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61. Heart Disease and Stroke Statistics 2017 Update: A Report From the American Heart Association Full Text available with Trip Pro

14) • When considered separately from other CVDs, stroke ranks No. 5 among all causes of death, behind dis- eases of the heart, cancer, chronic lower respiratory disease, and unintentional injuries/accidents. • Globally, in 2013 there were 6.5 million stroke deaths, making stroke the second-leading cause of death behind ischemic heart disease. • Approximately 795 000 strokes occur in the United States each year. On average, every 40 seconds, someone in the United States has a stroke (...) . . . . . . . . . . . . . . . . . e295 11. Metabolic Syndrome . . . . . . . . . . . . . . . e313 12. Chronic Kidney Disease . . . . . . . . . . . . . e336 Cardiovascular Conditions/Diseases 13. Total Cardiovascular Diseases . . . . . . . . . . e349 14. Stroke (Cerebrovascular Disease). . . . . . . . . e374 15. Global CVD and Stroke . . . . . . . . . . . . . . e414 16. Congenital Cardiovascular Defects and Kawasaki Disease . . . . . . . . . . . . . . . . e423 17. Disorders of Heart Rhythm . . . . . . . . . . . . e440 18. Sudden

2017 American Heart Association

62. Telemedicine quality and outcomes in stroke

benchmarked telestroke consultations as they related to time performance and reviewed the clinical data from 8 stroke centers that provided 235 telestroke consults over a 7-month period. Of the 203 consults that met their study criteria, 60 of 203 or ≈ 30% carried a diagnosis of stroke or transient ischemic attack, and 13 of 60 stroke cases (21.7%) were recommended for intravenous tPA. Although the mean response time (time from arrival to physician log-on) was 76 minutes, the percent of patients eligible (...) , that are used as guides in the endorsement process. Prior Experience With the Use of Quality Measures in Stroke Since 2001, more than a dozen performance measure guidelines have been published and sponsored or cosponsored by the American Heart Association/American Stroke Association. These include guidelines for the treatment of chronic heart failure, myocardial infarction, coronary artery disease and hypertension, and acute ischemic stroke. In acute stroke, implementation of quality improvement initiatives

2016 American Academy of Neurology

63. Canadian best practice recommendations for stroke care

ESO European Stroke Organization: Guidelines for the management of ischaemic stroke and transient ischaemic attack 26 EXPRESS Early use of Existing Preventive Strategies for Stroke 47 HSFO Heart and Stroke Foundation of Ontario: Consensus Panel on the Stroke Rehabilitation System 48 MATCH Management of Atherothrombosis with Clopidogrel in High-risk patients with recent TIA or ischemic stroke 49 NAEMSP National Association of EMS Physicians 50 NICE National Institute for Health and Clinical (...) : • emergency medical services care of stroke patients before hospital arrival or during transport between hospitals • acute management of transient ischemic attack and minor stroke, especially for patients managed in the community or discharged home from the emergency department • components of acute stroke management, to minimize the risk of complications • vascular cognitive impairment and dementia as manifesta- tions of stroke, to emphasize that those symptoms of vas- cular cognitive impairment should

2009 CPG Infobase

64. Canadian best practice recommendations for stroke care

be managed with lifestyle modi?cation, dietary guidelines, and medication recommendations. (CSQCS, Australian, VA/DOD; Evidence Level A) • Statin agents should be prescribed for all patients who have had an ischemic stroke/TIA event (Australian, VA/DOD; evidence level A), in order to achieve a target goal of an LDL-C of 3.4 to simvastatin or placebo for a mean duration of 5 years; inclusion criteria were any of the following: coronary artery disease, cerebrovascular disease, peripheral vascular disease (...) , diabetes, or patients over 65 years with hypertension. The Heart Protection Study showed that simvastatin 40 mg once daily rapidly produced a de?nite and substantial reduction in ischaemic stroke, irrespective of the patient’s age, gender, or blood lipid concentrations when treatment was initiated. It also demonstrated that statin therapy reduced the risk of major vascular events among people who have previously had a stroke or other cerebrovascular event, even if they did not already have manifest

2008 CPG Infobase

65. Covid-19: Stroke

, stroke patients are advised to protect themselves from contagion, given they are at increased risk for complications if they get COVID-19. Moreover, based on current information, it appears that elderly people with coronary heart disease or hypertension are more likely to present with more severe symptoms. People affected by infectious diseases as COVID-19 are also at increased risk of ischaemic and haemorrhagic cerebrovascular complications. For this reason, an increased number of strokes could (...) be forecast. However, an unexpected reduction of stroke patients in the emergency room throughout Europe has been observed. It is reasonable to assume that patients with acute mild stroke or TIA remain at home, because they are asked to stay at home, limit emergency room visits, and minimise travel. The patients may be prioritising avoiding contagion. Another issue is that stroke care organization and pathways within hospitals are currently adapted to cover the requirements of dealing with COVID-19

2020 European Academy of Neurology

66. Canadian Stroke Best Practice recommendations, seventh edition: acetylsalicylic acid for prevention of vascular events

on antiplatelet and anticoagulant use, 9 and Thrombosis Canada clinical guides. 8GUIDELINE E304 CMAJ | MARCH 23, 2020 | VOLUME 192 | ISSUE 12 of placebo reduced the number of serious vascular events by 36 (standard error [SE] 5) per 1000 per year in patients with a previ- ous myocardial infarction and also by 36 (SE 6) per 1000 per year in patients with a previous history of stroke or transient ischemic attack. In patients with peripheral arterial disease, treatment with ASA instead of placebo reduced (...) outcome were 0.96 (95% confidence interval [CI] 0.81–1.13) and 0.95 (95% CI 0.83–1.08), respectively. In the ASCEND trial, 4 the risk of the primary outcome (first serious vascular event [myocardial infarction, stroke, transient ischemic attack or cardiovascular death]) was significantly lower in the ASA group (8.5% v. 9.6%; relative risk [RR] 0.88, 95% CI 0.79–0.97). The results of these 3 trials were incorporated into 2 system- atic reviews, the results of which conflicted. 5,6 The use of ASA did

2020 CPG Infobase

67. Covid-19: Clinical guide for the management of stroke patients during the coronavirus pandemic

to hospital for patients with a stroke mimic or transient ischaemic attack (TIA) – this may include the rapid introduction of pre- hospital tele medicine, eg via apps such as GoodSam/Facetime. Work on the direct to CT pathway for patients with clear stroke symptoms and an onset time that makes them amenable to recanalisation therapy. Maintaining high standards of stroke care across the pathway Many facets of the stroke pathway are deemed important, but during this time of considerable pressure some (...) /Facetime/WhatsApp video call) mobile apps with established virtual assessments should be considered for extension to settings such as multidisciplinary teams (MDTs), pre-hospital, virtual ward rounds and rehabilitation. There are pre-existing GDPR clauses offering flexibility in times of crisis, as laid out by NHSX, and we would encourage use of facilitative technologies during this time. Consider enhanced pre hospital communication with senior stroke decision maker to reduce unnecessary conveyance

2020 Covid-19 Ad hoc guidelines

68. Glycaemic management during enteral feeding in stroke

, Becker KJ, et al. Treatment of hyperglycemia in ischemic stroke (THIS): a randomized pilot trial. Stroke. 2008;39:384-9 8 Hamilton MG, Tranmer BI, Auer RN. Insulin reduction of cerebral infarction due to transient focal ischemia. J Neurosurg 1995 Feb;82(2):262-8. 9 Bruno A. Management of Hyperglycaemia during acute stroke. Curr Cardiol Rep. 2009 Jan;11(1):36-41. 10 American Diabetes Association. Nutrition Recommendations and Interventions for Diabetes: A position statement of the American Diabetes (...) . Management of Blood Glucose and Diabetes in the Critically Ill Patient Receiving Enteral Feeding. Nutr Clin Practl 2004;19(2): 129-136 19 The European Stroke Organization (ESO) Executive Committee and the ESO Writing Committee. Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008. Basel: The European Stroke Organization, 2009. www.eso-stroke.org/pdf/ESO%20Guidelines_update_Jan_2009.pdf Accessed July 2012. 20 Grant PS, Ali K. A prospective, observational study

2018 Association of British Clinical Diabetologists

69. Stroke Assessment Across the Continuum of Care

on the entire family , and nurses have a role to play in the assessment of the family and family caregivers. However, the focus of this document is on the screening and/or assessment of the adult stroke survivor. This is not meant to exclude the pediatric client, but children have unique assessment needs related to developmental stages that are beyond the scope of this guideline. For the purpose of this guideline, types of stroke include transient ischemic attacks (TIAs), ischemic and hemorrhagic stroke (...) hemorrhage. The remaining half are due to subarachnoid hemorrhage (SAH) or bleeding from an arteriovenous malformation (StopSTROKE, 2004; The Internet Stroke Center, 2004). Transient Ischemic Attack (TIA): Ischemic stroke may be preceded by one or more transient ischemic attacks (The Internet Stroke Center, 2004), the sudden occurrence of a focal neurologic deficit that disappears completely within 24 hours. Symptoms of most TIAs, however, usually resolve within minutes to approximately an hour

2005 Registered Nurses' Association of Ontario

70. 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 (...) the views that (a) with age inevitably comes demen- tia; (b) older adults have high rates of mental illness, particularly depression; (c) older adults are inef?cient in the workplace; (d) most older adults are frail and ill; (e) older adults are socially isolated; (f) older adults have no interest in sex or intimacy; and (g) older adults are in?ex- ible and stubborn (Edelstein & Kalish, 1999). These ste- reotypes are not accurate, since research has found that the vast majority of older adults

2014 American Psychological Association

71. Guidelines for the Evaluation of Dementia and Age-Related Cognitive Change

are not intended to be mandatory or exhaustive and may not be applicable to every professional situation. They are not de?nitive, and they are not intended to take precedence over the judgment of psychologists. Guidelines on this topic were originally developed by an APA Presidential Task Force, approved as policy of APA by the APA Council of Representatives, and pub- lished in 1998 (APA Presidential Task Force on the As- sessment of Age-Consistent Memory Decline and Demen- tia, 1998). Consistent with APA (...) . The Diagnostic and Statistical Manual of Mental Dis- orders (4th ed.; DSM–IV; American Psychiatric Associa- tion, 2000) outlines diagnostic criteria for the clinical syn- drome of dementia and additional criteria for diagnosing dementia of the Alzheimer type and vascular dementia, as well as briefer guidelines for diagnosing less common causes of dementia, such as head trauma, Parkinson’s dis- ease, and general medical disorders. Diagnostic guidelines for AD have also been provided by the National Institute

2012 American Psychological Association

73. 2016 Canadian Cardiovascular Society guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult

-HDL-C or apoB in the future. Anderson et al. 1267 2016 CCS Dyslipidemia Guidelinesintervention or coronary artery bypass graft surgery), other arterial revascularization procedures, angina pectoris, cerebro- vascular disease including transient ischemic attack, or pe- ripheral arterial disease (claudication and/or ankle-brachial index 3.0 cm diameter); (3) diabetes mellitus (DM) with age 40 years,> 15-year duration for age 30 years (type 1 diabetes mellitus [DM]), or with the presence (...) , nonfatal myocardial infarction (MI), ischemic stroke, revascularization, and acute coronary syndromes hospitalizations. Number needed to treat (NNT): NNT to prevent 1 CVD event for 5 years of treatment per 1 mmol/L reduction in LDL-C. NNT of 20%).Despitethecontroversy,wecontinuetoadvocateforlow- density lipoprotein cholesterol targets for subjects who start therapy. Detailed recommendations are also presented for health behaviour modi?cation that is indicated in all subjects. Finally, recommendation

2016 CPG Infobase

74. The Canadian Cardiovascular Society heart failure companion: bridging guidelines to your practice

of MRA for patients who have had an increased NP level. (5) Correction of any condition, such as systemic hyperten- sion, valvular heart disease, cardiac ischemia, or tachy- cardia and/or atrial ?brillation that might have aggravated or precipitated HF. (6) Treatment of concomitant comorbid conditions. (7) Use of minimal doses of diuretics necessary to maintain euvolemia. (8) Access to HF clinics, cardiac rehabilitation, and self-care management as per any other patient with HF. How Should I Manage (...) - ci?c forms of HF, many of which are outlined in Table 5. 38 Second, withdrawal of chronic ACEi/b-blocker therapy for patients with dilated cardiomyopathy (ischemic or non- ischemic) whose LVEF improved with triple therapy will result in a 60%-80% likelihood of recurrence of low LVEF, usually with symptoms. 39 As such, withdrawal of these medications should only be considered after consultation with a physician experienced and competent in the treatment of HF. Finally, reassessment of LVEF should

2016 CPG Infobase

76. Patients Hospitalized with Heart Failure: Risk Assessment, Management, and Clinical Trajectory

Achieve optimal rate control. Consider restoration of normal sinus rhythm. Anticoagulation as warranted. 2014 ACC/AHA/HRS Guideline for the Management of Patients with Atrial Fibrillation 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS GuidelinefortheManagementofPatientsWithAtrialFibrillation Cerebrovascular disease, TIA/stroke Treat according to current guidelines. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack Peripheral vascular disease Treat (...) . -,NO. -,2019 Hollenberg et al. -,2019:-–- Heart Failure Hospitalization Pathway 9TABLE 4 Key Comorbid Conditions to Consider Comorbidity Management Relevant Guidelines/Pathways Cardiovascular Coronary artery disease/acute coronary syndrome Assess and treat ischemia, and consider revascularization. 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction Atrial ?brillation/ ?utter

2019 American College of Cardiology

77. Canadian guideline for Parkinson disease

licensors 17 disease strokes [“vascular parkinsonism”] and tumours). It should also be separated from other neurodegenerative forms of parkinsonism, which include multiple system atrophy, progressive supranuclear palsy, corticobasal syndrome and several dementia syndromes. Ideally, patients suspected of having Parkinson disease or a related move- ment disorder should be referred to a neurologist, and if possible to a specialized movement disorders clinic or centre for evaluation. Typical Parkinson (...) a trial of dopamine replacement therapy to help with diagnosis. n Impulse control disorders can develop on dopami- nergic therapy at any stage in the disease but are more common in patients on dopamine agonists. n Deep brain stimulation and gel infusion are now routinely used to manage motor symptoms. n Rehabilitation therapists experienced with Parkinson disease can help newly diagnosed patients, and others through all stages. VISUAL SUMMARY OF RECOMMENDATIONS FROM THE CANADIAN GUIDELINE

2019 CPG Infobase

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

Events CASS Coronary Artery Surgery Study CCB Calcium channel blocker CCS Chronic coronary syndrome(s) CFR Coronary flow reserve CHA 2 DS 2 - VASc Cardiac failure, Hypertension, Age ≥75 [Doubled], Diabetes, Stroke [Doubled] – Vascular disease, Age 65–74 and Sex category [Female] CHD Coronary heart disease CI Confidence interval CKD Chronic kidney disease CMR Cardiac magnetic resonance COMPASS Cardiovascular Outcomes for People Using Anticoagulation Strategies COURAGE Clinical Outcomes Utilizing (...) anticoagulant o.d. Omni die (once a day) ORBITA Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina PAD Peripheral artery disease PCI Percutaneous coronary intervention PCSK9 Proprotein convertase subtilisin-kexin type 9 PEGASUS- TIMI 54 Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin–Thrombolysis in Myocardial Infarction 54 PET Positron emission tomography PROMISE

2019 European Society of Cardiology

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

to 33% of total 24 hour urine output during the period of sleep, which is age- dependent with 20% for younger individuals and 33% for elderly individuals), 28 low nocturnal bladder capacity or both. In nocturnal polyuria, nocturnal voids are frequently normal or large volume as opposed to the small volume voids commonly observed in nocturia associated with OAB. Sleep disturbances, vascular and/ or cardiac disease and other medical conditions are often associated with nocturnal polyuria (...) 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

80. 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

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