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181. Endorsement of the Kidney Disease Improving Global Outcomes (KDIGO) Chronic Kidney Disease?Mineral and Bone Disorder (CKD-MBD) Guidelines: a European Renal Best Practice (ERBP) commentary statement

to curtail plasma phosphate values. We suggest that for detailed information about this important matter the interested reader should consult the recent ERBP nutrition guidelines [30]. In brief, the most important recommendations in that text refer to a maximum of 800–1000 mg (25–35 mmoL/day) daily dietary phosphate intake. Reference is also made to the need for education, for support, and for avoiding the risk of prejudicing dietary protein intake. Also see KDIGO 4.1.4. 4.1.8 In patients with CKD stage

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2010 European Renal Best Practice

184. The Joint IAEA, EANM, and SNMMI Practical Guidance on Peptide Receptor Radionuclide Therapy (PRRNT) in Neuroendocrine Tumors

witheverolimusthanwithplacebowithbestsupportivecare (77.7 % vs. 52.7 %). Side effects were rarely grade 3 or 4; themostfrequentlyreportedsideeffectsincludedstomatitis, anaemia and hyperglycaemia. In May 2011 the US FDA approved everolimus for the treatment of progressive NETs of pancreatic origin in patients with nonresectable, locally advanced, or metastatic disease. In the global supportive approach to the patient, and when delivering PRRNT, nutrition and pain control are an essential component of care. Treatment of pain in patients with NET

2013 Society of Nuclear Medicine and Molecular Imaging

185. The Non-Surgical Management of Hip & Knee Osteoarthritis (OA)

Module E: Complementary & Alternative Medicine 43 E1. Nutritional Supplements/Nutraceuticals/Dietary Supplements 43 E2. Acupuncture and Chiropractic Care 45 Module F. Referrals for Surgical Consultation 47 Appendix A: Guideline Development Process 50 Introduction 50 Methodology 50 Appendix B: Evidence Table 83 Page 4 of 126 Clinical Practice Guideline for the Non-Surgical Management of Osteoarthritis Appendix C: Patient History and Physical Examination 88 Knee History 88 Knee Physical Examination 88

2014 VA/DoD Clinical Practice Guidelines

186. Management of Chronic Kidney Disease (CKD) in Primary Care

, routine nutritional vitamin D supplementation, weight loss, exercise, health education, over-the-counter medication use, and smoking cessation. More broadly, evidence suggests that patient self-management plays an essential role in the management of any chronic disease. According to the Wagner model of chronic disease management, which has been adopted by many chronic care providers, patient self-management is a critical element. [54] Dietary Sodium Restriction Recommendation 9. We suggest the use (...) or renally cleared medications (to include prescription drugs, over-the-counter medications, and nutritional or herbal supplements) for patients with CKD. Boussadi et al. noted that automated alert systems may assist pharmacists in monitoring for drug prescription safety in patients with CKD. [92] The utility of a pharmacovigilance system to reduce adverse drug events in CKD should be the subject of future research. Correction of Acidosis Recommendations 20. We suggest the use of bicarbonate

2014 VA/DoD Clinical Practice Guidelines

187. Management of Obesity and Overweight

Nutritional Concerns 15 2 Appendix L: Participant List 15 6 References 15 8 Page 5 of 17 8 Executive Summary Obesity and associated chronic health conditions cause significant morbidity and negatively impact military readiness. Sixty-one to 83% of Department of Defense (DoD) beneficiaries and 78% of Veterans are overweight or obese, and excess weight is estimated to cost at least $370 per patient per year in additional medical and non-medical costs. Treatment of both overweight and obesity is consistent (...) with the priorities outlined by the leadership of the Department of Veterans Affairs as a part of personalized, proactive Veteran-driven care. Similarly, it is consistent with the DoD’s priority for a fit fighting force and embodied in the US Army’s Performance Triad of Nutrition, Physical Activity, and Sleep. Moreover, screening, treatment, and follow-up of overweight and obesity can be successfully managed in the primary care setting with an interdisciplinary approach. Overweight and obesity are typically

2014 VA/DoD Clinical Practice Guidelines

188. Diagnosis and treatment of limb-girdle and distal dystrophies

and nutrition. Patients with muscular dystrophy may have difficulty receiving adequate oral intake due to dysphagia or inability to feed themselves due to arm weakness. Maintaining adequate nutrition and body weight is important for optimizing strength, function, and quality of life. When oral intake is inadequate, other means of maintaining intake (e.g., gastrostomy or jejunostomy feeding tubes) may be needed to maintain optimal nutrition. There is evidence from related conditions (amyotrophic lateral (...) sclerosis [ALS]) that maintenance of nutrition and body weight prolongs survival. e243 Recommendation. Clinicians should refer muscular dystrophy patients with dysphagia, frequent aspiration, or weight loss for swallowing evaluation or gastroenterology evaluation to assess and manage swallowing function and aspiration risk, to teach patients techniques for safe and effective swallowing (e.g., chin tuck maneuver, altered food consistencies), and to consider placement of a gastrostomy/jejunostomy tube

2014 American Academy of Neurology

190. The Management of Dyslipidemia for Cardiovascular Risk Reduction (Lipids)

for Secondary Prevention 29 Statins 29 Fibrates (gemfibrozil, fenofibrate) 32 Bile acid sequestrants 32 Niacin 33 Ezetimibe 33 Long Chain Omega-3 Fatty Acids (Fish oils) 33 Non-Pharmacologic Approaches 35 Therapeutic Lifestyle Changes Diet 35 Weight Loss 36 Physical Activity 36 Smoking Cessation 36 Nutrition Counseling 37 Mediterranean Diet 37 Monitoring and Follow-up 40 Appendix A: Evidence Review Methodology 41 Population(s) 41 Interventions 42 December 2014 Page 2 of 112 Outcomes 42 Conducting (...) , asp) b. Therapeutic Lifestyle Changes (TLC) diet to optimize nutrition (For overweight and/or obese patients, see 2014 Obesity CPG, DoDCPGManagementOfOverweightAndObesityFINAL07071 4.pdf) c. Optimal physical activity (See 2008 Physical Activity Guidelines for Americans, Modified from the 2006 CPG without an updated systematic review

2014 VA/DoD Clinical Practice Guidelines

192. Vomiting in Infants Up to 3 Months of Age

, when compared to esophageal pH monitoring. The recent clinical practice guidelines from the North American and European Societies for Pediatric Gastroenterology, Hepatology, and Nutrition state that the UGI is not useful for diagnosing GER but can help exclude or confirm anatomic abnormalities that cause symptoms similar to GER [22]. The brief duration of the UGI series results in false-negative results, whereas the frequent occurrence of nonpathological reflux results in false-positive results (...) : recommendations of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 2001;32 Suppl 2:S1-31. 22. Vandenplas Y, Rudolph CD, Di Lorenzo C, et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr. 2009;49(4

2014 American College of Radiology

193. Management of Colon Cancer

patients, successful preoperative stenting may allow for colonic decompression, metabolic and nutritional recovery, and adequate workup (operabil- ity, colonic evaluation) to optimize subsequent elective resection. 81 Patients should be carefully selected, however, because a randomized trial of palliative stenting versus surgery was prematurely closed owing to an unexpectedly high rate of perforations in the stented group. 82 The se- lection of the surgical approach should consider the pa- tient’s

2012 American Society of Colon and Rectal Surgeons

194. Key Concepts in the Evaluation of Screening Approaches for Heart Disease in Children and Adolescents

Association Council on Nutrition, Physical Activity, and Metabolism.” That panel emphasized the importance of risk assessment with questionnaires and physical examination but did “not believe it to be either prudent or practical to recommend the routine use of tests such as 12-lead ECG or echocardiography in the context of mass, universal screening.” More recently a National Institutes of Health, National Heart, Lung, and Blood Institute Working Group addressed several of the key outstanding issues (...) . Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism . Circulation . 2007 ; 115 : 1643– 1655. Kaltman JR, Thompson PD, Lantos J, Berul CI, Botkin J, Cohen JT, Cook NR, Corrado D, Drezner J, Frick KD, Goldman S, Hlatky M, Kannankeril PJ, Leslie L, Priori S, Saul JP, Shapiro-Mendoza CK, Siscovick D, Vetter VL

2012 American Heart Association

196. Nonnutritive Sweeteners: Current Use and Health Perspectives

Nutrition Committee of the Council on Nutrition, Physical Activity and Metabolism, Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiovascular Disease in the Young, and the American Diabetes Association Originally published 9 Jul 2012 Circulation. 2012;126:509–519 You are viewing the most recent version of this article. Previous versions: Introduction A 2009 American Heart Association scientific statement titled “Dietary Sugars Intake and Cardiovascular Health” concluded (...) that current intake of added sugars among Americans greatly exceeds discretionary calorie allowances based on the 2005 US Dietary Guidelines. For this reason, the American Heart Association Nutrition Committee recommended population-wide reductions in added sugars intake. The present statement from the American Heart Association and the American Diabetes Association addresses the potential role of nonnutritive sweeteners (NNS) in helping Americans to adhere to this recommendation in the context of current

2012 American Heart Association

197. Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management

. Recently, focused neurodevelopmental follow-up clinics for children with complex CHD have been created at several pediatric cardiac centers in North America. These clinics have tremendous expertise in the identification of DDs and developmental delay through multidisciplinary teams, which may include a developmental pediatrician, pediatric psychologist, and neurologist, as well as important consultative services such as nutrition, special education or school intervention, speech and language therapy

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2012 American Heart Association

198. Sodium, Blood Pressure, and Cardiovascular Disease

grouped into the following 5 categories: experimental and laboratory studies, survey data, risk association, clinical trials, and nutritional adequacy. Experimental and Clinical Laboratory Studies Excess sodium intake has been shown to increase BP and to cause adverse cardiovascular effects in humans and several species of experimental animals, including mice, rats, rabbits, dogs, pigs, green monkeys, baboons, and chimpanzees. , These observations have been made under carefully controlled conditions (...) experience in 4 National Health and Nutrition Examination Surveys (NHANES) conducted between 1971 to 1974 and 1999 to 2000. The NHANES results showed a 48% and 69% increase in daily sodium intake in men and women, respectively, between 1971 to 1974 and 1988 to 1994. There was little change between 1988 to 1994 and 1999 to 2000, with average sodium intakes in adult men and women of 4127 and 3002 mg/d, respectively, in 1999 to 2000. The NHANES report benefits from the use of a representative national

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2012 American Heart Association

199. Evolution of Critical Care Cardiology: Transformation of the Cardiovascular Intensive Care Unit and the Emerging Need for New Medical Staffing and Training Models

in protocol development and implementation, therapeutic drug monitoring, adverse drug event surveillance and reporting, orchestration of clinical trials, and provision of drug information within the ICU setting. Nutritional management of critically ill cardiovascular patients, particularly those with multiple coexisting disorders, is challenging. Dieticians evaluate dietary intake, formulate tailored nutritional delivery, and help patients to attain or maintain optimal nutritional status. Physical

2012 American Heart Association

200. Lead Screening During Pregnancy and Lactation

of the increased bone turnover. Pregnant and lactating women with a current or past blood lead level of 5 micrograms/dL or higher should receive specific nutritional recommendations regarding calcium and iron supplementation. A balanced diet that contains 2,000 mg of calcium and 60–120 mg of iron daily is recommended (8). This can be achieved through either food intake or supplementation. Supplements should be divided into doses of 500 mg of calcium and 60 mg of iron to improve absorption. Lactation Women (...) lead level is greater than 20 micrograms/dL and the infant blood lead level is 5 micrograms/dL or more, breast milk should be suspected as the source and temporary interruption of breastfeeding until the maternal blood lead level decreases should be considered. In addition to removing the source of lead exposure for the mother and infant, several nutritional interventions have been studied. Calcium supplementation (1,200 mg daily) has been associated with a 5–10% decrease in breast milk lead levels

2012 American College of Obstetricians and Gynecologists


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