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193 results for

Failure to Thrive in the Elderly

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141. Colorectal Tumors (Overview)

(17%) at an early age; the mean age at diagnosis of carcinoma is 35.5 years. [ ] Close long-term surveillance is important. The amount of polyps increases the risk of chronic bleeding, which subsequently leads to iron deficiency anemia, hypoproteinemia, and failure to thrive. [ , ] Macroscopically, these polyps resemble the isolated juvenile polyps; however, histologically, they have more epithelium with a villous or papillary configuration. Epithelial dysplasia can occur. Adenomas can also (...) cessation of rectal bleeding. [ , , ] Colonoscopy is performed to eliminate juvenile polyposis (ie, >5 polyps). [ ] The polyps can be endoscopically removed. When managing a prolapsed polyp, controlling the polyp stalk prior to resection is mandatory. Failure to control the polyp stalk can result in retraction, which makes hemostatic control very difficult. [ ] Juvenile polyposis syndromes Diffuse juvenile polyposis of infancy This entity occurs within the first months of life and is not familial

2014 eMedicine Pediatrics

142. Hutchinson-Gilford Progeria (Diagnosis)

with the cutaneous and musculoskeletal manifestations may not occur until age 6-12 months or older, when the development of failure to thrive engenders a more thorough evaluation. Previous Next: Prognosis The average life expectancy for a patient with HGPS is 13 years, with an age range of 7-27 years. Data from the largest cohort of HGPS patients indicated a mean survival of 14.6 years, with an increased mean survival of 1.6 years in patients treated with a protein farnesylation inhibitor after a median follow (...) -up of 5.3 years from treatment initiation. [ ] Morbidity and mortality in persons with HGPS occur primarily as a result of atherosclerosis of the coronary and cerebrovascular arteries, with at least 90% of patient deaths directly related to complications of progressive atherosclerosis. Cardiovascular complications include myocardial infarction and congestive heart failure. Interstitial fibrosis, diffuse myocardial fibrosis, and calcification of the mitral and aortic valves may occur

2014 eMedicine.com

143. Scrub Typhus (Diagnosis)

, ocular pain, wet cough, malaise, and injected conjunctiva Centrifugal macular rash on the trunk Enlargement of the spleen, cough, and delirium Pneumonitis or encephalitis Central nervous system (CNS), pulmonary, or cardiac involvement Rarely, acute renal failure, shock, and disseminated intravascular coagulation (DIC) See for more detail. Diagnosis Laboratory studies in patients with scrub typhus may reveal the following: Early lymphopenia with late lymphocytosis Decreased CD4:CD8 lymphocyte ratio (...) of scrub typhus varies with the climate in different countries because the mites are able to thrive as conditions change. The mites prefer the rainy season and certain areas (eg, forest clearings, riverbanks, and grassy regions). In the past few years, cases have been noted earlier in the season because of increased mite activity as the weather warms. [ ] Areas in which mites thrive pose a greater risk to humans. The prevalence of scrub typhus in Japan has been rising, and much of the current research

2014 eMedicine.com

144. Seizures and Epilepsy: Overview and Classification (Diagnosis)

frequently (70%) caused by a deletion in the paternal inherited portion of chromosome 15q11.2-q13. The remainder of cases are caused by maternal uniparental disomy of chromosome 15, complex chromosomal rearrangements, or defects in specific imprinting centers. Patients with Prader-Willi syndrome have neonatal hypotonia and failure to thrive during infancy. Patients have hyperphagia, and onset of weight gain occurs between age 1 and 6 years. Affected individuals also have mild-moderate intellectual (...) remains unknown. Identified causes tend to vary with patient age. Inherited syndromes, congenital brain malformations, infection, and head trauma are leading causes in children. Head trauma is the most common known cause in young adults. Strokes, tumors, and head trauma become more frequent in middle age, with stroke becoming the most common cause in the elderly, along with Alzheimer disease and other degenerative conditions. The genetic contribution to seizure disorders is not completely understood

2014 eMedicine.com

145. Strongyloidiasis (Diagnosis)

local cutaneous involvement, or both. During chronic uncomplicated infections, the larvae may migrate to the skin, where they can cause cutaneous strongyloidiasis, known as larva currens because of the quick migratory rate of the larva. Infection is clinically characterized by watery diarrhea, abdominal cramping, and urticarial rash. In malnourished children, strongyloidiasis remains an important cause of chronic diarrhea, cachexia, and failure to thrive. This condition can also be a health (...) the preleukemic phase of HTLV-1 infection [ ] ; the Strongyloides antigen accelerates leukemogenesis, and treatment of the infection may actually decrease HTLV-1 viral load [ ] Hypogammaglobulinemia Malignancy/neoplasms, particularly hematologic malignancies (lymphoma, leukemia): Studies have suggested that Strongyloides infection may be associated with increased incidence of gastrointestinal lymphoma [ ] Organ transplantation [ , , , ] and malnutrition Chronic renal failure and end-stage renal disease

2014 eMedicine.com

146. Strongyloidiasis (Diagnosis)

local cutaneous involvement, or both. During chronic uncomplicated infections, the larvae may migrate to the skin, where they can cause cutaneous strongyloidiasis, known as larva currens because of the quick migratory rate of the larva. Infection is clinically characterized by watery diarrhea, abdominal cramping, and urticarial rash. In malnourished children, strongyloidiasis remains an important cause of chronic diarrhea, cachexia, and failure to thrive. This condition can also be a health (...) the preleukemic phase of HTLV-1 infection [ ] ; the Strongyloides antigen accelerates leukemogenesis, and treatment of the infection may actually decrease HTLV-1 viral load [ ] Hypogammaglobulinemia Malignancy/neoplasms, particularly hematologic malignancies (lymphoma, leukemia): Studies have suggested that Strongyloides infection may be associated with increased incidence of gastrointestinal lymphoma [ ] Organ transplantation [ , , , ] and malnutrition Chronic renal failure and end-stage renal disease

2014 eMedicine.com

147. Protein-Energy Malnutrition (Diagnosis)

, and 30-40% for those in long-term care facilities. A 2019 systematic review, meta-analysis, and meta-regression of the prevalence of protein-energy malnutrition among the elderly found that rural communities were affected twice as much as urban communities and women were affected more than males. [ ] Other recent studies of geriatric patients hospitalized for orthopedic conditions [ ] or heart failure [ ] also note protein-energy malnutrition is prevalent in this population. Previous Next: Prognosis (...) to be a primary factor of poor prognosis in elderly persons. In a study designed to assess the quality of care in nursing home residents, there was a direct association between mortality and anorexia in elderly residents of both genders with an almost two-fold higher risk of death for all causes in patients with anorexia. [ ] In a separate propensity-matched study of 32,771 elderly patients hospitalized for heart failure, protein-match malnutrition was associated with higher mortality, cardiogenic shock

2014 eMedicine.com

148. Pyelonephritis, Acute (Diagnosis)

but may not occur at the same time. If the patient is male, elderly, or a child or has had symptoms for more than 7 days, the infection should be considered complicated until proven otherwise. The classic manifestations of acute pyelonephritis observed in adults are often absent in children, particularly neonates and infants. In children aged 2 years or younger, the most common signs and symptoms of urinary tract infection (UTI) are as follows: Failure to thrive Feeding difficulty Fever Vomiting (...) -to-male ratio 1:1.5 10:1 10:1 30:1 Route of infection Blood Ascending Ascending Ascending Signs and symptoms Failure to thrive, fever, hypothermia, irritability, jaundice, poor feeding, sepsis, vomiting Diarrhea, failure to thrive, fever, irritability, poor feeding, strong-smelling urine, vomiting Abdominal pain, dysuria, enuresis, fever, gross hematuria, meningismus, strong-smelling urine, urinary urgency, urinary frequency, vomiting Dysuria, enuresis, fever, flank pain or tenderness, urinary urgency

2014 eMedicine.com

149. Hirsutism (Diagnosis)

genitalia, symptoms of salt wasting, and failure to thrive. Additionally, they may develop masculine features. See for more information. Late-onset CAH usually occurs as an incomplete version of CAH and affects approximately 1-5% of women who are hyperandrogenic. In patients with late-onset CAH, hirsutism (without salt-wasting symptoms) may not develop until adulthood. Signs of virilization and menstrual irregularities may not be observed until puberty or adulthood. Patients have clinical features (...) , and areolae. Idiopathic hirsutism in an elderly woman. Although the terms hirsutism and hypertrichosis often are used interchangeably, hypertrichosis actually refers to excess hair (terminal or vellus) in areas that are not predominantly androgen dependent. Whether a patient is hirsute often is difficult to judge because hair growth varies among individual women and across ethnic groups. What is considered hirsutism in one culture may be considered typical in another. For example, women from

2014 eMedicine.com

150. Atrial Septal Defect, General Concepts (Diagnosis)

with moderate or large (ie, nonrestrictive) atrial septal defects, but no other left to right shunting lesion (eg, patent ductus arteriosus, ventricular septal defect), have tachypnea and failure to thrive. In these individuals, the pulmonary artery pressure, when measured during catheterization or Doppler echocardiography, is at or near systemic level. In most instances, this is a flow-related phenomena (high flow/low resistance), but in infants predisposed to abnormal pulmonary vasculature, there may (...) view of a child with a secundum atrial septal defect (ASD). AO = aorta; LA = left atrium; RA = right atrium. The second type is an . This atrial septal defect presumably results from failure of the endocardial cushions to close the ostium primum. Because endocardial cushions also form the mitral and tricuspid valves, ostium primum defects are virtually always associated with a cleft in the anterior mitral valve leaflet (see the images below). Apical echocardiographic view of a primum atrial septal

2014 eMedicine Pediatrics

151. Strongyloidiasis (Overview)

local cutaneous involvement, or both. During chronic uncomplicated infections, the larvae may migrate to the skin, where they can cause cutaneous strongyloidiasis, known as larva currens because of the quick migratory rate of the larva. Infection is clinically characterized by watery diarrhea, abdominal cramping, and urticarial rash. In malnourished children, strongyloidiasis remains an important cause of chronic diarrhea, cachexia, and failure to thrive. This condition can also be a health (...) the preleukemic phase of HTLV-1 infection [ ] ; the Strongyloides antigen accelerates leukemogenesis, and treatment of the infection may actually decrease HTLV-1 viral load [ ] Hypogammaglobulinemia Malignancy/neoplasms, particularly hematologic malignancies (lymphoma, leukemia): Studies have suggested that Strongyloides infection may be associated with increased incidence of gastrointestinal lymphoma [ ] Organ transplantation [ , , , ] and malnutrition Chronic renal failure and end-stage renal disease

2014 eMedicine Pediatrics

152. Down Syndrome (Follow-up)

to control hypersecretion in the airways. Other airway complications include subglottic stenosis and obstructive apnea, which may result from a relatively large tongue, enlarged adenoids, and midfacial hypoplasia. Adenotonsillectomy may be performed to manage obstructive sleep apnea. Previous Next: Diet and Activity No special diet is required, unless celiac disease is present. A balanced diet and regular exercise are needed to maintain appropriate weight. Feeding problems and failure to thrive usually (...) an echocardiogram if a new murmur or gallop or symptoms of heart failure develop. Continue subacute bacterial endocarditis prophylaxis in adolescents with cardiac defects; during adolescence, an additional 2% of patients die of complications of congenital heart disease, infections, leukemia, and accidents Counsel regarding the importance of protecting the cervical spine during anesthetic or surgical interventions; monitor for signs and symptoms of cervical myopathy; repeat cervical spine radiography as needed

2014 eMedicine Pediatrics

153. Atrial Septal Defect, Ostium Primum (Follow-up)

septal defects (ASDs) and partial atrioventricular (AV) canal defects is operative repair. Its timing has been debated over the years; more recent reports encourage a trend toward earlier repair. Patients with an isolated ostium primum ASD are typically referred for elective repair between the ages of 2 and 5 years. Occasionally, repair may be recommended at an earlier age because of significant congestive heart failure (CHF) or failure to thrive, especially if associated with significant mitral (...) syndrome manifested by chest pain, fever, pericardial inflammation with a rub, and pericardial effusion. High-dose salicylates or nonsteroidal anti-inflammatory drugs (NSAIDs) generally improve symptoms. Hemodynamically significant effusions may require pericardiocentesis. Failure to respond to salicylates may warrant pulsed steroid therapy. Diet and activity For asymptomatic patients, no specific dietary recommendations are warranted. For infants or very young children with congestive heart failure

2014 eMedicine Pediatrics

154. Strongyloides Stercoralis (Diagnosis)

passage, its local cutaneous involvement, or both. During chronic uncomplicated infections, the larvae may migrate to the skin, where they can cause cutaneous strongyloidiasis, known as larva currens because of the quick migratory rate of the larva. Infection is clinically characterized by watery diarrhea, abdominal cramping, and urticarial rash. In malnourished children, strongyloidiasis remains an important cause of chronic diarrhea, cachexia, and failure to thrive. This condition can also (...) with Strongyloides shortens the preleukemic phase of HTLV-1 infection [ ] ; the Strongyloides antigen accelerates leukemogenesis, and treatment of the infection may actually decrease HTLV-1 viral load [ ] Hypogammaglobulinemia Malignancy/neoplasms, particularly hematologic malignancies (lymphoma, leukemia): Studies have suggested that Strongyloides infection may be associated with increased incidence of gastrointestinal lymphoma [ ] Organ transplantation [ , , , ] and malnutrition Chronic renal failure and end

2014 eMedicine Emergency Medicine

155. Mononucleosis (Diagnosis)

. It is estimated that 1-3% of college students are affected annually. In children younger than 4 years, the infection is most often asymptomatic, but they may present with atypical symptoms (eg, irritability, failure to thrive, abdominal pain due to mesenteric adenopathy or splenomegaly, upper respiratory infection [URI] symptoms). Elderly patients with Epstein-Barr virus infection usually present with nonspecific complaints (eg, fever, fatigue, malaise, myalgias). Previous Next: Prognosis Infectious (...) -Barr virus. Mortality/Morbidity Fatalities secondary to infectious mononucleosis (IM) are rare and most often are the result of splenic rupture. Other fatal occurrences have been attributed to secondary bacterial infection, hepatic failure, and myocarditis. Airway obstruction can occur due to massive edema of the Waldeyer ring. Serious nonfatal complications also are rare and may include involvement of the CNS or the hematologic system. CNS complications can include meningitis, encephalitis

2014 eMedicine Emergency Medicine

156. Strongyloides Stercoralis (Overview)

passage, its local cutaneous involvement, or both. During chronic uncomplicated infections, the larvae may migrate to the skin, where they can cause cutaneous strongyloidiasis, known as larva currens because of the quick migratory rate of the larva. Infection is clinically characterized by watery diarrhea, abdominal cramping, and urticarial rash. In malnourished children, strongyloidiasis remains an important cause of chronic diarrhea, cachexia, and failure to thrive. This condition can also (...) with Strongyloides shortens the preleukemic phase of HTLV-1 infection [ ] ; the Strongyloides antigen accelerates leukemogenesis, and treatment of the infection may actually decrease HTLV-1 viral load [ ] Hypogammaglobulinemia Malignancy/neoplasms, particularly hematologic malignancies (lymphoma, leukemia): Studies have suggested that Strongyloides infection may be associated with increased incidence of gastrointestinal lymphoma [ ] Organ transplantation [ , , , ] and malnutrition Chronic renal failure and end

2014 eMedicine Emergency Medicine

157. Mononucleosis (Overview)

. It is estimated that 1-3% of college students are affected annually. In children younger than 4 years, the infection is most often asymptomatic, but they may present with atypical symptoms (eg, irritability, failure to thrive, abdominal pain due to mesenteric adenopathy or splenomegaly, upper respiratory infection [URI] symptoms). Elderly patients with Epstein-Barr virus infection usually present with nonspecific complaints (eg, fever, fatigue, malaise, myalgias). Previous Next: Prognosis Infectious (...) -Barr virus. Mortality/Morbidity Fatalities secondary to infectious mononucleosis (IM) are rare and most often are the result of splenic rupture. Other fatal occurrences have been attributed to secondary bacterial infection, hepatic failure, and myocarditis. Airway obstruction can occur due to massive edema of the Waldeyer ring. Serious nonfatal complications also are rare and may include involvement of the CNS or the hematologic system. CNS complications can include meningitis, encephalitis

2014 eMedicine Emergency Medicine

158. Scrub Typhus (Treatment)

, ocular pain, wet cough, malaise, and injected conjunctiva Centrifugal macular rash on the trunk Enlargement of the spleen, cough, and delirium Pneumonitis or encephalitis Central nervous system (CNS), pulmonary, or cardiac involvement Rarely, acute renal failure, shock, and disseminated intravascular coagulation (DIC) See for more detail. Diagnosis Laboratory studies in patients with scrub typhus may reveal the following: Early lymphopenia with late lymphocytosis Decreased CD4:CD8 lymphocyte ratio (...) of scrub typhus varies with the climate in different countries because the mites are able to thrive as conditions change. The mites prefer the rainy season and certain areas (eg, forest clearings, riverbanks, and grassy regions). In the past few years, cases have been noted earlier in the season because of increased mite activity as the weather warms. [ ] Areas in which mites thrive pose a greater risk to humans. The prevalence of scrub typhus in Japan has been rising, and much of the current research

2014 eMedicine.com

159. Assistive Devices to Improve Independence (Treatment)

> Geriatric Rehabilitation Updated: Mar 19, 2019 Author: Julie A Muché, MD; Chief Editor: Stephen Kishner, MD, MHA Share Email Print Feedback Close Sections Sections Geriatric Rehabilitation Overview Overview As we age, we face many physical and emotional changes that can affect our level of function and well-being. Our baby-boomer population is aging, and people are living longer. We must maintain functional independence in the elderly and address the needs of our older generation. Rehabilitation (...) of geriatric patients is imperative for the patients' well-being and for society, so that we can thrive socially and economically. [ ] Essential to geriatric rehabilitation is communication, specifically improving any sensory impairment, including those related to vision and hearing. The prevention of falls and osteoporosis can protect the patient's health and improve longevity. Addressing malnutrition can promote healing and vitalize the patient to participate in a formal rehabilitation program

2014 eMedicine.com

160. Eviplera - emtricitabine / rilpivirine / tenofovir disoproxil

chromatography IAS-USA International AIDS Society-United States of America ICH International Conference on Harmonization IC50 50% inhibitory concentration IDV indinavir ITT intent-to-treat Ki inhibition constant LDL low-density lipoprotein LOCF last observation carried forward LPV lopinavir LPV/r lopinavir/ritonavir M = F missing = failure MAA (EU) Marketing Authorization Application MCS mental component summary MDCK Madin-Darby canine kidney MDRD modification of diet in renal disease MITT modified intent (...) -to-treat MRP (2,4) multidrug resistance protein (type 2, type 4) mtDNA mitochondrial DNA NC = F noncompleter = failure NNRTI nonnucleoside reverse transcriptase inhibitor non-VF non-virologic failure NRTI nucleoside reverse transcriptase inhibitor NtRTI, N(t)RTI nucleotide reverse transcriptase inhibitor NVP nevirapine PBMC peripheral blood mononuclear cell PCS Physical Component Summary P-gp P-glycoprotein PI protease inhibitor PK pharmacokinetic PMPA 9-R-2-(phosphonomethoxy)propyl]adenine PP per

2011 European Medicines Agency - EPARs

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