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BRASH Syndrome

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1. Gastroesophageal Reflux Disease (GERD) - Guidelines for Prescribing H2RAs and PPIs

Gastroesophageal Reflux Disease (GERD) - Guidelines for Prescribing H2RAs and PPIs Gastroesophageal Reflux Disease (GERD) - Guidelines for Prescribing H2RAs and PPIs - medSask Home - College of Pharmacy and Nutrition - University of Saskatchewan Toggle Menu Search the U of S Search Gastroesophageal Reflux Disease (GERD) - Guidelines for Prescribing H2RAs and PPIs Most common acid-related condition in Canada. Approximately 10% to 20% of people in developed countries suffer from GERD. It can (...) affect children and infants as well as adults Classic symptoms are heartburn and regurgitation Caused by a number of mechanisms, the most important being a transient relaxation of the lower esophageal sphincter. Increased lower abdominal pressure, reduced lower esophageal sphincter tone, delayed gastric emptying, and impaired esophageal clearance may also be involved Risk factors: Being overweight or obese Diet Pregnancy Smoking Other conditions: crohn’s disease, celiac disease, hypothyroidism

2018 medSask

2. Gastroesophageal Reflux Disease (GERD)

syndromes can be categorized as conditions that have an established association with GERD (cough, laryngitis, asthma, dental erosions) and those that have only a proposed association (pharyngitis, sinusitis, idiopathic pulmonary fibrosis, otitis media) [6]. Reflux-related symptoms occur with frequency and severity across a continuum. There are individuals who experience occasional, mild reflux symptoms that do not © World Gastroenterology Organization 2015 WGO Global Guidelines GERD 5 trouble them (...) [26] are: heartburn before pregnancy, parity, and duration of pregnancy. Maternal age is inversely correlated with the occurrence of pregnancy-related heartburn [27]. Other pathobiological factors • The higher incidence of GERD in Caucasians [28] is likely to be related to lifestyle rather than genetic factors. • Comorbidities are frequent in patients with GERD: diabetes, metabolic syndrome, cardiovascular disease, and sleep apnea are all common. Overweight and obesity are common risk factors both

2015 World Gastroenterology Organisation

3. NY Times hails discovery of new genetic heart disease risk factor, but what about researchers’ industry ties?

NY Times hails discovery of new genetic heart disease risk factor, but what about researchers’ industry ties? NY Times hails discovery of new genetic heart disease risk factor, but what about researchers' industry ties? - HealthNewsReview.org Note to our followers: Our nearly 13-year run of daily publication of new content on HealthNewsReview.org came to a close at the end of 2018. Publisher Gary Schwitzer and other contributors may post new articles periodically. But all of the 6,000+ articles (...) we have published contain lessons to help you improve your critical thinking about health care interventions. And those will be still be alive on the site for a couple of years. 6093 Posts Menu January 31, 2018 NY Times hails discovery of new genetic heart disease risk factor, but what about researchers’ industry ties? Posted By Categories , Tags , , Kevin Lomangino is the managing editor of HealthNewsReview.org. He tweets as @KLomangino. Earlier this week, The New York Times introduced

2018 HealthNewsReview

4. A prospective evaluation of undiagnosed joint hypermobility syndrome in patients with gastrointestinal symptoms. (Abstract)

A prospective evaluation of undiagnosed joint hypermobility syndrome in patients with gastrointestinal symptoms. The Joint Hypermobility Syndrome (JHS) is a common connective tissue disorder characterized by joint hyperflexibility, dysautonomia, and chronic pain. Gastrointestinal (GI) symptoms are reported in JHS patients attending rheumatology clinics, but the prevalence and symptom pattern of previously undiagnosed JHS in GI clinics are unknown.By using validated questionnaires, a prospective (...) , 180 (33%) had JHS (JHS-G) and 372 did not (non-JHS-G). Forty-four JHS-Rh patients were included. JHS-G patients were more likely to be younger, female with poorer quality of life (P = .02) than non-JHS-G patients. After age and sex matching, heartburn (odds ratio [OR], 1.66; confidence interval [CI], 1.1-2.5; P = .01), water brash (OR, 2.02; CI, 1.3-3.1; P = .001), and postprandial fullness (OR, 1.74; CI, 1.2-2.6; P = .006) were more common in JHS-G vs non-JHS-G. Many upper and lower GI symptoms

2014 Clinical Gastroenterology and Hepatology

5. Swallowing Disorders (Overview)

aspirated or by estimating the depth of bolus invasion into the airway. The Eight-Point Penetration-Aspiration Scale is an example of an estimation tool. [ ] Previous Next: Etiology Central nervous system disorders Central nervous system (CNS) pathologies that can produce dysphagia include the following: Alzheimer disease Brain tumors Guillain-Barré syndrome Huntington disease CNS infections Stroke Traumatic brain injury (TBI) [ ] Parkinson disease [ , ] Poliomyelitis Cerebral palsy Multiple sclerosis (...) supplementation. In patients who have sustained a stroke, continued swallowing dysfunction after 6 months is associated with increased morbidity and mortality. In static or progressive conditions (eg, neuromuscular disorders, postpolio syndrome), periodic evaluation of swallowing disorders is mandatory, especially with the onset of new symptoms, and the appropriate strategies (the use of nonoral feeding techniques or new compensatory mechanisms) should be considered. Aspiration pneumonia Pneumonia accounts

2014 eMedicine.com

6. Gastroesophageal Reflux Disease (Overview)

with suspected gastroesophageal reflux disease: Upper gastrointestinal endoscopy/esophagogastroduodenoscopy: Mandatory Esophageal manometry: Mandatory Ambulatory 24-hour pH monitoring: Criterion standard in establishing a diagnosis of gastroesophageal reflux disease Imaging studies Upper gastrointestinal contrast-enhanced studies are the initial radiologic procedure of choice in the workup gastroesophageal reflux disease. Plain chest radiographic findings are not useful in the evaluation of this condition (...) , and only a very small minority require surgery. Because symptomatic gastroesophageal reflux after age 18 months likely represents a chronic condition, long-term risks are increased. For patients whose gastroesophageal reflux persists into later childhood, long-term therapy with antisecretory agents is often required. In refractory cases or when complications related to reflux disease are identified (eg, stricture, aspiration, airway disease, Barrett esophagus), surgical treatment (fundoplication

2014 eMedicine.com

7. Swallowing Disorders (Follow-up)

aspirated or by estimating the depth of bolus invasion into the airway. The Eight-Point Penetration-Aspiration Scale is an example of an estimation tool. [ ] Previous Next: Etiology Central nervous system disorders Central nervous system (CNS) pathologies that can produce dysphagia include the following: Alzheimer disease Brain tumors Guillain-Barré syndrome Huntington disease CNS infections Stroke Traumatic brain injury (TBI) [ ] Parkinson disease [ , ] Poliomyelitis Cerebral palsy Multiple sclerosis (...) supplementation. In patients who have sustained a stroke, continued swallowing dysfunction after 6 months is associated with increased morbidity and mortality. In static or progressive conditions (eg, neuromuscular disorders, postpolio syndrome), periodic evaluation of swallowing disorders is mandatory, especially with the onset of new symptoms, and the appropriate strategies (the use of nonoral feeding techniques or new compensatory mechanisms) should be considered. Aspiration pneumonia Pneumonia accounts

2014 eMedicine.com

8. Swallowing Disorders (Diagnosis)

aspirated or by estimating the depth of bolus invasion into the airway. The Eight-Point Penetration-Aspiration Scale is an example of an estimation tool. [ ] Previous Next: Etiology Central nervous system disorders Central nervous system (CNS) pathologies that can produce dysphagia include the following: Alzheimer disease Brain tumors Guillain-Barré syndrome Huntington disease CNS infections Stroke Traumatic brain injury (TBI) [ ] Parkinson disease [ , ] Poliomyelitis Cerebral palsy Multiple sclerosis (...) supplementation. In patients who have sustained a stroke, continued swallowing dysfunction after 6 months is associated with increased morbidity and mortality. In static or progressive conditions (eg, neuromuscular disorders, postpolio syndrome), periodic evaluation of swallowing disorders is mandatory, especially with the onset of new symptoms, and the appropriate strategies (the use of nonoral feeding techniques or new compensatory mechanisms) should be considered. Aspiration pneumonia Pneumonia accounts

2014 eMedicine.com

9. Gastroesophageal Reflux Disease (Diagnosis)

with suspected gastroesophageal reflux disease: Upper gastrointestinal endoscopy/esophagogastroduodenoscopy: Mandatory Esophageal manometry: Mandatory Ambulatory 24-hour pH monitoring: Criterion standard in establishing a diagnosis of gastroesophageal reflux disease Imaging studies Upper gastrointestinal contrast-enhanced studies are the initial radiologic procedure of choice in the workup gastroesophageal reflux disease. Plain chest radiographic findings are not useful in the evaluation of this condition (...) , and only a very small minority require surgery. Because symptomatic gastroesophageal reflux after age 18 months likely represents a chronic condition, long-term risks are increased. For patients whose gastroesophageal reflux persists into later childhood, long-term therapy with antisecretory agents is often required. In refractory cases or when complications related to reflux disease are identified (eg, stricture, aspiration, airway disease, Barrett esophagus), surgical treatment (fundoplication

2014 eMedicine.com

10. Swallowing Disorders (Treatment)

aspirated or by estimating the depth of bolus invasion into the airway. The Eight-Point Penetration-Aspiration Scale is an example of an estimation tool. [ ] Previous Next: Etiology Central nervous system disorders Central nervous system (CNS) pathologies that can produce dysphagia include the following: Alzheimer disease Brain tumors Guillain-Barré syndrome Huntington disease CNS infections Stroke Traumatic brain injury (TBI) [ ] Parkinson disease [ , ] Poliomyelitis Cerebral palsy Multiple sclerosis (...) supplementation. In patients who have sustained a stroke, continued swallowing dysfunction after 6 months is associated with increased morbidity and mortality. In static or progressive conditions (eg, neuromuscular disorders, postpolio syndrome), periodic evaluation of swallowing disorders is mandatory, especially with the onset of new symptoms, and the appropriate strategies (the use of nonoral feeding techniques or new compensatory mechanisms) should be considered. Aspiration pneumonia Pneumonia accounts

2014 eMedicine.com

11. Anthropometric Measures and Severity of Gastroesophageal Reflux Disease

Montasser, Ain Shams University Study Details Study Description Go to Brief Summary: evaluate the impact of different anthropometric measures on clinical and endoscopic severity of GERD and its relation to serum leptin. Condition or disease Gastroesophageal Reflux Disease Study Design Go to Layout table for study information Study Type : Observational [Patient Registry] Actual Enrollment : 80 participants Observational Model: Case Control Time Perspective: Prospective Target Follow-Up Duration: 6 Weeks (...) , case-controlled study included 60 Egyptian patients who attended Ain Shams University Hospitals and Theodor Bilharz Research Institute; Cairo, Egypt Criteria Inclusion Criteria: Gastro esophageal reflux symptoms (e.g. heart burn, regurgitation, water brash or atypical symptoms such as hoarseness of voice, asthma and cough) complete upper gastrointestinal endoscopy. Exclusion Criteria: Receiving medication for reflux disease (including proton pump inhibitor, histamine type 2 receptors blocker

2013 Clinical Trials

12. Actinic Keratoses

: ricardo.werner@charite.de Methodsandresultsreport[availableatDOI:10.1111/jdv.13179]:detaileddescriptionoftheguidelinesdevelopmentprocess andmethodologyandcomprehensivedescriptionoftheresultsoftheguidelinesdevelopmentincludingSummaryofFindingstables. Longversionoftheguidelines(onlinesupplement):containsmoredetaileddataonthegoals,methodologicalandclinical backgroundandtheresultsoftheguidelinesdevelopment. Abstract Background Actinic keratosis (AK) is a frequent health condition attributable to chronic exposure (...) of patients with AK, primarily derma- tologists, histopathologists andgeneral practitioners. Along with a clearance of AK lesions and prevention of their recurrence, the provision of evidence-based treatment algo- rithms intends to decrease the percentage of patients with pro- gression from AK to invasive squamous cell carcinoma (SCC). To take frequent clinical situations into account, different patient subgroups were de?ned, according to the severity of the disease and the medical history of the patients

2015 European Dermatology Forum

13. An elderly woman found down with bradycardia and hypotension

coined The BRASH syndrome was coined on social media, not yet in peer-reviewed literature (like OMI). This interesting article on EmCrit references many cases with all of these findings, but none gave it this name, so you will have a hard time searching PubMed for this syndrome! Briefly, BRASH occurs when a patient taking AV nodal blockers develops renal failure leading to decreased clearance of both potassium and AV nodal blocking medications, with worsening bradycardia and hypotension resulting (...) of three etiologies remembered by the mnemonic " DIE ": D rugs (e.g., AV nodal blockers), I schemia (acute coronary occlusion), and E lectrolytes (esp. potassium). 3) In BRASH syndrome, a patient taking an AV nodal blocking medication develops renal failure and hyperkalemia which manifests on the ECG with peaked T-waves and/or any of the 4 B’s of hyperkalemia: Broad (Widened QRS), Brady, Bizarre, Blocks (AV Blocks). ----------------------------------------------------------- Comments by KEN GRAUER, MD

2018 Dr Smith's ECG Blog

14. Rehabilitation Planning Consult Phase II Trial

with plans and goal attainment are facilitated by a Rehabilitation Consultant. Results from this study will be used to plan for a larger multi-site trial and subsequent real world implementation. Condition or disease Intervention/treatment Phase Head and Neck Neoplasms Behavioral: Rehabilitation Planning Consult (RPC) Other: Wait list control (WLC) Not Applicable Detailed Description: Survivors of head and neck cancer (HNC) often have significant impairments, functional limitations, and reduced quality (...) to achieve a minimal important difference (MID) in QL, thus 56 participants per arm, 112 participants total, will be recruited. The primary outcome will be QL related to physical health, measured using the SF-36 Physical Component Summary Score (PCS). Secondary measures will include individualized goal performance measured using the Brief Rehabilitation Assessment for Survivors of HNC, disease-specific QL measured with the FACT-HN, and self-efficacy. Study Design Go to Layout table for study information

2018 Clinical Trials

15. Prevention of skin cancer

not only serve for the structured transfer of © German Guideline Program in Oncology | Evidence-based Guideline on Prevention of Skin Cancer | April 2014 1.9 Other documents relating to this guideline 9 knowledge, but can also play a part in formulating health system structures. Examples that may be mentioned here are those of evidence-based guidelines as a basis for compiling and updating Disease Management Programmes or the use of quality indicators derived from guidelines for certifying organ tumour (...) involved Representative German Society of Pathology (DGP) PD Dr. Christian Rose* German Society of Paediatric and Adolescent Medicine (DGKJ) Prof. Dr. Peter Höger German Society of Urology (DGU) Prof. Dr. Jürgen Gschwend German Working Party for the Assistance of Persons with Disabilities and Chronic Diseases and their Relatives (BAG Selbsthilfe) Christiane Regensburger Otorhinolaryngology, Oral and Maxillofacial Surgical Oncology Working Group (AHMO) Prof. Dr. Jochen A. Werner (retired), PD Dr

2014 German Guideline Program in Oncology

16. Gastroesophageal reflux disease

of the chest) due to severe reflux Pronunciation Symptoms Taste of acid, , , , breathing problems , , Duration Long term Causes Inadequate closure of the , , , , taking certain medicines , , , , , , Treatment Lifestyle changes, medications, surgery Medication , , , Frequency ~15% (Western populations) Gastroesophageal reflux disease ( GERD ), also known as acid reflux , is a condition in which stomach contents rise up into the , resulting in either symptoms or complications. Symptoms include the taste (...) . and , which can feature esophageal dysmotility. The use of medicines such as . or Glénard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach. GERD has been linked to a variety of respiratory and laryngeal complaints such as , chronic , , , and , even when not clinically apparent. These atypical manifestations of GERD are commonly referred to as (LPR) or as extraesophageal reflux disease (EERD). Factors that have been linked with GERD

2012 Wikipedia

17. Family Practice Notebook Updates 2018

, statistical techniques, study duration (cv, cad) Up to 30-30% with may have complete coronary and would benefit from PCI criteria for leads V2 and V3 are age and gender dependent (2.5 mm for man <40, 2 mm for man>40, 1.5 mm for woman) ST depression >1mm in 8 or more leads and in aVR or V1 suggests left main obstruction or multi-vessel disease (cv, ekg) BRASH syndrome is , , er (e.g. , ), , (endo, dm, pharm) Mild benefit in albuminuria reduction with and (cv, exam, cad, prevent) Since 2013, ACC/AHA has (...) (prevent, ) At any one time in the U.S., 720,000 persons are incarcerated, roughly the population size of San Francisco are at higher risk for nearly every medical and psychiatric condition, especially communicable disease and Most undergo an initial brief evaluation to confirm that they are fit for incarceration, and later undergo a more complete intake health evaluation (gi, ibd) Consider as an initial test to rule-out , then confirm with endoscopy or CT or MRI enterography Biologic agents are first

2019 FP Notebook

18. Bradycardia

reflex) (e.g. ) Acute ingestions or s (GHB) Muscarinic Other conditions Severe or starvation Infections Acute Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Bradycardia." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Bradyarrhythmia (disorder) (C0079035) Concepts Disease or Syndrome ( T047 ) SnomedCT 421869004 Italian Bradiaritmia English (...) From Related Chapters II. Causes: Primary See Sinus Arrhythmia Sinoatrial Node Block III. Causes: Secondary Approach - simplified top secondary causes to consider in symptomatic Bradycardia Electrolytes ( , ) Electrolyte disturbance Important cause of Bradycardia that should not be missed Associated with short s and tall s BRASH Syndrome Bradycardia er (e.g. or ) (out of proportion to degree of , requires fluid and possible pressors) References EMCrit (Josh Farkas, MD) Intracranial cause ( or dive

2018 FP Notebook

19. Gastroesophageal Reflux

to the esophageal mucosal. Symptoms include heartburn and acid indigestion. Definition (NCI) A chronic disorder characterized by reflux of the gastric and/or duodenal contents into the distal esophagus. It is usually caused by incompetence of the lower esophageal sphincter. Symptoms include heartburn and acid indigestion. It may cause injury to the esophageal mucosa. Concepts Disease or Syndrome ( T047 ) MSH ICD9 530.81 ICD10 , SnomedCT 235595009 , 102620007 , 54856001 , 266498005 , 196624002 , 155673008 (...) Gastroesophageal Reflux Aka: Gastroesophageal Reflux , Esophageal Relux , Reflux Esophagitis , Heartburn , Acid Reflux , Acid Regurgitation , Water Brash , Pyrosis , GERD From Related Chapters II. Epidemiology : 36% in U.S. Most take OTC medications and do not seek medical help GERD patients wait 1-3 years before seeing a doctor III. Risk Factors: Reduced LES pressure Smooth muscle relaxants Nitrates s Inhaled abuse Pregnancy -mediated relaxation of the lower esophageal sphincter (esp. longer standing disease

2018 FP Notebook

20. Science and medicine are seemingly at constant odds

scientists and clinicians who argue over where the boundary lies between cruel inaction versus brash risk-taking. The scientist in me tells me that a large swath of medicine needs urgent update, but the clinician in me reminds me that medical progress must remain slow and methodical for the sake of our patients’ safety. Yet in spite of the push and pull, we find ourselves with lifespans at an all-time high, diseases being eradicated, and maternal deaths on the decline. So maybe it doesn’t matter whether (...) , the very illness he tried to prevent. Imagine that: Sterility, now considered foundational to proper medical care with hand sanitizers mounted every few feet in hospital hallways, took decades and the findings of Louie Pasteur and Joseph Lister to finally convince the medical community. Two centuries later, medicine is still stubborn. It from a finding to be translated into a policy and then into change in practice. In fact, — what we now know as “evidence-based medicine” and is the gold standard

2018 KevinMD blog

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