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Medication Causes of Dyspepsia

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181. Miglustat (Yargesa) - Gaucher Disease

is an autosomal recessive disorder caused by mutations in the GBA (glucosidase, beta, acid) gene (on chromosome 1q21) which results in a deficiency of the lysosomal enzyme beta-glucocerebrosidase. Beta- glucocerebrosidase is an enzyme that helps break down a large molecule called glucocerebroside (=glucosylceramide) into a sugar (glucose) and a simpler fat molecule (ceramide). This enzymatic deficiency results in an accumulation of glucocerebroside, primarily in macrophages, in the liver, spleen, bone marrow (...) of the root cause was conducted and as a result the manufacturing process was modified accordingly as discussed previously. No significant changes to any of the measured parameters were observed under either storage condition and all remained within specification. The active substance was subjected to induced degradation under the following stress conditions: hydrolytic and oxidative degradation, thermal degradation, photolytic degradation with UV light and photolytic degradation with sun light. It has

2017 European Medicines Agency - EPARs

182. The Cytosponge: An Alternative to Endoscopy in Detecting Barrett Esophagus

Practice As BE does not cause symptoms, most patients are being investigated for symptoms of gastroesophageal reflux or dyspepsia (indigestion, nausea, bloating, or upper abdominal pain). 20 The evidence on the benefits of screening for BE is currently unclear, but both US and UK guidelines recommend screening patients with chronic gastroesophageal reflux and other risk factors. 18,26 Endoscopy (upper gastrointestinal endoscopy or gastroscopy) with sedation, followed by tissue biopsy, is the standard (...) of BE: Trefoil factor 3 (TFF3). 6,11,13,14 Regulatory Status The Cytosponge does not have Health Canada licencing approval and when it may become available in Canada is not yet known. The Cytosponge has a CE Marking, which allows it to be marketed in Europe, 15 and received United States (US) Food and Drug Administration 510(k) approval as a Class II device in 2014. 16 The sponge was developed by a United Kingdom (UK) research group at the University of Cambridge/Medical Research Council (MRC) and is now

2015 CADTH - Issues in Emerging Health Technologies

183. Vagal Nerve Blockade for Obesity: VBLOC Therapy Using the Maestro RC2 Device

% of the population in developed countries could be overweight, with more than 22.0% potentially being considered obese. 32 Obesity-related conditions such as hypertension, stroke, cardiovascular disease, dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, obstructive sleep apnea, mood and self-esteem difficulties, osteoarthritis, and increased cancer risk are leading causes of morbidity, decreased life expectancy, and preventable death in developing countries. 2,9,33-36 Moreover, in 2011, the risk (...) , electrically powered medical device, or gastrointestinal device or prosthesis (e.g., pacemaker, implanted defibrillator, neurostimulator) Patients for whom shortwave, microwave, or therapeutic ultrasound diathermy (treatment using high- frequency electromagnetic radiation, electric currents, or ultrasonic waves to produce heat in body tissues) is planned To conduct a 5-year post- approval study to collect follow-up effectiveness and safety data (e.g., weight loss, adverse events, surgical revisions

2015 CADTH - Issues in Emerging Health Technologies

184. The Agenda for Familial Hypercholesterolemia (PubMed)

Disease in the Young, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, and Council on Lifestyle and Cardiometabolic Health Originally published 28 Oct 2015 Circulation. 2015;132:2167–2192 You are viewing the most recent version of this article. Previous versions: Introduction Familial hypercholesterolemia (FH) is an autosomal-dominant genetic disease present in all racial and ethnic groups and has long been recognized as a cause of premature (...) atherosclerotic coronary heart disease. Heterozygous FH has the highest prevalence of genetic defects that cause significant premature mortality (≈1:200 to 1:500 or higher in founder populations). The genetic basis of the disorder, impaired functioning of the low-density lipoprotein (LDL) receptor, was first recognized by Goldstein and Brown in their Nobel Prize–winning work. Studies of LDL receptor function have identified additional mechanisms for the pathogenesis of FH (defects in apolipoprotein [apo] B

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2015 American Heart Association

185. The Cytosponge: An Alternative to Endoscopy in Detecting Barrett Esophagus

Practice As BE does not cause symptoms, most patients are being investigated for symptoms of gastroesophageal reflux or dyspepsia (indigestion, nausea, bloating, or upper abdominal pain). 20 The evidence on the benefits of screening for BE is currently unclear, but both US and UK guidelines recommend screening patients with chronic gastroesophageal reflux and other risk factors. 18,26 Endoscopy (upper gastrointestinal endoscopy or gastroscopy) with sedation, followed by tissue biopsy, is the standard (...) of BE: Trefoil factor 3 (TFF3). 6,11,13,14 Regulatory Status The Cytosponge does not have Health Canada licencing approval and when it may become available in Canada is not yet known. The Cytosponge has a CE Marking, which allows it to be marketed in Europe, 15 and received United States (US) Food and Drug Administration 510(k) approval as a Class II device in 2014. 16 The sponge was developed by a United Kingdom (UK) research group at the University of Cambridge/Medical Research Council (MRC) and is now

2015 CADTH - Issues in Emerging Health Technologies

186. Vagal Nerve Blockade for Obesity: VBLOC Therapy Using the Maestro RC2 Device

% of the population in developed countries could be overweight, with more than 22.0% potentially being considered obese. 32 Obesity-related conditions such as hypertension, stroke, cardiovascular disease, dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, obstructive sleep apnea, mood and self-esteem difficulties, osteoarthritis, and increased cancer risk are leading causes of morbidity, decreased life expectancy, and preventable death in developing countries. 2,9,33-36 Moreover, in 2011, the risk (...) , electrically powered medical device, or gastrointestinal device or prosthesis (e.g., pacemaker, implanted defibrillator, neurostimulator) Patients for whom shortwave, microwave, or therapeutic ultrasound diathermy (treatment using high- frequency electromagnetic radiation, electric currents, or ultrasonic waves to produce heat in body tissues) is planned To conduct a 5-year post- approval study to collect follow-up effectiveness and safety data (e.g., weight loss, adverse events, surgical revisions

2015 CADTH - Issues in Emerging Health Technologies

187. Treatment of Idiopathic Pulmonary Fibrosis: An Official ATS/ERS/JRS/ALAT Guideline

of contents at www.atsjournals.org Am J Respir Crit Care Med Vol 192, Iss 2, pp e3–e19, Jul 15, 2015 Copyright© 2015 by the American Thoracic Society DOI: 10.1164/rccm.201506-1063ST Internet address: www.atsjournals.org American Thoracic Society Documents e3Question 6: Should Patients with IPF Be Treated with Pirfenidone? Question 7: Should Patients with IPF Be Treated with Antiacid Medication? Question 8: Should Patients with IPF Be Treated with Sildena?l, a Phosphodiesterase-5 Inhibitor? Question 9 (...) , but decisionsregardingarecommendationwere deferred until the next version of the guideline to gather additional information that was felt necessary before formulating a recommendation. Questions regarding newertreatments(e.g.,antibiotics)werenot addressed and were deferred until the next version of the guideline because of resource constraints. Introduction IPFisaspeci?cformofchronic,progressive ?brosinginterstitialpneumoniaofunknown cause occurring in adults. Radiologic and/or histopathologic patterns are consistentwith usual

2015 American Thoracic Society

188. Irritable Bowel Syndrome (IBS)

as being relevant to IBS [1]. • A transition of IBS to, and overlap with, other symptomatic gastrointestinal disorders (e.g., gastroesophageal reflux disease, dyspepsia, and functional constipation) may occur. • The condition usually causes long-term symptoms: — These may occur in episodes. — Symptoms vary and are often associated with food intake and, characteristically, with defecation. — Symptoms interfere with daily life and social functioning in many patients. — Symptoms sometimes seem to develop (...) for nongastrointestinal symptoms • History of previous medically unexplained symptoms • Aggravation after meals • Associated anxiety and/or depression Noncolonic complaints that often accompany IBS: • Dyspepsia—reported in 42–87% of IBS patients • Nausea • Heartburn Associated non-gastrointestinal symptoms: • Lethargy, fatigue • Backache and other muscle and joint pains • Fibromyalgia • Headache © World Gastroenterology Organization, 2015 WGO Global Guidelines IBS 13 • Urinary symptoms: — Nocturia — Frequency

2015 World Gastroenterology Organisation

189. Gastroesophageal Reflux Disease (GERD)

uninvestigated dyspepsia, eradication therapy has been found to be associated with a lower prevalence of reflux-like symptoms (36%) than control therapy (49%) [53]. • A subgroup of patients infected with more proinflammatory strains of H. pylori (virulence factors vacA and cagA) may be less likely to have severe esophagitis or BE. This may be because infection in these patients more often causes severe corpus gastritis with atrophy, resulting in reduced acid output. However, these patients are at much (...) -centered and, more importantly, is likely not to be cost-effective. • WGO Cascades are thus context-sensitive, and the context is not necessarily defined solely by resource availability. A standardized global approach would require that the epidemiology of GERD and reflux-like symptoms be comparable in all parts of the world, and that the full ranges of diagnostic tests and medical treatment options be generally available. However, neither the epidemiology of the condition, nor the availability

2015 World Gastroenterology Organisation

190. Are We Overusing Proton Pump Inhibitors?

to the FDA approval of over-the-counter omeprazole (Prilosec-OTC) in 2010, more individuals have access to PPIs. Advertised as “on-demand” relief medication for people with frequent heartburn, Prilosec-OTC has a label warning against its use for more than 14 days. What is troubling with this message is that it may promote chronic on-and-off usage, which is not optimal, given that PPIs take several days to take maximal effect and can cause rebound acid reflux when stopped abruptly. Hence, over-the-counter (...) overutilization in the medical setting, as exemplified by the patient case above. However, PPI use can have potentially serious medical consequences, including an increased risk of infections, malabsorption, and adverse drug-drug interactions. Physicians use empiric PPI therapy to diagnose GERD, one of the most common gastrointestinal diseases. If symptoms improve with empiric therapy, PPIs are then continued, often indefinitely, though it may be possible to step down to acid suppression with H-2 blockers

2015 Clinical Correlations

191. Clinical Practice Guideline on the Management of Depression in Adults

CPG is an aid to decision-making in health care. It is not mandatory to comply with it, nor does it replace the clinical judgment of medical staff. Edition: 2014 Edited by: Galician Agency for Health Technology Assessment, avalia-t, Ministry of Health; Ministry of Health, Social Services and Equality. NIPO MSSSI: 680-14-079-0 Copyright: pending Layout: Tórculo Comunicación Gráfica, SAThis CPG has been financed through the collaboration agreement signed by the Carlos III Health Institute (...) and implementation 163 12.1. Diffusion and dissemination 163 12.2. Implementation of the CPG through integration into the electronic medical record 164 12.2.1. Benefits of Clinical Decision Suppor t Systems in depression 165 12.2.2. Selection of content or recommendations to integrate into the information system 166 12.2.3. National and international experiences in implementing depression guidelines via CDSS 167 13. Future research lines 169 Annexes 173 Annex 1. Criteria for severity/progress specifiers

2015 GuiaSalud

192. Acute Pain Management: Scientific Evidence

was the “Declaration of Montreal”, which called for “access to pain management as a fundamental human right” (Cousins 2011). This included the management of acute pain. This fourth edition sums up the evidence currently available to assist health professionals in the management of acute pain. Additional literature has been reviewed from August 2009 to August 2014. Levels of evidence have been documented according to the National Health and Medical Research Council (NHMRC) designation ( NHMRC 1999). The Jadad (...) scoring instrument was used to score the quality of all randomised controlled trials (RCTs) (Jadad 1996). Key iv Acute Pain Management: Scientific Evidence messages for each topic are specified with the highest level of evidence available to support them, or with a symbol showing that they are based on clinical experience or expert opinion. The volume of medical knowledge is doubling every 8 years (Carroll 2011). Such was the enormity of the challenge faced by Prof Stephan Schug and the other members

2015 Clinical Practice Guidelines Portal

193. Salazopyrine (A07EC01 (intestinal anti-inflammatory agents)) - Ulcerative colitis, Crohn's disease in the colon, Rheumatoid arthritis

Salazopyrine (A07EC01 (intestinal anti-inflammatory agents)) - Ulcerative colitis, Crohn's disease in the colon, Rheumatoid arthritis HAS - Medical, Economic and Public Health Assessment Division 1/15 The legally binding text is the original French version T TR RA AN NS SP PA AR RE EN NC CY Y C CO OM MM MI IT TT TE EE E Opinion 23 July 2014 SALAZOPYRINE 500 mg, tablet Bottle of 100 tablets - CIP code: 322 688-0 Applicant: PFIZER INN Sulfasalazine ATC Code (2014) A07EC01 (intestinal anti (...) -inflammatory agents) Reason for the review Renewal of inclusion List concerned National Health Insurance (French Social Security Code L.162-17) Indications concerned "Gastroenterology: Ulcerative colitis: treatment of attacks and prevention of relapses. Crohn's disease in the colon. Rheumatology: Rheumatoid arthritis." HAS - Medical, Economic and Public Health Assessment Division 2/15 01 ADMINISTRATIVE AND REGULATORY INFORMATION Marketing Authorisation (national procedure) Date initiated: 31 March 1992

2015 Haute Autorite de sante

195. 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes

Estimation of Risk e355 3.3.2.4. Electrocardiogram e355 3.3.2.5. Physical Examination e357 3.4. Cardiac Biomarkers and the Universal Definition of MI: Recommendations e357 3.4.1. Biomarkers: Diagnosis e357 3.4.2. Biomarkers: Prognosis e357 3.4.3. Cardiac Troponins e357 3.4.3.1. Prognosis e358 3.4.4. CK-MB and Myoglobin Compared With Troponin e359 3.5. Immediate Management e359 3.5.1. Discharge From the ED or Chest Pain Unit: Recommendations e359 Early Hospital Care e359 4.1. Standard Medical Therapies (...) e360 4.1.1. Oxygen: Recommendation e360 4.1.2. Anti-Ischemic and Analgesic Medications e360 4.1.2.1. Nitrates: Recommendations e360 4.1.2.2. Analgesic Therapy: Recommendations e361 4.1.2.3. Beta-Adrenergic Blockers: Recommendations e362 4.1.2.4. Calcium Channel Blockers: Recommendations e362 4.1.2.5. Other Anti-Ischemic Interventions e363 4.1.2.6. Cholesterol Management e363 4.2. Inhibitors of the Renin-Angiotensin-Aldosterone System: Recommendations e363 4.3. Initial Antiplatelet/Anticoagulant

2014 American Heart Association

196. Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement

in the trial. We propose to track the change in quality that these guidelines may produce in published trials testing infertility treatments. Our ultimate goal is to increase the transparency of bene?ts and risks of infertility treatments to provide better medical care to affected individuals and couples. (Fertil Steril 2014;102:952-9.2014 by American Society for Reproductive Medicine.) Key Words: Infertility trial, CONSORT, reporting, IMPRINT, modi?cation Discuss: You candiscuss thisarticlewithits (...) history, and cause of infertility in women and men. Numbers analyzed 16 For each group, number of participants (denominator) included in each analysis and whether the analysis was by original assigned groups The preferred unit of analysis is per randomized individual/couple (not cycles or oocytes/embryos) for a speci?ed period of time (preferably displayedwithlifetableanalysis).Ifper-cycleanalysisisused,itshould bejusti?edandmustaccountforindividualsreceivingmultiplecycles

2014 Society for Assisted Reproductive Technology

197. The Non-Surgical Management of Hip & Knee Osteoarthritis (OA)

and/or therapeutic interventions within these guidelines does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor. Version 1.0 – 2014 Prepared by: THE NON-SURGICAL MANAGEMENT OF HIP & KNEE OSTEOARTHRITIS Working Group With support from: The Office of Quality and Performance, VA, Washington, DC & Office of Evidence Based Practice, US Army Medical Command Version 1.0 (...) duty US Service Members between 1999 and 2008 where they concluded that rates of OA were “significantly higher in military populations than in comparable age groups in the general population.” Severe OA of the hip and knee causes debilitating pain and is a common cause of mobility impairment in elderly patients. [2] The Department of Veterans Affairs (VA) and Department of Defense (DoD) have an obligation to ensure that all patients with OA receive a full range of high quality care. This clinical

2014 VA/DoD Clinical Practice Guidelines

198. Management of Obesity and Overweight

Nutritional Concerns 15 2 Appendix L: Participant List 15 6 References 15 8 Page 5 of 17 8 Executive Summary Obesity and associated chronic health conditions cause significant morbidity and negatively impact military readiness. Sixty-one to 83% of Department of Defense (DoD) beneficiaries and 78% of Veterans are overweight or obese, and excess weight is estimated to cost at least $370 per patient per year in additional medical and non-medical costs. Treatment of both overweight and obesity is consistent (...) associated with increased all-cause mortality, which in turn results in increased direct and indirect healthcare costs. A 2004 estimate found that obesity accounted for $190 billion annually or 21% of the overall US healthcare costs. [17] The CDC cites another study that estimates health costs attributed to overweight and obesity may be upwards of $78.5 billion. [18] Regarding the VA and DoD populations, the estimated direct medical costs of obesity among TRICARE Prime enrolled beneficiaries was $1.1

2014 VA/DoD Clinical Practice Guidelines

199. Pharmacologic Therapy for Pulmonary Arterial Hypertension in Adults

the University of Pennsylvania (Drs Taichman and Palevsky), Philadelphia, P A; CHEST (Mr Ornelas and Dr Lewis), Glenview , IL; Stanford University and Palo Alto V A Health Care System (Dr Chung), Palo Alto, CA; Brown University (Dr Klinger), Providence, RI; the Uni- versity of California (Dr Mandel), San Diego, CA; the University of Chi- cago (Dr Rich), Chicago, IL; Ohio State University (Dr Sood), Columbus, OH; Columbia University Medical Center (Dr Rosenzweig), New Y ork, NY; Yale University (Dr Trow), New (...) or the presence of a known mutation placing the patient at risk for P AH) be monitored for the development of symptoms of P AH (Grade CB) . 6. We suggest also that contributing causes of PH (eg, sleep apnea and systemic hypertension) in patients with PAH be treated aggressively (Grade CB) . Symptomatic Patients With PAH Vasoreactivity Testing and Use of Calcium Channel Blockers 7. We suggest that patients with P AH, in the absence of contraindications, should undergo acute vasoreactivity testing using a short

2014 American College of Chest Physicians

200. The Management of Dyslipidemia for Cardiovascular Risk Reduction (Lipids)

be that they are based on data that were collected before the recent significant improvement in clinical care and prevention for CVD, when the overall population was at higher risk of events or death from CVD causes. Another limitation of risk calculators is that they provide an average risk or probability and cannot precisely predict whether an individual patient will develop a CVD event or benefit from medications. They can, however, be useful to discuss CVD risks and potentials for harm or benefit from (...) : Participant List 105 References 106 December 2014 Page 3 of 112 Background Cardiovascular disease (CVD) is a major cause of morbidity and mortality in the United States (US) and globally. In Western countries, most CVD is due to atherosclerosis. [1] Atherosclerosis is the buildup of plaque (cholesterol, proteins, calcium and inflammatory cells) in the walls of arteries that carry oxygenated blood to the heart and other parts of the body. This plaque narrows the opening of the arteries, limiting the flow

2014 VA/DoD Clinical Practice Guidelines

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