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Propranolol discount wellbutrin 300mg mastercard anxiety 30000 diagnosis, a (e g effective wellbutrin 300mg depression young males, secobarbital) beta-blocker cheap 300mg wellbutrin fast delivery depression inventory, is sometimes used in alcohol with- drawal treatment along with either benzodiaz- *For more information on benzodiazepines purchase 300mg wellbutrin anxiety 30002, epines or anticonvulsants to decrease anxiety, heart anticonvulsants and barbiturates see Antimanic rate, sweating, and blood pressure. Antipsychotics Medications, Antianxiety Medications and may be used if the person develops severe alcohol Hypnotics sections in this publication. Alcohol relapse prevention agents Alcohol relapse prevention: The oldest medication disulfram Antabuse used in alcohol relapse prevention is disulfram. Disulfram blocks naltrexone extended- Vivitrol the breakdown of alcohol, resulting in toxic release injection acetaldehyde28 levels in the body. It works by causing the person to Medications involved in alcohol treatment include rethink a move to impulsive drinking, since they those used for acute alcohol withdrawal as well as know if they have disulfram on board, they will a growing number used for alcohol relapse preven- get sick. Alcohol relapse prevention medications are just starting to be accepted in the feld. It is antici- Naltrexone was frst developed as an opioid pated that within the next few years, medications receptor blocker and used in monitored treatment like naltrexone and acamprosate will be more programs for opioid dependence. Many opioid widely used given the developing body of research addicts, however, stopped taking it and returned to indicating that these medications work. In spite of this, clinical observation Alcohol withdrawal: Though usually only treated of persons taking naltrexone showed that those for 1 to 5 days, signs and symptoms of alcohol who also used alcohol seemed to drink less and withdrawal go on for weeks or months. Use of this monthly treatment with even naloxone those persons who are less motivated about their clonidine Catapres recovery has led to a reduction in days drinking; and when drinking does occur, they consume less methadone Dolophine, Methadose alcohol. Thus, naltrexone may be best seen as a naltrexone ReVia “harm reduction” medicine versus a “complete naltrexone extended- Vivitrol abstinence” treatment enhancer. It is reported to have shown marked ability to decrease illness, be nonpsychoactive, does not interact with most crime, and deaths in this population. Methadone other medications, and does not cause any kind of maintenance treatment is extensively researched. Because of the way the medication is absorbed be accomplished with clonidine, a medication for in the body, it must be taken several times a day. Usually clonidine Outcome studies indicate that acamprosate is best is used in combination with sedatives such as at increasing complete abstinence from alcohol, or benzodiazepines, antihistamines or even phenobar- increasing the time before the frst drink (relapse). Major opioid withdrawal is usually treated The profle of the person for whom acamprosate with either an equivalent dose of methadone would be selected is one seeking complete absti- gradually decreased over time, or more recently, a nence and who is moderately to highly motivated single dose of 24 mg of buprenorphine. The study found synthetic, long-acting medication used in heroin 29 detoxifcation programs to maintain abstinence psychoactive: Substances or drugs that affect the mind, especially mood, thought, or perception. Many varenicline Chantix people who have been addicted to heroin have bupropion Zyban returned to a productive life because of methadone nortriptyline Aventyl, Pamelor treatment programs. Methadone also is occasion- ally used to provide relief for specifc types of pain. It can be used for both opioid with- containing products is the goal of tobacco cessa- drawal and as a substitute for opioids in long-term tion therapies. Buprenorphine is the frst medication tobacco cessation assist clients with nicotine dependence32 to achieve abstinence by alleviating available to doctors for use in their offce-based practice. At low doses, it acts like methadone and or reducing common nicotine withdrawal symp- toms33 and cravings. Numerous scientifc studies satisfes the dependent person’s need for an opioid to avoid painful withdrawal. It does not provide have shown that it’s easier for individuals to quit the user with the euphoria or rush typically tobacco when supported by a medical or a mental associated with use of other opioids or narcotics. For this reason, recommended At moderate to high doses, it can precipitate treatment strategies incorporate both behavioral withdrawal. Suboxone is buprenorphine combined pharmacotherapy is contraindicated for some with naloxone, a narcotic antagonist31 used to specifc populations (i. They are transdermal nicotine patch, nicotine polacrilex beginning to be more widely used for alcohol gum and lozenge, nicotine nasal spray, and nicotine relapse prevention (see pp. These therapies reduce more commonly used in its injectable form to withdrawal symptoms and cravings by replacing reverse the effects of opioids. It is beginning to be used in its oral form to reduce alcohol craving; it is 32 nicotine dependence: Nicotine dependence is a recognized also beginning to be used in gambling and nicotine mental health disorder that is often overlooked by counselors. This substance use disorder signifcantly reduces the overall quality-of-life and is considered the deadliest yet most preventable disease to be treated. This causes the brain to release noradrenaline and dopamine, which act as stimulants nicotine polacrilex Commit (implicated in mood, memory, and sense of well-being). This agent is tive of the damage caused to nerve cells by some of thought to affect dopamine34 and norepinephrine35 these drugs. Antipsychotics and sedatives are used levels, and blocks nicotinic acetylcholinergic to treat induced psychoses associated with club receptors36, thereby decreasing cravings for drug abuse. Marijuana: Recently, a withdrawal syndrome to The use of bupropion roughly doubles cessation marijuana dependence has been described and rates relative to placebo, and the combination of validated. Medications for treating this syndrome bupropion with the nicotine patch has shown 37 have not been adequately tested. Therefore some clinicians smoking cessation medication and the frst in its have used moderate doses of the older tricyclic class targeting specifcally the neurobiology of antidepressants (e. It reduces the smoker’s to treat withdrawal from marijuana as they also craving for nicotine by binding to nicotine recep- have anticholinergic and sedating qualities but do tors in the brain and thereby reducing withdrawal not cause a high, nor are they abused. A Stimulant intoxication: Agitation, paranoia and daily, uninterrupted dose of disulfram is continued psychosis are treated with antipsychotics, often until the person is in full and mature recovery and combined with benzodiazepines. Stimulant withdrawal: There are no standard Naltrexone in its oral form is usually taken once a effective agents to treat stimulant withdrawal, day but can be taken at a higher dose every second though dopamine-enhancing agents such as or third day. The amantadine, bupropion, and desipramine have injectable form of naltrexone is taken once a month. This area has not Because of the way acamprosate is absorbed, it must been well researched. During the initial 6 weeks of If injected intravenously, buprenorphine will cause therapy, clients should use one lozenge every 1 to 2 opioid withdrawal. This is an advantage for persons who do lozenges in 6 hours or a maximum of 20 lozenges not live near a methadone clinic. The lozenges should be used for up to 12 People should continue to take naltrexone, acam- weeks with no more than 20 lozenges used a day. Generally, for the tion, including the nicotine patch, gum, and frst 3 days of treatment, individuals take 150 mg, lozenge. The approved course of varenicline treatment is 12 weeks; however, an additional 12 weeks of treat- The nicotine patch is available in three strengths ment may increase the likelihood of long-term and a “step-down” approach is used: 21 mg for 6 smoking cessation for some individuals. For the weeks, then 14 mg for 2 weeks, then 7 mg for 2 frst 3 days of treatment, individuals take 0. A new patch next four days, and then 1 mg twice a day for the needs to be reapplied each day, at roughly the same remainder of the treatment period.

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It is always important to therapy virological remission of[2 to 5 years cheap wellbutrin 300mg visa anxiety explained,41the optimal dura- check for compliance order wellbutrin 300 mg on line depression test from doctors. Retreatment criteria are also tinue treatment with the same agent given the rise in rates of important buy discount wellbutrin 300mg on line mood disorder checklist, but have yet to be determined buy wellbutrin 300 mg low cost depression conceptual definition. Table 6 shows cross-resistance data for Similar rates were confirmed by real life studies. Healthcare workers performing exposure prone pro- an enhanced requirement for safety, and thus extrapolation from cedures that are not on antiviral treatment might be more fre- adult strategies may be unhelpful. Overall, a conservative safety, efficacy, complications and economic implications of such approach is warranted. Therefore, further studies are awaited pro- tion rate) may be found in these patients. Patients who are will- George Papatheodoridis: advisor/lecturer for Abbvie, Boehrin- ing to participate and/or are in phases of the disease that are not ger Ingelheim, Bristol-Myers Squibb, Gilead, GlaxoSmithKline, eligible for therapy within the current guidelines may be consid- Janssen, Merck Sharp & Dohme, Novartis, Roche; research ered for clinical trial participation. Unresolved issues and unmet needs References [1] European Association for the Study of the Liver. Definition of novel hepatitis B burden in general population: Results from a population-based endpoints survey and longitudinal follow-up study in Taiwan. Biomarkers for the cure of infection and for the cure of the [6] Coppola N, Alessio L, Gualdieri L, Pisaturo M, Sagnelli C, Caprio N, et al. Bundesgesundheitsblatt tests for evaluation of liver disease severity and prognosis. The global burden of viral hepatitis from 1990 to 2013: findings from 2016;36:1755–1764. Intervi- incidence of hepatocellular carcinoma is reduced in patients with chronic rology 2014;57:141–150. Genome-wide association study [39] Su T-H, Hu T-H, Chen C-Y, Huang Y-H, Chuang W-L, Lin C-L, et al. Association of integration and clonal hepatocyte expansion in chronic hepatitis B patients nucleos(t)ide analogue therapy with reduced risk of hepatocellular carci- considered immune tolerant. T-cell function in children and young adults with immune-tolerant chronic [41] Papatheodoridis G, Vlachogiannakos I, Cholongitas E, Wursthorn K, hepatitis B. Risk of population-based cohort of persons with chronic hepatitis B virus infection. J Gastroenterol Entecavir treatment does not eliminate the risk of hepatocellular carci- Hepatol 2016;31:1882–1887. Incidence and predictors of hepatocellular carcinoma in Caucasian 2013;56:100–105. J Hepatol Hepatitis B surface antigen seroclearance during nucleoside analogue 2016;64:800–806. Preventing hepatitis B reactivation due to risk of hepatocellular carcinoma development with good accuracy. Systematic review Management of viral hepatitis in patients with haematological malignancy with meta-analysis: The diagnostic accuracy of transient elastography for and in patients undergoing haemopoietic stem cell transplantation: Journal of Hepatology 2017 vol. Combination of tenofovir disoproxil fumarate and peginterferon a-2a [81] Maggi P, Montinaro V, Leone A, Fasano M, Volpe A, Bellacosa C, et al. Bone increases loss of hepatitis B surface antigen in patients with chronic and kidney toxicity induced by nucleotide analogues in patients affected by hepatitis B. Seven-year 5-Year entecavir treatment in nuc-naïve, field-practice patients with efficacy and safety of treatment with tenofovir disoproxil fumarate for chronic hepatitis B showed excellent viral suppression and safety profile chronic hepatitis B virus infection. Entecavir continuous entecavir therapy in nucleos(t)ide-naive chronic hepatitis B safety and effectiveness in a national cohort of treatment-naïve chronic patients. A randomized, Effectiveness and safety of tenofovir disoproxil fumarate in chronic open-label trial to evaluate switching to elvitegravir/cobicistat/emtric- hepatitis B: A 3-year prospective field practice study in Germany. Dig Dis itabine/tenofovir alafenamide plus darunavir in treatment-experienced Sci 2016;61:3061–3071. Dig Dis Sci tenofovir alafenamide, coformulated with elvitegravir, cobicistat, and 2016;61:3072–3083. J Acquir [112] Lampertico P, Messinger D, Cornberg M, Brunetto M, Petersen J, Kennedy P, Immune Defic Syndr 2016;71:530–537. Gastroenterology [93] Papatheodoridis G, Yurdaydin C, Dalekos G, Buti M, Chi H, Van Boemmel F. Liver Int durability of response to entecavir therapy in hepatitis B e antigen-negative 2015;35:1540–1548. Hepatitis B surface antigen levels: Association with 5-year response with treatment failure and antiviral drug resistance. Liver Int is superior to nucleos(t)ide analogues for prevention of hepatocellular 2016;36:1108–1115. Effects of Entecavir plus tenofovir combination as rescue therapy in pre-treated tenofovir disoproxil fumarate in hepatitis B e antigen-positive patients chronic hepatitis B patients: an international multicenter cohort study. J with normal levels of alanine aminotransferase and high levels of hepatitis Hepatol 2012;56:520–526. Efficacy of prolonged Response-guided peginterferon therapy in hepatitis B e antigen-positive entecavir monotherapy in treatment-naïve chronic hepatitis B patients chronic hepatitis B using serum hepatitis B surface antigen levels. Clinical surface antigen seroreversion: the bane of combination therapy in chronic relevance of minimal residual viremia during long-term therapy with hepatitis B? An observational, carcinoma in hepatitis B viral cirrhotic patients: comparison between multicenter, cohort study evaluating the antiviral efficacy and safety in compensated and decompensated cirrhosis. Am J Gastroenterol korean patients with chronic hepatitis B receiving pegylated interferon- 2014;109:1223–1233. Alternative therapies for chronic hepatitis B patients with partial virolog- [110] Chen X, Chen X, Chen W, Ma X, Huang J, Chen R. A randomized, open-label [154] Wang P, Tam N, Wang H, Zheng H, Chen P, Wu L, et al. Meta-analysis: seroconversion and hbsag decline-week 48 results from a multicenter antiviral treatment for hepatitis D. O4 prolonged therapy of hepatitis delta for 96 weeks with pegylated- 2016;6:32722. Understanding early serum hepatitis D virus and hepatitis B surface [143] Miquel M, Núñez Ó, Trapero-Marugán M, Díaz-Sánchez A, Jiménez M, antigen kinetics during pegylated interferon-alpha therapy via mathemat- Arenas J, et al. Effects of entecavir and lamivudine for hepatitis B interferon therapy and outcome. Hepatitis B virus and hepatitis C virus antiviral therapy on disease course after decompensation in patients with dual infection. Comparison of the epidemiology, clinical characteristics, viralinteractions and management. Fulminant hepatitis B [196] Chen H-L, Lee C-N, Chang C-H, Ni Y-H, Shyu M-K, Chen S-M, et al. Efficacy of reactivation leading to liver transplantation in a patient with chronic maternal tenofovir disoproxil fumarate in interrupting mother-to-infant hepatitis C treated with simeprevir and sofosbuvir: a case report.

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Regarding hemodynamic Regarding the infection risk wellbutrin 300 mg cheap mood disorder general medical condition, the Panel noted that the instability cheap wellbutrin 300mg on line depression free naturally, the recommendation to continue the current cutoff for immunosuppression according to the Centers daily dose of glucocorticoids in adult patients who are for Disease Control and Prevention was 20 mg/day of receiving glucocorticoids buy discount wellbutrin 300 mg anxiety 10 year old, rather than administering prednisone for at least 2 weeks buy 300 mg wellbutrin amex mood disorder related to pms, in the context of risk 1120 Goodman et al associated with the administration of live vaccines. In risks attributable to perioperative management of anti- addition, observational studies demonstrate an increase in rheumatic drug therapy. The optimal management of antirheu- many patients do not return to their surgeon within 2 matic medications to treat these diseases may mitigate weeks of discharge, screening mechanisms to assess the risks. To date, there has been and recommended that they be targeted for future little to no consensus among orthopedic surgeons or rheu- research: 1) Perioperative glucocorticoid management. The Patient Panel thought infection risk was tive management regimens and include assessment of much more important than flare risk, and this drove the comorbidities and glucocorticoid use in the study design. The authors recognize that not all risk, risk of 90-day readmissions, and management and potential perioperative clinical scenarios are covered by care of the cervical spine are related to the perioperative this guideline, but the most common clinical scenarios are care of patients with rheumatic disease who are undergo- addressed. The recommendations provide important juvenile idiopathic arthritis, and spondyloarthritis. The acknowledgment of low-quality evidence arthritis have declined from 1986 to 2011, but large-joint in this area should lay the foundation for future research. Adverse outcomes after major surgery in patients with sys- with patient involvement in this guideline project, as well temic lupus erythematosus: a nationwide population-based as the patients who participated on the Patient Panel study. Rheumatoid Laureen Fable, Nancy Franklin-Hicks, Jennifer Kangal, arthritis is associated with higher ninety-day hospital re- Marna McDermott, Tiffany Ann Ohlin, Jodi Pound, admission rates compared to osteoarthritis after hip or knee arthroplasty: a cohort study. Patients with systemic lupus erythematosus tive aspects of the project, and Ms Robin Lane for assis- have increased risk of short-term adverse events after total tance in manuscript preparation. Patients with rheumatoid egy and performing the literature search and updates, and arthritis are more likely to have pain and poor function Ms Janet Joyce for reviewing the literature search strategy. Patients with rheumatoid arthritis have similar excellent outcomes after total knee replacement All authors were involved in drafting the article or revising it compared with patients with osteoarthritis. J Rheumatol critically for important intellectual content, and all authors 2016;43:46–53. Rheumatoid arthritis does not increase risk of for the integrity of the data and the accuracy of the data analysis. J Rheumatol 2015;42:1123– Abdel, Dasa, George, Gewurz-Singer, Giles, Johnson, Mandl, Mont, 30. Patterns and associated risk of George, Gewurz-Singer, Giles, Johnson, Mandl, Sculco, Sporer, perioperative use of anti-tumor necrosis factor in patients Stryker, Turgunbaev, Brause, Kirou, Russell, Sah, Singh, Yates. TheMayoprosthetic joint infection risk Rosenblatt, Kirou, Losina, MacKenzie, Michaud, Mikuls, Russell, score: implication for surgical site infection reporting and Sah, Singh, Yates. Incidence and risk factors of pros- thetic joint infection after total hip or knee replacement in 1. Arthritis Rheum 2008; with effective disease-modifying antirheumatic drugs: evi- 59:1713–20. The changing demographics of total joint arthroplasty: a systematic review and meta-analysis. Rheu- arthroplasty recipients in the United States and Ontario matology (Oxford) 2016;55:573–82. J Clin Epidemiol 2013;66:719– nomic burden of periprosthetic joint infection in the 25. Going mendations on immunization: recommendations of the from evidence to recommendation-determinants of a rec- Advisory Committee on Immunization Practices. The effect of combined estrogen and progester- early postoperative complications in patients with rheuma- one hormone replacement therapy on disease activity in toid arthritis undergoing elective orthopaedic surgery. Combined oral contraceptives in ment on the incidence of infectious complications after women with systemic lupus erythematosus. Cochrane Database Syst Rev 2014;6: matoid arthritis and systemic lupus erythematosus. Arthritis Rheumatol American Society of Echocardiography, American Society 2015;67 Suppl:S2664. Strand V, Ahadieh S, French J, Geier J, Krishnaswami S, Cardiovascular Anesthesiologists, Society for Cardiovascu- Menon S, et al. Mod Rheumatol 2015;25: surgery patients: antithrombotic therapy and prevention of 672–8. Etanercept for the treatment of rheumatoid The comparative efficacy and safety of biologics for the arthritis. Etanercept in the treat- tematic review and meta-analysis of rare harmful effects in ment of ankylosing spondylitis: a meta-analysis of random- randomized controlled trials. Capogrosso Sansone A, Mantarro S, Tuccori M, Ruggiero E, interleukin-6 in rheumatoid arthritis and other inflamma- Montagnani S, Convertino I, et al. Safety profile of tory rheumatic diseases: systematic literature review and certolizumab pegol in patients with immune-mediated meta-analysis informing a consensus statement. Ann Rheum inflammatory diseases: a systematic review and meta-analy- Dis 2013;72:583–9. J Zhejiang Univ Sci B 2012;13: ent biological and targeted synthetic disease-modifying 731–44. J Am Acad Dermatol 2011;64:1035– atic literature review and meta-analyses from biologic reg- 50. Serious adverse events associated tematic review and meta-analysis of randomized controlled with using biological agents to treat rheumatic diseases: trials. Meta-analysis of malignancies, serious infec- arthritis: a meta-analysis of randomized controlled trials. Tumor necrosis factor a drugs in psoriatic disease: a systematic review and metaanalysis of rheumatoid arthritis: systematic review and metaanalysis randomized controlled trials. Risks risk of serious infection and malignancy in patients with and benefits of tumor necrosis factor-a inhibitors in the early rheumatoid arthritis: a meta-analysis of randomized management of psoriatic arthritis: systematic review and controlled trials. Incidence of serious infectious events of belimumab, a monoclonal antibody that inhibits B lym- with methotrexate treatment: metaanalysis of randomized phocyte stimulator, in patients with systemic lupus erythe- controlled trials. Ann Rheum with rheumatoid arthritis receiving concomitant metho- Dis 2015;74:1311–6. Rituximab pharmacokinetics in patients with rheu- total joint arthroplasty in solid organ transplant recipients: matoid arthritis: B-cell levels do not correlate with clinical a case series. Risk of serious adverse effects of biological and tar- recipients fare after primary total knee arthroplasty? Off-label use of rituximab in systemic zoster: recommendation of the Advisory Committee on Immu- lupus erythematosus: a systematic review. The and improve the global outcomes of patients with acute and challenge is how to accurately estimate a patient’s kidney chronic kidney disease. In particular, although glomerular Prescribing in Kidney Disease: Initiative for Improved filtration rate is the metric used to guide dose adjustment, Dosing’. Clinicians must assess patient assessment considerations should be factored into the kidney function and consider how the kidney function- decision-making process?

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Such assistance may be provided by court personnel including intake personnel of juvenile probation services trusted wellbutrin 300mg lithium depression definition. That the petitioner is sufficiently mature and well enough informed to intelligently decide whether to have an abortion without the consent of either of her parents or legal guardian order wellbutrin 300mg online mood disorder forum. That one or both of her parents or her guardian has engaged in a pattern of physical purchase wellbutrin 300mg otc mood disorder dsm 4 code, sexual purchase 300 mg wellbutrin free shipping depression recurrence symptoms, or emotional abuse against her, or that the consent of her parents, parent or legal guardian otherwise is not in her best interest. Provided, however, this time requirement may be extended on the request of the minor. If a juvenile court judge is not available for the hearing provided herein, the clerk of the court in which the petition was filed shall forthwith notify the presiding circuit court judge and the presiding circuit court judge of the circuit shall immediately appoint a district or circuit court level judge to hear the petition. A transcript of the proceedings shall be recorded and if there is an appeal as provided in subsection (h), a transcript of the proceedings shall be prepared forthwith. If notice of appeal is given, the record of appeal shall be completed and the appeal shall be perfected within five days from the filing of the notice of appeal. Because time may be of the essence regarding the performance of the abortion, the Alabama Supreme Court shall issue promptly such additional rules as it deems are necessary to insure that appeals under this section are handled in an expeditious, confidential and anonymous manner. In all pleadings or court documents, the minor shall be identified by initials only. An individual designated by the physician may initiate the notification process, but the actual notice shall be given by the physician. The physician giving notice of the abortion must document the notice or attempted notice in the minor’s medical record and take reasonable steps to verify that the person to whom the notice is provided is the parent, legal guardian, or custodian of the minor seeking an abortion. Reasonable steps to provide notice must include 16 (1) if in person, requiring the person to show government-issued identification along with additional documentation of the person’s relationship to the minor; additional documentation may include the minor’s birth certificate or a court order of adoption, guardianship, or custodianship; (2) if by telephone, initiating the call, attempting to verify through a review of published telephone directories that the number to be dialed is that of the minor’s parent, legal guardian, or custodian, and asking questions of the person to verify that the person’s relationship to the minor is that of parent, legal guardian, or custodian; when notice is attempted by telephone but the physician or physician’s designee is unsuccessful in reaching the parent, legal guardian, or custodian, the physician’s designee shall continue to initiate the call, in not less than two-hour increments, for not less than five attempts, in a 24-hour period. Constructive notice is considered to have been given 48 hours after the certified notice is mailed. In this subsection, “constructive notice” means that notice of the abortion was provided in writing and mailed by certified mail, delivery restricted to addressee only, to the last known address of the parent, legal guardian, or custodian after taking reasonable steps to verify the mailing address. An emancipation order issued pursuant to this article recognizes the minor as an adult for the following purposes: 1. The right to consent to medical, dental and psychiatric care without parental consent, knowledge or liability. The right to consent to medical, dental and psychiatric care for the emancipated minor’s child. Obligation to financially support the emancipated minor after the first day of the month following entry of this order. The consent of the parent, parents or legal guardian of such minor shall not be necessary to authorize such hospital, medical and surgical 18 examination, diagnosis and care, and such parent, parents or legal guardian shall not be liable for payment for any services rendered pursuant to this section. Notwithstanding § 41-319, the notarized statement of parental consent and the description of the document or notarial act recorded in the notary journal are confidential and are not public records. A judge of the superior court, on petition or motion, and after an appropriate hearing, shall authorize a physician to perform the abortion if the judge determines that the pregnant minor is mature and capable of giving informed consent to the proposed abortion. If the pregnant minor claims to be mature at a proceeding held pursuant to subsection B of this section, the minor must prove by clear and convincing evidence that she is sufficiently mature and capable of giving informed consent without consulting her parent or legal guardian based on her experience level, perspective and judgment. The court shall advise her that she has the right to court appointed counsel and, on her request, shall provide her with counsel unless she appears through private counsel or she knowingly and intelligently waives her right to counsel. Proceedings in the court under this section are confidential and have precedence over other pending matters. Members of the public shall not inspect, obtain copies of or otherwise have access to records of court proceedings under this section unless authorized by law. For purposes of this subsection, public does not include judges, clerks, administrators, professionals or other persons employed by or working under the supervision of the court or employees of other public agencies who are authorized by state or federal rule or law to inspect and copy closed court records. The court shall hold the hearing and shall issue a ruling within forty-eight hours, excluding weekends and holidays, after the petition is filed. If the court fails to issue a ruling within this time period, the petition is deemed to have been granted and the consent requirement is waived. An expedited confidential appeal is available to a pregnant minor for whom the court denies an order authorizing an abortion without parental consent. The appellate court shall hold the hearing and issue a ruling within forty-eight hours, excluding weekends and holidays, after the petition for appellate review is filed. Filing fees are not required of the pregnant minor at either the trial or the appellate level. Parental consent or judicial authorization is not required under this section if either: 1. The physician performing the abortion shall report the sexual conduct with a minor to the proper law enforcement officials pursuant to § 13-3620 and shall preserve and forward a sample of the fetal tissue to these officials for use in a criminal investigation. A person who performs an abortion in violation of this section is guilty of a class 1 misdemeanor. A person is not subject to any liability under this section if the person establishes by written evidence that the person relied on evidence sufficient to convince a careful and prudent person that the representations of the pregnant minor regarding information necessary to comply with this section are true. The civil action may be based on a claim that failure to obtain consent was a result of simple negligence, gross negligence, wantonness, wilfulness, intention or any other legal standard of care. The civil action may be brought against the person who performs the abortion in violation of this section and any person who causes, aids or assists a minor to obtain an abortion without meeting the requirements of this section. Money damages for all psychological, emotional and physical injuries that result from the violation of this section. Statutory damages in an amount equal to five thousand dollars or three times the cost of the abortion, whichever is greater. A civil action brought pursuant to this section must be initiated within six years after the violation occurred. The consent required by this section must be obtained on a form prescribed by the department of health services. List the possible medical risks that may occur with any surgical, medical or diagnostic procedure, including the potential for infection, blood clots, hemorrhage, allergic reactions and death. List the possible medical risks that may occur with a surgical abortion, including hemorrhage, uterine perforation, sterility, injury to the bowel or bladder, a possible hysterectomy as a result of a complication or injury during the procedure and failure to remove all products of conception that may result in an additional procedure. List the possible medical risks that may occur with a medication abortion, including hemorrhage, infection, failure to remove all products of conception that may result in an additional procedure, sterility and the possible continuation of the pregnancy. The information may be given to or withheld from the spouse, parent, or guardian without the consent and over the express objection of the minor. This section shall not apply to custodial property given or held under the terms of the “Colorado Uniform Transfers to Minors Act”, article 50 of title 11, C. Such consent shall not be subject to disaffirmance because of minority, and, when such consent is given, said minor shall have the same rights, powers, and obligations as if he or she had obtained majority. Consent to organ or tissue donation may be revoked pursuant to section 12-34-106, C. The consent of a minor parent shall not be subject to disaffirmance because of minority, and, when such consent is given, said minor parent has the same rights, powers, and obligations as if he or she were of legal age.

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