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121. Management of Glaucoma

(Second Edition) 35 ischaemia. Initially fibrovascular membrane covers the angle, causing secondary open angle glaucoma. This can progress to angle closure glaucoma. The common conditions associated with NVG are proliferative diabetic retinopathy, central retinal vein occlusion and other conditions such as ocular ischaemic syndrome and tumours. Management of NVG involves optimising treatment of the underlying disease and control of high IOP. The treatment for NVG includes: 15 • medical treatment (...) ) 8. REHABILITATION 29 9. REFERRAL 30 10. SPECIAL CONDITIONS 31 10.1 Ocular Hypertension 31 10.2 Primary Open Angle Glaucoma Suspect 33 10.3 Steroid-Induced Glaucoma 34 10.4 Neovascular Glaucoma 34 10.5 Intraocular Pressure Monitoring in 35 Post-Refractive Surgery Cases 11. IMPLEMENTING THE GUIDELINES 37 11.1 Facilitating and Limiting Factors 37 11.2 Potential Resource Implications 37 REFERENCES 39 Appendix 1 Example of Search Strategy 45 Appendix 2 Clinical Questions 46 Appendix 3 Van Herick Test

2017 Ministry of Health, Malaysia

122. Clinical Practice Guidelines on Hypertension

, the results from a 2011 meta-analysis of RCTs of BP targets in subjects with type 2 diabetes and impaired fasting glucose 91 suggest that most of the beneficial reduction in all-cause mortality in the intensive treatment group (systolic BP 220 mmHg or diastolic BP > 120 mmHg, before specific treatment begins. 121 The rate of BP reduction would depend on the specific comorbidities. 9.4.2 Lowering of the BP after transient ischemic attack and after acute phase of stroke D After the acute phase of stroke (...) , begin antihypertensive treatment in hypertensive patients if the systolic BP is more than 140 mmHg and diastolic BP is more than 90 mmHg. 122,123 Grade D, Level 4 KEY RECOMMENDATION KEY RECOMMENDATION 53 A Use any of the five major pharmacological classes of antihypertensive drugs for stroke prevention in patients after the acute phase of stroke, provided that the BP is effectively lowered. 21,75 Grade A, Level 1 ++ GPP The target BP level in patients after transient ischemic attack and after acute

2017 Ministry of Health, Singapore

123. Global Vascular Guidelines for patients with chronic limb-threatening ischemia Full Text available with Trip Pro

Global Vascular Guidelines for patients with chronic limb-threatening ischemia Global vascular guidelines on the management of chronic limb-threatening ischemia - Journal of Vascular Surgery Email/Username: Password: Remember me Search JVS Journals Search Terms Search within Search Access provided by Volume 69, Issue 6, Supplement, Pages 3S–125S.e40 Global vascular guidelines on the management of chronic limb-threatening ischemia x Michael S. Conte Affiliations Division of Vascular (...) grade is 3 (chronic total occlusion of target artery origin). ---- | ---- Fig 5.7 Flow chart illustrating application of Global Limb Anatomic Staging System ( GLASS ) to stage infrainguinal disease pattern in chronic limb-threatening ischemia ( CLTI ). FP, Femoropopliteal; IP, infrapopliteal; PLAN, patient risk estimation, limb staging, anatomic pattern of disease; TAP, target arterial path; WIfI, Wound, Ischemia, and foot Infection. ---- | ---- Fig 6.1 Paradigm for evidence-based revascularization

2019 Society for Vascular Surgery

124. Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome

internation- ally accepted terminology, of the practice of orthopaedic physical therapists and hand rehabilitation • Provide information for payers and claims reviewers re- garding the practice of orthopaedic and hand therapy for common musculoskeletal conditions • Create a reference publication for clinicians, academic in- structors, clinical instructors, students, interns, residents, and fellows regarding the best current practice of ortho- paedic physical therapy and hand rehabilitation STATEMENT (...) below. Each team developed recommendations based on the strength of ev- idence, including how directly the studies addressed the ques- tion on hand pain and sensory deficits: CTS. In developing their recommendations, the authors considered the strengths and limitations of the body of evidence and the health benefits, side effects, and risks of tests and interventions. GUIDELINE REVIEW PROCESS AND VALIDATION Identified reviewers who are experts in management and rehabilitation reviewed this CPG

2019 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

126. Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence

intervention compared with standard care? 38 4.5 For people with moderate and severe alcohol dependence who have significant comorbid problems, is an intensive residential rehabilitation programme clinically and cost effective when compared with intensive community-based care? 39 4.6 For people with alcohol dependence, which medication is most likely to improve adherence and thereby promote abstinence and prevent relapse? 40 5 Other versions of this guideline 41 5.1 Full guideline 41 5.2 Information (...) -related accidents or physical illness such as acute pancreatitis. In the longer term, harmful drinkers may go on to develop high blood pressure, cirrhosis, heart disease and some types of cancer, such as mouth, liver, bowel or breast cancer. Alcohol dependence is characterised by craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (for example, liver disease or depression caused by drinking). Alcohol dependence is also associated with increased

2011 National Institute for Health and Clinical Excellence - Clinical Guidelines

127. Cardiovascular disease prevention

Cardiovascular disease prevention Cardio Cardiovascular disease pre vascular disease prev vention ention Public health guideline Published: 22 June 2010 nice.org.uk/guidance/ph25 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising (...) of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 113Introduction Introduction The Department of Health (DH) asked the National Institute for Health and Clinical Excellence (NICE) to produce public health guidance on the prevention of cardiovascular disease (CVD) at population level. CVD includes coronary heart disease (CHD), stroke and peripheral arterial disease. These conditions are frequently brought about by the development of atheroma and thrombosis (blockages

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

128. BMI: preventing ill health and premature death in black, Asian and other minority ethnic groups

to prevent conditions such as diabetes, myocardial infarction or stroke. The guideline did not include women who are pregnant. NICE has also produced guidelines on preventing type 2 diabetes (this guideline extends those recommendations to black African and African-Caribbean groups) and obesity. Who is it for? Healthcare and health improvement professionals Exercise referral practitioners Directors and managers of public health, local authority, voluntary and non-government organisations Providers (...) ? This guidance assesses how body mass index (BMI) and waist circumference among adults from black, Asian and other minority ethnic groups in the UK links to the risk of a range of non- communicable diseases. The aim was to determine whether lower cut-off points or thresholds should be used for these groups, compared to those used for the white population, as a trigger for lifestyle interventions to prevent conditions such as diabetes, myocardial infarction or stroke. The guidance did not assess interventions

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

129. Sickle cell disease: managing acute painful episodes in hospital

a variety of conditions, including dehydration, low oxygen levels and elevated temperature. Changes in any of these conditions may cause the cells to block small blood vessels and cause tissue infarction. Repeated episodes may result in organ damage. Acute painful sickle cell episodes occur unpredictably, often without clear precipitating factors. Their frequency may vary from less than one episode a year to severe pain at least once a week. Pain can fluctuate in both intensity and duration, and may (...) sickle cell episode, at any time from presentation to discharge, including: acute stroke aplastic crisis infections osteomyelitis splenic sequestration. Sickle cell disease: managing acute painful episodes in hospital (CG143) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 10 of 15Management of underlying pathology 1.1.21 Do not use corticosteroids in the management of an uncomplicated acute painful sickle cell

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

130. Spasticity in under 19s: management

reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 4 of 41Introduction Introduction This guideline covers the management of spasticity and co-existing motor disorders and their early musculoskeletal complications in children and young people (from birth up to their 19th birthday) with non-progressive brain disorders. Cerebral palsy is the most common condition associated with spasticity in children and young people. The incidence of cerebral (...) palsy is not known, but its prevalence in the UK is 186 per 100,000 population, with a total of 110,000 people affected. The guideline covers the management of spasticity associated with cerebral palsy, but not all aspects of the management of cerebral palsy. The impact of spasticity and co-existing motor disorders and their early musculoskeletal complications on the child or young person varies. Common problems include impaired motor function affecting the person's ability to participate in society

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

131. Urinary incontinence in neurological disease: assessment and management

Examples of neurological conditions that can affect lower urinary tract function act function Congenital and Congenital and perinatal conditions perinatal conditions Acquired, stable Acquired, stable conditions conditions Acquired, progressiv Acquired, progressive e or degener or degenerativ ative e conditions conditions Br Brain conditions ain conditions Cerebral palsy Stroke Head injury Multiple sclerosis Parkinson's disease Dementia Multiple system atrophy Supr Suprasacr asacral spinal al spinal (...) ] drug treatment in people with: conditions affecting the brain (for example, cerebral palsy, head injury or stroke) and and symptoms of an overactive bladder. 1.3.5 Consider antimuscarinic [2] drug treatment in people with urodynamic investigations showing impaired bladder storage. 1.3.6 Monitor residual urine volume in people who are not using intermittent or indwelling catheterisation after starting antimuscarinic treatment. 1.3.7 When prescribing antimuscarinics, take into account

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

132. Transition between inpatient hospital settings and community or care home settings for adults with social care needs

-and- conditions#notice-of-rights). Page 9 of 31changes to their plans for transfer from hospital. 1.4.4 Provide care for older people with complex needs in a specialist, geriatrician-led unit or on a specialist geriatrician-led ward. 1.4.5 Treat people admitted to hospital after a stroke in a stroke unit and offer them early supported discharge. (See recommendations 1.1.8 and 1.1.9 in NICE's guideline on stroke rehabilitation.) 1.4.6 Encourage people to follow their usual daily routines as much as possible (...) The discharge coordinator should ensure that people who have end-of-life care needs are assessed and support is in place so they can die in their preferred place. Early supported discharge Early supported discharge 1.5.25 Ensure that older people with identified social care needs are offered early supported discharge with a home care and rehabilitation package. 1.5.26 Consider early supported discharge with a home care and rehabilitation package provided by a community-based multidisciplinary team

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

133. Diabetic foot problems: prevention and management

), or both. Peripheral arterial disease affects 1 in 3 people with diabetes over the age of 50, and can also increase the risk of heart attack and stroke. For more information, see the NICE guideline on lower limb peripheral arterial disease. Foot complications are common in people with diabetes. It is estimated that 10% of people with diabetes will have a diabetic foot ulcer at some point in their lives. A foot ulcer can be defined as a localised injury to the skin and/or underlying tissue, below (...) , Area and Depth) or the University of T exas classification system. 1.5.3 Do not use the Wagner classification system to assess the severity of a diabetic foot ulcer. T T reatment reatment 1.5.4 Offer 1 or more of the following as standard care for treating diabetic foot ulcers: Offloading. Control of foot infection. Control of ischaemia. Wound debridement. Wound dressings. 1.5.5 Offer non-removable casting to offload plantar neuropathic, non-ischaemic, uninfected forefoot and midfoot diabetic

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

134. Cardiovascular disease: identifying and supporting people most at risk of dying early

Cardiovascular disease: identifying and supporting people most at risk of dying early Cardio Cardiovascular disease: identifying and vascular disease: identifying and supporting people most at risk of dying supporting people most at risk of dying early early Public health guideline Published: 24 September 2008 nice.org.uk/guidance/ph15 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our (...) and complement other initiatives to reduce premature mortality. Of particular relevance is the coordinated vascular disease control programme commissioned by the UK National Screening Committee. This is set out in the 'Handbook for vascular risk Cardiovascular disease: identifying and supporting people most at risk of dying early (PH15) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 20 of 57assessment, risk reduction

2008 National Institute for Health and Clinical Excellence - Clinical Guidelines

135. Stable angina: management

of secondary prevention treatment is to prevent cardiovascular events such as heart attack and stroke. 1.4.3 Discuss how side effects of drug treatment might affect the person's daily activities and explain why it is important to take drug treatment regularly. 1.4.4 Patients differ in the type and amount of information they need and want. Therefore the provision of information should be individualised and is likely to include, but not be limited to: what the medicine is how the medicine is likely to affect (...) for symptom relief. The trial should use drug-eluting stents and wider inclusion criteria than BARI-2D and COURAGE. 2.4 Cardiac rehabilitation Is an 8-week, comprehensive, multidisciplinary, cardiac rehabilitation service more clinically and cost effective for managing stable angina than current clinical practice? Wh Why this is important y this is important Cardiac rehabilitation programmes are an established treatment strategy for certain heart conditions, such as for people who have had a heart attack

2011 National Institute for Health and Clinical Excellence - Clinical Guidelines

136. Unstable angina and NSTEMI: early management

, the prognosis is poor and mortality high, particularly in people who have had myocardial damage. Appropriate triage, risk assessment and timely use of acute pharmacological or invasive interventions are critical for the prevention of future adverse cardiovascular events (myocardial infarction, stroke, repeat revascularisation or death). The guideline does not cover the management of STEMI or specific complications of unstable angina and NSTEMI such as cardiac arrest or acute heart failure. Assessment (...) [GRACE]). 1.2.2 Include in the formal risk assessment: a full clinical history (including age, previous myocardial infarction [MI] and previous percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]) a physical examination (including measurement of blood pressure and heart rate) resting 12-lead electrocardiography (ECG) (looking particularly for dynamic or unstable patterns that indicate myocardial ischaemia) blood tests (such as troponin I or T, creatinine, glucose

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

137. Weight management: lifestyle services for overweight or obese adults

lifestyle weight management services including programmes, courses, clubs or groups provided by the public, private and voluntary sector. The aim is to help people lose weight and become more physically active to reduce the risk of diseases associated with obesity. This includes coronary heart disease, stroke, type 2 diabetes and various cancers. NICE has also produced guidelines on: obesity identification and management and the local strategic approach to obesity. This guideline does not cover (...) and encourage them to be physically active. The aim is to help meet a range of public health goals. These include helping reduce the risk of the main diseases associated with obesity, for example: coronary heart disease, stroke, hypertension, osteoarthritis, type 2 diabetes and various cancers (endometrial, breast, kidney and colon). The focus is on lifestyle weight management programmes that: accept self-referrals or referrals from health or social care practitioners are provided by the public, private

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

138. Physical activity: exercise referral schemes

programmes to manage specific health conditions, or for rehabilitation after recovery from a specific condition (see box 1). These include stroke, cardiac and pulmonary rehabilitation programmes. They are outside the scope of this guideline. Benefits of physical activity Physical activity can play an important role in preventing and managing health conditions such as coronary heart disease, type 2 diabetes, stroke, mental health problems, musculoskeletal conditions and some cancers. It also has (...) -of-rights). Page 10 of 46Collating and sharing data on exercise referral schemes Recommendation 3 Recommendation 3 This recommendation has been withdrawn. Please see update information for more details. Box 1 The role of structured exercise programmes in the management of, and rehabilitation following, a health condition NICE recommends structured exercise programmes tailored to individual need to manage, and for rehabilitation after, certain health conditions, including: myocardial infarction (see NICE

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

139. Neuropathic pain in adults: pharmacological management in non-specialist settings

secondary to tumour antigens, or caused by direct invasion or compression of neural structures). Examples of conditions that can cause central neuropathic pain include stroke, spinal cord injury and multiple sclerosis. Neuropathic pain can be intermittent or constant, and spontaneous or provoked. Typical descriptions of the pain include terms such as shooting, stabbing, like an electric shock, burning, tingling, tight, numb, prickling, itching and a sensation of pins and needles. People may also (...) , and concurrent medications the importance of dosage titration and the titration process, providing the person with individualised information and advice coping strategies for pain and for possible adverse effects of treatment non-pharmacological treatments, for example, physical and psychological therapies (which may be offered through a rehabilitation service) and surgery (which may be offered through specialist services). For more information about involving people in decisions and supporting adherence

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

140. Atrial fibrillation: management

and over) with suspected or diagnosed atrial fibrillation. 1.1 Diagnosis and assessment 1.1.1 Perform manual pulse palpation to assess for the presence of an irregular pulse that may indicate underlying atrial fibrillation in people presenting with any of the following: breathlessness/dyspnoea palpitations syncope/dizziness chest discomfort stroke/transient ischaemic attack. [2006] [2006] 1.1.2 Perform an electrocardiogram (ECG) in all people, whether symptomatic or not, in whom atrial fibrillation (...) Apixaban aban 1.5.5 Apixaban is recommended as an option for preventing stroke and systemic embolism within its marketing authorisation, that is, in people with nonvalvular atrial fibrillation with 1 or more risk factors such as: prior stroke or transient ischaemic attack age 75 years or older hypertension diabetes mellitus symptomatic heart failure. [This recommendation is from Apixaban for preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation (NICE technology

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

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