patients who receive nondurable MCS (either percutaneous or surgically placed) should always be evaluated for possible ventricular recovery, particularly in the setting of postcardiotomy shock, myocardial infarction, or myocarditis. Weaning can be performed by assessing clinical parameters (hemodynamics and echocardiographic left ventricular function) while MCS is temporarily reduced. Although uniform guidelines for weaning MCS do not exist, it is common (...) the concept and indication of bridge to recovery in which temporary MCS sustained the circulation until cardiac recovery. A robust experience with temporary MCS for failure to wean from bypass led to the application of MCS in nonpostcardiotomy settings such as cardiogenic shock caused by myocardial infarction, fulminant or acute myocarditis, or acute cardiac allograft dysfunction after heart transplantation. Compared with early options for MCS, modern devices ( ) provide longer duration and more versatile

2012 American Heart Association PubMed abstract

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