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81. 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

82. Incontinence after Prostate Treatment

is managed satisfactorily with shields or lower density guards, while severe incontinence requires briefs or underwear with or without inserts to prevent accidents. From a cost perspective, briefs and underwear systems have been demonstrated to be more effective than pads. 92 Thus, the patient should be advised along these lines if they wish to continue wearing pads as their primary mechanism for urinary containment. In the individual patient, absorbent products alone may constitute a long-term (...) effective product based on their degree of incontinence. Occlusive Devices (Clamps). Occlusive devices may function as a stand-alone therapy for incontinence or as an adjunct to absorbent products. Combination therapy between the two types of devices, such as pads and clamps together, decreases the number of pads required during active periods with a resultant decrease in incontinence products expenditure. Patients must be instructed to release the clamp every two hours to allow for circulation

2019 American Urological Association

83. Integrated care for older people (?ICOPE)?: guidance for person-centred assessment and pathways in primary care

CEREBROVASCULAR DISEASES See malnutrition pathway dentify cause (medical conditions, intoxication from substances, use of drugs) and treat Review medications and withdraw as appropriate Assess history of vascular disease in the brain (stroke/transient ischaemic event) and prevent further events 6 PASS ultimodal exercise Provide cognitive stimulation ASSESS COGNITIVE CAPACITY 1 FAIL FAIL cognitive decline likely PASS ASSOCIATED CONDITIONS ASSESS & MANAGE i SOCIAL AND PHYSICAL ENVIRONMENTS ASSESS & MANAGE (...) with the surgical team and anaesthetist before any future surgeries or anaesthesia. Cerebrovascular disease. Vascular disease in the brain is closely associated with cognitive decline. If the patient has a history of stroke/mini-stroke/transient ischaemic event, then prevention of further events is the primary approach to stop further declines in cognition. ASSESS & MANAGE ASSOCIATED DISEASES Uncovering a reversible medical cause of cognitive decline involves a full diagnostic work-up. It may be necessary

2019 World Health Organisation Guidelines

84. Guidelines on Supraventricular Tachycardia (for the management of patients with) Full Text available with Trip Pro

-entrant tachycardia AVRT Atrioventricular re-entrant tachycardia BBB Bundle branch block b.p.m. Beats per minute CHA2DS2- VASc Cardiac failure, Hypertension, Age ≥75 (Doubled), Diabetes, Stroke (Doubled) – Vascular disease, Age 65–74 and Sex category (Female) CL Cycle length CMR Cardiac magnetic resonance CT Computed tomography CTI Cavotricuspid isthmus CV Conduction velocity CYP Cytochrome P450 DAD Delayed after-depolarization DC Direct current DCS Distal coronary sinus EA Enhanced automaticity EAD (...) JET Junctional ectopic tachycardia LA Left atrial/atrium LAL Left anterolateral LBBB Left bundle branch block LL Left lateral LP Left posterior LPL Left posterolateral LPS Left posteroseptal LV Left ventricle/ventricular MI Myocardial infarction MRAT Macro−re-entrant atrial tachycardia MS Mid-septal NT-proBNP N-terminal pro-B-type natriuretic peptide PJRT Permanent junctional reciprocating tachycardia p.o. Per os (by mouth) POTS Postural orthostatic tachycardia syndrome PPM Permanent pacemaker

2019 European Society of Cardiology

85. Diagnosis and Management of Acute Pulmonary Embolism Full Text available with Trip Pro

considerations 3.1 Epidemiology Venous thromboembolism (VTE), clinically presenting as DVT or PE, is globally the third most frequent acute cardiovascular syndrome behind myocardial infarction and stroke. In epidemiological studies, annual incidence rates for PE range from 39–115 per 100 000 population; for DVT, incidence rates range from 53–162 per 100 000 population. , Cross-sectional data show that the incidence of VTE is almost eight times higher in individuals aged ≥80 years than in the fifth decade (...) and heart failure increase the risk of PE. , Conversely, patients with VTE have an increased risk of subsequent myocardial infarction and stroke, or peripheral arterial embolization. 3.3 Pathophysiology and determinants of outcome Acute PE interferes with both circulation and gas exchange. Right ventricular (RV) failure due to acute pressure overload is considered the primary cause of death in severe PE. Pulmonary artery pressure (PAP) increases if >30–50% of the total cross-sectional area

2019 European Society of Cardiology

86. Management of Dyslipidaemias Full Text available with Trip Pro

TGs Triglycerides TIA Transient ischaemic attack TIMI Thrombolysis In Myocardial Infarction TNF Tumour necrosis factor TNT Treating to New Targets TRL Triglyceride-rich lipoprotein ULN Upper limit of normal VA-HIT Veterans Affairs High Density Lipoprotein Intervention Trial VITAL VITamin D and OmegA-3 Trial VLDL Very low-density lipoprotein WHO World Health Organization WOSCOPS West of Scotland Coronary Prevention Study 1 Preamble Guidelines summarize and evaluate available evidence with the aim (...) -lowering therapy in very- high-risk patients with acute coronary syndromes 47 Recommendations for lipid-lowering therapy in very-high-risk patients undergoing percutaneous coronary intervention 47 Recommendations for lipid-lowering therapy for prevention of atherosclerotic cardiovascular disease events in patients with prior ischaemic stroke 48 Recommendations for the treatment of dyslipidaemias in chronic heart failure or valvular heart diseases 49 Recommendations for lipid management in patients

2019 European Society of Cardiology

87. Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases developed in collaboration with the EASD Full Text available with Trip Pro

Microvascular Outcome Study With Linagliptin in Patients With Type 2 Diabetes Mellitus CAROLINA Cardiovascular Outcome Study of Linagliptin Versus Glimepiride in Patients With Type 2 Diabetes CCS Chronic coronary syndrome CE Cardiac event CHA 2 DS 2 -VASc Congestive heart failure, Hypertension, Age ≥75 years (Doubled), Diabetes mellitus, Stroke or transient ischaemic attack (Doubled), Vascular disease, Age 65–74 years, Sex category CHARISMA Clopidogrel for High Atherothrombotic Risk and Ischemic (...) is not recommended for CV risk stratification. 5.1 Diabetes, pre-diabetes, and cardiovascular risk The Emerging Risk Factor Collaboration, a meta-analysis of 102 prospective studies, showed that DM in general (data on DM type were unavailable) confers a two-fold excess risk of vascular outcomes (coronary heart disease, ischaemic stroke, and vascular deaths), independent of other risk factors ( Figure ). The excess relative risk of vascular events with DM was greater in women and at younger ages. Both relative

2019 European Society of Cardiology

88. Musculoskeletal Strains and Sprains - Guidelines for Prescribing NSAIDs

drugs (NSAIDs) should be considered first. CVD includes: Myocardial infarction, angina, heart failure Peripheral artery disease (eg. intermittent claudication) Atherosclerosis Cerebrovascular disease includes: Stroke or transient ischemic attack Risk factors include: Age >65 Family history of premature cardiovascular disease Uncontrolled hypertension NSAIDs may raise blood pressure to a small degree and should be monitored during therapy, even if patient has controlled hypertension Uncontrolled (...) with the differential assessment. Diabetes - expect longer healing times Stroke - could cause one-sided weakness Cancer - pain with no apparent cause could be a sign of worsening cancer control in a patient with a history of cancer Bleeding disorders - avoid NSAIDs in these patients History of DVT - significant leg or calf pain may be a sign of a DVT, especially in a patient who has had a prior DVT GI disorders - may choose to avoid NSAIDs in these patients Cardiovascular disorders - may choose to avoid NSAIDs

2017 medSask

90. Assessment and Management of Patients at Risk for Suicide

are eligible for care in the VA and DoD healthcare delivery systems 2 See the VA/DoD Clinical Practice Guideline for the Management of Major Depressive Disorder. Available at: https://www.healthquality.va.gov/guidelines/MH/mdd/ 3 See the VA/DoD Clinical Practice Guideline for the Management of Concussion-mild Traumatic Brain Injury. Available at: https://www.healthquality.va.gov/guidelines/Rehab/mtbi/ 4 See the VA/DoD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute

2019 VA/DoD Clinical Practice Guidelines

91. Clinical Practice Guidelines on Falls Prevention among Older Adults living in the Community

and balance deficit such as vertigo/giddiness, arthritis, Parkinson’s disease and strokes can predispose older adults to falls. Sensory impairment including visual impairment and hearing loss also increases risk of falls, as do cognitive impairment and dementia. Polypharmacy and the use of certain medications have been associated with an increase in the risk of falls. Drugs that have been implicated include anti-hypertensives, hypnotics, tranquilisers/sedatives, anti-depressants and anti-arrhythmics. c (...) . It is therefore important when assessing home and environmental hazards to consider the personal risk factors of the person who is living in the home or environment.7 Intrinsic risk factors Extrinsic risk factors • Age 7, 9, 10 • Female 7, 9, 10 • Not married, including single and widowed 10 • Living alone 10 • Arthritis of knees 9-12 • Stroke 9 • Parkinson’s disease 9 • Hypertension 7, 10 • Diabetes 13 • Osteoporosis 12 • Chronic conditions 10 • Urinary incontinence 11, 12 • Cognitive impairment 11, 12, 14

2015 Ministry of Health, Singapore

92. Early Management of Head Injury in Adults

, alcohol consumption and/or drug misuse, age =65 years old, previous cranial surgery and history of pre-trauma epilepsy6 Early Management of Head Injury in Adults 4. DIFFERENTIAL DIAGNOSES The differential diagnoses of adult head injury include the following: • primary anoxic, inflammatory, infectious, toxic or metabolic encephalopathies, which are not complications of head trauma • neoplasm • brain infarction (ischaemic stroke) and intracranial haemorrhage (haemorrhagic stroke) without associated (...) guidelines to those involved in the early management of head injury in primary and secondary/tertiary care CLINICAL QUESTIONS Refer to Appendix 2 TARGET POPULATION Inclusion Criteria Adult patients presenting with head injury (18 years old and above) Exclusion Criteria The guidelines do not cover definitive management of head injury: • all surgeries pertaining to neurosurgery and post-operative care • rehabilitation • management of multisystem injuries TARGET GROUP/USERS This document is intended

2015 Ministry of Health, Malaysia

93. Management of Osteoporosis

vitamin D increase the risk of myocardial infarction, relative risk 1.27 (95% CI 1.01 -1.59). 40 (Level Ia) A prospective randomised interventional trial on calcium carbonate showed no excess cardiovascular risk. 42 Another prospective randomised trial with vitamin D 800 IU and calcium 1000 mg daily compared to placebo showed no difference between both groups in vascular mortality. 43 The results of these studies are not directly comparable, as different endpoints were used. (Level Ib) The risk (...) has also been shown to improve muscle strength, balance, and risk of falling (Grade B, Level IIa) as well as improve survival. 49,50 (Grade A, Level Ia) In a recent analysis of calcium with or without vitamin D supplementation, incorporating data from the Women’s Health Initiative study, the relative risk for myocardial infarction in women without baseline personal calcium supplementation, was 1.24 (1.07–1.45, p=0.004) and the composite of myocardial infarction or stroke 1.15 (1.03-1.27, p=0.009

2015 Ministry of Health, Malaysia

94. Guidance addressing all aspects of the care of people with schizophrenia and related disorders. Includes correct diagnosis, symptom relief and recovery of social function

, Australia 3 Northern Adelaide Local Health Network, Adelaide, SA, Australia 4 Department of Psychiatry, St Vincent’s Health and The University of Melbourne, Melbourne, VIC, Australia 5 Rehabilitation Services, Metro South Mental Health Service, Brisbane, QLD, Australia 6 Mental Health and Addiction Services, Northland District Health Board, Whangarei, New Zealand 7 Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia (UWA (...) and related psychoses, and policy makers. It does not override the responsibility of clinicians to make appropriate decisions, taking into account the unique circumstances of the person they are treating. The scope of this guideline is the schizophrenia spectrum which includes schizophrenia, schizoaffective disorder, schizotypal disorder, schizophreniform disorder and acute transient psychotic disorder with symptoms of schizophrenia. The spectrum notion is based on the presumption (and partial evidence

2016 Royal Australian and New Zealand College of Psychiatrists

95. ELVO Management - Post-Thrombectomy

are most likely to provide post-procedural care that is specific of the needs of patients after ELVO treatment. Stroke units should therefore be prioritized for ELVO post-procedural care disposition. (Class I, level of evidence B) 3. Sustaining ischemic penumbral tissue through hemodynamic support should be considered in patients with unsuccessful or partially successful recanalization. Induced hypertension and patient positioning are likely to be most helpful, although optimized protocols remain (...) . Significant complications can develop acutely or subacutely at the access site, with investigations and interventions that may be urgently or emergently needed. Appropriate and standardized monitoring strategies should be used to detect these complications in the post-procedural setting. (Class I, level of evidence C) 20. All patients admitted with acute stroke should have an initial assessment by multidisciplinary rehabilitation professionals (physical, occupational, and speech therapy) as soon

2017 Society of NeuroInterventional Surgery

97. The treatment of Glenohumeral Joint Osteoarthritis

, IL 60018 Janet L. Wies MPH AAOS Clinical Practice Guideline Manager Sara Anderson MPH – Lead Analyst Kevin Boyer Laura Raymond MA Patrick Sluka MPH AAOS v1.0 12.05.09 x Peer Review The following organizations participated in peer review of this clinical practice guideline: Arthroscopy Association of North America American Academy of Family Physicians American Academy of Physical Medicine and Rehabilitation American Orthopaedic Society for Sports Medicine American Physical Therapy Association

2009 American Academy of Orthopaedic Surgeons

98. Clinical Practice Guideline on Management of Hip Fractures in the Elderly

Research 254 Results 255 Rehabilitation 258 Sub-Recommendation Summary 258 Risks and Harms of Implementing these Recommendations 258 Future Research 258 Occupational and Physical Therapy 259 Rationale 259 Intensive Physical Therapy 260 Rationale 260 Nutrition 261 Rationale 261 Interdisciplinary Care Program 262 Rationale 262 Results 263 Postoperative MultiModal Analgesia 346 Rationale 346 Risks and Harms of Implementing this Recommendation 346 Future Research 346 Results 347 Calcium and Vitamin D

2014 American Academy of Orthopaedic Surgeons

99. Transcatheter Mitral Valve Intervention: Operator and Institutional Requirements

, Kansas City Cardiomyopathy Questionnaire; MDT, multidisciplinary team; MR, mitral In-hospital and 30-day all-cause mortality* “As expected” or “better than expected” based on national benchmark data with 95% CIs 30-day stroke, TIA Performance falls within 95% (outlier) and/or 90% (warning) boundaries on funnel plot 30-day major vascular complication Performance falls within 95% (outlier) and/or 90% (warning) boundaries on funnel plot 30-day major bleeding Performance falls within 95% (outlier (...) ; cardiac diagnostic and interventional catheters, vascular closure devices; balloon dilatation catheters ranging from 2 mm to 30 mm in diameter and of various lengths and profiles; a full inventory of coronary and peripheral stents, including covered stents, Bonow, et al. Mitral Valve Systems of Care Document 18 occlusive vascular devices, snares, and other retrieval devices; drainage catheters; portable vascular access ultrasound; and various implantable device sizes with their delivery systems. o

2020 American College of Cardiology

100. 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)

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