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Medication Causes of Dyspepsia

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61. Istradefylline (Nourianz) - Parkinson's disease

of a dose response in Pools 1 and 8. The most frequent AEs causing discontinuation belonged to the groupings Nausea/Vomiting and Psychosis/Delusions/Hallucinations. The most frequent AEs causing discontinuation in Pool 8 was similar to Pool 1 and were Psychosis/Delusions/Hallucinations. Significant AEs. Evaluation of severe AEs did not identify a new safety signal. Most common AE. The most common AE for the 20 mg and 40 mg dose of istradefylline in Pool 1 belonged to the groupings Dyskinesias, Dyspepsia (...) , including rebound Parkinson’s Disease symptoms, the sponsor summarized any AE occurring up to 40 days after the treatment end date (> 5 plasma elimination half-lives) in Pool 1. Reviewer comment: Variability exists in how TEAEs were defined by study. Presumption of causality by the investigator appears to have played a role in whether AEs were assessed as TEAEs as the investigator had to assess whether an AE worsened in severity after exposure to the study drug. This could cause potential underreporting

2019 FDA - Drug Approval Package

62. Iron Deficiency – Diagnosis and Management

history, symptom review and physical examination. Directed history should include: nutrition and physical activity history pregnancy status and number of pregnancies history of blood loss, including GI bleeding, hematuria, menorrhagia, and blood donation GI symptoms including changes in bowel habits, abdominal pain, dyspepsia, and unexplained weight loss family history including colorectal cancer Menorrhagia is the most frequent cause of iron deficiency among pre-menopausal women. Consider referral (...) preparations may cause nausea, vomiting, dyspepsia, constipation, diarrhea or dark stools. Strategies to minimize these effects include: start at a lower dose and increase gradually after 4 to 5 days (to reach target dose in a few weeks) give divided doses give the lowest effective dose take supplements with meals (note: iron absorption is enhanced when supplements are taken on an empty stomach; however, tolerance and adherence may be improved when iron is taken with meals) try a different iron preparation

2019 Clinical Practice Guidelines and Protocols in British Columbia

63. Management of Dyslipidaemias

hypercholesterolaemia 41 9.1.2.3 Familial hypercholesterolaemia in children 41 9.1.3 Familial dysbetalipoproteinaemia 41 9.1.4 Genetic causes of hypertriglyceridaemia 41 9.1.4.1 Action to prevent acute pancreatitis in severe hypertriglyceridaemia 41 9.1.5 Other genetic disorders of lipoprotein metabolism 42 9.2 Women 42 9.2.1 Effects of statins in primary and secondary prevention 42 9.2.2 Non-statin lipid-lowering drugs 42 9.2.3 Hormone therapy 42 9.3 Older people 42 9.3.1 Effects of statins in primary (...) and are regularly updated. The ESC carries out a number of registries which are essential to assess diagnostic/therapeutic processes, use of resources and adherence to Guidelines. These registries aim at providing a better understanding of medical practice in Europe and around the world, based on data collected during routine clinical practice. The guidelines are developed together with derivative educational material addressing the cultural and professional needs for cardiologists and allied professionals

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2019 European Society of Cardiology

64. Trastuzumab (Ogivri) - breast cancer or stomach cancer

infusion only. If an alternate route of administration is required, other trastuzumab products offering such an option should be used In order to prevent medication errors it is important to check the vial labels to ensure that the medicinal product being prepared and administered is trastuzumab and not trastuzumab emtansine. 4 Posology Metastatic breast cancer Three-weekly schedule The recommended initial loading dose is 8 mg/kg body weight. The recommended maintenance dose at three-weekly intervals (...) 2 ). The incidence of symptomatic cardiac dysfunction was 1.7 % in the trastuzumab arm. Clinical experience is limited in patients above 65 years of age. Infusion-related reactions (IRRs) and hypersensitivity Serious IRRs to trastuzumab infusion including dyspnoea, hypotension, wheezing, hypertension, bronchospasm, supraventricular tachyarrhythmia, reduced oxygen saturation, anaphylaxis, respiratory distress, urticaria and angioedema have been reported (see section 4.8). Pre-medication may

2019 European Medicines Agency - EPARs

65. Gastritis

Gastritis Gastritis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Gastritis Last reviewed: February 2019 Last updated: October 2018 Summary Helicobacter pylori infection and use of non-steroidal anti-inflammatory drugs (NSAIDs) or alcohol are the most common causes. Other causes include stress (secondary to mucosal ischaemia) and autoimmune gastritis. Rare forms include phlegmonous gastritis (a rare bacterial (...) pylori infection may cause both an acute and chronic gastritis. Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2017;112(2):212-239. https://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf http://www.ncbi.nlm.nih.gov/pubmed/28071659?tool=bestpractice.com Erosive gastritis may occur in response to NSAID/alcohol use or misuse Varis K. Gastritis - a misused term in clinical gastroenterology

2018 BMJ Best Practice

66. Peptic ulcer disease

Peptic ulcer disease Peptic ulcer disease - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Peptic ulcer disease Last reviewed: February 2019 Last updated: February 2019 Summary Peptic ulcers usually present as chronic, upper abdominal pain related to eating a meal (dyspepsia). Use of non-steroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori infection are the most common causes. There may be some (...) M Meyer and Dr Steven Moss, previous contributors to this topic. Peer reviewers Consultant Gastrounit Medical Division Copenhagen University Hospital Hvidovre Copenhagen Denmark Disclosures LLG declares that she has no competing interests. Use of this content is subject to our Services Legal © BMJ Publishing Group 2018 ISSN 2515-9615 Help us improve Thank you × Your feedback has been submitted successfully.

2018 BMJ Best Practice

67. Gastritis

Gastritis Gastritis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Gastritis Last reviewed: February 2019 Last updated: October 2018 Summary Helicobacter pylori infection and use of non-steroidal anti-inflammatory drugs (NSAIDs) or alcohol are the most common causes. Other causes include stress (secondary to mucosal ischaemia) and autoimmune gastritis. Rare forms include phlegmonous gastritis (a rare bacterial (...) pylori infection may cause both an acute and chronic gastritis. Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2017;112(2):212-239. https://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf http://www.ncbi.nlm.nih.gov/pubmed/28071659?tool=bestpractice.com Erosive gastritis may occur in response to NSAID/alcohol use or misuse Varis K. Gastritis - a misused term in clinical gastroenterology

2018 BMJ Best Practice

68. Assessment of chronic abdominal pain

, and gynaecological tracts. The aetiology of chronic abdominal pain is so wide that only the more common causes can be covered here. A clear relationship with an anatomical structure or underlying process may not always be present. Classification Chronic abdominal pain is divided into organic and functional aetiologies. Organic aetiologies have a clear anatomical, physiological, or metabolic cause. Chronic abdominal pain without clear source, in spite of a thorough diagnostic evaluation, is usually termed (...) abdominal pain is 22.9 per 1000 person-years. Abdominal pain was reported in 25% of the adult population during cross-sectional surveys. Wallander MA, Johansson S, Ruigomez A, et al. Unspecified abdominal pain in primary care: the role of gastrointestinal morbidity. Int J Clin Pract. 2007;61:1663-1670. http://www.ncbi.nlm.nih.gov/pubmed/17681003?tool=bestpractice.com Penston JG, Pounder RE. A survey of dyspepsia in Great Britain. Aliment Pharmacol Ther. 1996;10:83-89. http://www.ncbi.nlm.nih.gov/pubmed

2018 BMJ Best Practice

69. Ascariasis

asymptomatic, ascariasis can cause gastrointestinal and hepatobiliary obstruction, and can contribute to cognitive and growth delay in children. Seltzer E, Barry M, Crompton DWT. Ascariasis. In: Guerrant RL, Walker DH, Weller PF, eds. Tropical infectious diseases: principles, pathogens and practice. 2nd ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2006:1257-1264. Bethony J, Brooker S, Albonico M, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. 2006;367 (...) :1521-1532. http://www.ncbi.nlm.nih.gov/pubmed/16679166?tool=bestpractice.com History and exam presence of risk factors asymptomatic co-infection with other parasites developmental delay malnutrition fever cough wheezing dyspnoea haemoptysis hypoxia tachypnoea rhonchi, rales retractions urticarial skin lesions abdominal pain anorexia dyspepsia nausea vomiting diarrhoea constipation abdominal distension reduced or absent bowel sounds hypotension RUQ tenderness hepatomegaly jaundice signs/symptoms

2018 BMJ Best Practice

70. Assessment of nausea and vomiting in children

:1456-68. http://www.ncbi.nlm.nih.gov/pubmed/27144632?tool=bestpractice.com Vomiting is usually preceded by nausea; the only exceptions are rumination syndrome, in which oral regurgitation is not preceded by nausea, and possibly gastro-oesophageal reflux disease. Nausea is not always followed by vomiting, as in conditions such as chronic functional nausea, postural nausea, and functional dyspepsia. Aetiology There are various established mechanisms that are known to cause nausea and vomiting (...) or central nervous system infection Metabolic or endocrine abnormalities such as diabetic ketoacidosis, adrenal insufficiency, and protein or carbohydrate metabolism disorders Urological/gynaecological or renal causes such as gonadal torsion Renal causes such as haemolytic uraemic syndrome and nephrolithiasis Psychiatric causes such as eating disorders, rumination, or factitious disorder Environmental causes such as toxic ingestions and adverse effects associated with the use of medications or illicit

2018 BMJ Best Practice

71. Assessment of nausea and vomiting in children

:1456-68. http://www.ncbi.nlm.nih.gov/pubmed/27144632?tool=bestpractice.com Vomiting is usually preceded by nausea; the only exceptions are rumination syndrome, in which oral regurgitation is not preceded by nausea, and possibly gastro-oesophageal reflux disease. Nausea is not always followed by vomiting, as in conditions such as chronic functional nausea, postural nausea, and functional dyspepsia. Aetiology There are various established mechanisms that are known to cause nausea and vomiting (...) or central nervous system infection Metabolic or endocrine abnormalities such as diabetic ketoacidosis, adrenal insufficiency, and protein or carbohydrate metabolism disorders Urological/gynaecological or renal causes such as gonadal torsion Renal causes such as haemolytic uraemic syndrome and nephrolithiasis Psychiatric causes such as eating disorders, rumination, or factitious disorder Environmental causes such as toxic ingestions and adverse effects associated with the use of medications or illicit

2018 BMJ Best Practice

72. Assessment of nausea and vomiting, adults

Assessment of nausea and vomiting, adults Assessment of nausea and vomiting, adults - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of nausea and vomiting, adults Last reviewed: February 2019 Last updated: June 2018 Summary Nausea and vomiting are extremely common symptoms and may be caused by a vast array of medical conditions. Koch KL. Nausea and vomiting. In: Wolfe MM, Davis GL, Farraye FA, et al, eds (...) and disorders that originate in peripheral organ systems, such as the GI tract, stimulate vagal or spinal afferent nerves that connect with the vagal sensory (tractus solitarius) and vagal efferent motor nuclei. Ultimately, cortical centres where nausea is perceived and the efferent pathways that mediate vomiting are stimulated. Tumours, infections, and drugs in the periphery may cause local dysfunction in a variety of organ systems that is sensed as nausea, and severe nausea eventually evokes vomiting

2018 BMJ Best Practice

73. Managing GORD with PPIs in primary care

PPI treatment was withdrawn. No signs of symptoms caused by rebound acid hypersecretion were found in three studies that investigated PPI withdrawal in patients with reflux disease. In this randomised controlled trial with healthy patients (no upper GI symptoms) given a PPI or placebo, 11 of 25 patients (44%) taking a PPI developed dyspepsia after PPI discontinuation, compared with 2 of 23 patients (9%) in the placebo group (p <0.01). In this randomised controlled trial with healthy patients (...) Managing GORD with PPIs in primary care Managing GORD with PPIs in primary care | NPS MedicineWise 20 Years Of Helping Australians Make Better Decisions About Medicines, Medical Tests And Other Health Technologies. Log in Facebook Twitter LinkedIn Google Signing you in Use another account OR Login Form Email Password Log in to NPS MedicineWise Forgot password Forgot password Email Send reset instructions Set new password Reset Password Password Set password Account exists We found an existing

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2019 National Prescribing Service Limited (Australia)

74. Diagnosis and management of gonorrhoea and syphilis

to antimicrobial resistance 84 Table 35 – Minimum inhibitory concentrations for gonorrhoea 597 isolates 2016 Belgium by the EUCAST 85 Table 36 – Recommendations from national guides – Molecules and dosages for adults and adolescents 92 Table 37 – Gonorrhoea medication prices and availability in Belgium 98 Table 38 – Recommendations from national guides – Molecules and dosages for pregnant women 101 Table 39 – Recommendations from national guides – Molecules and dosages for people with an allergy (...) for syphilis 139 Table 52 – Recommendations from international guidelines – Information for the patient 142 Table 53 – Recommendations from national guides – Molecules and dosages for adults and adolescents ...150 Table 54 – Included primary studies 152 Table 55 – Syphilis medication prices and availability in Belgium 162 Table 56 – When to perform a test of cure for syphilis – Definitions from international guidelines 164 Table 57 – Conclusions and recommendations from guidelines – Follow-up 165 Table 58

2019 Belgian Health Care Knowledge Centre

75. Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness

and lifestyle modifications, there is increasing interest in performing MBS in adolescents with severe or morbid obesity, especially in those at very high risk or those with associated co- morbidities like hypertension, diabetes and non-alcoholic steatohepatitis (NASH), as well as in those with extreme BMI values, who cannot be managed successfully otherwise. A particular medical challenge constitute children and adolescents with monogenic traits causing morbid or super- obesity. Psychopathology and social (...) the presence of (pre- )diabetes, hypertension, a low HDL-cholesterol, high triglycerides, and/or a high waist-circumference might indicate a higher associated risk, as is also the presence of non-alcoholic steato-hepatitis. Insulin resistance and metabolic syndrome are more prevalent in people with visceral adiposity. Obesity clearly does imply risks, may lead to physical and psychological symptoms, can cause functional limitation, the development of co- morbidities and complications, and cause psycho

2019 Belgian Health Care Knowledge Centre

76. Depression

/escitalopram : Tablet and oral suspension available. It is useful for agitated depression/anxiety and relatively safe if the patient is at risk of . There is a risk of QTc prolongation and drug interactions. Review concurrent medications, see British National Formulary Fluoxetine: It is long acting and offers low risk of withdrawal effects. It has many drug interactions so it may not be suitable in palliative care patients. Side effects include: , , dyspepsia, risk of gastrointestinal (GI) bleeding - avoid (...) Depression Scottish Palliative Care Guidelines - Depression Scottish Palliative Care Guidelines search / / / Depression Depression Introduction Depression: is strongly and consistently associated with a poor quality of life. causes more reduction in role and social functioning than would be due to the physical illness alone. reduces physical functioning. is often associated with symptoms that are difficult to control. has a major impact on the patient’s family. Treatment of depression can

2018 Scottish Palliative Care Guidelines

78. Ranitidine

Coronary Artery Disease: A Double-Blind, Double Dummy, Randomized Study. 275-84 10.1007/s40256-016-0172 (...) -5 Proton-pump inhibitors (PPIs) are often prescribed to patients receiving dual antiplatelet therapy (DAPT). However, this class of medication, especially omeprazole, has been associated with a reduction in clopidogrel efficacy, leading many clinicians to substitute omeprazole with ranitidine . Our objective was to compare the antiplatelet effect of clopidogrel before and after the addition (...) information leaflet on is available at . Summary Histamine H2 (H 2 ) receptor antagonists (...) (cimetidine, famotidine, nizatidine and ranitidine ) reduce gastric acid output and thus gastric acidity. H 2 receptor antagonists are used in the symptomatic relief of chronic episodic dyspepsia and gastro-oesophageal reflux disease, in the prevention and treatment of gastric or duodenal ulceration, and prior to general anaesthesia in patients at risk of acid aspiration. The BNF suggests ranitidine

2018 Trip Latest and Greatest

79. Proton pump inhibitors

the small number of studies. Authors' objectives To evaluate the effectiveness of proton pump inhibitors compared to histamine-2 receptor antagonists in the prevention of stress 2009 8. Proton pump inhibitors for functional dyspepsia. BACKGROUND: Functional dyspepsia (FD or non-ulcer dyspepsia) is defined as continuous or frequently recurring epigastric pain or discomfort for which no organic cause can be found. Acid suppressive therapy, including proton pump inhibitors ( PPIs ), has been proposed (...) , but the poor quality of the included trials and the potential for publication and language biases should be considered when interpreting the results. Authors' objectives 2010 4. Are We Overusing Proton Pump Inhibitors ? Are We Overusing Proton Pump Inhibitors ? | Clinical Correlations Are We Overusing Proton Pump Inhibitors ? November 13, 2015 By Shimwoo Lee Peer Reviewed Case: A 31-year-old man with poorly controlled type 2 diabetes was hospitalized for community-acquired pneumonia. His home medications

2018 Trip Latest and Greatest

80. Finasteride

Academy of Dermatology J. Am. Acad. Dermatol. A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride (...) in the treatment of male subjects with androgenetic alopecia. 489-498.e3 10.1016/j.jaad.2013.10.049 S0190-9622(13)01171-7 Dihydrotestosterone is the main androgen causative of androgenetic alopecia, a psychologically and physically harmful condition warranting medical treatment. We sought to compare (...) and ejaculatory dysfunction, and gynecomastia. Purported mechanisms for these effects include the decreased production of neurosteroids, which may regulate sexual desire and function, and impaired testosterone 2018 5. Assessing finasteride -associated sexual dysfunction using the FAERS database. BACKGROUND: Post-marketing reports suggest that finasteride causes sexual dysfunction despite a low incidence reported in clinical trials. Therefore, the extent of risk remains unknown. OBJECTIVE: To determine whether

2018 Trip Latest and Greatest

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