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Medication Causes of Dyspepsia

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81. Management of Non-neurogenic Male LUTS

: 563. 16. Ficarra, V., et al. The role of inflammation in lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) and its potential impact on medical therapy. Curr Urol Rep, 2014. 15: 463. 17. He, Q., et al. Metabolic syndrome, inflammation and lower urinary tract symptoms: possible translational links. Prostate Cancer Prostatic Dis, 2016. 19: 7. 18. Drake, M.J. Do we need a new definition of the overactive bladder syndrome? ICI-RS 2013. Neurourol Urodyn, 2014. 33: 622. 19 (...) : 827. 77. Mochtar, C.A., et al. Post-void residual urine volume is not a good predictor of the need for invasive therapy among patients with benign prostatic hyperplasia. J Urol, 2006. 175: 213. 78. Jorgensen, J.B., et al. Age-related variation in urinary flow variables and flow curve patterns in elderly males. Br J Urol, 1992. 69: 265. 79. Kranse, R., et al. Causes for variability in repeated pressure-flow measurements. Urology, 2003. 61: 930. 80. Reynard, J.M., et al. The ICS-’BPH’ Study

2019 European Association of Urology

82. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss. 5. Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity. 6. For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first-line therapy, followed (...) levels (=190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion. 10. Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be $200 billion annually in healthcare services, medications, and lost productivity. Much of this is attributable

2019 American Heart Association

83. Robot-assisted surgery in thoracic and visceral indications

IN THORACIC AND VISCERAL INDICATIONS Project ID: OTCA14 Robot-assisted surgery for thoracic and visceral surgery Version 1.4, 06.05.2019 EUnetHTA Joint Action 3 WP4 2 DOCUMENT HISTORY AND CONTRIBUTORS Version Date Description V1.0 31.01.19 First draft. V1.1 27.02.19 Input from co-author has been processed. V1.2 29.03.19 Input from dedicated reviewers has been processed. V1.3 30.04.19 Input from external experts and manufacturer(s) has been processed. V1.4 06.05.19 Input from medical editing has been (...) MD Mean difference Ø Mean M Median MeSH Medical Subject Headings mg milligram Robot-assisted surgery for thoracic and visceral surgery Version 1.4, 06.05.2019 EUnetHTA Joint Action 3 WP4 7 ml milliliter n Number n/a Not applicable NCCN National Comprehensive Cancer Network NIH National Institute for Health NR Not reported NRS Numeric Rating Scale ns Not significant NSCLC Non-small cell lung Cancer p Power PFDI Pelvic Floor Distress Inventory PFIQ Pelvic Floor Impact Questionnaire PISQ Pelvic

2019 EUnetHTA

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

or non-existent, suggest that approximately 80% of people dying from cancer experience moderate or severe pain lasting on average for 90 days (5). Thus, cancer pain is a major cause of unnecessary suffering.15 1. I NTRODUCTION Everyone has a right to the enjoyment of the highest attainable standard of physical and mental health, and states have an obligation to take steps towards “the creation of conditions which would assure to all medical service and medical attention in the event of sickness” (6 (...) 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

2019 World Health Organisation Guidelines

85. AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm

, but these reductions came at the cost of requiring more antihypertensive medications and produced a significantly higher number of serious adverse events (SAEs). In particular, a greater likelihood of decline in renal function was observed in the intensive arm of ACCORD-BP ( ). A meta-analysis of antihypertensive therapy in patients with T2D or impaired fasting glucose demonstrated similar findings. Systolic BP ≤135 mm Hg was associated with decreased nephropathy and a significant reduction in all-cause mortality (...) patient and cannot replace the judgment of a clinician. From the 1 Chair, Professor, Departments of Medicine, Biochemistry and Molecular Biology, and Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas 2 Beth Israel Deaconess Medical Center, Department of Medicine and Harvard Medical School, Boston, Massachusetts 3 Division of Endocrinology Kaiser Permanente of Georgia and the Division of Endocrinology, Emory University School of Medicine, Atlanta, Georgia 4 Director, Ochsner

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2019 American Association of Clinical Endocrinologists

86. Deprescribing proton pump inhibitors

in conjunction with patients. D eprescribing is the planned and supervised process of dose reduction or stopping of medication that might be caus- ing harm or might no longer be providing benefit. 1 The goal of deprescribing is to reduce medication burden and harm while maintaining or improving quality of life. However, deprescribing can be difficult, especially when medications do not appear to be causing overt harm. 2 In an effort to provide evidence-based recom- mendations and tools to aid clinicians (...) Association • RxFiles PPI—proton pump inhibitor.Vol 63: may • mai 2017 | Canadian Family Physician • Le Médecin de famille canadien 363 Deprescribing proton pump inhibitors | Clinical Practice Guidelines caused by the PPI) and negative (such as recurrence of upper GI symptoms) patient-specific effects of PPI depre- scribing, particularly over the longer term, would be help- ful. Evaluating cost-effectiveness and long-term medical resource use is also important. Next steps The deprescribing team

2017 CPG Infobase

87. Management of Acute Myocardial Infarction in patients presenting with ST-segment elevation

. The two chairmen contributed equally to the document: Borja Ibanez, Director Clinical Research, Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Melchor Fernández Almagro 3, 28029 Madrid, Spain; Department of Cardiology, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; and CIBERCV, Spain. Tel: +34 91 453.12.00 (ext: 4302), Fax: +34 91 453.12.45, E-mail: bibanez@cnic.es or bibanez@fjd.es. Stefan James, Professor of Cardiology, Department of Medical Sciences (...) Carlos III (CNIC), Melchor Fernández Almagro 3, 28029 Madrid, Spain; Department of Cardiology, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; and CIBERCV, Spain. Tel: +34 91 453.12.00 (ext: 4302), Fax: +34 91 453.12.45, E-mail: bibanez@cnic.es or bibanez@fjd.es. Stefan James, Professor of Cardiology, Department of Medical Sciences, Scientific Director UCR, Uppsala University and Sr. Interventional Cardiologist, Department of Cardiology Uppsala University Hospital UCR Uppsala Clinical

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2017 European Society of Cardiology

88. Asthma

— minor update. The range of dry powder inhaler devices included as prescriptions has been updated. Issued in February 2011. December 2010 — minor update. The Flixotide Diskhaler ® (fluticasone) range has been discontinued. The prescription has been removed. Issued in December 2010. October 2010 — minor update. Information on fitness to drive from the Driver and Vehicle Licensing Agency's guidance for medical practitioners, At a glance guide to the current medical standards of fitness to drive has (...) . British Medical Journal. [ ] BMJ (2018) Improving the global diagnosis and management of asthma in children . British Medical Journal. [ ] Busse, W., et al. (2018) Combined analysis of asthma safety trails of long-acting ß 2 -agonists. The New England Journal of Medicine. [ ] NIHR (2018) Increasing inhaled steroids for short periods reduces asthma exacerbations. National Institute for Health Research [ ] Connett, G., Connett, L., and Thomas, M. (2019) Determining the reasons for poorly controlled

2017 Prodigy

89. Antiocoagulation - oral

of a bleeding complication in secondary care consists of stopping treatment and general haemostatic measures, such as mechanical compression and surgical haemostasis with bleeding control procedures, fluid replacement and haemodynamic support, blood products (packed red cells or fresh frozen plasma, depending on associated anaemia or coagulopathy), or platelets. People taking oral anticoagulants should be advised: To seek immediate medical advice if spontaneous bleeding occurs and does not stop, or recurs (...) . This includes bruising, bleeding gums, nosebleeds, prolonged bleeding from cuts, blood in the urine or stools, haemoptysis, subconjunctival haemorrhage, and vaginal bleeding in a postmenopausal woman. To seek medical advice if they get sudden severe back pain (which may indicate spontaneous retroperitoneal bleeding). Not to take over-the-counter medicines such as nonsteroidal anti-inflammatory drugs. What to do if there has been a missed dose or if a double dose has been taken. The duration of treatment

2017 Prodigy

90. Palliative Care for the Patient with Incurable Cancer or Advanced Disease: Part 2: Pain and Symptom Management

Management Nausea and Vomiting Effective Date: February 22, 2017 Key Recommendations • Select anti-nausea medication based on the etiology of the nausea and vomiting. Assessment 1. Nausea and vomiting are common, but can be controlled with antiemetics. 2. Identify and discontinue medications that may be the cause. 3. Further assessment may include lab tests and imaging to investigate (e.g., GI tract disturbance, electrolyte/calcium imbalance, intracranial disease, and sepsis). 4. Good symptom control may (...) . Pharmacological: match treatment to cause (e.g., if opioid-induced, metoclopramide (sometimes IV or SC initially) and domperidone are most effective). Most drugs are covered by the BC Palliative Care Drug Plan, exc ept olanzapine and ondansetron (refer to Appendix B – Medications Used in Palliative Care for Nausea and Vomiting). 3. Consider pre-emptive use of anti-nauseates in opioid-naive patients. BCGuidelines.ca: Palliative Care for the Patient with Incurable Cancer or Advanced Disease Part 2: Pain

2017 Clinical Practice Guidelines and Protocols in British Columbia

91. CRACKCast Episode 149 – Aspirin and Nonsteroidal Agents

warrants IV glucose supplementation. NSAIDs: Most NSAID overdoses are asymptomatic or cause only minor symptoms. Ibuprofen, along with other propionic acid derivatives, has been associated with sporadic cases of aseptic meningitis. The management of NSAID overdose is supportive, and there is no specific antidote. Hemodialysis is reserved for patients with massive overdose and pH <7.1. Patients who have ingested a pyrazolone or fenamate require observation for possible seizures until 8 hours after (...) ingestion. Rosen’s In Perspective Aspirin, or acetylsalicylic acid, is widely consumed for its analgesic, anti-inflammatory, and antiplatelet effects… however salicylate toxicity is not a benign condition and causes a complex set of life-threatening metabolic derangements with significant morbidity and mortality. 20-30 people die every year from ASA overdoses. The very young and very old are at particular risk! It’s not just ASA that we worry about: other potential sources of salicylate toxicity include

2018 CandiEM

92. 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

93. Diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion

with lifestyle modi?cations, substituting alternative medications in place of those that can exacerbate ED, and moving on to PDE5i in patients who have organic causes of ED such as spinal cord injuries, radical pelvic surgery, severe atherosclerosis, or those who fail lifestyle therapy or desire rapid improvement in their ED. Typically,thesemenmaybestartedonaPDE5itrial,with appropriate counseling about risk of priapism (de?ned as an erection lasting longer than 4 hours). Contraindications for PDE5i use (...) include use of nitrates and inadequate cardiac reserve for sexual activity requiring clearance by a cardiolo- gist.Further,thesemedicationsshouldbeusedwithcautionin menonanalphablocker astheycancauseanunsafedropin bloodpressure.SideeffectsofPDE5iagentsincludeheadache, facial?ushing,muscleaches,nasalcongestion,abluetingein vision, dizziness, dyspepsia, and priapism. Typical doses of PDE5iaresildena?l50–100mg,tadala?l5–20mg,vardena?l 10–20 mg, and avana?l50–200 mg. All of these drugs are expensive, $10

2018 Society for Assisted Reproductive Technology

94. 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

95. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutritio

events cause one or multiple symptoms is often difficult (1,12). This is particularly true in nonverbal infants in whom defining trouble- some is problematic. Reported symptoms of infant GERD vary widely and may include excessive crying, back arching, regurgi- tation and irritability. Many of these symptoms, however, occur in all babies with or without GERD, making a definitive diagnosis challenging. Therefore, the degree of concern of parents is often the factor driving the need for a diagnosis (...) to be a prominent phenomenon in children who have other underlying medical conditions such as prematurity, neurologic impairment, and pulmonary problems, including cystic fibrosis. The present guideline was not intended Original studies, n = 16 - Massage therapy, n=1 - Feeding modifications, n=14 - Positioning therapy, n =1 Systematic reviews, n = 2 Records identified through database searching (n = 3068) Additional records identified through other sources (n = 11) Records screened Records after duplicates

2018 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

96. Deprescribing Proton Pump Inhibitors

drug”, spawning multiple imita- tors. Eventually this included (as patent extensions) the single enantiomers esomeprazole and dexlansoprazole. Prescription PPIs are approved for peptic ulcer disease (PUD), gastro- esophageal reflux (GERD), and non-ulcer dyspepsia. About 1 in 12 British Columbians receives a prescription in any year. 1 Over the counter omeprazole and esomeprazole are also approved for heartburn occurring on >2 days/week, achieving full acid suppressant effect in 1-4 days. 2 Most (...) people taking PPIs have not been endoscoped, so that “GERD” often refers to reflux or heartburn. Our previous reviews 3-9 of randomized clinical trial (RCT) evidence on PPIs concluded: • Over 8-12 weeks, PPIs are effective for GERD 3 and PUD 4 . • Patients treated effectively do not require chronic acid suppressive medications. 4 • Long-term PPIs are appropriate in relapsing severe erosive esophagitis. 3 • No PPI demonstrated superiority for GERD or symptoms related to PUD. 9 • No long-term RCTs

2018 Therapeutics Letter

97. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology

, Connecticut Search for other works by this author on: Karen C Carroll Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland Search for other works by this author on: Kimberle C Chapin Department of Pathology, Rhode Island Hospital, Providence Search for other works by this author on: Peter H Gilligan Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill Search for other works by this author on: Mark D Gonzalez Department of Pathology (...) , Children’s Healthcare of Atlanta, Georgia Search for other works by this author on: Robert C Jerris Department of Pathology, Children’s Healthcare of Atlanta, Georgia Search for other works by this author on: Sue C Kehl Medical College of Wisconsin, Milwaukee Search for other works by this author on: Robin Patel Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota Search for other works by this author on: Bobbi S Pritt Division of Clinical

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2018 Infectious Diseases Society of America

98. Core IM: 5 pearls on proton pump inhibitors

antagonists blockers work and how can it explain why H2 blockers might not be as effective as PPIs? (13:30) How should you educate patients to take PPIs to get the maximize benefit? (16:48) How do you manage ongoing symptoms in patients on PPIs? (21:41) Many thanks to Dr. Peter Stanich from the Division of Gastroenterology, Hepatology and Nutrition at The Ohio State University Medical Center for peer-reviewing this podcast! Subscribe to CORE IM on any podcast app! Follow us on Facebook || Twitter (...) you had someone in mind when you developed the pearls for this podcast. C: I do – thanks Shreya! My patient was a 74 year old man who had seen several providers in clinic. He had multiple medical problems including, CKD, osteoporosis, some early cognitive impairment, and a problem list with its own table of contents–you know what I mean. Anyway, he had been on omeprazole 20mg for years and years, but from the past bunch of notes, I didn’t even know he had reflux. Turns out he hadn’t had symptoms

2018 Clinical Correlations

99. Cannabis

for Addiction and Mental Health, T oronto, Ontario, Canada; 3 Acute Care Program, Centre for Addiction and Mental Health, T oronto, Ontario, Canada; 4 Departments of Family and Community Medicine, Pharmacology and T oxicology, Psychiatry, Institute of Medical Science, University of T oronto, T oronto, Ontario, Canada; 5 Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, T oronto, Ontario, Canada; 6 Institute for Mental Health Policy Research, Centre for Addiction (...) @ucalgary.ca Keywords: Cannabis; Hepatic disorders; Gastroenterological disorders; Position statement Medical cannabinoid products are widely used in Canada to treat medical symptoms of all kinds, and gastrointestinal (GI) symptoms are among the most commonly cited reasons for use (1). Cannabis is also widely used recreationally (2), and legal- ization of recreational use has occurred in Canada. Currently, cannabis is not an approved therapeutic product in Canada. However, health care practitioners may

2018 Canadian Association of Gastroenterology

100. Should PPIs be routinely co-prescribed with long-term NSAIDs?

the PPIs. What were the results? Comparing PPI vs placebo on total endoscopic ulcers for patients taking NSAIDs: 8 weeks or longer: risk ratio 0.34 (95% CI 0.28 to 0.42), P < 0.00001 Other results: PPIs might cause more diarrhoea: risk ratio 1.66 (95% CI 0.85 to 3.22), P = 0.13 PPIs probably reduce dyspepsia: risk ratio 0.50 (95% CI 0.30 to 0.82), P = 0.0059 One small study looked at “clinical ulcers”. Although a statistically significant result wasn’t found, clinical ulcers were observed only (...) Health District and Ingham Institute of Applied Medical Research. The Unit provides targeted primary care services to vulnerable populations in South Western Sydney, medical education, research, and health services development, especially in integrated care. He is also a Conjoint Senior Lecturer of the School of Public Health and Community Medicine, UNSW Sydney. Michael's clinical interest is in comorbid substance use disorder and mental health disorders. His research interests are in integrated care

2017 Morsels of Evidence

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