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Failure to Thrive in the Elderly

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61. The Spirochete Brachyspira pilosicoli, Enteric Pathogen of Animals and Humans (PubMed)

of Australian Aboriginal children showed that colonization was significantly associated with failure to thrive. B. pilosicoli has been detected in the bloodstream of elderly patients or individuals with chronic conditions such as alcoholism and malignancies. This review describes the spirochete and associated diseases. It aims to encourage clinicians and clinical microbiologists to consider B. pilosicoli in their differential diagnoses and to develop and use appropriate diagnostic protocols to identify

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2017 Clinical microbiology reviews

62. Another cancer quack dies…of cancer.

part of the treatment. While you might think that “cheating” on your cancer diet by 10% would only affect the effectiveness of your treatment by 10%, such is not the case with this protocol. The cancer patient must be fanatical about sticking to the diet, as it is an integral part of the treatment. The purpose of the diet is to create a highly alkaline inner terrain in which microbes cannot thrive. Because microbes are an integral part of cancer, the cancer diet is critical. Wow. There’s a heck (...) , and died on July 4. That’s not a particularly long time between diagnosis and death. It’s also not unexpected in an 84 year old man. Non-Hodgkins lymphoma, after all, tends to be nastier than Hodgkins lymphoma, and patients who are elderly tend not to do as well as children or young adults. Those are just facts. Another fact that we know is that Bill Henderson was being treated in Cancun, Mexico to be treated for “leukemia and lymphoma.” Ty Bollinger, however, will have none of it. It’s that cancer

2016 Respectful Insolence

63. The annals of “I’m not antivaccine,” part 20: “There is no safe vaccine” and excusing the murder of autistic children

Wakefield to walk away to their next project, leaving his mother with nothing when the hope they were sold proved false. Alex was murdered. Brutally murdered. By his mother and another caregiver. Alex was poisoned. When that failed to kill him, he was stabbed. Repeatedly. His wrist was slit to the bone. By his mother and caregiver. Alex bled to death, leaving a grisly scene for when his father, estranged from the mother, found him. The fact that Polly Tommey won’t face up to her abject failure with Alex (...) Spourdalakis is not surprising. It is also not surprising that Polly Tommey won’t judge the people who committed that brutal murder, or any other murder by a parent of an autistic child. Not surprising, but an example of the failure of Polly Tommey and other faux autism advocates to actually stand up and lead. How hard is it to say, “No! Murder is wrong”? Polly Tommey met Alex Spourdalakis. But she “won’t judge” the person who plunged a knife into his chest. She won’t judge the person who poisoned him. She

2016 Respectful Insolence

64. Guidelines for the Clinical and Operational Management of Drug-Resistant Tuberculosis

: the Green Light Committee and other international alliances 36 References 37 5 How drug resistance affects tuberculosis treatment outcome and monitoring parameters 39 Effect of drug resistance on treatment outcome 39 Effect on treatment monitoring parameters 42 References 45 6 High-risk groups for drug-resistant tuberculosis 47 Case ? nding and prioritisation of interventions 47 Failures, bacteriological relapses, defaulters and the dangers of poor adherence 51 References 52 7 Laboratory diagnosis

2013 International Union Against TB and Lung Disease

65. Guidelines for the Management of Hiatal Hernia

, belching, and vomiting have been suggested to be predisposing factors for anatomical failure and the need for revision 73 . Morbidity is substantially higher among elderly patients and those with co-morbidities when compared to younger patients, but with no increase in the recurrence rate. Mortality rate among elderly patients undergoing PEH repair continues to be high following emergency procedures 74 . The mortality is related mainly to pulmonary complications, thromboembolic events and hemorrhage 75 (...) the lesser and greater curvature, is less common. A combination of the two may exist. Primary gastric volvulus has no causative condition but the more common secondary gastric volvulus is associated with underlying conditions such as paraesophageal hernias, connective tissue disorders and anterior abdominal wall defects. Although gastric volvulus has been reported in all ages, it is more often diagnosed in elderly patients. Hiatal hernia with intrathoracic acute gastric volvulus usually presents

2013 Society of American Gastrointestinal and Endoscopic Surgeons

66. Clinical Practice Guidelines for Healthy Eating for the Prevention and Treatment of Metabolic and Endocrine Diseases in Adults: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology and The Obesity Society

the intake of vitamin B 12 in food (Grade A, BEL 1). • R7. The prevalence of vitamin D deficiency and insufficiency warrants case finding by measure - ment of 25-hydroxyvitamin D (25[OH]D) levels in populations at risk, including institutionalized elderly patients, people with hyperpigmented skin, and people with obesity (Grade B BEL 2). Older adults, people with increased skin pigmen- tation, and those exposed to insufficient sunlight should increase vitamin D intake from vitamin D-fortified foods (...) (OH)D should be measured in individuals at risk for vitamin D deficiency (e.g., elderly, institutionalized, or malnourished patients) and in those with known osteopenia or osteoporosis (Grade A, BEL 1). Vitamin D should be supplemented to keep the plasma 25(OH)D level greater than 30 ng/mL (Grade A, BEL 1). For most patients, a daily intake of at least 1,000 to 2,000 IU of ergocalciferol (D 2 ) or cholecalcif- erol (D 3 ) should be adequate (Grade A, BEL 1). For patients with advanced renal

2013 American Association of Clinical Endocrinologists

67. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults

mg/dL S14 4.5. Primary Prevention in Individuals With Diabetes S16 4.6. Primary Prevention in Individuals Without Diabetes and With LDL-C 70 to 189 mg/dL S16 4.7. Risk Assessment in Primary Prevention S17 4.8. Heart Failure and Hemodialysis S17 5. Safety: Recommendations S18 6. Managing Statin Therapy: Recommendations S21 6.1. Monitoring Statin Therapy S21 6.2. Optimizing Statin Therapy S21 6.3. Insufficient Response to Statin Therapy S21 6.3.1 Testing S21 6.3.2 Nonstatins Added to Statins (...) focused on these statin RCTs to develop evidence-based guidelines for the reduction of ASCVD risk. We recognize that this represents a significant departure from current strategies. This should not come as a surprise to clinicians. The recent guideline on heart failure has changed long-standing paradigms on the basis of the evidence, and this guideline does as well. Future RCTs will be needed to determine the optimal treatment strategy to provide the greatest reduction in ASCVD events with best margin

2013 American Heart Association

70. Quantitative serum immunoglobulin tests

to detect the presence of any monoclonal band (also called ‘paraprotein’ or ‘M spike’) and urine protein electrophoresis for Bence-Jones protein. Full blood count (FBC) is important to identify lymphopenia, anaemia, and thrombocytopenia (all can occur with hypogammaglobulinaemia) and to exclude neutropenia. Lymphocytosis may be seen in CLL or lymphoma. Lymphopenia in infants with infections, diarrhoea and/or failure to thrive is an important finding as it suggests severe combined immunodeficiency (...) . myeloma), serum immunoglobulin tests may also be ordered periodically to monitor disease progression. When shouldn’t the test be ordered? Otherwise healthy thriving children with frequent ‘colds’ do not need their immunoglobulin levels measured. In Australia, normal healthy toddlers can have up to 12 infections a year. The number of infections increases if the child attends childcare, has older siblings and/or parents who smoke. How does the test work? Nephelometry and turbidimetry are the most widely

2013 Clinical Practice Guidelines Portal

72. Patient Dignity (Formerly:Patient Modesty):Volume 99

instilled is that patients have no rights and no one will help them if they have been abused or violated. Absolutely no on cares! This further reinforces that we will not seek any hospitalization or emergency care. Our fears are not groundless and our realization that abuse is allowed to happen and thrive is also very real and confirmed by CMS. JR At , said... Another comment from a medical school dean regarding separating "good" and "bad" medical students and residents as published in the medical (...) with most closely. This could potentially exacerbate the disparity and social justice issues in the medical school admissions process. There are opportunities, though, for us to recognize unprofessional behavior and intervene after a student has matriculated into medical school. Often, those of us in positions to do so, do not intervene swiftly enough, or definitively enough when unprofessional behavior is demonstrated by a medical student or resident. This is a failure on our part, as medical educators

2019 Bioethics Discussion Blog

73. Patient Dignity (Formerly:Patient Modesty): Volume 96

, others here who work in hospitals can speak more definitively but my understanding is that for new inpatients a full skin assessment is for purposes of identifying bruises, pressure sores, or anything that should be documented as occurring prior to admission. Subsequent skin exams would be for purposes of determining if pressure sores or ulcers are developing. This can be a big problem with the elderly. Because that wasn't your situation is probably why they didn't make it mandatory. My wife's

2019 Bioethics Discussion Blog

75. Guidelines for Responsible Opioid Prescribing in Chronic Non-Cancer Pain

is considered as low dose, 41 to 90 mg of morphine equivalent as a moderate dose, and greater than 91 mg of morphine equivalence as high dose. (Evidence: fair) C) In reference to long-acting opioids, titration must be carried out with caution and overdose and misuse must be avoided. (Evidence: good) 8. A) Methadone is recommended for use in late stages after failure of other opioid therapy and only by clinicians with specific training in the risks and uses. (Evidence: limited) B) Monitoring recommendation (...) necessary. (Evidence: good) 11. Chronic opioid therapy may be continued, with continuous adherence monitoring, in well-selected populations, in conjunction with or after failure of other modalities of treatments with improvement in physical and functional status and minimal adverse effects. (Evidence: fair) Disclaimer: The guidelines are based on the best available evidence and do not constitute inflexible treatment recommendations. Due to the changing body of evidence, this document is not intended

2012 American Society of Interventional Pain Physicians

76. Acute Diarrhea in Adults and Children: A Global Perspective

malnutrition, chronic liver disease, or lymphoproliferative disorders. — Invasive intestinal amebiasis. — Symptomatic giardiasis (anorexia and weight loss, persistent diarrhea, failure to thrive). • Consider antimicrobial treatment for: — Shigella, Salmonella, Campylobacter (dysenteric form) or parasitic infections. — Nontyphoidal salmonellosis among at-risk populations (malnutrition, infants and elderly, immunocompromised patients, and those with liver diseases and lymphoproliferative disorders (...) — Salmonella enterica serovar Typhi and Paratyphi A, B, or C (typhoid fever); fever lasts for 3 weeks or longer; patients may have normal bowel habits, constipation or diarrhea. • Animals are the major reservoir for salmonellae. Humans are the only carriers of typhoidal Salmonella. • In nontyphoidal salmonellosis (Salmonella gastroenteritis), there is an acute onset of nausea, vomiting, and diarrhea that may be watery or dysenteric in a small fraction of cases. • The elderly and people with immune

2012 World Gastroenterology Organisation

77. Toolkit: Implementation of Best Practice Guidelines, Second Edition

supports the implementation of best practice guidelines (BPG) developed by RNAO to date. It is a comprehensive resource manual, grounded in theory, research and experience. It brings practical processes, strategies and tools to clinicians and others committed to initiating and sustaining practice change in health care, and supporting the creation of healthy and thriving work environments. RNAO is delighted to provide this key resource. We offer our heartfelt thanks to the Government of Ontario

2012 Registered Nurses' Association of Ontario

78. My Story: When the Signs of Sepsis are Missed

the odds. We understand now that my Disney half marathon training is what prepared my heart for the real life marathon I was to endure. It took a new medical team, two additional surgeries, another full year of supplemental IV nutrition, countless hours of physical therapy and sheer determination to get me where I am today. I am lucky to be alive, and thriving, and grateful for the ICU team that saved my life, but reminded that more has to be done to educate families, nurses, and doctors to so (...) will be in pain daily stomack cramps its hell. But sepsis honestly scares the life out of me and I think has changed me as a person Back in early March of 2014, I went in for surgery to get my C-section done to have my set of boy/girl twins. Never did I know that I would be setting myself up for failure. Not only did they go fishing around in my spine trying to give me a local after I told them I was born with congenital scoliosis and they weren’t going to find my spine, but then they weren’t even able to use

2016 CDC Safe Healthcare blog

79. Unintentional Weight Loss

Unintentional Weight Loss Aka: Unintentional Weight Loss , Geriatric Failure to Thrive , Cachexia , Wasting Syndrome , Malnutrition , Anorexia From Related Chapters II. Epidemiology: Incidence residents: 25-40% Overall over age 64 years: 13% III. Definition Unintentional Weight Loss of >5% of body weight within 6-12 months IV. Causes See V. Precautions Substantial weight loss should not be attributed to aging alone See VI. History How much weight loss over how much time? Patients down play weight changes (...) See See See or VII. Exam Record accurate weights on same scale at every visit Unexplained weight loss >5% should be investigated Anticipated time for 15% weight loss Complete starvation: 15% of weight lost in 3 weeks Half of normal food intake: 3 months Half food intake and comorbid conditions: 3 weeks clues (BMI) predicts mortality in elderly Women: BMI <22 kg/m2 predicts increased mortality Men: BMI <23.5 kg/m2 predicts increased mortality Head and neck changes Thyromegaly Other examination

2018 FP Notebook

80. Burden of Geriatric Events Among Older Adults Undergoing Major Cancer Surgery. (PubMed)

admissions for major cancer surgery among elderly patients (ie, age ≥ 65 years) and a referent group age 55 to 64 years. From these observations, we identified geriatric events that included delirium, dehydration, falls and fractures, failure to thrive, and pressure ulcers. We then estimated the collective prevalence of these events according to age, comorbidity, and cancer site and further explored their relationship with other hospital-based outcomes.Within a weighted sample of 939,150 patients, we

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2016 Journal of Clinical Oncology

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