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Cushing Response

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201. Overweight, Obesity and Contraception

who were at risk for diabetes due to being overweight. There were few data available for progestogen-only injectables, and one study showed a higher mean fasting glucose, glucose 2-hour response, and fasting insulin level amongst DMPA users compared to those using NET-EN. Overall the review suggested that there was little evidence on which to base conclusions about the impact of hormonal contraceptives in women with diabetes. Among women without diabetes, there did not appear to be any major (...) to COC users, 167,168 other studies have reported a significant two-fold greater VTE risk among patch and ring users compared to COC users. 61,169 Evidence level 2+ A recent systematic review 170 investigated whether CHC use modifies the risk of VTE in obese women, and also evaluated evidence for a dose–response relationship between BMI and VTE. No studies regarding the contraceptive patch or vaginal ring met the inclusion criteria in this review. Data from one pooled analysis, 171 one cohort study

2019 Faculty of Sexual & Reproductive Healthcare

202. Male Sexual Dysfunction

-being in men with erectile dysfunction in a randomized, placebo-controlled trial. Andrology, 2013. 1: 475. 217. Spitzer, M., et al. Effect of testosterone replacement on response to sildenafil citrate in men with erectile dysfunction: a parallel, randomized trial. Ann Intern Med, 2012. 157: 681. 218. Mulhall, J., et al. Impact of Baseline Total Testosterone Level on Successful Treatment of Sexual Dysfunction in Men Taking Once-Daily Tadalafil 5 mg for Lower Urinary Tract Symptoms and Benign (...) phentolamine versus prostaglandin E1 in erectile dysfunction. J Urol, 1997. 157: 2132. 254. McMahon CG, et al. A comparison of the response to the intracavernosal injection of papaverine and phentolamine, prostaglandin E1 and a combination of all three agents in the management of impotence J Urol, 1999. 162. [No abstract available]. 255. Dinsmore, W.W., et al. Vasoactive intestinal polypeptide/phentolamine for intracavernosal injection in erectile dysfunction. BJU Int, 2008. 102: 933. 256. McMahon, C.G

2019 European Association of Urology

203. Immune Modulating Therapies in Pregnancy and Lactation

a variety of immunomodulating drugs, defined in this document as agents that inhibit or modulate the immune response. Because autoimmune conditions occur more often among women of childbearing age ( ), continuation of these medications during pregnancy is often considered to optimize disease management in the woman and pregnancy outcomes ( ), without placing the fetus at undue risk ( ). Emerging safety and efficacy data regarding the use of these medications during pregnancy and lactation can be used (...) the VACTERL association among tumor necrosis factor antagonist-exposed pregnancies is similar to the general population. EUROCAT Working Group. J Rheumatol 2011;38:1871–4. Gisbert JP, Chaparro M. Safety of anti-TNF agents during pregnancy and breastfeeding in women with inflammatory bowel disease. Am J Gastroenterol 2013;108:1426–38. Clowse ME, Scheuerle AE, Chambers C, Afzali A, Kimball AB, Cush JJ, et al. Pregnancy outcomes after exposure to certolizumab pegol: updated results from a pharmacovigilance

2019 American College of Obstetricians and Gynecologists

204. An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of PCOS in Adolescence Full Text available with Trip Pro

increase in androgen production are hypothesized to contribute to IR and hyperinsulinemia. The association between IR and androgen excess in women has long been recognized because of the association of hyperandrogenic features with the rare syndromes of extreme IR due to mutations of the insulin receptor or autoantibodies targeting the insulin receptor [ - ]. Insulin may also potentiate the steroidogenic response to gonadotropins indirectly, by acting at the pituitary to increase gonadotrope (...) levels, and greater IR among women with PCOS [ - ]. Endothelial dysfunction has been described and may promote chronic inflammation [ ]. Although the mechanisms responsible for obesity-related IR are not completely clear, ectopic accumulation of fatty acids in organs and tissue that are not meant to store large amounts of fat appears to play a role [ ]. Ectopic fat accumulation can also occur in the absence of obesity, i.e., when there has been reduced prenatal growth and thus a reduction

2019 Pediatric Endocrine Society

205. Update of the guideline synopsis for the DMP "rheumatoid arthritis" - rapid report

Gesundheitswesen Im Mediapark 8 50670 Köln Germany Phone: +49 221 35685-0 Fax: +49 221 35685-1 E-mail: berichte@iqwig.de Internet: www.iqwig.de Extract of rapid report V17-01 Version 1.0 DMP “rheumatoid arthritis” 24 November 2017 Institute for Quality and Efficiency in Health Care (IQWiG) - ii - The rapid report was subject to an external review. The responsibility for the contents of the report lies solely with IQWiG. According to §139 b (3) No. 2 of Social Code Book (SGB) V, Statutory Health Insurance (...) (continued) V1.5/T2 – K1 (structural changes) (continued) Imaging can also be used to assess response to treatment. Monitoring of functional instability of the cervical spine by radiograph should be performed in RA patients with suspicion of cervical involvement. When the radiograph is positive or neurological symptoms and signs are present, MRI should be performed. EULAR 2013 Imaging 0/5 Not assessable Suitable from a clinical point of view T3: Follow-up V1.5/T3 – K1 (follow-up) Therapy should

2017 Institute for Quality and Efficiency in Healthcare (IQWiG)

206. Systematic guideline search and appraisal, as well as extraction of relevant recommendations, for a DMP "rheumatoid arthritis"

for a DMP “rheumatoid arthritis” 16 March 2016 Institute for Quality and Efficiency in Health Care (IQWiG) - ii - This report was prepared in collaboration with external experts. The responsibility for the contents of the report lies solely with IQWiG. According to §139 b (3) No. 2 of Social Code Book (SGB) V, Statutory Health Insurance, external experts who are involved in the Institute’s research commissions must disclose “all connections to interest groups and contract organizations, particularly (...) monitoring of drug therapy. ? Recommendations on disease-modifying antirheumatic drugs (DMARDs): recommendations on the use of conventional synthetic and biological DMARDs (csDMARDs and bDMARDs) are described. The recommendations refer to the selection of suitable drugs and drug combinations depending on disease duration, symptoms, previous treatment attempts, clinical response, and tolerance. Further recommendations refer to the conduct and monitoring of DMARD therapy. ? Recommendations for patients

2017 Institute for Quality and Efficiency in Healthcare (IQWiG)

207. Adrenocorticotrophic hormone (ACTH) responsiveness to ghrelin increases after 6 months of ketoconazole use in patients with Cushing's disease: comparison with GH-releasing peptide-6 (GHRP-6). (Abstract)

Adrenocorticotrophic hormone (ACTH) responsiveness to ghrelin increases after 6 months of ketoconazole use in patients with Cushing's disease: comparison with GH-releasing peptide-6 (GHRP-6). In Cushing's disease (CD), adrenocorticotrophic hormone (ACTH)/cortisol responses to growth hormone secretagogues (GHS), such as ghrelin and GHRP-6, are exaggerated. The effect of clinical treatment of hypercortisolism with ketoconazole on ACTH secretion in CD is controversial. There are no studies (...) evaluating ACTH/cortisol responses to GHS after prolonged ketoconazole use in these patients.To compare ghrelin- and GHRP-6-induced ACTH/cortisol release before and after ketoconazole treatment in patients with CD.Eight untreated patients with CD (BMI: 28.5 +/- 0.8 kg/m(2)) were evaluated before and after 3 and 6 months of ketoconazole treatment and compared with 11 controls (BMI: 25.0 +/- 0.8).After ketoconazole use, mean urinary free cortisol values decreased significantly (before: 613.6 +/- 95.2 nmol

2010 Clinical endocrinology Controlled trial quality: uncertain

208. CRACKCast Episode 183 – The Immunocompromised Patient

likely to be associated with bacteremia than other localized Infections. Gram-positive organisms are responsible for most serious infections in neutropenic cancer patients, but infections due to gram-negative organisms are more rapidly lethal. Neutropenic cancer patients with chemotherapy-induced oral mucositis can develop rapid onset of fever with shock, acute respiratory distress syndrome and rash due to viridans streptococci. If the chest radiograph is normal or inconclusive but there is still (...) . Including infectious complications of immunosuppressive and immunomodulating medications used for a wide variety of disorders. (Not microbe specific) Surface barriers Innate immunity Initial inflammatory response Reticuloendothelial system (Microbe-specific) Acquired immunity Humoral immunity Antibodies Immunoglobulins Complement Cell-mediated Granulocytic phagocytes Box 187.1 shows immune system defects predisposing to infection and the most common pathogens associated with each – This FIGURE IS HUGE

2018 CandiEM

209. Association of Anaesthetists guidelines: cell salvage for peri-operative blood conservation 2018

where blood loss is a recognised complication. There should be a named clinical lead and nominated CS coordinator (e.g. theatre practitioner registered nurse, operating department practitioner/anaesthetic assistant, perfusionist) within the operating theatre department who are responsible for ensuring overall management and facilitation of the hospital CS service. Every surgical and obstetric unit should have a local guideline/protocol and standard operating procedure in place. These should specify (...) coordinator, and individuals should be encouraged to include them in their professional portfolios, which must be kept within the department and as part of individual records. Local policy should define which roles within the CS team require what training and how frequently retraining is required, in line with established guidance . The individual practitioner is responsible for working within their professional boundaries and sphere of competence ; CS operators should maintain a clinical log of cases

2018 Association of Anaesthetists of GB and Ireland

210. Male Sexual Dysfunction

-being in men with erectile dysfunction in a randomized, placebo-controlled trial. Andrology, 2013. 1: 475. 217. Spitzer, M., et al. Effect of testosterone replacement on response to sildenafil citrate in men with erectile dysfunction: a parallel, randomized trial. Ann Intern Med, 2012. 157: 681. 218. Mulhall, J., et al. Impact of Baseline Total Testosterone Level on Successful Treatment of Sexual Dysfunction in Men Taking Once-Daily Tadalafil 5 mg for Lower Urinary Tract Symptoms and Benign (...) phentolamine versus prostaglandin E1 in erectile dysfunction. J Urol, 1997. 157: 2132. 254. McMahon CG, et al. A comparison of the response to the intracavernosal injection of papaverine and phentolamine, prostaglandin E1 and a combination of all three agents in the management of impotence J Urol, 1999. 162. [No abstract available]. 255. Dinsmore, W.W., et al. Vasoactive intestinal polypeptide/phentolamine for intracavernosal injection in erectile dysfunction. BJU Int, 2008. 102: 933. 256. McMahon, C.G

2018 European Association of Urology

212. Evaluation and Treatment of Hirsutism in Premenopausal Women

, we suggest either pharmacological therapy or direct hair removal methods. For pharmacological therapy, we suggest oral combined estrogen–progestin contraceptives for the majority of women, adding an antiandrogen after 6 months if the response is suboptimal. We recommend against antiandrogen monotherapy unless adequate contraception is used. We suggest against using insulin-lowering drugs. For most women who choose hair removal therapy, we suggest laser/photoepilation. Summary of Recommendations (...) 3.9. We suggest against using insulin-lowering drugs for the sole indication of treating hirsutism. (2 |⊕⊕OO) 3.10. We suggest against using gonadotropin-releasing hormone agonists except in women with severe forms of hyperandrogenemia (such as ovarian hyperthecosis) who have a suboptimal response to oral contraceptives and antiandrogens. (2 |⊕OOO) 3.11. We suggest against the use of topical antiandrogen therapy for hirsutism. (2 |⊕OOO) 4.0 Direct hair removal methods 4.1. For women who choose

2018 The Endocrine Society

213. Management of Hypertension (5th Edition)

to use local data and publications to ensure local relevance. Adherence to this guideline may not necessarily lead to the best clinical outcome in individual patient care. Every health care provider is responsible for the care of his/her unique patient based on the clinical presentation and treatment options available locally. However adherence to this guideline is strongly recommended as a starting point in managing patients as it constitute the best available evidence at the time of writing. REVIEW (...) • Sleep apnoea • Drug-induced or drug-related — Oral contraceptives — Steroids — Non-Steroidal Anti-inflammatory Drugs / Cyclooxygenase 2 Inhibitors — Erythropoeitin • Cushing syndrome • Phaeochromocytoma • Acromegaly • Thyroid disease • Parathyroid disease • Coarctation of the aorta • T akayasu Arteritis Table 4. Manifestations of Target Organ Damage (TOD) / Target Organ Complication (TOC) Organ Manifestations Heart Left ventricular hypertrophy, coronary heart disease, heart failure Brain Transient

2018 Ministry of Health, Malaysia

214. Physiologic Predictors of Severe Injury: Systematic Review

are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report. The information in this report is intended to help health care decisionmakers—patients (...) Chief, Medical Director of Quality Division of Emergency Medicine Children's National Medical Center Washington, DC Mary Fallat, M.D., FACS, FAAP Hirikati S. Nagaraj Professor and Chief, Pediatric Surgery University of Louisville School of Medicine Louisville, KY Richard C. Hunt, M.D., FACEP Senior Medical Advisor, National Healthcare Preparedness Programs Office of the Assistant Secretary for Preparedness and Response U.S. Department of Health and Human Services Washington, DC vii Physiologic

2018 Effective Health Care Program (AHRQ)

215. Cardiovascular Disease and Breast Cancer: Where These Entities Intersect: A Scientific Statement From the American Heart Association

, with advancements in cancer care, survivors could develop latent cardiac effects secondary to the cancer treatment, which can include chemotherapy, radiotherapy, and targeted therapy (eg, trastuzumab). The field of cardio-oncology has emerged in response to the need to provide the best cancer care without compromising cardiovascular health. Societal committees and new organizations have rapidly emerged to address patients’ needs, including clinical care, research, and education. , Recent societal publications (...) (≈1.5 drinks per day) compared with women who abstained from alcohol before first pregnancy. There was a dose-response relationship between alcohol intake before first pregnancy and breast cancer risk, with an RR of 1.11 (95% CI, 1.00–1.23) for each additional 10-g/d intake; there was no such relationship for alcohol consumption and breast cancer after the first pregnancy. Furthermore, in the NHS, the risk of breast cancer was increased by 21% in adult binge drinkers compared with nondrinkers after

2018 American Heart Association

216. Evaluation and Treatment of Hirsutism in Premenopausal Women

, we suggest either pharmacological therapy or direct hair removal methods. For pharmacological therapy, we suggest oral combined estrogen–progestin contraceptives for the majority of women, adding an antiandrogen after 6 months if the response is suboptimal. We recommend against antiandrogen monotherapy unless adequate contraception is used. We suggest against using insulin-lowering drugs. For most women who choose hair removal therapy, we suggest laser/photoepilation. Summary of Recommendations (...) 3.9. We suggest against using insulin-lowering drugs for the sole indication of treating hirsutism. (2 |⊕⊕OO) 3.10. We suggest against using gonadotropin-releasing hormone agonists except in women with severe forms of hyperandrogenemia (such as ovarian hyperthecosis) who have a suboptimal response to oral contraceptives and antiandrogens. (2 |⊕OOO) 3.11. We suggest against the use of topical antiandrogen therapy for hirsutism. (2 |⊕OOO) 4.0 Direct hair removal methods 4.1. For women who choose

2018 The Endocrine Society

217. Appropriate Use Criteria: Quantitative CT (QCT) Bone Mineral Densitometry

appropriate services based on a patient’s unique circumstances. In all cases, clinical judgment consistent with the standards of good medical practice should be used when applying the Guidelines. Guideline determinations are made based on the information provided at the time of the request. It is expected that medical necessity decisions may change as new information is provided or based on unique aspects of the patient’s condition. The treating clinician has final authority and responsibility (...) or pathologic fracture ? Anyone with a disease or condition associated with development of osteoporosis, including any of the following abnormalities: ? Anorexia nervosa ? Chronic liver disease ? Chronic renal failure ? Cushing’s syndrome ? Delayed menarche or untreated premature menopause ? Heavy alcohol consumption ? Hypercalciuria ? Hypogonadism ? Inflammatory bowel disease ? Low trauma fractures or vertebral fractures ? Malabsorption syndromes ? Primary hyperparathyroidism ? Prolonged immobilization

2018 AIM Specialty Health

218. Hirsutism: Evaluation and Treatment

. Evaluation A thorough history and physical examination plus selected laboratory evaluations will confirm the diagnosis and direct treatment. Treatment Pharmacologic interventions can suppress ovarian or adrenal androgen production and block androgen receptors in the hair follicle. Hair removal methods and lifestyle modifications may improve or hasten the therapeutic response. Outcomes At least 6 to 9 months of therapy are required to produce improvement in hirsutism. Evidence The quality of evidence (...) should be educated regarding the associated health problems or long-term medical consequences of hyperandrogenism, particularly in the context of polycystic ovary syndrome, including obesity, irregular menses, anovulation, infertility, pregnancy-induced hypertension, diabetes, hyperlipidemia, hypertension, and heart disease. Summary Statements 1. The Ferriman-Gallwey score can be used in the assessment of hirsutism to help quantify the problem and help assess response to treatment. A score ≥8

2017 Society of Obstetricians and Gynaecologists of Canada

219. Is it possible to improve children?s and adolescents? health through mobile telephony?

for Data Protection) Links to external sites This page may include links to other websites that might be of interest to users. This does not involve any property or responsibility of this journal site on the content of such links, neither on the updating or access conditions. However, these items are checked regularly by the Evidencias en Pediatría (EP) journal Editorial Board. Linking from external sites Linking to this website is permitted, and we promote and encourage it. There is no need (...) concerning the content of their published manuscripts. Any use of these manuscripts must recognize this authorship in an explicit manner. The journal Evidencias en Pediatría (EP / Evidences in Pediatrics) therefore, accepts that the authors could deposit, at institutional repositories or personal websites, an electronic copy of the revised and finally accepted version of the manuscript once it has been already published. This deposit will be done under the responsibility of the authors and specifically

2017 Evidencias en Pediatría

220. Clinical Practice Guideline for the Behavioral Treatment of Obesity and Overweight in Children and Adolescents

], arrived at after careful consideration of the evidence available. When exercising their judge- ment, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommen- dations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient

2018 American Psychological Association

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