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82. Radiation Therapy for the Whole-Breast (ASTRO)

be as homogeneous as possible. Several investigators have found less desquamation when the maximum dose is minimized to 105% or 107% of the prescription dose. 44,67,68 Although no dosimetric constraint regarding dose homogeneity has been widely embraced, one might consider a constraint such as no more than 200cc >105% and 2cc >107%, which was endorsed by the experts on the task force as a reasonable goal for most cases. Additional research is needed to establish optimal benchmarks for dose homogeneity

2019 American Society for Radiation Oncology

85. Peramivir (Alpivab) - Influenza, Human

inflammation and oedema of the larynx, trachea, and bronchi; mucosal biopsies show lymphocytic and histiocytic inflammatory infiltrate and desquamation (Walsh et al., 1961). The viral neuraminidase cleaves sialic acid groups from glycoproteins and facilitates viral escape from infected cells, making it possible for daughter virions to infect new host cells. 2.1.4. Clinical presentation, diagnosis and stage/prognosis Typical influenza illness is characterised by abrupt onset of fever, headache, myalgia

2018 European Medicines Agency - EPARs

86. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. (PubMed)

mouthrinse on calculus formation were inconclusive. Effect of concentration and frequency of rinsing There were insufficient data to determine whether there was a difference in effect for either chlorhexidine concentration or frequency of rinsing. Other adverse effects The adverse effects most commonly reported in the included studies were taste disturbance/alteration (reported in 11 studies), effects on the oral mucosa including soreness, irritation, mild desquamation and mucosal ulceration/erosions

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2017 Cochrane

87. CRACKCast E167 – Pediatric Fever

drop in diastolic blood pressure by 15 mm Hg Orthostatic syncope or dizziness Diffuse erythroderma Desquamation : 1 to 2 weeks after onset of illness, particularly involving palms and soles Multisystem involvement (three or more of the following organ systems): Gastrointestinal : Vomiting or diarrhea at onset of illness Muscular : Severe myalgia or creatine kinase elevation more than two times the normal upper limit Mucous membranes : Vaginal, oropharyngeal, or conjunctival hyperemia Renal : Blood (...) for Staphylococcus aureus ) Serologic tests for Rocky Mountain spotted fever, leptospirosis, or measles Criteria for a probable case include a patient with temperature >102° F (38.9° C), hypotension, diffuse erythroderma, desquamation (unless the patient dies before desquamation can occur), and involvement of at least three organ systems. A probable case is a patient who is missing one of the characteristics of the confirmed case definition. [11] Which sickle cell patients require prophylaxis and why? Which

2018 CandiEM

88. CRACKCast E169 – Paediatric Respiratory Emergencies: Lower Airway Obstruction

patient, viral replication often begins in the epithelial cells of the upper airway before spreading to the mucosal surfaces of the lower respiratory tract. The infected epithelial cells are generally destroyed by lysis or apoptosis, which results in the desquamation of these cells and release of host inflammatory mediators. Affected lungs demonstrate epithelial cell necrosis, monocytic inflammation and edema of the peribronchial tissues, and mucus and fibrin plugging of the distal airways

2018 CandiEM

89. CRACKCast E141 – Heat Illness

inflammatory skin disorder: the blockage of sweat gland pores by macerated stratum corneum and secondary staphylococcal infection. intensely pruritic vesicles on an erythematous base. The rash is confined to clothed areas. Rash can persist for weeks Chlorhexidine in a light cream or lotion is the antibacterial treatment of choice during the acute phase. Salicylic acid, 1% tid, can be applied to localized affected areas to assist in desquamation, Prickly heat can be prevented by wearing light, loose fitting

2018 CandiEM

92. Thyroid Cancer

receiving sorafenib during the DECISION trial [96]: hand-and-foot skin reactions, diarrhoea, alopaecia, rash or desquamation, fatigue, weight loss and hypertension were the most common. Serum TSH levels exceeding 0.5 µIU/mL were observed in 33.3% patients (69/207) in the sorafenib arm. TSH increases are a recognised AE of sorafenib and other MKIs, and levels should be checked monthly to ensure that suppression is maintained. Serious AEs were documented in 37.2% (77/207) of the sorafenib-treated

2019 European Society for Medical Oncology

93. Use of Silver Diamine Fluoride for Dental Caries Management in Children and Adolescents, Including Those with Special Health Care Needs

if allowed to come in contact with skin). Skin pigmentation is temporary since the silver does not penetrate the dermis. Desquamation of the skin with pigmentation occurs when keratinocytes are shed over a period of 14 days. 25 Silver diamine fluoride also perma- nently stains most surfaces (e.g., counters, clothing) with which it comes into contact. Guideline implementation. This guideline will be pub- lished in the AAPD’s Reference Manual and the journal, Pediatric Dentistry. Social media, news items

2017 American Academy of Pediatric Dentistry

94. CRACKCast E120 – Dermatologic presentations

are a useful alternative to older sedating ones to control pruritus and histamine-mediated rashes while allowing the patient to remain active. Scabies infestations should be diagnosed clinically and treated expeditiously even without definitive proof of the infestation. Medication reactions are common and may results from any medication, typically within 4 to 21 days after taking the medication. Rashes that are associated with mucosal lesions, blisters, or desquamating skin are often caused by significant (...) ) [12] Describe the presentation and management of Staphylococcal Scalded Skin Syndrome and TSS Staphylococcal Scalded Skin Syndrome This is a dx in kids < 6 yrs. caused by an infection with phage group 2 exotoxin-producing The illness begins with erythema and crusting around the mouth. The erythema then spreads down the body, followed by bulla formation and desquamation. Mucous membranes are usually typically involved . After desquamation occurs, the lesions dry up quickly, with clinical resolution

2017 CandiEM

95. Chlorhexidine mouthwash is useful short-term for people with mild gum disease

of rinsing. Other adverse effects The adverse effects most commonly reported in the included studies were taste disturbance/alteration (reported in 11 studies), effects on the oral mucosa including soreness, irritation, mild desquamation and mucosal ulceration/erosions (reported in 13 studies) and a general burning sensation or a burning tongue or both (reported in nine studies). AUTHORS' CONCLUSIONS: There is high-quality evidence from studies that reported the Loe and Silness Gingival Index

2019 NIHR Dissemination Centre

96. CrackCAST E129 – Bacteria

”* Probable TSS: Labs/cultures -ve and ⅘ of the clinical criteria Confirmed TSS: Labs/cultures -ve and 5/5 of the clinical criteria present Clinical criteria: High fever Diffuse Rash Desquamation Hypotension >3 systems involved. Lab criteria: Body cultures -ve (except bloods may show staph. aureus) Rise in titre to RMSF, rubeola, leptospirosis Management: Resuscitation! Often large volumes needed for to combat distributive shock 10-15 L/day! Airway management and oxygenation Source control / culture

2017 CandiEM

97. CRACKCast E130 – Viruses

, malaise, sore throat, and profuse vomiting and diarrhea. After 5 to 7 days, patients can progress to develop the hemorrhagic manifestations, which include spontaneous bleeding, ecchymosis, and petechiae. It is also common for patients to not develop any hemorrhagic complications. An erythematous maculopapular rash can occur during that time that eventually desquamates. Patients can become hypovolemic and develop severe metabolic derangements secondary to fluid losses via the gastrointestinal tract

2017 CandiEM

98. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association

2. Bilateral bulbar conjunctival injection without exudate 3. Rash: maculopapular, diffuse erythroderma, or erythema multiforme-like 4. Erythema and edema of the hands and feet in acute phase and/or periungual desquamation in subacute phase 5. Cervical lymphadenopathy (≥1.5 cm diameter), usually unilateral A careful history may reveal that ≥1 principal clinical features were present during the illness but resolved by the time of presentation. Patients who lack full clinical features of classic (...) , jaundice Gallbladder hydrops Pancreatitis Nervous system Extreme irritability Aseptic meningitis (pleocytosis of cerebrospinal fluid) Facial nerve palsy Sensorineural hearing loss Genitourinary Urethritis/meatitis, hydrocele Other Desquamating rash in groin Retropharyngeal phlegmon Anterior uveitis by slit lamp examination Erythema and induration at BCG inoculation site The differential diagnosis includes other infectious and noninfectious conditions, including the following: Measles Other viral

2017 American Heart Association

99. Lymphangioleiomyomatosis Diagnosis and Management Part II: An Official ATS/JRS Clinical Practice Guideline

were blinded to clinical and histopathological information. Clinicians included thoracic radiologists (7–9),pulmonologists(9),and pulmonary fellows (9). Diseases included LAM (7–9), pulmonary Langerhans cell histiocytosis (7–9), emphysema (7–9), usual interstitial pneumonia (8), lymphoid interstitial pneumonia (8, 9), desquamative interstitial pneumonia (8), Birt-Hogg-Dub´ e syndrome (9), amyloidosis (9), hypersensitivity pneumonitis (9), nonspeci?c Table 3. Interpretation of Strong and Conditional

2017 American Thoracic Society

100. AIUM Practice Parameter for the Performance of Physiologic Evaluation of Extremity Arteries

? ?to ? ?the ? ?skin ? ?in ? ?an ? ?area ? ?of ? ?questionable ? ?viability. ? 17 ? ? ?The ? ?usual ? ?locations ? ?on ? ?the ? ?lower extremities ? ?are ? ?on ? ?the ? ?foot, ? ?ankle, ? ?and ? ?calf, ? ?with ? ?a ? ?reference ? ?point ? ?on ? ?the ? ?chest. ? ? ??After ? ?the desquamated ? ?cells ? ?are ? ?cleaned ? ?from ? ?the ? ?skin, ? ?a ? ?coupling ? ?solution ? ?such ? ?as ? ?distilled ? ?water ? ?is applied ? ?to ? ?the ? ?skin, ? ?and ? ?the ? ?tcP ?O ?2 ? ??sensor ? ?is ? ?affixed

2017 American Institute of Ultrasound in Medicine

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