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Hepatotoxic Medication

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121. Pre-emptive compared with empirical antifungal strategies for invasive Aspergillus infection

current diagnostic methods have poor sensitivity and can be slow, overuse of empirical antifungal therapies in this clinical setting is a significant problem which exposes patients to potential harms of treatment from which they derive no benefit. Resistance to antifungal medications is emerging as a serious threat. Our review assesses whether pre-emptive antifungal strategies incorporating novel biomarker tests could potentially address these issues. What was our approach? We produced an evidence (...) medications. ? There is no strong evidence that these potential benefits can be attained without adverse effects on mortality, meaning that there is substantial uncertainty surrounding the safety of pre-emptive strategies. ? Cost-effectiveness evidence is subject to similar issues of heterogeneity, and the applicability of some economic analyses to the UK context may be limited. ? One Australian economic study reported a non-significant difference in costs between a pre-emptive diagnostic-driven strategy

2019 SHTG Advice Statements

122. BSG consensus guidelines on the management of inflammatory bowel disease in adults

0SF, UK 31. University of Glasgow, Glasgow, G12 8QQ, UK 32. Queen Elizabeth Hospital Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK 33. University of Birmingham, Birmingham, B15 2TT, UK 34. University College London, London, WC1E 6BT, UK 35. University College London Hospitals NHS Foundation Trust, London, NW1 2PG, UK 36. Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE, UK 37. Brighton and Sussex Medical School, Brighton, BN1 9PX, UK 38. Royal Wolverhampton NHS (...) manuscript 10 Version accepted by Gut 10 th June 2019 4.7 Stricturing disease 90 4.7.1 Medical therapy for strictures 90 4.7.2 Surgical therapy for strictures 90 4.7.3 Strictureplasty 91 4.7.4 Endoscopic therapy for strictures 92 4.8 Non-perianal fistulising Crohn’s disease and abscesses 93 4.8.1 Intra-abdominal abscesses 93 4.8.2 Medical therapy 93 4.8.3 Enterovaginal and enterovesical fistulae 94 4.8.4 Enteroenteric fistulae 94 4.8.5 Enterocutaneous fistulae 95 4.8.6 Anti-TNF therapy for non-perianal

2019 British Society of Gastroenterology

124. Lenvatinib (Lenvima) - for the treatment of adult patients with advanced or unresectable hepatocellular carcinoma

of administration. Treatment should continue as long as clinical benefit is observed or until unacceptable toxicity occurs. Optimal medical management (ie treatment or therapy) for nausea, vomiting, and diarrhoea should be initiated prior to any lenvatinib therapy interruption or dose reduction; gastrointestinal toxicity should be actively treated in order to reduce the risk of development of renal impairment or failure. Treatment should be initiated and supervised by a health care professional experienced (...) more commonly in the lenvatinib group included hypothyroidism (16% versus 1.7%) and vomiting (16% versus 7.6%). 3 Concomitant anti- hypertensive medication was taken by 73% and 68% of patients in the lenvatinib and sorafenib groups respectively. Levothyroxine was given to more patients in the lenvatinib group, 14% compared with 4.6% in the sorafenib group. 2 The European Medicines Agency (EMA) noted that the incidence of hepatic-related serious adverse events and hepatic-related deaths was higher

2019 Scottish Medicines Consortium

126. An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of PCOS in Adolescence

of UPMC, Pittsburgh, PA, USA e University of Michigan, MSRBII, Ann Arbor, MI, USA f Department of Reproductive Medicine, UCSD School of Medicine, La Jolla, CA, USA g Institute of Maternal and Child Research, University of Chile, School of Medicine, Santiago, Chile h Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India i Istanbul Tıp Fakültesi, Çocuk Kliniği, Istanbul, Turkey j Ain Shams University, Cairo, Faculty of Medicine, Cairo, Egypt k Department (...) of Medical and Surgical Sciences, University of Bologna, Bologna, Italy l Division of Women, Youth and Children, Australian National University, Canberra, ACT, Australia m Department of OBGYN, University of Rochester Medical Center, Rochester, NY, USA n Pediatric Endocrinology, Hospital de Girona Dr. Josep Trueta, Girona, Spain o MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom p The University of Adelaide and Robinson

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2019 Pediatric Endocrine Society

127. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics

Menter Affiliations Baylor Scott and White, Dallas, Texas , MD ((Co-Chair)) a , x Bruce E. Strober Affiliations University of Connecticut, Farmington, Connecticut Probity Medical Research, Waterloo, Ontario, Canada , MD, PhD b , c , x Daniel H. Kaplan Affiliations University of Pittsburgh, Pittsburgh, Pennsylvania , MD, PhD d , x Dario Kivelevitch Affiliations Baylor Scott and White, Dallas, Texas , MD a , x Elizabeth Farley Prater Affiliations University of Oklahoma Health Sciences Center, Oklahoma (...) Clinic, Rochester, Minnesota , MD j , x Boni E. Elewski Affiliations University of Alabama, Birmingham, Alabama , MD h , x Joel M. Gelfand Affiliations University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania , MD, MSCE k , x Kenneth B. Gordon Affiliations Medical College of Wisconsin, Milwaukee, Wisconsin , MD l , x Alice B. Gottlieb Affiliations Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York , MD, PhD m , x Arthur Kavanaugh Affiliations

2019 American Academy of Dermatology

128. WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents

interests were managed 104 ANNEX 5: OPIOID ANALGESICS AND INTERNATIONAL CONVENTIONS 105 United Nations drug conventions and their governance system 105 The Single Convention on Narcotic Drugs and opioid analgesics 106 Drug misuse versus patient need 107 Competent national authorities under the international drug control treaties 108 The Convention’s requirements for national estimates of medical need for opioids 108 The importance of reliable estimates 109 Domestic manufacture of strong opioid (...) Prevention; the Department of Essential Medicines and Health Products; the Department of Service Delivery and Safety; the Department of Mental Health and Substance Abuse; and the Eastern Mediterranean Regional Office, Department of Noncommunicable Disease Management. These departments were represented on the WHO Steering Group for the Medical Management of Cancer Pain in Adults and Adolescents Guidelines. Responsible technical officer: Dr Cherian Varghese WHO Steering Group members: Marie-Charlotte

2019 World Health Organisation Guidelines

129. Recurrent Uncomplicated Urinary Tract Infections in Women

Retroperitoneum Cytology Online Learning For Medical Students Exams/LLL/Certifications Exam Prep Research Research Funding AUA Funding Research Education & Events Online Research Education Courses Research Resources Biorepositories and Other Resources Research Publications Research Career Opportunities Advocacy Scholar & Fellowship Programs Comment Letters & Resources International International Opportunities Annual Meeting Membership Collaborations Academic Exchanges Giving Back Practice Resources Coding (...) or may not be evidence in the medical literature. Expert Opinion refers to a statement, achieved by consensus of the Panel, that is based on members' clinical training, experience, knowledge, and judgment for which there is no evidence. Table 2: AUA Nomenclature Linking Statement Type to Level of Certainty, Magnitude of Benefit or Risk/Burden, and Body of Evidence Strength Evidence Strength A (High Certainty) Evidence Strength B (Moderate Certainty) Evidence Strength C (Low Certainty) Strong

2019 American Urological Association

130. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils (...) or anatomic airway abnormalities that might increase the potential for airway obstruction, a clear understanding of the medication’s pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of appropriately trained staff to both carry out the procedure and monitor

2019 American Academy of Pediatrics

131. Hepatic steatosis

discomfort pruritus jaundice spider angioma palmar erythema nail changes Dupuytren's contracture bruising petechiae excoriations gynaecomastia parotid gland enlargement testicular atrophy alopecia caput medusae Cruveilhier-Baumgarten murmur peripheral oedema ascites low blood pressure hepatic encephalopathy fetor hepaticus haematemesis melaena obesity insulin resistance or diabetes dyslipidaemia hypertension metabolic syndrome rapid weight loss hepatotoxic medications total parenteral nutrition (TPN (...) abdominal MRI oesophogastroduodenoscopy (OGD) EEG portal venous pressure measurements liver biopsy elastography cytokeratin-18 fragments Treatment algorithm ONGOING Contributors Authors Assistant Professor of Medicine Division of Gastroenterology, Hepatology and Nutrition Associate Program Director Transplant Hepatology Fellowship Program Department of Medicine University of Pittsburgh Medical Center Pittsburgh PA Disclosures SMM declares that he has no competing interests. Professor of Medicine Medical

2017 BMJ Best Practice

132. Kaiser Permanente National Dyslipidemia Clinician Guide

: ? Reinforce medication adherence; ? Reinforce adherence to intensive lifestyle changes; and ? Exclude secondary causes of hyperlipidemia. ? Consider using the following indicators of anticipated therapeutic response to the recommended intensity of statin therapy. Focus is on the intensity of the statin therapy. As an aid to monitoring: ? High-intensity statin therapy generally results in an average LDL–C reduction of = 50% from the untreated baseline. ? Moderate-intensity statin therapy generally results (...) pattern, engage Cardiovascular Risk and Dyslipidemia Management Clinician Guide | SEPTEMBER 2017 ©2017 Kaiser Permanente Care Management Institute 9 in physical activity, achieve and maintain a healthy body weight, cease tobacco use, and continue statin therapy to reduce their risk of ASCVD events. ? For adults taking any dose of statins, consider using caution in those aged >75 years and in those taking concomitant medications that alter drug metabolism, multiple drugs, or drugs for conditions

2017 Kaiser Permanente National Guideline Program

133. Be Careful, Mom and Doc: Hepatotoxicity Associated with Prescribed Medications in Young Infants (PubMed)

Be Careful, Mom and Doc: Hepatotoxicity Associated with Prescribed Medications in Young Infants Accidental poisonings in young infants are relatively uncommon, and the careless caregiver is usually the culprit. We report two cases of hepatotoxicity due to prescribed medications. An infant was given 15 mL instead of 1.5 mL of paracetamol by his mother because she omitted the decimal point on the label of the drug bottle. The infant became symptomatic, and liver enzyme and clotting profile were

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2009 International journal of pediatrics

134. CRACKCast Episode 148 – Acetaminophen

testing Give the antidote = NAC when appropriate. Its all about the nomogram! Don’t forget about the differential diagnosis! In patients with elevated Liver enzymes / abnormal liver function and with or without Renal failure, think: acute tubular necrosis Rhabdomyolysis ischemic hepatitis alcoholic hepatic disease cyclopeptide-containing mushroom toxicity (eg Amanita Phalloides) viral hepatitis Wilson disease, other hepatic toxicities (eg, valproic acid, isoniazid [INH], statins, herbal medications (...) NAC diluted in 200 ml of 5% dextrose IV over 15-60 minutes. Followed by: 50 mg/kg NAC diluted in 500 ml of 5% dextrose IV over 4 hours. Followed by: 100 mg /kg NAC diluted in 1000 ml of 5% dextrose IV over 16 hours. (depending on amount ingested, sometimes the final infusion rate is doubled) If further doses of NAC are required e.g. for late presentations, repeated supra therapeutic ingestion or biochemical evidence of hepatotoxicity then repeat the final dose. For adults this is a: repeat

2018 CandiEM

135. Erectile Dysfunction

Erectile Dysfunction Erectile Dysfunction (ED) Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning For Medical Students Exams/LLL/Certifications Exam (...) is the cornerstone of the treatment and management of ED, a model that relies on the concepts of autonomy and respect for persons in the clinical encounter. It is also a process in which the patient and the clinician together determine the best course of therapy based on a discussion of the risks, benefits and desired outcome. Using this approach, all men should be informed of all treatment options that are not medically contraindicated to determine the appropriate treatment. Although many men may choose

2018 American Urological Association

136. BSG and UKPBC primary biliary cholangitis treatment and management guidelines

of several pathways 13 Hirschfield GM, et al. Gut 2018;0:1–27. doi:10.1136/gutjnl-2017-315259 Guidelines leading to bile acid synthesis. 162 It is important for practising clinicians to take clinical note that, while there is long-standing interest regarding these agents in cholestatic liver disease, in the UK drug labelling has documented contraindication to their use in PBC because of concerns over reported hepatotoxicity. Fibrates at high dose inhibit some CYP enzymes, in particular CYP2C9

2018 British Society of Gastroenterology

137. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy

, TX; Jeffrey M. Caterino, The Ohio State University Wexner Medical Center, Columbus, OH; Ian Chau, The Royal Marsden Hospital and Institute of Cancer Research, London and Surrey, United Kingdom; Marc S. Ernstoff and Igor Puzanov, Roswell Park Cancer Institute, Buffalo; Bianca D. Santomasso and Jedd D. Wolchok, Memorial Sloan Kettering Cancer Center; Jeffrey S. Weber, New York University Langone Medical Center, New York, NY; Pamela Ginex, Oncology Nursing Society, Pittsburgh, PA; Jennifer M (...) . Gardner, Seattle Cancer Care Alliance and University of Washington, Seattle, WA; Sigrun Hallmeyer, Oncology Specialists SC, Park Ridge, IL; Jennifer Holter Chakrabarty, University of Oklahoma, Stephenson Cancer Center, Oklahoma City, OK; Natasha B. Leighl, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; David F. McDermott, Beth Israel Deaconess Medical Center; Carole Seigel, Massachusetts General Hospital Cancer Center, Boston, MA; John A. Thompson, Seattle Cancer Care Alliance, University

2018 American Society of Clinical Oncology Guidelines

138. Erectile Dysfunction

treatment options that are not medically contraindicated to determine the appropriate treatment. Although many men may choose to begin with the least invasive option, the Panel notes that it is valid for men to begin with any type of treatment, regardless of invasiveness or reversibility. Men also may choose to forego treatment. In each scenario, the clinician’s role is to ensure that the man and his partner have a full understanding of the benefits and risks/burdens of the various management strategies (...) ) Copyright © 2018 American Urological Association Education and Research, Inc.® Guideline Statements: Evaluation and Diagnosis: 1. Men presenting with symptoms of ED should undergo a thorough medical, sexual, and psychosocial history; a physical examination; and selective laboratory testing. (Clinical Principle) 2. For the man with ED, validated questionnaires are recommended to assess the severity of ED, to measure treat- ment effectiveness, and to guide future management. (Expert Opinion) 3. Men should

2018 American Urological Association

139. Targeted Immunomodulators for the Treatment of Moderate-to-Severe Plaque Psoriasis: Effectiveness and Value

Immunomodulators for Plaque Psoriasis | Condition Update About ICER The Institute for Clinical and Economic Review (ICER) is an independent non-profit research organization that evaluates medical evidence and convenes public deliberative bodies to help stakeholders interpret and apply evidence to improve patient outcomes and control costs. The funding for this report comes from government grants and non-profit foundations, with the largest single funder being the Laura and John Arnold Foundation. No funding (...) . New England CEPAC seeks to help patients, clinicians, insurers, and policymakers interpret and use evidence to improve the quality and value of health care. The New England CEPAC is an independent committee of medical evidence experts from across New England, with a mix of practicing clinicians, methodologists, and leaders in patient engagement and advocacy. All Council members meet strict conflict of interest guidelines and are convened to discuss the evidence summarized in ICER reports and vote

2018 California Technology Assessment Forum

140. Comprehensive Systematic Review Summary: Disease-modifying Therapies for Adults with Multiple Sclerosis

, MO 3. Departments of Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada 4. Department of Neurology, Mayo Clinic, Rochester, MN 5. UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco 6. Department of Neurology, Kansas University Medical Center, Kansas City 7. Department of Neurology, School of Medicine, University of Louisville, KY 8. Consortium (...) California Permanente Medical Group, Kaiser, Los Angeles 14. National Multiple Sclerosis Society, Arlington, VA 15. National Multiple Sclerosis Society, New York, NY 16. Santa Fe, NM 17. Heart Rhythm Society, Washington, DC 18. American Academy of Neurology, Minneapolis, MN 19. Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada 2 Acknowledgment The authors acknowledge the North American Research

2018 American Academy of Neurology

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