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Endocrine Manifestations of HIV


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81. Male Infertility

partner may compensate for the fertility problem of the man and thus infertility usually manifests if both partners have reduced fertility [ ]. Male fertility can be impaired as a result of [ ]: congenital or acquired urogenital abnormalities; malignancies; urogenital tract infections; increased scrotal temperature (e.g. as a consequence of varicocele); endocrine disturbances; genetic abnormalities; immunological factors. In 30-40% of cases, no male-infertility-associated factor is found (idiopathic (...) . Ultrasound of the male genital tract in relation to male reproductive health. Human Reprod Update, 2015. 21: 56. 14. WHO, WHO Laboratory Manual for the Examination and Processing of Human Semen, in 5th edn. 2010. 15. Hauser, R., et al. Fertility in cases of hypergonadotropic azoospermia. Fertil Steril, 1995. 63: 631. 16. Martin-du-Pan, R.C., et al. Increased follicle stimulating hormone in infertile men. Is increased plasma FSH always due to damaged germinal epithelium? Hum Reprod, 1995. 10: 1940. 17

2018 European Association of Urology

82. Evaluation and Management of Right-Sided Heart Failure

was conducted through May 2017, with references selected as appropriate. Searches were limited to studies, reviews, and other evidence conducted in human subjects and published in English. In addition, the committee reviewed documents related to the subject matter previously published by clinical practice guideline task forces from the American Heart Association (AHA) and American College of Cardiology. References selected and published in this document are representative but not all inclusive. To provide (...) RV Cardiomyopathy Arrhythmogenic RV cardiomyopathy (ARVC) is a disease of the cardiac myocytes caused by impaired desmosome function. Desmosomes are intercellular junctions that provide adhesion between cells. Mutations in desmosomal proteins such as plakophilin and desmoplakin decrease the ability of the cells to tolerate mechanical stress, resulting in myocyte detachment and cell death. The inflammation that accompanies this process manifests as fibrofatty infiltration, causing ventricular

2018 International Society for Heart and Lung Transplantation

83. Gynecologic Issues in Children and Adolescent Cancer Patients and Survivors

the ages of 9 and 26 years after hematopoietic stem cell transplant (17). The presence of immunosup- pression, like that experienced in patients with human immunodeficiency virus (HIV) infection or organ trans- plantation, is not a contraindication to HPV vaccination. However, theimmuneresponse may be less robust in the immunocompromised patient (18). The three-dose regi- men is recommended for immunosuppressed men and women (19). Surgery Surgical resection of the vagina, uterus, ovaries, or fallopian (...) for Disease Control and Prevention. Altered immunocompetence. General best practice guidelines for immunization: best practices guidance of the Advisory Committee on Immunization Practices (ACIP). Atlanta (GA): CDC; 2017. 18. Levin MJ, Moscicki AB, Song LY, Fenton T, Meyer WA III, Read JS, et al. Safety and immunogenicity of a quadri- valent human papillomavirus (types 6, 11, 16, and 18) vac- cine in HIV-infected children 7 to 12 years old. IMPAACT P1047 Protocol Team. J Acquir Immune Defic Syndr 2010; 55

2018 American College of Obstetricians and Gynecologists

84. CRACKCast E173 – Infectious Diarrheal Disease and Dehydration

diagnoses of vomiting in children Refer to Table 172.7 in Rosen’s 9 th edition for the common causes of vomiting in children. Important categories of differential diagnoses include: Central Nervous System Gastrointestinal Drug Endocrine Renal Cardiac Infection [5] When should you initiate a medical evaluation of children with acute diarrhea? Otherwise well children with acute, non-bloody diarrhea and no exposures to increase the risk of bacterial enteritis are usually managed without any ancillary (...) immigration, travel to an underdeveloped country, backcountry camping, exposure to poultry or other farm animals, or consumption of processed meat: stool for ova and parasites. Immunocompromised (HIV) Stool cultures should also be considered in patients with systemic involvement or underlying chronic medical conditions, if the illness involves dysenteric features, or if it lasts longer than 2 weeks. Many hospital laboratories do not include testing for E. coli O157:H7 or Y. enterocolitica in their routine

2018 CandiEM

85. British Association of Dermatologists? guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis

variables are that iron overload is asso- ciated with both liver in?ltration 35 (see section 7.7) and Table 2 Causes of generalized pruritus without rash Pruritic skin diseases before rash Disorders of iron metabolism Uraemia Hepatic disease (especially cholestasis) Malignancy Haematological disorders Infection Endocrine disease Neurological disorders Psychological and emotional factors Adverse drug reactions Heart failure Pregnancy Pruritus of elderly skin Pruritus of unknown origin (GPUO) © 2017 (...) , lung, testicular and stomach cancers; insulinoma; gastric carcinoid and thymoma. 63,68,69 Although GPWOR can be an initial manifestation of cancer prior to clinically detectable disease, a full investigation to rule out malignancy is not necessarily bene?cial to patients or cost- effective, and is therefore not routinely recommended. 70,71 A5- year cohort study found that GPWOR statistically correlated with an increased risk of later haematological malignancies or cholangiocarcinoma, but not other

2018 British Association of Dermatologists

86. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy Full Text available with Trip Pro

pathways are mechanisms for the human immune system to control the immune response. The immune checkpoint proteins cytotoxic T-lymphocyte–associated-4 (CTLA-4) and programmed cell death protein 1 (PD-1) are receptors expressed on the surface of cytotoxic T cells that interact with their ligands CD80/CD86 in the case of CTLA-4 and programmed death-ligand 1 (PD-L1) in the case of PD-1. These pathways can be co-opted to help cancer cells to evade cytotoxic T-cell–mediated death. ICPis work by preventing (...) from other systemic therapies such as cytotoxic chemotherapy. The adverse effects can affect multiple organs of the body and are most commonly seen in the skin; GI tract; lungs; and endocrine, thyroid, adrenal, pituitary, musculoskeletal, renal, nervous, hematologic, cardiovascular, and ocular systems, and there should be a high level of suspicion that any changes are treatment-related (Appendix , online only). ICPi therapy can usually continue in the presence of mild immune-related adverse events

2018 American Society of Clinical Oncology Guidelines

87. Hoarseness (Dysphonia) Full Text available with Trip Pro

, amyloidosis, granulomatosis with polyangiitis), allergic, pulmonary (eg, COPD), musculoskeletal (eg, muscle tension dysphonia [MTD], fibromyalgia, cervicalgia), psychological (functional voice disorders), traumatic (eg, laryngeal fracture, inhalational injury, iatrogenic injury, blunt/penetrating trauma), and infectious (eg, candidiasis), among others. Prevalence of dysphonia within these conditions varies. For example, patients with SD or other laryngeal dystonia almost universally manifest

2018 American Academy of Otolaryngology - Head and Neck Surgery

88. CRACKCast E171 – Pediatric Cardiac Disorders

Echoviruses, influenza A and B viruses, adenovirus, varicella-zoster virus, Epstein-Barr virus, cytomegalovirus, and hepatitis B virus. Bacterial Corynebacterium diphtheriae, Streptococcus pyogenes, S. aureus, Mycoplasma pneumoniae, Borrelia burgdorferi, and meningococcus. Non-infectious Kawasaki disease, Acute rheumatic fever (ARF), Collagen vascular disorders (eg, systemic lupus erythematosus), Toxins (eg, cocaine and doxorubicin), Endocrine disorders (eg, hyperthyroidism), Drug-induced hypersensitivity (...) in the infant CHF = the cardiac output doesn’t meet the hemodynamic or metabolic demands of the body. Ddx includes more than congenital heart disease: anomalous left coronary artery in infants, myocarditis, endocarditis, rheumatic heart disease, pericardial effusions, anemia, cardiomyopathies, systemic hypertension, hypothyroidism, hyperthyroidism, electrolyte imbalances, endocrine disorders, cardiac toxins, and dysrhythmias that compromise cardiac output. Presentation is different than the adults we’re

2018 CandiEM

89. Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

), and proposed areas for future investigation. The recommendations and suggestions/considerations listed in this document are, whenever possible, evidence based. An extensive literature review was conducted through May 2017, with references selected as appropriate. Searches were limited to studies, reviews, and other evidence conducted in human subjects and published in English. In addition, the committee reviewed documents related to the subject matter previously published by clinical practice guideline (...) , resulting in myocyte detachment and cell death. The inflammation that accompanies this process manifests as fibrofatty infiltration, causing ventricular irritability and arrhythmias and eventually ventricular dysfunction. In affected patients, this process shows a predilection for the thinnest portions of the RV where mechanical stress is greatest. However, the LV also is often affected in advanced disease. The prevalence of ARVC is estimated to be 1 in 2000 to 5000, and ARVC affects men more frequently

2018 American Heart Association

90. Evaluation and Management of Testosterone Deficiency

than the general population. 37 Cohort studies in HIV infected men have estimated that the rate of testosterone deficiency in this group ranges from 17- 38%, 37, 148, 149 while population-based studies have estimated the rate of testosterone deficiency much lower. 6, 37, 87 It was once thought that gonadal dysfunction in HIV infected men is caused by virus- induced reduction in Leydig cells, but in the post- antiretroviral therapy era, it is postulated that the etiology of testosterone deficiency (...) to testicular radiation, HIV/AIDS, chronic narcotic use, male infertility, pituitary dysfunction, and chronic corticosteroid use even in the absence of symptoms or signs associated with testosterone deficiency. (Moderate Recommendation; Evidence Level: Grade B) 5. The use of validated questionnaires is not currently recommended to either define which patients are candidates for testosterone therapy or to monitor symptom response in patients on testosterone therapy. (Conditional Recommendation; Evidence

2018 American Urological Association

92. Venetoclax (Venclyxto) - Chronic, B-Cell Lymphocytic Leukemia

Venetoclax (Venclyxto) - Chronic, B-Cell Lymphocytic Leukemia 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website © European Medicines Agency, 2017. Reproduction is authorised provided the source is acknowledged. 13 October 2016 EMA/725631/2016 Committee for Medicinal Products for Human Use (CHMP) Assessment report Venclyxto (...) Questionnaire ESMO European Society for Medical Oncology FCR fludarabine cyclophosphamide and rituximab FISH fluorescence in situ hybridization FT-IR Fourrier Transform Infrared Spectroscopy Assessment report EMA/725631/2016 Page 4/132 G CSF granulocyte colony stimulating factor GC Gas Chromatography GC-MS Gas chromatography mass spectrometry GCP Good Clinical Practice HBsAg hepatitis B surface antigen HBV hepatitis B virus HCV hepatitis C virus HDPE High Density Polyethylene HPLC High performance liquid

2017 European Medicines Agency - EPARs

93. Obeticholic acid (Ocaliva) - Liver Cirrhosis, Biliary

Obeticholic acid (Ocaliva) - Liver Cirrhosis, Biliary 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website © European Medicines Agency, 2016. Reproduction is authorised provided the source is acknowledged. 13 October 2016 EMA/725757/2016 Committee for Medicinal Products for Human Use (CHMP) Assessment report OCALIVA International (...) enhanced liver fibrosis (markers) EOT end of treatment EU European Union FGF-19 fibroblast growth factor-19 FXR farnesoid X receptor GCP Good Clinical Practice GGT gamma-glutamyl transferase HA hyaluronic acid HBV hepatitis B virus HCV hepatitis C virus HDL high-density lipoprotein HDLc high-density lipoprotein cholesterol ICF informed consent form ICH International Conference on Harmonisation IEC independent ethics committee IL-6 interleukin-6 INR international normalized ratio IRB institutional

2017 European Medicines Agency - EPARs

94. Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services

Gastrointestinal GIST Gastrointestinal Stromal Tumours GP General Practitioner HAD Hospitalisation at Home (‘Hospitalisation à Domicile’) (France) HAS High Authority of Health (‘Haute Autorité de Santé’) (France) HBP Hepato-Pancreato-Biliary HCUP Healthcare Cost and Utilization Project HERO Health Economics in Radiation Oncology HIV Human Immunodeficiency Virus HPST Hospital, Patients, Health and Territories (‘Hôpital, Patients, Santé et Territoire’) (France) HRG Healthcare Resource Group ICD-10 (...) External Beam Radiotherapy EC Endoscopic ED Emergency Department ENT Ear, Nose, and Throat ERCP Endoscopic Retrograde Cholangiopancreatography ERNs European Reference Networks ESRG Extended Service Related Groups ET Endocrine Tumour EU European Union EUS Endoscopic ultrasound FANC – ACFN Federaal Agentschap voor Nucleaire Contrôle/Agence Fédérale de Contrôle Nucléaire/ FDP-PET Fluorodeoxyglucose - Positron Emission Tomography FOD – SPF Federal Public Service Health, Food Chain Safety and Environment

2017 Belgian Health Care Knowledge Centre

95. Proposals for a further expansion of day surgery in Belgium

”, the Netherlands) HES Hospital Episode Statistics HIV Human Immunodeficiency Virus HTA Health technology assessment HRG Healthcare Resource Group(s) I.V. Intravenous IAAS International Association for Ambulatory Surgery ICD International Classification of Diseases ICD-10-AM International Classification of Diseases, Tenth Revision, Australian Modification ICD-9-CM International Classification of Diseases, Ninth Revision, Clinical Modification ICHI International Classification of Health Interventions IGF

2017 Belgian Health Care Knowledge Centre

96. Biologic therapy for psoriasis

to recommendations 112 9 Biologic therapy and cancer risk 116 9.1 Introduction 116 9.2 Review question 116 9.3 Clinical evidence 117 9.4 Link from evidence to recommendations 125 10 Biologic therapy and chronic viral infections: hepatitis B, hepatitis C or HIV 129 10.1 Introduction 129 10.2 Review question: 129 10.3 Clinical evidence 130 10.4 Link from evidence to recommendations 148 11 Additional safety aspects relating to screening, monitoring and contraindications to biologic therapy 151 11.1 Tuberculosis 151 (...) : Evidence tables clinical studies 227 Appendix F: Forest plots 296 Appendix G: Stakeholders 342 Appendix H: Study selection flow charts 343 Appendix I: GRADE tables 349 Appendix J: Choice of biologic treatment for psoriasis (decision aid) 385 Appendix K: Groups at increased risk of tuberculosis, hepatitis B, hepatitis C and HIV 389 British Association of Dermatologists guidelines for biologic therapy for psoriasis 2017 1 Guideline Development Group members Name Role CLINICAL Ms Tracy Bale British

2017 British Association of Dermatologists

97. CRACKCast E110 – Thought Disorders

erythematosus Temporal (giant cell) arteritis ORGAN FAILURE Hepatic encephalopathy Uremia NEUROLOGIC DISORDERS Alzheimer’s disease Cerebrovascular disease Encephalitis (including HIV infection) Encephalopathies Epilepsy Huntington’s disease Multiple sclerosis Neoplasms Normal-pressure hydrocephalus Parkinson’s disease Pick’s disease Wilson’s disease ENDOCRINE DISORDERS Addison’s disease Cushing’s disease Panhypopituitarism Parathyroid disease Postpartum psychosis Recurrent menstrual psychosis Sydenham’s (...) , corticosteroids Under the table hallucinogens Tranquilizers!!! (diazepam, clonazepam) ETOH Propranolol Sedatives phenYtoin Captopril Heavy metals Opioids SteroIdS [3] Describe the DSM V diagnostic criteria for schizophrenia “ Schizophrenia often manifests as a thought disorder or psychosis …..Although the etiology of schizophrenia is multifactorial, it has a substantial genetic component with 80% of the variation in the trait of the disease attributed to genetic factors. Definition from Rosens – 9th Edition

2017 CandiEM

98. CRACKCast E128 – Thyroid and Adrenal Disorders

CRACKCast E128 – Thyroid and Adrenal Disorders CRACKCast E128 – Thyroid and Adrenal Disorders - CanadiEM CRACKCast E128 – Thyroid and Adrenal Disorders In , , by Chris Lipp November 20, 2017 This episode of CRACKCast covers Rosen’s Chapter 120, Thyroid and Adrenal disorders. This episode is going to have a nice breakdown of how each of these major endocrine glands can go haywire and what to do when the storm approaches. The shownotes also have some additional material worth checking out (...) event in patients with untreated or undertreated hypothyroidism. Treatment with thyroid hormone replacement must be initiated, often solely on clinical findings. Adrenal Insufficiency Clinical manifestations of primary and secondary adrenal insufficiency may be vague and nonspecific and require a high index of suspicion for diagnosis. Predominant complaints include fatigue, weakness, dizziness, nausea, vomiting, and other nonspecific GI symptoms. Patients with primary adrenal insufficiency

2017 CandiEM

99. CRACKCast E124 – Acid-Base Disorders

alkalosis in addition to a metabolic acidosis is likely to be present. Patients who have a chronic respiratory acidosis (eg, in chronic obstructive pulmonary disease) are at risk for dangerous alkalemia if they are ventilated with routine parameters. Blood gas analysis in these cases should be performed frequently and settings titrated to the serum pH. Alcoholic ketoacidosis may be manifested similarly to diabetic ketoacidosis but is much less common; insulin is contraindicated in alcoholic ketoacidosis (...) by hypoxia High altitude Severe anemia Ventilation-perfusion mismatch Central hyperventilation Voluntary or psychogenic Cerebrovascular accident Increased intracranial pressure (tumor, hemorrhage, trauma) Toxic or pharmacologic Salicylates** Caffeine, nicotine Catecholamines Thyroxine Pulmonary Pulmonary embolism Pneumonia Pulmonary edema Asthma Mechanical hyperventilation (iatrogenic) Endocrine Pregnancy Paco2 between 31 and 35 mm Hg, serum pH between 7.46 and 7.50, and serum bicarbonate concentration

2017 CandiEM

100. Management of Uterine Fibroids

Management of Uterine Fibroids Comparative Effectiveness Review Number 195 Management of Uterine Fibroids eComparative Effectiveness Review Number 195 Management of Uterine Fibroids Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 Contract No. 290-2015-00003-I Prepared by: Vanderbilt Evidence-based Practice Center Nashville, TN Investigators: Katherine E. Hartmann, M.D., Ph.D. Christopher (...) ), Rockville, MD (Contract No. 290-2015-00003-I). The findings and conclusions in this document 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

2017 Effective Health Care Program (AHRQ)

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