How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

399 results for

Clinical Index of Stable Febrile Neutropenia

by
...
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

281. Pneumonia, Bacterial (Treatment)

for Healthcare Research and Quality. Pneumonia severity index calculator. Available at . Accessed: January 13, 2011. Sligl WI, Majumdar SR, Marrie TJ. Triaging severe pneumonia: what is the "score" on prediction rules?. Crit Care Med . 2009 Dec. 37(12):3166-8. . Phua J, See KC, Chan YH, Widjaja LS, Aung NW, Ngerng WJ, et al. Validation and clinical implications of the IDSA/ATS minor criteria for severe community-acquired pneumonia. Thorax . 2009 Jul. 64(7):598-603. . Bloos F, Marshall JC, Dellinger RP, et al (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzAwMTU3LXRyZWF0bWVudA== processing > Bacterial Pneumonia Treatment & Management Updated: Mar 19, 2019 Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH Share Email Print Feedback Close Sections Sections Bacterial Pneumonia Treatment Approach Considerations Almost all major decisions regarding management of pneumonia address the initial assessment of severity. See Risk Stratification under Clinical Presentation. Perhaps the most important initial determination is that of the need for hospitalization

2014 eMedicine Emergency Medicine

282. Shock, Septic (Treatment)

source of sepsis,” with daily reevaluation of the anti-infective therapy for potential de-escalation. [ , ] Generally, a 7- to 10-day treatment course is followed. Longer treatment regimens may be warranted in the presence of a slow clinical response, undrainable foci of infection, and immunologic deficiencies (eg, neutropenia). The use of procalcitonin or similar biomarkers may facilitate discontinuance of antibiotics in patients with clinical improvement and no further evidence of infection (...) host responses. Source control is an essential component of sepsis management. Venous access In all cases of septic shock, adequate venous access must be ensured for volume resuscitation. When sepsis is suspected, 2 large-bore (16-gauge) intravenous (IV) lines should be placed if possible to allow administration of aggressive fluid resuscitation and broad-spectrum antibiotics. Central venous access is useful when administering vasopressor agents and in establishing a stable venous infusion site

2014 eMedicine Emergency Medicine

283. Transplants, Liver (Overview)

is suspected Cultures of blood, urine, pharynx, and/or sputum: Obtain if infection is suspected Imaging studies Chest radiography: Obtain in the presence of fever, cough, dyspnea, or abnormalities on chest examination Abdominal ultrasonography, computed tomography scan, or endoscopic retrograde cholangiopancreatography, as indicated Management of rejection or infection Every clinical complaint by the transplant patient should be taken seriously, and the transplant team should at least know of every (...) dysfunction. Acute rejection is represented clinically as jaundice with laboratory evidence of abnormal liver function tests. Bilirubin and alkaline phosphatase levels rise initially, followed by elevations in the hepatocellular enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Other symptoms may include fever, liver tenderness, and eosinophilia. Acute rejection is most commonly treated with high-dose steroids (prednisolone 200 mg or methylprednisolone 1 g for 3 days) or a high

2014 eMedicine Emergency Medicine

284. Inflammatory Bowel Disease (Treatment)

TPMT activity, require monitoring for complications. [ ] Adverse effects and monitoring Use of immune modifiers mandates monitoring of blood parameters; they can cause significant neutropenia or pancytopenia that warrants a dose reduction or discontinuation. Routine complete blood cell (CBC) counts with differentials and platelet counts are checked monthly, and liver function tests (LFTs) can be performed intermittently. After a year of stable dosing with no difficulties with blood counts (except (...) . In independent studies, metabolite levels have not shown any correlation with clinical efficacy, but they may help in monitoring compliance. Other adverse effects of the immune modifiers include fever, rash, infectious complications, hepatitis, pancreatitis, and bone marrow depression. The most common reason for discontinuing the immune modifiers within the first few weeks is the development of abdominal pain; occasionally, a biochemically demonstrable pancreatitis occurs. Concerns have been raised about

2014 eMedicine Emergency Medicine

285. Inflammatory Bowel Disease (Follow-up)

TPMT activity, require monitoring for complications. [ ] Adverse effects and monitoring Use of immune modifiers mandates monitoring of blood parameters; they can cause significant neutropenia or pancytopenia that warrants a dose reduction or discontinuation. Routine complete blood cell (CBC) counts with differentials and platelet counts are checked monthly, and liver function tests (LFTs) can be performed intermittently. After a year of stable dosing with no difficulties with blood counts (except (...) . In independent studies, metabolite levels have not shown any correlation with clinical efficacy, but they may help in monitoring compliance. Other adverse effects of the immune modifiers include fever, rash, infectious complications, hepatitis, pancreatitis, and bone marrow depression. The most common reason for discontinuing the immune modifiers within the first few weeks is the development of abdominal pain; occasionally, a biochemically demonstrable pancreatitis occurs. Concerns have been raised about

2014 eMedicine Emergency Medicine

286. Breast Cancer Evaluation (Diagnosis)

-stained Axillary lump See for more detail. Diagnosis Breast cancer is often first detected as an abnormality on a mammogram before it is felt by the patient or health care provider. Evaluation of breast cancer includes the following: Clinical examination Imaging Needle biopsy Physical examination The following physical findings should raise concern: Lump or contour change Skin tethering Nipple inversion Dilated veins Ulceration Paget disease Edema or peau d’orange If a palpable lump is found (...) and possesses any of the following features, breast cancer may be present: Hardness Irregularity Focal nodularity Fixation to skin or muscle Screening Early detection remains the primary defense in preventing breast cancer. Screening modalities include the following: Breast self-examination Clinical breast examination Mammography Ultrasonography Magnetic resonance imaging Ultrasonography and MRI are more sensitive than mammography for invasive cancer in nonfatty breasts. Combined mammography, clinical

2014 eMedicine.com

287. Breast Cancer (Diagnosis)

Axillary lump See for more detail. Diagnosis Breast cancer is often first detected as an abnormality on a mammogram before it is felt by the patient or health care provider. Evaluation of breast cancer includes the following: Clinical examination Imaging Needle biopsy Physical examination The following physical findings should raise concern: Lump or contour change Skin tethering Nipple inversion Dilated veins Ulceration Paget disease Edema or peau d’orange If a palpable lump is found and possesses any (...) of the following features, breast cancer may be present: Hardness Irregularity Focal nodularity Fixation to skin or muscle Screening Early detection remains the primary defense in preventing breast cancer. Screening modalities include the following: Breast self-examination Clinical breast examination Mammography Ultrasonography Magnetic resonance imaging Ultrasonography and MRI are more sensitive than mammography for invasive cancer in nonfatty breasts. Combined mammography, clinical examination, and MRI

2014 eMedicine.com

288. Agranulocytosis (Diagnosis)

with solid tumors who have undergone mild- to moderate-intensity chemotherapy, who appear to be clinically stable, and who are in close proximity to an appropriate medical facility that can provide 24-hour access, the Clinical Index of Stable Febrile Neutropenia (CISNE) may be used as an additional tool to determine the risk of major complications. [ ] Splenectomy In individuals with neutropenia and Felty syndrome who have recurrent, life-threatening bacterial infections, splenectomy is the treatment (...) for antibacterial prophylaxis is an oral fluoroquinolone, while that for antifungal prophylaxis is an oral triazole or parenteral echinocandin. [ ] A companion ASCO/IDSA guideline contains recommendations on outpatient management of fever and neutropenia in patients with cancer. The guideline recommends using clinical judgment and the Multinational Association for Supportive Care in Cancer (MASCC) scoring system or Talcott's rules to identify patients who may be candidates for outpatient management. In patients

2014 eMedicine.com

289. Hematopoietic Stem Cell Transplantation (Diagnosis)

, and, in the most severe cases, surgery. may be helpful in viral infection with BK virus. [ ] Prolonged and severe pancytopenia Severe (< 500/µL but often < 100/µL), prolonged (up to 4 wk) neutropenia is common after transplantation and invariably requires the use of empiric broad-spectrum antimicrobials until recovery of the neutrophils. Empiric antifungal therapy with , , or other agents is often administered if unexplained fever persists despite the use of broad-spectrum antibacterials. Antiviral therapy (...) Aplastic anemia Pure red-cell aplasia Paroxysmal nocturnal hemoglobinuria Fanconi anemia Thalassemia major Sickle cell anemia Severe combined immunodeficiency (SCID) Wiskott-Aldrich syndrome Hemophagocytic lymphohistiocytosis Inborn errors of metabolism Epidermolysis bullosa Severe congenital neutropenia Shwachman-Diamond syndrome Diamond-Blackfan anemia Leukocyte adhesion deficiency HSCT-related morbidity and mortality Complications associated with HSCT include both early and late effects. Early-onset

2014 eMedicine.com

290. Granulocytopenia (Diagnosis)

with solid tumors who have undergone mild- to moderate-intensity chemotherapy, who appear to be clinically stable, and who are in close proximity to an appropriate medical facility that can provide 24-hour access, the Clinical Index of Stable Febrile Neutropenia (CISNE) may be used as an additional tool to determine the risk of major complications. [ ] Splenectomy In individuals with neutropenia and Felty syndrome who have recurrent, life-threatening bacterial infections, splenectomy is the treatment (...) for antibacterial prophylaxis is an oral fluoroquinolone, while that for antifungal prophylaxis is an oral triazole or parenteral echinocandin. [ ] A companion ASCO/IDSA guideline contains recommendations on outpatient management of fever and neutropenia in patients with cancer. The guideline recommends using clinical judgment and the Multinational Association for Supportive Care in Cancer (MASCC) scoring system or Talcott's rules to identify patients who may be candidates for outpatient management. In patients

2014 eMedicine.com

291. Hematopoietic Stem Cell Transplantation (Follow-up)

, and, in the most severe cases, surgery. may be helpful in viral infection with BK virus. [ ] Prolonged and severe pancytopenia Severe (< 500/µL but often < 100/µL), prolonged (up to 4 wk) neutropenia is common after transplantation and invariably requires the use of empiric broad-spectrum antimicrobials until recovery of the neutrophils. Empiric antifungal therapy with , , or other agents is often administered if unexplained fever persists despite the use of broad-spectrum antibacterials. Antiviral therapy (...) Aplastic anemia Pure red-cell aplasia Paroxysmal nocturnal hemoglobinuria Fanconi anemia Thalassemia major Sickle cell anemia Severe combined immunodeficiency (SCID) Wiskott-Aldrich syndrome Hemophagocytic lymphohistiocytosis Inborn errors of metabolism Epidermolysis bullosa Severe congenital neutropenia Shwachman-Diamond syndrome Diamond-Blackfan anemia Leukocyte adhesion deficiency HSCT-related morbidity and mortality Complications associated with HSCT include both early and late effects. Early-onset

2014 eMedicine Pediatrics

292. Pneumonia, Bacterial (Follow-up)

for Healthcare Research and Quality. Pneumonia severity index calculator. Available at . Accessed: January 13, 2011. Sligl WI, Majumdar SR, Marrie TJ. Triaging severe pneumonia: what is the "score" on prediction rules?. Crit Care Med . 2009 Dec. 37(12):3166-8. . Phua J, See KC, Chan YH, Widjaja LS, Aung NW, Ngerng WJ, et al. Validation and clinical implications of the IDSA/ATS minor criteria for severe community-acquired pneumonia. Thorax . 2009 Jul. 64(7):598-603. . Bloos F, Marshall JC, Dellinger RP, et al (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzAwMTU3LXRyZWF0bWVudA== processing > Bacterial Pneumonia Treatment & Management Updated: Mar 19, 2019 Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH Share Email Print Feedback Close Sections Sections Bacterial Pneumonia Treatment Approach Considerations Almost all major decisions regarding management of pneumonia address the initial assessment of severity. See Risk Stratification under Clinical Presentation. Perhaps the most important initial determination is that of the need for hospitalization

2014 eMedicine Emergency Medicine

293. Hematopoietic Stem Cell Transplantation (Treatment)

, and, in the most severe cases, surgery. may be helpful in viral infection with BK virus. [ ] Prolonged and severe pancytopenia Severe (< 500/µL but often < 100/µL), prolonged (up to 4 wk) neutropenia is common after transplantation and invariably requires the use of empiric broad-spectrum antimicrobials until recovery of the neutrophils. Empiric antifungal therapy with , , or other agents is often administered if unexplained fever persists despite the use of broad-spectrum antibacterials. Antiviral therapy (...) Aplastic anemia Pure red-cell aplasia Paroxysmal nocturnal hemoglobinuria Fanconi anemia Thalassemia major Sickle cell anemia Severe combined immunodeficiency (SCID) Wiskott-Aldrich syndrome Hemophagocytic lymphohistiocytosis Inborn errors of metabolism Epidermolysis bullosa Severe congenital neutropenia Shwachman-Diamond syndrome Diamond-Blackfan anemia Leukocyte adhesion deficiency HSCT-related morbidity and mortality Complications associated with HSCT include both early and late effects. Early-onset

2014 eMedicine Pediatrics

294. Hematopoietic Stem Cell Transplantation (Overview)

, and, in the most severe cases, surgery. may be helpful in viral infection with BK virus. [ ] Prolonged and severe pancytopenia Severe (< 500/µL but often < 100/µL), prolonged (up to 4 wk) neutropenia is common after transplantation and invariably requires the use of empiric broad-spectrum antimicrobials until recovery of the neutrophils. Empiric antifungal therapy with , , or other agents is often administered if unexplained fever persists despite the use of broad-spectrum antibacterials. Antiviral therapy (...) Aplastic anemia Pure red-cell aplasia Paroxysmal nocturnal hemoglobinuria Fanconi anemia Thalassemia major Sickle cell anemia Severe combined immunodeficiency (SCID) Wiskott-Aldrich syndrome Hemophagocytic lymphohistiocytosis Inborn errors of metabolism Epidermolysis bullosa Severe congenital neutropenia Shwachman-Diamond syndrome Diamond-Blackfan anemia Leukocyte adhesion deficiency HSCT-related morbidity and mortality Complications associated with HSCT include both early and late effects. Early-onset

2014 eMedicine Pediatrics

295. Hematopoietic Stem Cell Transplantation (Diagnosis)

, and, in the most severe cases, surgery. may be helpful in viral infection with BK virus. [ ] Prolonged and severe pancytopenia Severe (< 500/µL but often < 100/µL), prolonged (up to 4 wk) neutropenia is common after transplantation and invariably requires the use of empiric broad-spectrum antimicrobials until recovery of the neutrophils. Empiric antifungal therapy with , , or other agents is often administered if unexplained fever persists despite the use of broad-spectrum antibacterials. Antiviral therapy (...) Aplastic anemia Pure red-cell aplasia Paroxysmal nocturnal hemoglobinuria Fanconi anemia Thalassemia major Sickle cell anemia Severe combined immunodeficiency (SCID) Wiskott-Aldrich syndrome Hemophagocytic lymphohistiocytosis Inborn errors of metabolism Epidermolysis bullosa Severe congenital neutropenia Shwachman-Diamond syndrome Diamond-Blackfan anemia Leukocyte adhesion deficiency HSCT-related morbidity and mortality Complications associated with HSCT include both early and late effects. Early-onset

2014 eMedicine Pediatrics

296. Shock, Septic (Diagnosis)

sepsis, and it removed the severe sepsis definition. What was previously called severe sepsis is now the new definition of sepsis. Signs and symptoms Detrimental host responses to infection occupy a continuum that ranges from sepsis to severe sepsis to septic shock and multiple organ dysfunction syndrome (MODS). The specific clinical features depend on where the patient falls on that continuum. Signs and symptoms of sepsis are often nonspecific and include the following: Fever (usually >101°F [38°C (...) , ulceration, bullous formation, fluctuance See for more detail. Diagnosis Patients with sepsis may present in a myriad of ways, and a high index of clinical suspicion is necessary to identify subtle presentations. The hallmarks of severe sepsis and septic shock are changes that occur at the microvascular and cellular level and may not be clearly manifested in the vital signs or clinical examination. This process includes diffuse activation of inflammatory and coagulation cascades, vasodilation

2014 eMedicine Emergency Medicine

297. Toxicity, Cocaine (Diagnosis)

Management The general objectives of pharmacotherapeutic intervention in cocaine toxicity are to reduce the CNS and cardiovascular effects of the drug. These are accomplished by using benzodiazepines initially and then controlling clinically significant tachycardia and hypertension while simultaneously attempting to limit deleterious drug interactions. Hyperthermia and rhabdomyolysis If psychostimulant-intoxicated patients do not die as a result of cardiac or cerebrovascular complications (...) . Hyperthermia, which may also be caused by downregulation of dopamine receptors, increases the incidence of fatal excited delirium. Death from excited delirium is more common in the summer months than at other times (55% vs 33% for other accidental cocaine toxicity deaths); therefore, high ambient temperature and humidity may play roles in the development of hyperthermia. An independent risk factor for fatal excited delirium is a body mass index (weight in kilograms/height in square meters) in the upper 3

2014 eMedicine Emergency Medicine

298. Transplants, Liver (Follow-up)

is suspected Cultures of blood, urine, pharynx, and/or sputum: Obtain if infection is suspected Imaging studies Chest radiography: Obtain in the presence of fever, cough, dyspnea, or abnormalities on chest examination Abdominal ultrasonography, computed tomography scan, or endoscopic retrograde cholangiopancreatography, as indicated Management of rejection or infection Every clinical complaint by the transplant patient should be taken seriously, and the transplant team should at least know of every (...) dysfunction. Acute rejection is represented clinically as jaundice with laboratory evidence of abnormal liver function tests. Bilirubin and alkaline phosphatase levels rise initially, followed by elevations in the hepatocellular enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Other symptoms may include fever, liver tenderness, and eosinophilia. Acute rejection is most commonly treated with high-dose steroids (prednisolone 200 mg or methylprednisolone 1 g for 3 days) or a high

2014 eMedicine Emergency Medicine

299. Shock, Septic (Follow-up)

source of sepsis,” with daily reevaluation of the anti-infective therapy for potential de-escalation. [ , ] Generally, a 7- to 10-day treatment course is followed. Longer treatment regimens may be warranted in the presence of a slow clinical response, undrainable foci of infection, and immunologic deficiencies (eg, neutropenia). The use of procalcitonin or similar biomarkers may facilitate discontinuance of antibiotics in patients with clinical improvement and no further evidence of infection (...) host responses. Source control is an essential component of sepsis management. Venous access In all cases of septic shock, adequate venous access must be ensured for volume resuscitation. When sepsis is suspected, 2 large-bore (16-gauge) intravenous (IV) lines should be placed if possible to allow administration of aggressive fluid resuscitation and broad-spectrum antibiotics. Central venous access is useful when administering vasopressor agents and in establishing a stable venous infusion site

2014 eMedicine Emergency Medicine

300. Systemic Lupus Erythematosus (Follow-up)

function and endothelial repair in clinically stable systemic lupus erythematosus. Lancet . 2015 Feb 26. 385 Suppl 1:S83. . Kamen DL, Oates JC. A Pilot Randomized Controlled Trial of Vitamin D Repletion to Determine if Endothelial Function Improves in Patients With Systemic Lupus Erythematosus. Am J Med Sci . 2015 Sep 7. . Reynolds JA, Haque S, Williamson K, Ray DW, Alexander MY, Bruce IN. Vitamin D improves endothelial dysfunction and restores myeloid angiogenic cell function via reduced CXCL-10 (...) participation in early trials. The SLE Responder Index (SRI) is a tool that was developed following phase II trials and is composed of the following scores [ ] : SELENA-SLEDAI (Safety of Estrogens in Lupus Erythematosus: National Assessment– Systemic Lupus Erythematosus Disease Activity Index) BILAG (British Isles Lupus Assessment Group) PGA (physician global assessment) SRI response is defined by the following [ ] : A 4-point or greater reduction in the SELENA-SLEDAI score No new BILAG A or no more than 1

2014 eMedicine Emergency Medicine

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>