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Failure to Thrive in the Elderly

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161. Patent ductus arteriosus

and sequelae of a patent ductus arteriosus (PDA) are more significant in premature infants than infants born at full-term. Clinical history and presentation can vary significantly depending on age of the child and the size of the ductus. Patients may be entirely asymptomatic or have signs and symptoms of heart failure and haemodynamic instability. Treatment options vary depending on the age of the patient and the size of the ductus. Practice may vary significantly between institutions. Definition Patent (...) . http://www.ncbi.nlm.nih.gov/pubmed/5048708?tool=bestpractice.com History and exam presence of risk factors presentation in infancy tachypnoea/shortness of breath (SOB) failure to thrive exercise intolerance widened pulse pressure machine-like continuous murmur/Gibson murmur in children born at term apnoea low diastolic BP irritability diaphoresis increased respiratory symptoms with upper respiratory tract infection murmur heard only during systole hyperdynamic precordium systolic thrill third heart

2018 BMJ Best Practice

162. Hirschsprung's disease

stools abdominal distension delayed passage of meconium fever failure to thrive septic shock Down's syndrome multiple endocrine neoplasia type IIA male gender gene mutations (chromosome 10 and 21) Diagnostic investigations plain abdominal x-ray contrast enema rectal biopsy anorectal manometry Treatment algorithm ACUTE Contributors Authors Pediatric Surgeon Assistant Director of the International Center for Colorectal and Urogenital Care Children's Hospital Colorado Associate Professor of Surgery (...) , Switzerland: Springer International Publishing; 2015:399-436. Because of the aganglionosis, the lumen is tonically contracted, causing a functional obstruction. The aganglionic portion of the colon is always located distally, but the length of the segment varies. This determines the varied manifestations of the disease. The vast majority of patients present in the newborn period up to 1 year of age. Diagnosis later in life occurs rarely. History and exam vomiting explosive passage of liquid and foul

2018 BMJ Best Practice

163. Disorders of infant feeding

the requirements for healthy growth in the long term. Failure to thrive may be a consequence of unresolved feeding problems of any aetiology. Aetiologies are often complex and multifactorial, and are best managed by a multidisciplinary team. Causes include anatomical, neuromuscular/neurodevelopmental, immunological, physiological, and behavioural factors. Diagnosis is usually clinical, with a consistent history supported by dietetic assessment. Complementary diagnostic tests and subsequent management (...) Disorders of infant feeding Disorders of infant feeding - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Disorders of infant feeding Last reviewed: February 2019 Last updated: March 2018 Summary Common in children under 1 year of age. Causative conditions may persist, leading to ongoing feeding difficulties during childhood. Results in the inadequate intake or intolerance of fluids or nutrients necessary to meet

2018 BMJ Best Practice

164. Abetalipoproteinaemia

Abetalipoproteinaemia Abetalipoproteinaemia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Abetalipoproteinaemia Last reviewed: February 2019 Last updated: March 2018 Summary Typically presents in the first few months of life with symptoms of failure to thrive, diarrhoea, and steatorrhoea. A rare disorder; diagnosis is often missed due to vague symptoms more common to diseases such as viral gastroenteritis or child (...) ://www.ncbi.nlm.nih.gov/pubmed/11767031?tool=bestpractice.com History and exam age 0 to 12 years developmental delay steatorrhoea/diarrhoea muscle weakness night blindness poor eyesight muscle contractions poor appetite fatigue pale skin loss of deep tendon reflexes low weight hypaesthesia ataxia intention tremor chorea dysmetria dysarthria ophthalmoplegia optic disc swelling hepatomegaly genetic Diagnostic investigations fasting lipid panel vitamin A, E, K blood levels microsomal triglyceride transfer protein (MTTP

2018 BMJ Best Practice

165. Cystic fibrosis

newborn screen failure to pass meconium failure to thrive voracious appetite wet-sounding cough recurrent infection chronic sinusitis genital abnormalities in males haemoptysis malabsorptive stool with steatorrhoea digital clubbing gastro-oesophageal reflux wheeze increased anteroposterior (AP) diameter of the chest hx of pancreatitis hx of acute appendicitis enlarged liver or spleen FHx of CF known carrier status of both parents ethnicity Diagnostic investigations sweat test immunoreactive (...) Cystic fibrosis Cystic fibrosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cystic fibrosis Last reviewed: February 2019 Last updated: September 2018 Summary Genetic multisystem disease associated with abnormalities in salt and water transport across epithelial surfaces. Age of onset of symptoms is highly variable; implementation of newborn screening in some countries allows for early detection and treatment

2018 BMJ Best Practice

166. Giardiasis

. 2010 Jun;8(6):413-22. http://www.ncbi.nlm.nih.gov/pubmed/20400969?tool=bestpractice.com Escobedo AA, Almirall P, Robertson LJ, et al. Giardiasis: the ever-present threat of a neglected disease. Infect Disord Drug Targets. 2010 Oct;10(5):329-48. http://www.ncbi.nlm.nih.gov/pubmed/20701575?tool=bestpractice.com Children may present with weight loss and failure to thrive due to malabsorption. History and exam diarrhoea frequent belching abdominal bloating and discomfort malaise weight loss nausea (...) and vomiting contaminated water/food domestic animals living in or around the house hypogammaglobulinaemia young age male sex day-care use men having sex with men Diagnostic investigations FBC stool microscopy stool antigen detection; enzyme-linked immunosorbent assay and direct fluorescence antibody (DFA) ImmunoCard STAT! string test (EnteroTest) duodenal aspirates and biopsies polymerase chain reaction of stool sample Treatment algorithm ACUTE ONGOING Contributors Authors Chief Hospitalist Sound

2018 BMJ Best Practice

167. Vitamin D deficiency

not typically present with overt clinical signs and symptoms until the deficiency is severe and prolonged. Children with established vitamin D deficiency present with features of rickets (skeletal abnormalities, developmental delay, failure to thrive), whereas adults present with signs and symptoms of osteomalacia (bone pain and tenderness, proximal muscle weakness reported as difficulty in rising from a sitting position). In addition to the skeletal effects, it is now recognised that vitamin D deficiency (...) ://www.ncbi.nlm.nih.gov/pubmed/23790560?tool=bestpractice.com History and exam presence of risk factors bowing of the legs widening of the ends of the long bones delayed tooth eruption and early dental caries chest deformity throbbing, aching bone discomfort and/or irritability head sweating localised or generalised bone tenderness proximal muscle weakness rachitic rosary frontal bossing waddling gait failure to thrive delayed achievement of motor milestones fatigue and malaise symptoms of hypocalcaemia inadequate

2018 BMJ Best Practice

168. Foreign body ingestion

the gastrointestinal tract. History and exam presence of risk factors dysphagia non-specific abdominal pain stridor and wheezing drooling gagging, nausea/vomiting, neck/throat pain atypical chest pain or non-cardiac chest pain choking signs of upper gastrointestinal obstruction lower gastrointestinal bleeding odynophagia fever, poor feeding, failure to thrive, and irritability (in children) acute or chronic asthma-like symptoms or recurrent pneumonia signs of sepsis sign of acute drug intoxication age <15 years (...) Foreign body ingestion Foreign body ingestion - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Foreign body ingestion Last reviewed: February 2019 Last updated: November 2018 Summary Foreign body ingestion is a common clinical problem. Those at increased risk include children, older people, people who have an intellectual disability, patients with psychiatric pathologies, prisoners/inmates, and those with underlying

2018 BMJ Best Practice

169. Pulmonary stenosis

pathological systolic ejection murmur with or without a systolic click rheumatic fever dyspnoea fatigue chest pain syncope dysmorphic features of Noonan's syndrome dysmorphic features of LEOPARD syndrome dysmorphic features of Williams' syndrome dysmorphic features of Alagille's syndrome failure to thrive cyanosis signs of right heart failure right ventricular heave systolic thrill black ethnicity Noonan syndrome LEOPARD syndrome Alagille syndrome Williams syndrome congenital rubella syndrome carcinoid (...) testing. Diagnosis confirmed and severity classified by echocardiography. Mild pulmonary stenosis is a benign condition requiring sequential cardiac follow-up but no therapy; prophylaxis for infective endocarditis not recommended. Percutaneous balloon pulmonary valvuloplasty (PBPV) indicated in moderate to severe/critical lesions. Surgical valvotomy reserved for treatment failure and contraindication to PBPV. Definition Pulmonary stenosis (PS) obstructs the blood flow from the right ventricle (RV

2018 BMJ Best Practice

170. Coeliac disease

Coeliac disease Coeliac disease - Symptoms, diagnosis and treatment | BMJ Best Practice   Search  Coeliac disease Last reviewed: February 2019 Last updated: November 2018 Summary Coeliac disease is common, affecting up to 1% of the general population, and may present at any age. Presentation is varied and ranges from diarrhoea and failure to thrive, to iron-deficiency anaemia or osteoporosis. Diagnosis is suggested by positive immunoglobulin A tissue transglutaminase serology, but must (...) , hypertrophy of the intestinal crypts, and increased numbers of lymphocytes in the epithelium and lamina propria. Locally these changes lead to gastrointestinal symptoms and malabsorption. Systemic manifestations are diverse, potentially affecting almost every organ system. History and exam immunoglobulin (IgA) deficiency diarrhoea bloating abdominal pain/discomfort anaemia dermatitis herpetiformis family history osteopenia/osteoporosis fatigue weight loss failure to thrive type 1 diabetes autoimmune

2018 BMJ Best Practice

171. What helps to support people affected by Adverse Childhood Experiences? A Review of Evidence

on adult survivors of child sexual abuse (n=3). Of the studies that focused on young people eight focused predominantly on older adolescents and care leavers (i.e. those aged 16 years or older), seven focused predominantly on senior school-aged children (i.e. those aged 11-16 years) and just two studies included younger participants aged below 11 years. One study on young people did not specify their ages. With regards to ethnicity nine studies did not specify the ethnicity of participants, six (...) on the study aims, participants, key themes and findings. We used thematic synthesis to inductively code, compare and interpret study findings. For the overview of interventions we applied a systematic review of reviews (RoR) methodology to summarise evidence from existing systematic reviews on the effectiveness of any intervention to improve any outcome for people exposed to ACEs in childhood (age 3-18). Data on the prevention of ACEs were not included. We searched 23 database sources for systematic

2019 EPPI Centre

172. The Foyer model for homeless youth: a systematic mapping review

of four have children of dependent age, one of four suffer from a dual disorder of mental disorder and substance abuse, and 17% are young people un- der 25 years old. It can be hard to escape homelessness. Social welfare schemes, particularly social bene- fits, is the most common mechanism of help. Another support service for young people is the Foyer model (program). The Foyer model is a package of accommodation and in- tegrated support to young people aged between 16 and 24, who are homeless (...) , eating disorders, self-harm, and panic attacks. Table 2. Characteristics of the participants in the included studies (n=18) Author, year, country Participants Young people’s needs for support at referral Allen 2001 (24) UK 38 residents (age and gender not reported) Not reported 26 8BResults Number of staff inter- viewed not stated Anderson 1995 (11) UK 519 young people 67% 18-25 years old 83% male, 17% fe- male Number of staff inter- viewed not stated Housing: 15% been in care and 47% had slept rough

2018 Norwegian Institute of Public Health

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

with ICH or qualified levels and packaged to provide a shelf life of at least 2 years. The formulation and manufacturing development for the commercial product / process have been evaluated through the use of risk assessment, prior knowledge and design of experiments to identify the critical product quality attributes (CQAs) and critical process parameters (CPPs). A risk analysis was performed using the failure mode effect analysis (FMEA) method in order to define critical process steps and process (...) ) and critical process parameters (CPPs). A risk analysis was performed using the failure mode effect analysis (FMEA) method in order to define critical process steps and process parameters that may have an influence on the finished product quality attributes. The risk identification was based on the prior knowledge of products with similar formulations and manufacturing processes as well as on the experience from formulation development, process design and scale-up studies. The CQAs and CPPs have been

2018 European Medicines Agency - EPARs

174. Budesonide (Jorveza) - to treat adults with eosinophilic oesophagitis

, corticosteroids acting locally (A07EA06) Therapeutic indication(s): Jorveza is indicated for the treatment of eosinophilic esophagitis (EoE) in adults (older than 18 years of age). Pharmaceutical form(s): Orodispersible tablet Strength(s): 1 mg Route(s) of administration: Oral use Packaging: blister (Alu/Alu) Package size(s): 20 tablets, 30 tablets, 60 tablets, 90 tablets and 100 tablets Assessment report EMA/774645/2017 Page 3/83 Table of contents 1. Background information on the procedure 7 1.1. Submission (...) indication. More information on the COMP’s review can be found in the Orphan maintenance assessment report published under the ‘Assessment history’ tab on the Agency’s website: ema.europa.eu/Find medicine/Human medicines/European public assessment reports. The applicant applied for the following indication: Jorveza is indicated for the treatment of eosinophilic esophagitis (EoE) in adults (older than 18 years of age). The legal basis for this application refers to: Article 8.3 of Directive 2001/83/EC

2018 European Medicines Agency - EPARs

175. Glibenclamide (Amglidia) - Diabetes Mellitus

submitted and the scientific discussion within the Committee, issued a positive opinion for granting a marketing authorisation to Amglidia on 22 February 2017. CHMP assessment report EMA/153558/2018 Page 11/60 2. Scientific discussion 2.1. Introduction Neonatal diabetes is a disease of early infancy due to mutations in the genes coding for the Kir6.2 and SUR1 subunits of the pancreatic ß-cell ATP-sensitive potassium channel which result in failure of insulin secretion. The prevalence of neonatal (...) patients with neonatal diabetes (age 0.1–18.5 years) were enrolled and 18 patients switched from insulin to SU therapy to examine improvement of neuropsychological functioning (Beltrand et al. Diabetes Care, 2015). - a bioavailability study (1AMK1/Glibentek1) comparing pharmacokinetics of glibenclamide crushed tablets versus glibenclamide oral suspension in healthy volunteers (Clinical study report, 2012). - a Phase II, single-centre, prospective, open-label, non-randomised study to evaluate tolerance

2018 European Medicines Agency - EPARs

176. Our data-driven future in healthcare

Our data-driven future in healthcare Our data-driven future in healthcare People and partnerships at the heart of health related technologies November 2018The Academy of Medical Sciences is most grateful to Professor Carol Dezateux CBE FMedSci and to the members of the project steering group for undertaking this project. We thank the Academy’s Officers, Council members and staff, and the external review group, as well as our Fellows and all those who have contributed through the dialogue (...) into practice 52 Annex I. Key background reports on patient data and data-driven technologies in healthcare 56 Annex II. Project steering group 58 Annex III. Organisations consulted for this project 61 Annex IV. Case study 1. Stages of technology development 62 Our data-driven future in healthcare People and partnerships at the heart of health related technologiesExecutive summary New data-driven technologies, powered by novel ways of linking and analysing patient data, are set to transform the way

2018 Academy of Medical Sciences

177. Guidelines for Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa New Zealan

are considered to be young people; those aged 25 years and older are considered to be adults. 45 Tuia i runga Tuia i raro Tuia te hunga tangata Ka rongo te po Ka rongo te ao Tuia te muka tangata i takea mai i Hawaiki nui i Hawaiki roa i Hawaiki pamamao I te hono i wairua Ki te wheiao Ki te ao marama Tihei mauri ora! Tena koutou katoa, i roto i nga tini ahuatanga o te wa. Ki te hunga mate, koutou kua wheturangitia, hoki hoki hoki atu ra. Na koutou tenei hua i para. Waiho ma matou nga roimata e tuku, ma matou (...) and gender affirming care for trans young people significantly improves mental health and wellbeing outcomes. 23 Decisions regarding medical interventions are ideally made collaboratively between the trans young person, their whanau and the health team. However, it is not always possible to involve family. Lack of whanau support does not preclude trans young people from accessing care. While young people aged 16 years and older are considered to be able to make decisions about their medical care (Care

2018 New Zealand Sexual Health Society

178. Effect of the Consumption of a Fermented Milk on Common Infections in Children Aged 3-6 Years, Attending Day Care Centers

known food or respiratory allergy. Subject presenting a severe evolutive or chronic pathology (Ex: cancer, tuberculosis, Crohn disease, cirrhosis, multiple sclerosis, Type I diabetes…) or any past or actual health condition that could interfere with the outcome of the study (Ex: HIV, Chemotherapy, malabsorption, ulcer, celiac disease, failure to thrive…). Subject having experienced any infectious disease during the last 7 days. Subject with current diarrhoea or constipation Subject who (...) Effect of the Consumption of a Fermented Milk on Common Infections in Children Aged 3-6 Years, Attending Day Care Centers Effect of the Consumption of a Fermented Milk on Common Infections in Children Aged 3-6 Years, Attending Day Care Centers - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum

2010 Clinical Trials

179. Open-Label Study of Asfotase Alfa in Infants and Children &#8804; 5 Years of Age With Hypophosphatasia (HPP)

seizures Failure to thrive Onset of symptoms prior to 6 months of age Chronological age or adjusted age for premature infants born ≤ 37 weeks gestation of ≤ 5 years Otherwise medically stable in the opinion of the Investigator and/or Sponsor Exclusion criteria: Patients will be excluded from enrollment in this study if they meet any of the following exclusion criteria: Clinically significant disease that precludes study participation, in the opinion of the Investigator and/or Sponsor Serum calcium (...) Open-Label Study of Asfotase Alfa in Infants and Children ≤ 5 Years of Age With Hypophosphatasia (HPP) Open-Label Study of Asfotase Alfa in Infants and Children ≤ 5 Years of Age With Hypophosphatasia (HPP) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100

2010 Clinical Trials

180. Risk factors for weight faltering in infancy according to age at onset. (Abstract)

Risk factors for weight faltering in infancy according to age at onset. The aim of this study was to identify risk factors for failure to thrive (FTT) or weight faltering according to age of onset. The study is part of a Danish longitudinal population study of early risk mechanisms in child psychiatric disorders, The Copenhagen Child Cohort, which consists of a birth cohort of 6090 children born during the year 2000 and followed prospectively from birth. Weight faltering/FTT was defined as slow (...) conditional weight gain, and divided into subtypes according to age of onset in the first year of life: birth to 2 weeks, 2 weeks to 4 months, and 4-8 months. Regardless of the age of onset, slow weight gain was found to be strongly associated with feeding problems, but the risk factors involved differed according to age of onset. Thus, onset within the first weeks of life clearly differed from faltering later on, the former being strongly associated with low birthweight and gestational age, with single

2010 Paediatric and perinatal epidemiology

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