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193 results for

Failure to Thrive in the Elderly


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161. Edurant - rilpivirine

(type 1, type 3) HOMA-IR homeostasis model assessment insulin resistance HPLC high-performance liquid 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

2011 European Medicines Agency - EPARs

162. World Kidney Day 2011

say about their quality of life with optimal dialysis. Kt/v is less important than a patient's ability to live the life they wish to live. Why are professionals in the kidney community espousing a treatment (<4hrs/3x per week) that few or none would choose for themselves? Personally, I would opt for every other day nocturnal and I am not afraid to say so. Most nephs today are simply not used to dealing with thriving dialysis patients. Sadly, disability has become commonly accepted, but working (...) little resources to provide adequate dialysis. I have come across a number of patients on home hemo and in general they have done well. However, the majority of our patients these days are elderly and frail and are not necessarily suitable for home dialysis. Similarly, there are compliance issues, if a patient is motivated and reliable, then home hemo could be ideal but this is not always the case. That said, I welcome your comments and agree that we could all be doing better. This can only benefit

2011 Renal Fellow Network

163. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines

in infants with regurgitation or vomiting Bilious vomiting Gastrointestinal bleeding Hematemesis Hematochezia Consistently forceful vomiting Onset of vomiting after 6months of life Failure to thrive Diarrhea Constipation Fever Lethargy Hepatosplenomegaly Bulging fontanelle Macro/microcephaly Seizures Abdominal tenderness or distension Documented or suspected genetic/metabolic syndrome 506 NASPGHAN/ESPGHAN PEDIATRIC GER GUIDELINE COMMITTEE J Pediatr Gastroenterol Nutr, Vol. 49, No. 4, October

2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

164. Preventing and Managing Violence in the Workplace

’ Association of Ontario It is with great pleasure that the Registered Nurses’ Association of Ontario (RNAO) releases the Preventing and Managing Violence in the Workplace Healthy Work Environments Best Practice Guideline. This is one of a series of Best Practice Guidelines (BPGs) on Healthy Work Environments (HWEs) developed by the nursing community to date. The aim of these guidelines is to provide the best available evidence to support the creation of healthy and thriving work environments

2009 Registered Nurses' Association of Ontario

166. 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

2015 FP Notebook

167. Pharmacologic-based strategies for smoking cessation: clinical and cost-effectiveness analyses

are often the symptoms of nicotine withdrawal. Nicotine gum 16 : The common brand names are Nicorette and Thrive. It is available in low strength (2 mg) or full strength (4 mg). It is recommended that the gum be chewed slowly for 30 minutes. Most people typically use nine to 12 pieces of gum per day during the first month of treatment. It is recommended that daily use not exceed 24 pieces per day. The dose and duration of therapy may need to be titrated to reflect the nicotine needs and other clinical (...) circumstances of smoking patients. According to the product monograph, the use of this product typically lasts 12 weeks. The reported side effects include mouth, teeth, or jaw problems; headache; heartburn; sweating; diarrhea; dizziness; hiccups; nausea; vomiting; and trouble sleeping. Nicotine lozenge 17 : The common brand names are the Nicorette and Thrive lozenges. The lozenge is supplied in low strength (2 mg) or full strength (4 mg). The use of one piece every one to two hours (minimum of eight

2010 EvidenceUpdates

168. Carglumic acid (Carbaglu)

to 233 µmol/L (normal plasma ammonia = 50 µmol/L). During this same hospitalization, she became febrile and developed pneumonia. She required mechanical ventilation and (b) (b) (6) (b) (6) (b) (6)Clinical Review Virginia Elgin, M.D. and Helen Sile, M.D NDA 22-562/S-000 Carbaglu (carglumic acid) 17 experienced multi-organ system failure with encephalopathy leading to her death. was an 11 year-old female who experienced an acute episode of hyperammonemia (419 µmol/L) in December 2007 as a consequence

2010 FDA - Drug Approval Package

169. Buprenorphine Transdermal System (Butrans)

that the applicant include in the ISS analyses of electrocardiographic intervals. The applicant has analyzed the ECG data and in addition submitted a thorough QT study. Deficiency #59 required information to justify a dose titration interval of three days. This deficiency was resolved prior to this submission when the FDA agreed that three days was an appropriate dose titration interval. Deficiency #60 required a repeat abuse liability study to correct failures in the design of the first study. However (...) 21-306 BuTrans TM (Buprenorphine Transdermal System) 46 patch removal/application information in their diary. Subjects were to have been provided three BTDS 10 patches (2 patches for the 10-day treatment and 1 extra). Subjects were to have worn BTDS 5 for three days. At three days subjects were to have been contacted by the staff and those subjects not able to tolerate BTDS 5 were to have been discontinued from the study and considered Run-in Failure. Subjects able to tolerate BTDS 5 were to have

2010 FDA - Drug Approval Package

170. Vpriv - velaglucerase alfa

) Type 1 GD is the most common subtype affecting an estimated 30,000 people worldwide, and patients display a wide range of symptoms, including splenomegaly, hepatomegaly, anaemia, thrombocytopenia, bone complications. Type 2 GD presents in infancy and is characterised by a rapid neurodegenerative course with widespread visceral involvement. Failure to thrive and stridor due to laryngospasm are commonly observed, and death due to progressive psychomotor degeneration occurs within the first 2 to 3

2010 European Medicines Agency - EPARs

171. Overview of Immunodeficiency Disorders

-linked) Oral candidiasis, Pneumocystis jirovecii pneumonia, diarrhea before 6 mo, failure to thrive, graft vs host disease, absent thymic shadow, lymphopenia, bone abnormalities (in ADA deficiency), exfoliative dermatitis as part of Omenn syndrome* X-linked recessive WASP Typically, pyogenic and opportunistic infections, eczema, thrombocytopenia Possibly GI bleeding (eg, bloody diarrhea), recurrent respiratory infections, cancer (in 10% of patients > 10 yr), varicella-zoster virus infection (...) , herpesvirus infection *Omenn syndrome is an autosomal recessive form of severe SCID causing erythroderma, desquamation, alopecia, chronic diarrhea, failure to thrive, lymphadenopathy, eosinophilia, hepatosplenomegaly, and elevated serum IgE levels. ADA = adenosine deaminase; ATM = ataxia telangiectasia–mutated; DOCK = dedicator of cytokinesis; IL-2RG = IL-2 receptor gamma; JAK = Janus kinase; MHC = major histocompatibility complex; NEMO = nuclear factor–kappa-B essential modulator; PTPRC = protein

2013 Merck Manual (19th Edition)

172. Adverse Drug Reactions

information provided by the manufacturer. Symptoms and signs may manifest soon after the first dose or only after chronic use. They may obviously result from drug use or be too subtle to identify as drug-related. In the elderly, subtle ADRs can cause functional deterioration, changes in mental status, failure to thrive, loss of appetite, confusion, and depression. Table Classification of Adverse Drug Reactions (ADRs) Severity Description Example Mild No antidote or treatment is required; hospitalization (...) , coexisting disorders, genetic or geographic factors) and by drug factors (eg, type of drug, administration route, treatment duration, dosage, bioavailability). Incidence is higher with advanced age and polypharmacy. ADRs are more severe among the elderly (see ), although age per se may not be the primary cause. The contribution of prescribing and to the incidence of ADRs is unclear. Pearls & Pitfalls Adverse drug reactions occur in 10 to 20% of hospitalizations. About 10 to 20% of these reactions

2013 Merck Manual (19th Edition)

173. Vitamin Deficiency, Dependency, and Toxicity - Vitamin A

, severe headache, pseudotumor cerebri, and generalized weakness develop. Cortical hyperostosis of bone and arthralgia may occur, especially in children. Fractures may occur easily, especially in the elderly. In children, toxicity can cause pruritus, anorexia, and failure to thrive. Hepatomegaly and splenomegaly may occur. In carotenosis, the skin (but not the sclera) becomes deep yellow, especially on the palms and soles. Diagnosis Clinical evaluation Diagnosis of vitamin A toxicity is clinical. Blood (...) or treatment for skin disorders). Acute toxicity causes rash, abdominal pain, increased intracranial pressure, and vomiting. Chronic toxicity causes rash, increased intracranial pressure, sparse and coarse hair, dry and rough skin, and arthralgia; risk of fractures is increased, especially in the elderly. Diagnose based on clinical findings. When vitamin A is stopped, symptoms (except birth defects) usually resolve within 1 to 4 wk. Last full review/revision March 2018 by Larry E. Johnson, MD, PhD NOTE

2013 Merck Manual (19th Edition)

174. AIDS

without treatment. for HIV and AIDS per 100,000 inhabitants as of 2004. no data ≤ 10 10–25 25–50 50–100 100–500 500–1000 1,000–2,500 2,500–5,000 5,000–7500 7,500–10,000 10,000–50,000 ≥ 50,000 The primary causes of death from HIV/AIDS are and , both of which are frequently the result of the progressive failure of the immune system. Risk of cancer appears to increase once the CD4 count is below 500/μL. The rate of clinical disease progression varies widely between individuals and has been shown (...) , it became legal for people with AIDS to marry in China. In 2013 the developed a traveling exhibition titled, "Surviving and Thriving: AIDS, Politics, and Culture", covering medical research, U.S. government's response, and personal stories from people with AIDS, caregivers, and activists. Economic impact Main articles: and Changes in life expectancy in some African countries, 1960–2012 HIV/AIDS affects the economics of both individuals and countries. The of the most affected countries has decreased due

2012 Wikipedia

175. Hemoglobin

altitudes, such as those in the mountains. hemoglobin featured mutations that allowed for oxygen delivery at lower temperatures, thus enabling mammoths to migrate to higher latitudes during the . This was also found in hummingbirds that inhabit the Andes. Hummingbirds already expend a lot of energy and thus have high oxygen demands and yet Andean hummingbirds have been found to thrive in high altitudes. Non-synonymous mutations in the hemoglobin gene of multiple species living at high elevations (...) hemoglobin include loss of blood, nutritional deficiency, bone marrow problems, chemotherapy, kidney failure, or abnormal hemoglobin (such as that of sickle-cell disease). The ability of each hemoglobin molecule to carry oxygen is normally modified by altered blood pH or , causing an altered . However, it can also be pathologically altered in, e.g., . Decrease of hemoglobin, with or without an absolute decrease of red blood cells, leads to symptoms of anemia. Anemia has many different causes, although

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2012 Wikipedia

176. Hypertension

with hypertension in newborns and young infants. In older infants and children, hypertension can cause headache, unexplained irritability, , failure to thrive, , , and . Causes [ ] Primary hypertension [ ] Main article: Hypertension results from a complex interaction of genes and environmental factors. Numerous common genetic variants with small effects on blood pressure have been identified as well as some rare genetic variants with large effects on blood pressure. Also, have identified 35 genetic loci related (...) peripheral which may increase , increase cardiac and, ultimately, cause . (the difference between systolic and diastolic blood pressure) is frequently increased in older people with hypertension. This can mean that systolic pressure is abnormally high, but diastolic pressure may be normal or low, a condition termed . The high pulse pressure in elderly people with hypertension or isolated systolic hypertension is explained by increased , which typically accompanies aging and may be exacerbated by high

2012 Wikipedia

177. Soybean

quantities to reach a threshold to provoke actual symptoms. Soy can also trigger symptoms via , a situation where no allergic mechanism can be proven. One scenario is seen in very young infants who have vomiting and when fed soy-based formula, which resolves when the formula is withdrawn. Older infants can suffer a more severe disorder with vomiting, diarrhoea that may be bloody, , weight loss and failure to thrive. The most common cause of this unusual disorder is a sensitivity to cow's milk, but soy

2012 Wikipedia

178. Organ transplantation

medicine. Some of the key areas for medical management are the problems of , during which the body has an to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through to determine the most appropriate donor-recipient match and through the use of . Contents Types of transplant [ ] Autograft [ ] Main article: Autografts are the transplant of tissue to the same person. Sometimes (...) in the 4th century, many decades after their deaths; some accounts have them only instructing living surgeons who performed the procedure. The more likely accounts of early transplants deal with skin transplantation. The first reasonable account is of the Indian surgeon in the 2nd century BC, who used autografted skin transplantation in nose reconstruction, a . Success or failure of these procedures is not well documented. Centuries later, the surgeon performed successful skin autografts; he also failed

2012 Wikipedia

179. Chronic wound

be prevented, the factors may be sequestered and unable to perform their metabolic roles, or degraded in excess by cellular or bacterial proteases. Chronic wounds such as diabetic and venous ulcers are also caused by a failure of to produce adequate ECM proteins and by to epithelialize the wound. Fibroblast gene expression is different in chronic wounds than in acute wounds. Though all wounds require a certain level of elastase and proteases for proper healing, too high a concentration is damaging (...) are less effective. Classification [ ] The vast majority of chronic wounds can be classified into three categories: , , and . A small number of wounds that do not fall into these categories may be due to causes such as or . Venous and arterial ulcers [ ] , which usually occur in the legs, account for about 70% to 90% of chronic wounds and mostly affect the elderly. They are thought to be due to caused by improper function of that exist in the to prevent blood from flowing backward. results from

2012 Wikipedia

180. Pyelonephritis

, or of complications of significant renal damage: Fever Malaise Loin pain Nausea Vomiting Dysuria Hypertension Failure to thrive Features of CKD Investigations Urine microscopy, culture and sensitivity : this may be helpful in identifying the organism involved in recurrent infection but negative urine culture does not exclude diagnosis. Imaging : Renal ultrasound may show small kidneys with a thin cortex. Intravenous pyelogram (IVP) may show small kidneys, ureteric and caliceal dilatation/blunting with cortical (...) recommend admission for pregnant women, due to the risk of complications. [ ] Other indications for admission include: [ ] Severe vomiting. Comorbidity such as diabetes. Signs of sepsis (eg, tachypnoea, tachycardia, hypotension). Dehydration or inability to take fluids/medication. Severe pain or debility. Failure of response to treatment in primary care within 24 hours. [ ] Urinary tract obstruction. Oliguria or anuria. Suspected complications (see 'Complications', below). Uncertain diagnosis. Social

2008 Mentor

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