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Endocrine Manifestations of HIV


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121. Infertility

). In these men [ ; ]: There is no previous history of diseases affecting fertility, and physical findings, as well as endocrine, genetic, and biochemical laboratory testing (usually done in secondary care), are normal. However, semen analysis might reveal a decreased number of spermatozoa (oligozoospermia), decreased sperm motility (asthenozoospermia), and many abnormal sperm on morphological examination (teratozoospermia). Oligospermia, asthenozoospermia, and teratozoospermia usually occur together (...) [ ]. Prolactin measurement Hyperprolactinaemia is an endocrine disorder caused by increased prolactin secretion from the pituitary gland. This can result in galactorrhoea, irregular menstruation, and infertility [ ]. Evidence identified by NICE shows that the incidence of an increased prolactin level in infertile but ovulatory women ranges from 3.8–11.5%. NICE recommends that prolactin measurement should be reserved for women with symptoms of an ovulatory disorder (for example polycystic ovary syndrome

2018 NICE Clinical Knowledge Summaries

122. Depression, anxiety, pain and quality of life in people living with chronic hepatitis C: a systematic review and meta-analysis

infection 23 4.1 Summary of findings 23 4.2 Description of studies: HQROL general synthesis 24 4.3 Findings: quality of life in people with HCV compared to ‘general’ or ‘healthy populations’ 31 iv 4.4 Description of included studies: HRQOL HCV-HIV synthesis 35 4.5 Findings: quality of life in people co-infected with HCV and HIV compared to those with HIV only 39 4.6 Discussion 41 5. Results: depression, anxiety and hepatitis C infection 44 5.1 Summary of findings 44 5.2 Depression or anxiety in people (...) with HCV compared to people without HCV 45 5.3 Depression or anxiety in HCV-HIV co-infected groups 56 5.4 Discussion 61 6. Results: pain and hepatitis C infection 63 6.1 Summary of findings 63 6.2 Description of studies 64 6.3 Findings: arthralgia 72 6.4 Findings: arthritis 75 6.5 Findings: fibromyalgia syndrome 77 6.6 Findings: miscellaneous pain outcomes 81 6.7 Findings: association between pain outcomes and route of infection 82 6.8 Findings: association between pain outcomes and liver disease

2015 EPPI Centre

123. Letermovir (Prevymis) - to prevent illness caused by cytomegalovirus (CMV) in adults having an allogeneic haematopoietic stem cell transplant

the first 100 days post-transplant (Özdemir 2007). Some 20-35% of this population progress to CMV disease in the absence of preventive measures (Ljungman 2011). The clinical effects of CMV infection can be divided into direct and indirect effects. Direct effects include the spectrum of CMV disease manifestations. CMV colitis is the most common clinical presentation of CMV disease in the allogeneic HSCT population. While pneumonitis is the most serious manifestation, it has become relatively infrequent (...) with current preventative strategies. Other rare manifestations of CMV disease include hepatitis, retinitis, and encephalitis. The indirect effects of CMV infection include increased risk of opportunistic bacterial and invasive fungal infections, graft-versus-host disease (GVHD), and non-relapse mortality. All currently available anti-CMV agents, whether used for prophylaxis or pre-emptive therapy (PET), are nucleoside analogues with target related toxicities such as myelotoxicity and nephrotoxicity

2018 European Medicines Agency - EPARs

124. Childhood Hodgkin Lymphoma Treatment (PDQ®): Health Professional Version

lymphoma appears to be increased in HIV-infected individuals, including children.[ , ] Compared with the general population, the risk of Hodgkin lymphoma is increased in recipients of solid organ transplant who are maintained on chronic immunosuppressive medications.[ ] Hodgkin lymphoma is the second most common cancer type in children who have undergone solid organ transplant.[ ] Clinical Presentation The following presenting features of Hodgkin lymphoma result from direct or indirect effects of nodal (...) .: Hodgkin's disease in pediatric patients with naturally occurring immunodeficiency. Am J Pediatr Hematol Oncol 9 (2): 189-92, 1987. [ ] Straus SE, Jaffe ES, Puck JM, et al.: The development of lymphomas in families with autoimmune lymphoproliferative syndrome with germline Fas mutations and defective lymphocyte apoptosis. Blood 98 (1): 194-200, 2001. [ ] Biggar RJ, Jaffe ES, Goedert JJ, et al.: Hodgkin lymphoma and immunodeficiency in persons with HIV/AIDS. Blood 108 (12): 3786-91, 2006. [ ] [ ] Biggar

2017 PDQ - NCI's Comprehensive Cancer Database

125. Chronic prostatitis and chronic pelvic pain syndrome

. 6 CBP and CP/CPPS show heterogeneity in terms of clinical manifestations, which arise from a variety of possible underlying aetiologies. 7,8 These aetiological mechanisms include: 3 ? Infection ? Anatomical ? Genetic ? Endocrine ? Neuromuscular ? Immunological ? Psychological. The main four symptom domains of CBP and CP/CPPS are urogenital pain, lower urinary tract symptoms (LUTS), psychological issues and sexual dysfunction. 9 The most common presentation of CBP is recurrent urinary tract (...) to be in the ‘later stages’ of the disease if they have experienced persistent, recurrent symptoms for over six months and are refractory to initial lines of pharmacotherapy (Level 5). Signs and symptoms CBP and CP/CPPS show heterogeneity of clinical manifestations arising from the variety of possible underlying aetiologies (for example, bacterial infection and/or inflammation and/or neurological damage) and symptoms can vary between patients or fluctuate over time. 7,8 The four main symptom domains associated

2015 Prostate Cancer UK

126. Corticosteroids - oral

, which are: Endocrine — adrenal insufficiency, weight gain, and diabetes mellitus (new-onset, or worsening of blood glucose control in existing diabetes mellitus). Gastrointestinal — peptic ulceration with perforation and haemorrhage, dyspepsia, abdominal distension, and oesophageal ulceration; especially in . Psychiatric — confusion, irritability, delusions and suicidal thoughts early in treatment and especially with high doses. Musculoskeletal — osteoporosis and proximal myopathy. Ophthalmic (...) . The reason for this is because of an increased incidence of (possibly fatal) scleroderma renal crisis with hypertension and decreased urinary output. This is more likely with a daily dose of ≥15 mg prednisolone. [ ] Adrenal insufficiency Clinical manifestation of adrenal insufficiency The presenting symptoms of adrenal insufficiency are non-specific and include: Fatigue. Anorexia and weight loss (and in children, faltering growth). Abdominal pain, nausea, and vomiting. Headache. Joint pains. Dizziness

2017 NICE Clinical Knowledge Summaries

127. Candida - skin

. parapsilosis, and C. krusei, are far less common but may overgrow and cause candidiasis in high-risk people [ ]. Each of these organisms has unique virulence potential, antifungal susceptibility, and epidemiology. Candidal skin infection is more likely where skin rubs on skin (such as between skin folds in an obese person) and where heat and moisture lead to maceration and inflammation [ ; ] . Other risk factors include [ ; ]: Immunocompromise (such as due to HIV infection, chemotherapy, and the use (...) of immunosuppressive drugs [such as corticosteroids]). General debility, for example from cancer or malnutrition. Recent or concurrent use of drugs that promote candidal growth, particularly broad-spectrum antibiotics and inhaled or oral corticosteroids. Extremes of ages — due to immature or weakened immunity. Diseases in which the barrier function of the skin is disturbed (such as psoriasis and seborrhoeic eczema). Endocrine disorders, such as: Diabetes mellitus — see the CKS topics on and for more information

2017 NICE Clinical Knowledge Summaries

128. Candida - oral

of conditions, including: Haematological cancer (for example acute leukaemia). Chemotherapy and radiotherapy (for the treatment of cancer). HIV infection and AIDS. Recent or concurrent use of drugs that promote candidal growth, particularly broad spectrum antibiotics and inhaled or oral corticosteroids. Diabetes mellitus (types 1 and 2) — chronic hyperglycemia is associated with impaired wound healing and higher susceptibility to infections. Other endocrine disorders or disturbances, including undiagnosed (...) , HIV infection, and AIDS). Other risk factors include poor dental hygiene; local trauma; smoking; the use of broad spectrum antibiotics, or inhaled or oral corticosteroids; and malnutrition. Admission to hospital should be arranged if there is widespread infection (such as oesophageal candidiasis characterized by difficulty or pain on swallowing, or retrosternal pain), or the person is systemically unwell. If treating an immunocompetent person, a topical antifungal should be prescribed for 7 days

2017 NICE Clinical Knowledge Summaries

129. Diagnosis and Management of Aplastic Anaemia

Documented vitamin B12 or folate deficiency should be corrected before a final diagnosis of AA is confirmed. Bone marrow aplasia due to vitamin deficiency is exceedingly rare 9. Liver function tests Liver function tests should be performed to detect antecedent/on‐going hepatitis 10. Viral studies: hepatitis A/B/C, EBV, CMV, HIV and Parvovirus B19 AA due to hepatitis is rare, it usually occurs 2–3 months after an acute episode of hepatitis and is more common in young males (Brown et al , ). In post (...) ‐hepatic AA the serology is often negative for the known hepatitis viruses. CMV should be assessed if SCT is being considered. HIV more commonly causes isolated cytopenias but is a very rare cause of AA (Wolf et al , ; Hapgood et al , ). Likewise, parvovirus B19 is more usually associated with pure red aplasia but has been reported with AA (Mishra et al , ) 11. Anti‐nuclear antibody and anti‐double stranded DNA Pancytopenia in systemic lupus erythematosus may (i) be autoimmune with a cellular bone

2015 British Committee for Standards in Haematology

130. Systematic review of needs for medical devices for ageing populations

for pension schemes or retirement: this is usually between 60 and 65 years (11). Ageing is a diffuse biological process that can be described as the accumulation of deleterious changes in cells and tissues that occur with advancing age. Defining old age is challenging as its onset is not defined by a single physiological phenomenon and its manifestation varies across individuals. The process of ageing involves physical, physiological and social changes and is considered by many to be a stage of life


133. Medical eligibility criteria for contraceptive use

delivered subcutaneously 61 Recommendations for safety of Sino-implant (II) 67 Recommendations for use of emergency contraceptive pills, including adding the condition of obesity and the new method, ulipristal acetate 72 Recommendations for intrauterine devices among women with increased risk for sexually transmitted infections 77 Recommendations for use of progesterone-releasing vaginal ring 79 Recommendations for use of hormonal contraception among women at high risk of HIV, women living with HIV (...) , and women living with HIV using antiretroviral therapy 82 PART II. USING THE RECOMMENDATIONS Background 99 How to use this document 104 Using the categories in practice 105 Programmatic implications 106 Clients with special needs 106 Summary of changes within the MEC fifth edition 107 TABLES Combined hormonal contraceptives 111 Progestogen-only contraceptives 157 Emergency contraceptive pills 186 Intrauterine devices 189 Copper-bearing IUD for emergency contraception 211 Barrier methods 214 Fertility

2015 World Health Organisation Guidelines

134. Clinical Practice Guideline on management of patients with diabetes and chronic kidney disease stage 3b or higher (eGFR <45 mL/min)

comment or suggestion, the guideline development group evaluated whether the statement needed to be adapted, again taking into account the balance between desirable and undesirable consequences of the alternative management strategies, the quality of the evidence, and the variability in values and preferences. 6.10.2. External review The guideline was sent to the Endocrine Society of Australia (ESA), the European Society of Endocrinology, Kidney Health Australia–Caring for Australasians with Renal

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2015 European Renal Best Practice

135. The Society of Invasive Cardiovascular Professionals New 2015 Educational Guidelines for Invasive Cardiovascular Technology Personnel in the Cardiovascular Catheterization Laboratory

Environment and Safety Regulatory Compliance Procedure Room Preparation Body Mechanics a. Safely Moving Patients b. Safety Strategies for Staff 4. Electronics a. Biomedical Instrumentation b. Ohms Law, Resistance B. Aseptic Technique Pathogens a. Blood-borne, Air-borne, Bacteria, HIV, TB, Hepatitis, MRSA, C-Diff 2. OSHA Regulations 3. Universal Precautions 4. Hand Washing 5. PPE (Personal Protective Equipment) a. Accident Exposure Engineering Controls Workplace Controls 6. Gowning and Gloving a. Open (...) and Treatments A. Identification of Pathologies and Complications B. Evaluation of Statistical Data for Cardiovascular Diseases C. Etiology, Pathophysiology, Clinical Manifestations, and Treatment of: 1. Coronary Artery Disease – Atherosclerosis 2. Angina a. Stable, Unstable Variants (Printzmetal’s) 3. Acute Coronary Syndromes – Myocardial Infarction (STEMI, UA/NSTEMI) a. No-Reflow, Microvascular Obstruction 4. Heart Failure (Left Heart, Right Heart, Biventricular) 5. Shock (Cardiogenic, Hypovolemic, Septic

2015 Society for Cardiovascular Angiography and Interventions

136. Acute Pain Management: Scientific Evidence

307 8.6.1 Acute abdominal pain 307 8.6.2 Herpes zoster-associated pain 310 8.6.3 Acute cardiac pain 312 8.6.4 Acute pain associated with haematological disorders 313 8.6.5 Acute headache 317 8.6.6 Acute pain associated with neurological disorders 327 8.6.7 Orofacial pain 329 8.6.8 Acute pain in patients with HIV infection 336 8.7 Acute cancer pain 339 8.7.1 Assessment of acute cancer pain 339 8.7.2 Principles of management of acute cancer pain 339xviii Acute Pain Management: Scientific Evidence (...) and abbreviations 633 Index 641xxi CONTENTS List of tables Review and revision of key messages x Table 1.1 Examples of primary afferent and dorsal horn pain related receptors and ligands . 3 Table 1.2 Incidence of chronic pain after surgery 17 Table 1.3 Risk factors for chronic postsurgical pain 19 Table 1.4 Definitions of pre-emptive and preventive analgesia 23 Table 1.5 Metabolic immunologcal and endocrine responses to injury 27 Table 2.1 Fundamentals of a pain history 44 Table 3.1 Possible benefits

2015 Clinical Practice Guidelines Portal

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

do not manifest the signs and symptoms of illness. As shown in Figure 1, liver function begins to deteriorate prior to onset of symptoms. ALP levels correlate with disease progression, and over the first year, with and without treatment, are highly predictive of long-term clinical outcomes, e.g. transplant-free survival (Beuers 2011, Lammers 2014, Carbone 2013). Changes in ALP and bilirubin correlate with and fully capture the net effects of OCA on the primary pathophysiology of PBC. Persistent (...) participated in a clinical study of OCA - History or presence of clinically concerning cardiac arrhythmias - If female: known pregnancy, or had a positive urine pregnancy test (confirmed by a positive serum pregnancy test), or lactating - Known history of HIV infection - Presence of any other disease or condition that was interfering with the ADME of drugs including bile salt metabolism in the intestine. - Medical conditions that could cause non-hepatic increases in ALP (e.g., Paget's disease

2017 European Medicines Agency - EPARs

138. Clinical Practice Guideline on the Management of Depression in Adults

manifested. Depression can also be concurrent with the abuse of alcohol or other substances or some organic brain and systemic diseases 4. It is also frequently associated with eating behaviour disorders and some personality disorders 22 . Furthermore, it is more common among people with chronic physical illness; and the relationship between the two is mutual, as the physical problems may exacerbate depression and depression in turn may adversely affect the course of the physical pathology. Depression (...) . An association between migraine and depression has also been described, such that patients with major depression have a higher risk of migraine and, in turn, those with migraine (no other type of headache) have an increased risk of major depression 36. Also, the presence of heart disease and various endocrine diseases such as diabetes, hypo- or hyperthyroidism, Cushing’s syndrome, Addison’s disease and hyperprolactinaemic amenorrhoea seem to increase the risk of depres- sion 13 . Social circumstances

2015 GuiaSalud

139. Clinical practice guideline on Systemic Lupus Erythematosus

effects and monitoring guidelines for immunosuppressive and biological treatments 143 5.2.4. Indication for therapeutic aphaeresis 147 5.2.5. Prevention of disease reactivation 150 5.2.6. Treatment of associated asthenia 154 5.3. Lifestyle measures 160 5.4. Photoprotection 167 5.5. Educational programmes for patients 1716 CLINICAL PRACTICE GUIDELINES IN THE SNS 6. Management of specifi c clinical manifestations 175 6.1. Lupus nephritis 175 6.1.1. Indication for renal biopsy 175 6.1.2. Therapeutic (...) objectives 178 6.1.3. Refractoriness 179 6.1.4. Induction treatment 181 6.1.5. Maintenance treatment 195 6.1.6. Immunosuppressive treatment for type V lupus nephritis 201 6.2. Haematological manifestations 206 6.2.1. Specific therapeutic objectives for each cytopenia 206 6.2.2. Immunosuppressive treatment 206 6.2.3. Treatment with thrombopoietic agents 210 6.3. Neuropsychiatric lupus 212 6.3.1. Diagnosis of neuropsychiatric complications 212 6.3.2. Indication for high intensity immunosuppressants 220 6.4

2015 GuiaSalud

140. Male Infertility

attempting to conceive a subsequent child. Three percent of women remain involuntarily childless, while 6% of parous women are not able to have as many children as they would wish [5]. Infertility affects both men and women. In 50% of involuntarily childless couples, a male-infertility-associated factor is found together with abnormal semen parameters. A fertile partner may compensate for the fertility problem of the man and thus infertility usually manifests if both partners have reduced fertility [4 (...) ]. Male fertility can be reduced as a result of [4]: • congenital or acquir ed ur ogenital abnormalities; • malignancies; • ur ogenital tract infections; • incr eased scr otal temperatur e (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 male infertility). These men present with no previous history of diseases affecting fertility and have normal findings

2015 European Association of Urology

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