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641. Appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia

with the person and/or their relevant Decision Supporter 4 about the benefits and risks, including the increased risk of stroke, transient ischemic attack and mortality, should occur before antipsychotic medication is commenced. Quality of evidence Low High High High High Moderate Low Strength of recommendation Strong Strong Strong Strong Strong Conditional Conditional General principles of care Antipsychotic medication Section 1 A comprehensive assessment should include: review of medical history and mental (...) dementia (VaD) In vascular dementia, changes in thinking skills sometimes occur suddenly following strokes that block major brain blood vessels. Thinking problems also may begin as mild changes that worsen gradually as a result of multiple minor strokes or other conditions that affect smaller blood vessels, leading to cumulative damage. Z-drugs These types of medications work in a similar way to benzodiazepines and are often used to treat sleep problems (insomnia). Abbreviations The following

2019 National Clinical Guidelines (Ireland)

644. Enhanced Recovery

. Several meta- analyses of RCTs have shown that goal-directed fluid ther - apy (GDFT) reduces postoperative morbidity and length of hospital stay, especially in high-risk patients undergo- ing major surgery. 213–216 High-risk patients have been vari- ably defined but have been noted to include patients with a history of severe cardiorespiratory illness (acute myo- cardial infarction, chronic obstructive pulmonary disease, stroke, etc), planned extensive surgery (>8 h), age >70 years with evidence (...) However, inherent biases in the study design, lack of control group or randomization of participants, small sample sizes, wide variances in com- pliance with protocols, and limited generalizability limited these studies. When looking at postoperative quality out- comes, small, single-center studies report no differences in postoperative complication rates and hospital length of stay with prehabilitation compared with control subjects or postoperative rehabilitation 103,106,109 or results have been

2017 American Society of Colon and Rectal Surgeons

645. Managing Chronic Non-Terminal Pain in Adults Including Prescribing Controlled Substances

if ineffective. Extreme caution needed for older adults; use PPI with NSAID or with COX-2/aspirin . NSAID use in patients with heart disease or its risk factors increases overall risk of heart attack or stroke. Naproxen Aleve Initial: 225 – 550 mg BID Typical: 375 mg BID Max: 500 mg BID $13 / $13 NSAID use in patients with heart disease or its risk factors increases overall risk of heart attack or stroke. Opioids (listed in order of increasing potency) 1 Tramadol [Schedule 4] Ultram Initial: 25 or 50 mg QID (...) Managing Chronic Non-Terminal Pain in Adults Including Prescribing Controlled Substances 1 Quality Department Guidelines for Clinical Care Ambulatory Chronic Pain Management Guideline Team Team Leads Daniel W Berland, MD General Medicine / Anesthesiology Phillip E Rodgers, MD Family Medicine Team Members Carmen R Green, MD Anesthesiology R Van Harrison, PhD Medical Education Randy S Roth, PhD Physical Medicine & Rehabilitation Consultants Daniel J. Clauw, MD Rheumatology Jennifer A. Meddings

2017 University of Michigan Health System

646. Clinical practice guideline for limb salvage or early amputation

or by downloading to your smartphone or tablet via the Apple and Google Play stores! View background material via the LSA CPG eAppendix Page4 Table of Contents SUMMARY OF RECOMMENDATIONS 6 BURDEN OF INJURY 6 PSYCHOSOCIAL FACTORS 7 REHABILITATION 7 NERVE INJURY 7 MASSIVE SOFT TISSUE AND MUSCLE DAMAGE 7 VASCULAR INJURY/LIMB ISCHEMIA 8 SMOKING 8 LOWER EXTREMITY INJURY SCORES 8 AMPUTATION/LIMB SALVAGE 9 GUIDELINE DEVELOPMENT GROUP ROSTER 10 Voting Members 10 Non-Voting Members 10 INTRODUCTION 11 METHODS 15 Best (...) the LSA CPG eAppendix VASCULAR INJURY/LIMB ISCHEMIA 32 SMOKING 34 LOWER EXTREMITY INJURY SCORES 36 AMPUTATION/LIMB SALVAGE 38 CONSENSUS STATEMENTS 40 Methodology 41 Orthotics/Prosthetics 42 Massive Muscle Damage 43 Comorbidities 45 APPENDICES 47 Appendix I – References for Included Literature 48 Appendix II - Guideline Development Group Disclosures 51 Non-Voting Oversight Chairs’ and Voting Members’ Disclosures 51 Appendix III – PICO Questions Used to Define Literature Search 53 Appendix IV

2020 American Academy of Orthopaedic Surgeons

647. Clinical Exercise Stress Testing in Adults

determine the nature of the Position Statement on Clinical Exercise Stress Testing in Adults Page 6 of 11 tachy and brady arrhythmias that may occur during exercise. The physician must also be able to diagnose ischaemic patterns as they occur, and to correctly interpret the exercise electrocardiogram for the presence or absence of ischaemia. iii) Interpretation of Symptoms. The medical practitioner should be able to recognize symptoms occurring during exercise, and be able to differentiate ischaemic (...) of the Rehabilitation, Exercise and Prevention Working Group. The Position Statement was reviewed by a Working Group chaired by A/Prof David Colquhoun. None of the reviewers have a conflict of interest to declare. The revised Statement was considered by the Continuing Education and Recertification Committee and ratified at the CSANZ Board meeting held on 1 st August 2014. Position Statement on Clinical Exercise Stress Testing in Adults Page 2 of 11 1. PREAMBLE Clinical exercise testing has wide application

2014 Cardiac Society of Australia and New Zealand

648. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations Full Text available with Trip Pro

disturbances and delayed convalescence. Fitness can be subdivided into coexisting medical problems and physical fitness. Pre‐existing health factors such as myocardial infarction, heart failure, stroke, peripheral vascular disease and impaired kidney function can increase the risk of post‐operative complications. There is also sufficient evidence that patients with poor physical conditions and low anaerobic threshold have greater post‐operative morbidity and mortality. In patients with cardiopulmonary (...) associated with ageing are responsible for decreased reserve, impaired functional status, thus leading to poor capacity to withstand the stress of surgery. Co‐morbidities associated with the elderly include hypertension, ischaemic heart disease, stroke, hypercholesterolaemia, chronic obstructive airway disease and diabetes. Although age per se does not preclude surgery, the presence of coexisting diseases has a greater impact on post‐operative morbidity and mortality than age alone. Furthermore

2015 ERAS Society

649. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS) Society Recommendations

for cystectomy. Keywords: , , , Abbreviation: ( ), ( ), ( ) 1. Introduction Enhanced recovery after surgery (ERAS) protocols have been introduced to reduce surgical stress and facilitate postoperative recovery. x 1 Kehlet, H. Multimodal approach to control postoperative pathophysiology and rehabilitation. British Journal of Anaesthesia . 1997 May ; 78 : 606–617 | | | In colorectal surgery, meta-analyses have provided level 1 evidence (LE) for reduction of complications (−50%) and hospital stay (−2.5 days (...) in many other specialties including gynecology, thoracic, vascular, pediatric and orthopedic surgery. x 3 Ansari, D., Gianotti, L., Schroder, J., and Andersson, R. Fast-track surgery: procedure-specific aspects and future direction. Langenbeck's Archives of Surgery – Deutsche Gesellschaft fur Chirurgie . 2012 Jan ; 398 : 29–37 | | | Interestingly, ERAS protocol development or utilization in urology appears to have a low adoption. Radical cystectomy represents a significant surgical challenge

2013 ERAS Society

650. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice Full Text available with Trip Pro

abstinence in these patients even with replacement medical therapy. Patients with end stage liver failure due to cirrhosis are at extremely high risk and will need expert care for all types of procedures , . Smoking Smokers often have comorbidities due to smoking such as chronic obstructive airways disease, emphysema, peripheral vascular and ischaemic heart disease and cerebrovascular disease that can increase the risk of perioperative complications independently. Smokers without these comorbidities (...) for non‐cardiac surgery. The Lee index The Lee Index is a modification of the original Goldman cardiac risk index . It comprises six independent clinical determinants of major perioperative cardiac events: History of ischaemic heart disease (IHD) History of cerebrovascular disease Heart failure Preoperative insulin treatment for diabetes mellitus Serum creatinine > 177 μmol/l High‐risk type of surgery All factors contribute 1 point equally to the index, and for patients with an index of 0, 1, 2 and 3

2015 ERAS Society

652. Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk Full Text available with Trip Pro

Heart Attack (ALLHAT) trials. The recommendation for treatment with aspirin in this population has been eliminated due to a lack of sufficient evidence for its benefit. Subsequent data and a systematic review identified a relative risk (RR) reduction in nonfatal myocardial infarction (MI) but not in cardiovascular or all-cause mortality. The effects were modest and could be potentially outweighed by the risk of bleeding and other complications ( ). Dietary and exercise recommendations have been (...) Microsite Search Term Close search filter search input Article Navigation Close mobile search navigation Article Navigation September 2019 Article Contents Article Navigation Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk: An Endocrine Society Clinical Practice Guideline James L Rosenzweig Hebrew Rehabilitation Hospital, Boston, Massachusetts Correspondence: James L. Rosenzweig, MD, Hebrew Rehabilitation Hospital, 1200 Centre Street, Boston, Massachusetts 02131. E-mail: . Search

2019 The Endocrine Society

653. Integrating Tobacco Interventions into Daily Practice

(Reid et al., 2015). Based on current tobacco use rates, the 21st century will see one billion tobacco-related deaths globally (World Lung Foundation, 2015). The impact of tobacco use on public health remains extremely high. Furthermore, there are direct and indirect health-care costs as the use of tobacco is also a risk factor for serious acute and chronic illnesses, including cancer, stroke, and heart and lung diseases. In Canada, the health and economic costs associated with tobacco use (...) Edition Figure 1: Brief Intervention Flow Chart ^ These interventions should be done in addition to providing support relevant to context (in-patient vs. community). * In-patient setting refers to all settings where clients are admitted (including hospital, long-term care home, psychiatric, or rehabilitation facilities). ** Community setting refers to health promotion settings that are outside of hospital (clients are not admitted). ~ In-patient behavioural interventions (such as counselling support

2017 Registered Nurses' Association of Ontario

654. Pelvic Girdle Pain in the Antepartum Population: Physical Therapy Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health From the Section on Women's Health and the Orthopaedic Section of the American Full Text available with Trip Pro

. The organization and classification of the document can guide research to address the paucity of evidence especially in the interventions with this population. 1 Embody Physiotherapy & Wellness, LLC, Sewickley, Pennsylvania ; Department of Physical Therapy , University of Pittsburgh, Pittsburgh, Pennsylvania; and Department of Physical Therapy , Chatham University, Pittsburgh, Pennsylvania. 2 Oncology Rehab, Centennial, Colorado. 3 Department of Physical Therapy , Chatham University, Pittsburgh, Pennsylvania (...) course of PGP, impairments are failing to normalize, and the symptoms are worsening with increased disability. This should include the presence of transient osteoporosis and diastasis rectus abdominis (DRA) as possible comorbidities in this population, as well as the presence of pelvic floor muscle, hip, and lumbar spine dysfunctions. (Recommendations are based on strong evidence.) | Imaging Studies: F In the absence of good evidence, expert opinion and foundation science may be used to guide

2017 American Physical Therapy Association

656. Preventing Falls and Reducing Injury from Falls, Fourth Edition

, & Lemaire, 2013). Further research is needed regarding the feasibility of these technologies in daily life settings (Ejupi et al., 2014; Howcroft et al., 2013). Step Test Setting: rehabilitation Population: patients in post-stroke rehabilitation A clinical test of balance that requires stepping one foot on and off a 7.5-cm step as quickly as possible for 15 seconds and recording the number of completed steps (testing both legs and recording the lowest score). May be used in conjunction with clinical (...) adults with balance and gait impairments or frailty, living in the community and in institutional settings, but not necessarily to people with certain conditions such as Parkinson’s disease, stroke, dementia, and other cognitive impairments (Okubo et al., 2016).107 BEST PRACTICE GUIDELINES • www.RNAO.ca APPENDICES Preventing Falls and Reducing Injury from Falls — Fourth Edition TYPE OF TRAINING OR EXERCISE INTERVENTION DEFINITION POTENTIAL BENEFITS Tai chi (alternate names: taiji, tai chi chuan

2017 Registered Nurses' Association of Ontario

657. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Full Text available with Trip Pro

to return to activities; and monitor changes in the patient's status throughout the course of treatment. Examination — Physical Impairment Measures 2018 Recommendation Clinicians should administer appropriate physical impairment 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 improvement in clinical care and research, including the modified stroke test for effusion (...) improvement in clinical care and research, including the modified stroke test for effusion assessment, assessment of knee active range of motion, maximum voluntary isometric or isokinetic quadriceps strength testing, and palpation for joint-line tenderness. Interventions — Progressive Knee Motion 2018 Recommendation Clinicians may use early progressive active and passive knee motion with patients after knee meniscal and articular cartilage surgery. Interventions — Progressive Weight Bearing 2018

2018 American Physical Therapy Association

658. Core Set of Outcome Measures for Patients with Neurologic Conditions Full Text available with Trip Pro

of 243 standardized measures in clinical practice, education, and research. Each task force developed recommendations for specific patient subgroups (eg, acute, subacute, and chronic stroke) and across a variety of health care settings. This work may have enhanced the quality of rehabilitation by providing clinicians with a substantial amount of summarized information for each OM for the target patient population. However, due to the large number of OMs reviewed and recommended, it is unlikely (...) adult neurologic rehabilitation . Collaboratively, clinicians and patients should decide how the results should guide the plan of care. | METHODS The steps outlining the process of review and determination of the core set are shown in . The GDG consisted of 3 PTs (J.M., K.P., and J.S.) with expertise in outcome measurement. Two of the team leaders (J.S. and K.P.) served as Chair of the ANPT's EDGE task forces for stroke and multiple sclerosis, respectively. The third (J.M.) led the development

2018 American Physical Therapy Association

659. Prevention of Constipation in the Older Adult Population

, Henry & Lemieux, 1995; Haines, 1995).21 Nursing Best Practice Guideline Diseases/conditions cited as causing slow transit constipation include: colon cancer, dehydration, diabetes mellitus, hypercalcemia/hypokalemia, immobility, low fibre and hydrocarbohydrate diet, Parkinson’s disease and stroke. While it may not always be possible to eliminate the risk factors (e.g., person with cancer receiving palliative care), prevention is more cost-effective and consistent with quality of life for elders

2005 Registered Nurses' Association of Ontario

660. Nursing Management of Hypertension

Clinician, Stroke Rehabilitation St. Joseph’s Health Care Parkwood Site London, Ontario Heather DeWagner, RN, BScN Nurse Clinician – Stroke Strategy Chatham-Kent Health Alliance Stroke Secondary Prevention Clinic Chatham, Ontario Elaine Edwards, RN, BScN Clinical Stroke Nurse Thunder Bay Regional Health Sciences Centre Thunder Bay, Ontario BettyAnn Flogen, RN, BScN, MEd, ACNP Clinical Nurse Specialist Brain Health Centre Interim Nurse Clinician – Stroke and Cognition Clinic Baycrest Centre for Geriatric (...) Barrie, Ontario Susan Oates, RN, MScN Advanced Practice Nurse – Rehabilitation West Park Healthcare Centre Toronto, Ontario Tracy Saarinen, RN, BScN Secondary Stroke Prevention Nurse Thunder Bay Regional Health Sciences Centre Thunder Bay, Ontario Debbie Selkirk, RN(EC), BScN, ENC(c) Primary Care Nurse Practitioner Emergency Services: Chatham-Kent Health Alliance Chatham, Ontario Nursing Management of Hypertension 6 Declarations of interest and confidentiality were made by all members

2005 Registered Nurses' Association of Ontario

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