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Skin Discoloration

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161. Nonsurgical Management of Osteoarthritis of the Knee

, stinging and pain at the site of application. Local adverse events are the most commonly reported adverse events from steroid injections. These include pain on injection, redness, post injection flare and skin discoloration. The rate of joint infection is considered to be very low when strict aseptic techniques are followed. Systemic effects include rapid suppression of serum cortisol, adrenocorticotropin hormone (ACTH) and inflammatory markers (erythrocyte sedimentation rate [ESR], C-reactive protein (...) ., the elderly and patients with renal or hepatic impairment). Adverse events such as endocrine dysfunction and sleep-disordered breathing are associated with long-term opioid therapy in chronic pain. Results from two studies showed that oral diclofenac has a higher incidence of adverse GI symptoms, whereas topical diclofenac has a higher incidence of local application site reactions, commonly dry skin, rash, and pruritus. Adverse events associated with topical capsaicin are limited to temporary burning

2016 National Guideline Clearinghouse (partial archive)

162. SNMMI Procedure Standard-EANM Practice Guideline for Amyloid PET Imaging of the Brain

calibrator prior to administration. Inspection for dose infiltration at the injection site should be routinely performed. b) Specific precautions should be taken with an amyloid PET examination: Inspect the radiopharmaceutical dose solution prior toSNMMI Procedure Standard-EANM Practice Guideline for Amyloid PET Imaging of the Brain 7 administration. It should not be used if it contains particulate matter or is discolored. The radiotracer should be injected using a short intravenous catheter (...) Skin 6 6 7 Spleen 9 16 10 Testes 7 5 9 Thymus 7 6 9 Thyroid 7 7 8 Urinary Bladder Wall 27 62 70 Uterus 16 27 16 Total Body 12 14 11 Effective Dose (µSv/MBq) 19 34 19 X. ACKNOWLEDGEMENTS Task Force Members: Satoshi Minoshima, MD, PhD (Co-Chair) (University of Utah, Salt Lake City, UT); Alexander E. Drzezga, MD (Co-Chair) (University of Cologne, Cologne, Germany); Mehdi Djekidel, MD (Yale University, New Haven, CT); David H. Lewis, MD (Harborview Medical Center, Seattle, WA); Chester A. Mathis, PhD

2016 Society of Nuclear Medicine and Molecular Imaging

164. AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Neonatal and Infant Spine

: a. Midline or paramedian masses; b. Midline skin discolorations; c. Skin tags; d. Hair tufts; e. Hemangiomas; f. Small midline dimples; and g. Paramedian deep dimples; 2. The spectrum of caudal regression syndrome, including patients with sacral agenesis, anal atresia or stenosis; 2016—AIUM PRACTICE PARAMETER—Neonatal and Infant Spine 1 neonatalSpine.qxp_0616 6/29/16 4:02 PM Page 13. Evaluation of suspected cord abnormalities such as cord tethering, diastematomyelia, hydromyelia, and syringomyelia; 4 (...) abnormalities, such as syrinx or diastematomyelia. These latter abnormalities should be identified preoperatively. 2. Examination of the contents of a closed neural tube defect if the skin overlying the defect is thin or no longer intact. III. Qualifications and Responsibilities of Personnel See www.aium.org for AIUM Official Statements including Standards and Guidelines for the Accreditation of Ultrasound Practices and relevant Physician Training Guidelines. 14 IV . Written Request for the Examination

2016 American Institute of Ultrasound in Medicine

165. Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition

the RNAO BPG Assessment and Management of Stage I to IV Pressure Ulcers (2007). It provides evidence- based practice recommendations G for interprofesssional teams across all care settings who are assessing and providing care to people with existing pressure injuries. A pressure injury is defined as “localized damage to the skin and/or underlying soft tissue usually over a bony prominence or related to a medical or other device. The injury can present as intact skin or an open ulcer and may be painful (...) Acorn, DNP , NP PHC/Adult, GNC(C), CGP Primary Health Care NP Coordinator University of Toronto Lead NP , MRP at Lakeridge Health, Whitby & Primary Health Care Global Health NP Coordinator University of Toronto Newtonville, Ontario Kathryn Andrews-Clay, BSc Executive Director Canadian Skin Patient Alliance Ottawa, Ontario Elaine Angelic, BSc. O.T. Occupational Th erapist Sault Area Hospital Sault Ste. Marie, Ontario Patti Barton, RN, ETN Clinical Wound, Ostomy Consultant Specialty ET Services

2016 Registered Nurses' Association of Ontario

166. Accofil (filgrastim)

-like and in the area of the punctures, so they were considered to have been caused by the administration. Neither i.m. or p.v. administration caused visible oedema formation and no signs of pain were noted after treatment with either test article during the observation period of 96 hours. Paravenous administration of Neukine caused several slight red discolorations in 1 animal. After p.v. administration of the reference Neupogen, 2 animals showed slight hematoma formation and several slight red (...) discolorations were noted in 2 animals. Histopathological examination showed moderate (grade 3) haematoma at the paravenous administration site in 1 animal with Neukine. In comparison, after paravenous treatment with the reference item Neupogen, 2 animals developed a slight (grade 2) haematoma. These findings were near the injection sites and considered to be caused by the administration volume and / or the route and site of administration. No histopathological findings were noted at the intramuscular

2014 European Medicines Agency - EPARs

167. Adempas (riociguat)

. Photostability testing following ICH guideline Q1B was performed on one batch. The results showed that solid riociguat is not sensitive to light since CHMP assessment report EMA/144673/2014 Page 15/118 there was no discolorations of the solid, no decrease in the assay and no increase of any degradation products. Based on the results obtained, no special protection from light is necessary in the production or handling of the solid crystalline active substance. Results on stress conditions (thermal, hydrolytic (...) with the highest radioactivity 24 hours after administration were organs/tissues involved in riociguat and its related radioactivity elimination. Accumulation in human skin and eye could occur. Repeated versus single dosing revealed an increase in radioactivity for most organs, with a possible risk for accumulation after repeated dosing in adrenal tissue, kidney, liver, lung, skin, spleen, thyroid, bone marrow, testes, and aorta wall. The blood-to-brain and blood-to-testes penetration of radioactivity was low

2014 European Medicines Agency - EPARs

169. Scenesse - afamelanotide

, plasma and tissues, especially the skin. It is caused by a deficiency of ferrochelatase (FECH), the final enzyme in the haem biosynthetic pathway. As a result of this deficiency, the substrate for this enzyme, protoporphyrin IX (PPIX), accumulates. (Allo et al., 2013). This leads to excessive formation of protoporphyrin IX in bone marrow cells, resulting in its accumulation in erythrocytes, plasma, liver, and other tissues. In these patients, protoporhyrins accumulated in the skin can produce free (...) radicals upon exposure to light, strong artificial light or sunlight, causing ‘painful’ cutaneous damage. Its predominant characteristics include cutaneous phototoxicity to visible light from early infancy. Repeated phototoxic episodes may result in thickening and scarring of the skin, especially on the back of the hands, nose and forehead. EPP is a multisystem disease; cutaneous, also contribute to disease severity and impact on quality of life, in addition to the haematological signs. Assessment

2014 European Medicines Agency - EPARs

170. Jardiance - empagliflozin

after a 13-week recovery period in the 52-week study, but minimal mixed or mononuclear infiltrates were present in the cortex in both high dose recovery females. Moreover, interstitial nephritis was not fully recoverable in one dog of the 4-week study given a 8-week recovery period and was observed in one male of the 13-week study after a 13-week recovery. Renal cortical discoloration was observed in 0/6, 5/6, 6/6 and 6/6 animals in control, low, mid and high dose animals, respectively. In view

2014 European Medicines Agency - EPARs

171. Dinutuximab (Unituxin)

, or SBP decreased by more than 15% compared to baseline. Reference ID: 3711777 (b) (4) (b) (4) (b) (4)Addendum to Clinical Review Martha Donoghue BLA 125516 Unituxin (dinutuximab) Page 33 of 50 2.4 Instructions for Preparation and Administration Preparation ? Store vials in a refrigerator at 2°C to 8°C (36°F to 46°F). Protect from light by storing in the outer carton. DO NOT FREEZE OR SHAKE vials. ? Inspect visually for particulate matter and discoloration prior to administration. Do not administer (...) Unituxin and discard the single-use vial if the solution is cloudy, has pronounced discoloration, or contains particulate matter. ? Aseptically withdraw the required volume of Unituxin from the single-use vial and inject into a 100 mL bag of 0.9% Sodium Chloride Injection, USP. Mix by gentle inversion. Do not shake. Discard unused portions of the vial. ? Store the diluted Unituxin solution under refrigeration (2°C to 8° C). Initiate infusion within 4 hours of preparation. ? Discard diluted Unituxin

2014 FDA - Drug Approval Package

172. Peyronie's Disease

. Measurement of stretched penile length (SPL) from the penopubic skin junction to the coronal sulcus or the tip is recommended to establish baseline penile length prior to any intervention. Close Guideline Statement 2 Clinicians should perform an in-office intracavernosal injection (ICI) test with or without duplex Doppler ultrasound prior to invasive intervention. (Expert Opinion) × Discussion A careful history, physical examination of the genitalia, and documentation of the presence or absence

2015 American Urological Association

173. Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for UGT1A1 and Atazanavir Prescribing

by drugs 6 results in the accumulation of unconjugated (indirect) bilirubin in blood and tissues. When bilirubin eleva- tion is high enough to cause visible yellow discoloration of the skin and eyes it is called jaundice (also known as icterus). In neo- nates, extreme bilirubin accumulation can lead to severe adverse neurological effects, namely, kernicterus. 5 Genetic variants that have been identi?ed in UGT1A1 exon 1, promoter, enhancer, and shared UGT1A exons 2 to 5 as well as the accepted allele (...) Recommendeduseofatazanavir(boostedwitheitherritonavirorcobicistat*)byUGT1A1phenotype Phenotype Implicationsforphenotypic measures Dosingrecommendations Classificationofrecommendations a Extensive metabolizer Reference b UGT1A1 activity; very low likelihood of bilirubin-related discon- tinuation of atazanavir. There is no need to avoid prescribing of atazanavir based on UGT1A1 genetic test result. Inform the patient that some patients stop atazanavir because of jaun- dice (yellow eyes and skin), but that this patient’s

2015 Clinical Pharmacogenetics Implementation Consortium

174. Allergic Rhinitis

are consistent with an allergic cause (e.g., clear rhinorrhea, pale discoloration of nasal mucosa, and red and watery eyes) and one or more of the following symptoms: nasal congestion, runny nose, itchy nose, or sneezing. Individuals with AR should be assessed for the presence of associated conditions such as asthma, atopic dermatitis, sleep-disordered breathing, conjunctivitis, rhinosinusitis, and otitis media. Specific IgE testing (blood or skin) should be performed for patients with a clinical diagnosis

2015 American Academy of Family Physicians

175. Allergic Rhinitis

) Clinicians should make the clinical diagnosis of AR when patients present with a history and physical examination consistent with an allergic cause and 1 or more of the following symptoms: nasal congestion, runny nose, itchy nose, or sneezing. Findings of AR consistent with an allergic cause include, but are not limited to, clear rhinorrhea, nasal congestion, pale discoloration of the nasal mucosa, and red and watery eyes. (2) Clinicians should perform and interpret, or refer to a clinician who can (...) perform and interpret, specific IgE (skin or blood) allergy testing for patients with a clinical diagnosis of AR who do not respond to empiric treatment, or when the diagnosis is uncertain, or when knowledge of the specific causative allergen is needed to target therapy. (3) Clinicians should assess patients with a clinical diagnosis of AR for, and document in the medical record, the presence of associated conditions such as asthma, atopic dermatitis, sleep-disordered breathing, conjunctivitis

2015 American Academy of Otolaryngology - Head and Neck Surgery

176. Adult Sinusitis Full Text available with Trip Pro

attention should be paid to the presence or absence of the following: altered (hyponasal) speech indicating nasal obstruction, swelling, redness of the skin due to congestion of the capillaries (erythema) or abnormally large fluid volume (edema) localized over the involved cheek bone or periorbital area; palpable cheek tenderness or percussion tenderness of the upper teeth; purulent drainage in the nose or posterior pharynx; and signs of extra-sinus involvement (orbital or facial cellulitis, orbital

2015 American Academy of Otolaryngology - Head and Neck Surgery

177. ACS/ASCO Breast Cancer Survivorship Care Guideline Full Text available with Trip Pro

of local or regional recurrence, including new lumps (eg, in underarm or neck), rash or skin changes on the breast or chest wall, chest pain, changes in the contour/shape/size of the breast, and swelling of the breast or arm. Evaluation of patient-reported symptoms is essential in detecting a recurrence as early as possible, which may impact survival. Risk Evaluation and Genetic Counseling Recommendation 1.5. It is recommended that primary care clinicians (a) should assess the patient's cancer family (...) of a periodic health examination, the cancer-related checkup should include examination for cancers of the thyroid, ovaries, lymph nodes, oral cavity, and skin as well as health counseling about tobacco, sun exposure, diet and nutrition, risk factors, sexual practices, and environmental and occupational exposures Abbreviations: CT, computed tomography; DCBE, double-contrast barium enema; DRE, digital rectal examination; FIT, fecal immunochemical test; FOBT, fecal occult blood test; FSIG, flexible

2015 American Society of Clinical Oncology Guidelines

178. Colorectal cancer: "antioxidants" have no preventive effect

them. Adverse effects were observed with the antioxidants: itching (with vitamin A + C + E combinations), nosebleeds, hair loss (with selenium), and skin discoloration with beta-carotene. Strokes occurred more frequently in people taking vitamin E. Another study showed a higher mortality in groups taking vitamins A and E or beta-carotene compared with those not taking antioxidants. Antioxidants have no place in disease prevention: they have no proven efficacy, but are likely to cause harm

2014 Prescrire

179. Nail damage: sometimes due to medication

, trauma, tumours and various skin diseases. Prolonged exposure to water and irritants or allergens can cause nail brittleness and loss, coloration anomalies. Nail damage is observed in many general medical conditions, including psoriasis and other skin diseases and chronic illness. Several drugs expose patients to nail lesions through various mechanisms, particularly cytotoxic agents (anticancer drugs) and anti-infectives. Cytotoxic drugs often cause embarrassing and sometimes severe or painful nail (...) lesions. Anti-infectives, including tetracyclines, fluoroquinolones, antimalarial and leprosy drugs expose patients to lesions associated with light, such as nail loosening and discoloration. Retinoids, used in the treatment of acne, expose patients to nail brittleness, inflammation and deformation. The damage is generally reversible but sometimes persists for several years. ©Prescrire 1 July 2014 Download the full review. | | | Prescrire Your change of address has been received and will be processed

2014 Prescrire

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