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Tongue Carcinoma

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1521. Pegfilgrastim (Nyvepria) - neutropenia

of capillary leak syndrome have been reported in the post-marketing setting with G-CSF use. These have generally occurred in patients with advanced malignant diseases, sepsis, taking multiple chemotherapy medications or undergoing apheresis (see section 4.4). Paediatric population The experience in children is limited. A higher frequency of serious adverse reactions in younger children aged 0-5 years (92%) has been observed compared to older children aged 6-11 and 9 12-21 years respectively (80% and 67 (...) Each pre-filled syringe contains 30 mg sorbitol (E420) (see section 4.4). For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Solution for injection (injection). Clear, colourless, free from visible particles, solution for injection. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Reduction in the duration of neutropenia and the incidence of febrile neutropenia in adult patients treated with cytotoxic chemotherapy for malignancy (with the exception of chronic myeloid

2020 European Medicines Agency - EPARs

1522. Achlorhydria

present with signs and/or symptoms of iron, cobalamin (vitamin B12), or calcium deficiency and may predispose to enteric infection with organisms such as Clostridium difficile , Salmonella , and Campylobacter . May interfere with the absorption of certain drugs including thyroxine, ketoconazole, itraconazole, and dipyridamole. The most common cause of hypergastrinaemia. Although the prognosis is excellent, it carries a small increased risk for the development of gastric adenocarcinoma and gastric (...) carcinoid tumour. Definition Achlorhydria indicates the inability to produce gastric acid (i.e., hydrochloric acid [HCl]), even after stimulation with secretagogues (e.g., pentagastrin [gastrin analogue], histamine, betazole [histamine analogue], or a meal). Serum gastrin is a marker for gastric acid output. A decrease in gastric acid interrupts a negative feedback pathway controlling gastrin secretion, and leads to elevated serum gastrin levels (hypergastrinaemia). Schubert ML, Peura DA. Control

2018 BMJ Best Practice

1523. Assessment of cranial nerve mononeuropathy

) Apical lung tumour (IX, X) Iatrogenic (XI) Cerebrovascular accident (XII) Trauma (I) Neurodegenerative disorders (I) Congenital (I) CNS tumours (I) Optic canal trauma (II) CNS tumours (II) Idiopathic intracranial hypertension (II) Autoimmune disease: (e.g., SLE, Sjogren's, granulomatosis with polyangiitis, Behcet's [II]) Leber's hereditary optic neuropathy (II) Optical toxins or nutritional deficiency (II) Neuromyelitis optica (II) Uncal herniation (III, IV, VI) Migraine (III, IV, VI) Trauma (III, IV (...) ) Neurosarcoidosis (VII) CNS tumours (VII) Trauma (VII) Meningitis (VII) Iatrogenic (VII) Middle ear or mastoid infection (VII) Parotid tumour (VII) HIV associated (VII) Lyme disease (VII) CNS tumours (VIII) CNS tumours (IX, X) Parapharyngeal tumour (IX, X) Meningitis (IX,X) Skull-base osteomyelitis (IX, X) Trauma (IX, X) Parapharyngeal space infection (IX, X) Eagle's syndrome (IX) Cardiovocal syndrome (X) Trauma (XI) CNS tumours (XI) CNS tumours (XII) Progressive bulbar palsy (XII) Chiari I and II malformations

2018 BMJ Best Practice

1524. Oral candidiasis

confined to the outline of a dental prosthesis burning oral pain dysphagia or odynophagia rhomboid outline on the dorsal aspect of the tongue continuous or patchy band of erythema, involving the free gingival margin hyposalivation/xerostomia age >60 years female sex poor oral hygiene, especially among denture wearers malabsorption and malnutrition advanced malignancy cancer chemotherapy and radiotherapy HIV infection endocrine disturbance (e.g., diabetes mellitus, hypoparathyroidism, pregnancy (...) , oesophagitis, vulvovaginitis), focal invasion (endophthalmitis, meningitis, endocarditis), and dissemination (candidaemia). History and exam presence of risk factors creamy white or yellowish plaques, fairly adherent to oral mucosa cracks, ulcers, or crusted fissures radiating from angles of the mouth lesions on any part of the oral mucosa atrophic, fiery red, flat lesions on the palate patchy areas of loss of filiform papillae on the dorsum of the tongue spotty red areas on the buccal mucosa lesions

2018 BMJ Best Practice

1525. Assessment of dysphagia

lateral sclerosis (ALS) Progressive supranuclear palsy Wilson's disease Tardive dyskinesia Idiopathic achalasia Nutcracker oesophagus Caustic agents Pill-induced injury Radiation exposure Oesophageal carcinoma Foreign body Benign oesophageal tumours (leiomyoma, lipoma, polyps) Oesophageal metastases Oesophageal compression Schatzki ring Gastroesophageal muscular ring Oesophageal diverticulum Eosinophilic oesophagitis Oesophageal web Botulism Oral mucositis Cervical osteophytes Contributors Authors (...) candidiasis Stroke Muscle tension dysphagia Diffuse oesophageal spasm Gastro-oesophageal reflux Hiatal hernia Post-operative cervical spine surgery Epiglottitis Retropharyngeal abscess Oropharyngeal carcinoma (squamous cell carcinoma) and metastases Zenker diverticulum Cricopharyngeal bar Thyromegaly (goitre) Cervical lymphadenopathy Oropharyngeal stenosis Parkinson's disease Vocal cord paralysis Multiple sclerosis Myasthenia gravis Sjogren's syndrome Scleroderma Inflammatory myopathies Amyotrophic

2018 BMJ Best Practice

1526. Snoring

snore. Can be a significant problem for both the patient and his or her bed partner. It may result in serious strain in a relationship and be socially disruptive. Common clinical features in patients who snore are obesity, retrognathia, large tongue, and large tonsils. Most patients will benefit from losing weight, stopping smoking, and avoiding alcohol. Some patients may benefit from using a mandibular advancement splint or from upper airway surgery. Surgical options may produce high initial (...) consumption Down's syndrome gastro-oesophageal reflux active or passive smoking abnormal epiglottis hypo-pharyngeal cysts or tumours rhinitis/nasal obstruction asthma Diagnostic investigations nasal decongestant test Epworth sleepiness score (ESS) snoring scale score TFTs growth hormone level allergy tests sleep study acoustic analysis pharyngeal manometry sleep nasendoscopy head and neck 3-dimensional CT head and neck MRI Treatment algorithm ONGOING Contributors Authors Specialty Registrar

2018 BMJ Best Practice

1527. Oral mucositis

of cancer therapy, with a potential impact on patient prognosis. Lalla RV, Saunders DP, Peterson DE. Chemotherapy or radiation-induced oral mucositis. Dent Clin North Am. 2014;58:341-349. [Figure caption and citation for the preceding image starts]: Mucositis: dorsolateral tongue From the teaching collection of Rajesh V. Lalla, DDS, PhD, CCRP, DABOM; used with permission [Citation ends]. [Figure caption and citation for the preceding (...) with a superficial pseudomembranous membrane) or, rarely, overt necrosis. If severe, may warrant an undesirable chemotherapy dose-reduction and/or a break in radiotherapy. Lesions are often very painful. Treatment is symptomatic and includes oral hygiene and pain control. Preventive treatments include palifermin, low-level laser therapy, and use of ice-chips during chemotherapy infusion therapy. Definition Oral mucositis secondary to cancer therapy is an acute inflammation of the oral mucosa in response

2018 BMJ Best Practice

1528. Assessment of oral ulceration

Necrotising ulcerative gingivitis Syphilis Gonorrhoea Tuberculosis Varicella-zoster virus infection Cytomegalovirus infection Zygomycosis Aspergillosis Histoplasmosis Blastomycosis Paracoccidioidomycosis Infectious mononucleosis (EBV) Squamous cell carcinoma Malignant salivary gland tumours (mucoepidermoid carcinoma and adenoid cystic carcinoma) Non-Hodgkin's lymphoma Kaposi's sarcoma Oral melanoma Contributors Authors Professor Oral Medicine Subject Expert Department of Comprehensive Dentistry UTHSCSA (...) , malnutrition) may present with more severe, widespread, atypical presentations that require a comprehensive assessment. Pathophysiology Most of the mucosa lining the oral cavity (e.g., floor of the mouth, cheeks, ventral tongue) is thin and delicate, rendering it susceptible to trauma. By contrast, the mucosa of the hard palate and gingiva is keratinised and more resistant to injury. The biologically dynamic nature of the oral mucosa makes it vulnerable to the effects of systemic disease. Hodgson TA

2018 BMJ Best Practice

1529. Assessment of aphasia

Alzheimer's disease Traumatic head injury Subdural haematoma Subarachnoid haemorrhage Migraine Herpes encephalitis West Nile encephalitis Bacterial infection/abscess Fungal abscess Prion disease Toxoplasmosis Lyme disease Non-fluent/agrammatic variant primary progressive aphasia (PPA) Semantic variant PPA Logopenic variant PPA Aphasia dysarthria motor neuron disease (amyotrophic lateral sclerosis [ALS]-frontotemporal degeneration) Primary brain tumour Brain metastases Multiple sclerosis Sarcoidosis Acute (...) , slowness, reduced range of movement, or impaired timing and coordination of the muscles of the jaw, lips, tongue, palate, vocal folds, and/or respiratory muscles (the speech articulators). Apraxia of speech is an impairment in the motor planning and programming of the speech articulators that cannot be attributed to dysarthria. These 3 disorders can co-exist, but often occur separately. They can be distinguished by evaluation of language (tests of word and sentence comprehension, naming, repetition

2018 BMJ Best Practice

1530. Assessment of taste disorders

and targeted therapies in patients having solid-tumour cancer or stem cell transplant therapy. Hovan AJ, Williams PM, Stevenson-Moore P, et al. A systematic review of dysgeusia induced by cancer therapies. Support Care Cancer. 2010;18:1081-1087. Approximately 60% of patients receiving systemic chemotherapy will report some dysgeusia, which has been associated with the type of cytotoxic agents and the presence of oral mucositis. Okada N (...) ear infections Upper airway endoscopy Oral surgical procedures Skull base surgery Ramsay Hunt's syndrome Stroke Head trauma Parkinson's disease Alzheimer's dementia Amyotrophic lateral sclerosis Multiple sclerosis Epilepsy Myasthenia gravis Guillain-Barre syndrome Sjogren's syndrome Renal insufficiency Liver failure Diabetes mellitus Hypothyroidism Pontocerebellar angle tumours Paraneoplastic syndrome Iron deficiency Vitamin B12 deficiency Zinc deficiency Contributors Authors Associate Professor

2018 BMJ Best Practice

1531. Kawasaki disease

Kawasaki disease Kawasaki disease - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Kawasaki disease Last reviewed: February 2019 Last updated: March 2018 Summary Acute febrile illness lasting 5 or more days. Typical signs include fever, polymorphic rash, injected eyes, and mucosal erythema with strawberry tongue. Swelling and erythema of the hands and feet occur in the acute stage, followed by desquamation (...) in the second week. Unilateral non-purulent cervical lymphadenopathy is present in about 40% of cases. Coronary aneurysms develop in 20% to 25% of untreated patients. Standard treatment includes intravenous immunoglobulin and/or aspirin. In resistant cases, corticosteroids or a tumour necrosis factor (TNF)-alpha inhibitor may be necessary. Definition Kawasaki disease (KD) is an acute, febrile, self-limiting, systemic vasculitis of unknown origin that almost exclusively affects young children

2018 BMJ Best Practice

1532. Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness

morbidity including type 2 diabetes mellitus (T2DM), cardiovascular disease (such as stroke and coronary artery disease), obstructive sleep apnoea, osteoarthritis, obesity related cancers and depression. 3, 6 The risk for these co-morbidities increases with increasing BMI. Especially people with obesity category II (BMI 35 to 30.0 kg/m²). 13 The increased prevalence of comorbidities results in a reduction of life expectancy, and thus a higher early mortality risk. 4, 5 In a recent epidemiologic study (...) arterial disease, nephropathy, neuropathy, retinopathy Hypertension Chronic kidney disease Hyperlipidaemia Peripheral artery disease Other diabetes complications Gastrointestinal Gastro-oesophagal reflux Gallstones Liver fat accumulation and Non- alcoholic steatohepatitis KCE Report 316 Bariatric Surgery 23 Cirrhosis – hepatocellular carcinoma Restricted ventilation Exertional dyspnoe; asthma Obstructive sleep apnoe Obesity hypoventilation syndrome (Pickwick syndrome) Mechanical effects of weight

2019 Belgian Health Care Knowledge Centre

1533. Sepsis: recognition, diagnosis and early management

(see recommendation 1.1.9) – people who have impaired immune function (for example, people with diabetes, people who have had a splenectomy, or people with sickle cell disease) – people taking long-term steroids – people taking immunosuppressant drugs to treat non-malignant disorders such as rheumatoid arthritis • people who have had surgery, or other invasive procedures, in the past 6 weeks • people with any breach of skin integrity (for example, cuts, burns, blisters or skin infections) • people (...) criteria are now becoming available in an area where inconsistent disease coding has hindered the acquisition of good baseline data and therefore of studying management strategies. Studies have been done in hospital settings – particularly in intensive care units. However, with such high mortality the challenge posed has been how to recognise the occurrence of sepsis as early as possible, not just outside of ICU and in the post-operative patient, but in other wards and even in community. The 2017 UK

2018 Best Practice Advocacy Centre New Zealand

1534. Diagnosis and management of gonorrhoea and syphilis

), Ine Vanden Bussche (Dokters van de wereld), Walli Van Doren (RIZIV – INAMI), Heleen Van Mieghem (vzw Ghapro), Kristien Wouters (Helpcenter ITM) External validators: Charles Cazanave (Pathologie infectieuse et tropicale, clinique et biologique, CHU Bordeaux, France), Henry de Vries (University of Amsterdam, Amsterdam Public Health Service STD clinic and the National Centre for Infectious diseases control) CEBAM assessors: Dirk Ramaekers, Martine Goossens, Annelies Van Raemdonck Acknowledgements (...) of research: Sarah Swannet (Guideline HIV for first line) Payments to speak, training remuneration, subsidised travel or payment for participation at a conference: Charles Cazanave (fees for communication to congress GILEAD, MSD); Tania Crucitti (FWO fees to take part to congresses; fees from the European Society for Infection Diseases in Obstetrics and Gynaecology – ESIDOG – for training sessions), France Laurent (symposium on vaccination for travelling), Christiana Nöstlinger (Participation to European

2019 Belgian Health Care Knowledge Centre

1535. Cost-effectiveness analysis of HPV vaccination of boys in Belgium

cancer, as there is no international consensus on which codes should be considered regarding HPV, we selected ICD codes C01, C05.1-9, and C09-10. These codes show a proportion of HPV positive cases above 10% in an EU multicentre study, are included in the oropharynx definition in the 2018 TNM classification of malignant tumours f and correspond to the outcomes of the Belgian study on HPV oropharyngeal cancers. 6, 25, 26 To estimate the diseases that are attributable to HPV, we extracted (...) HPV and 35% (26; 45) for high-risk HPV types, but included only two European studies. 36 f­ Classification-of-Malignant-Tumours-8th-edition.pdf 18 HPV vaccination of boys KCE Report 308 A small Belgian study estimated the anal prevalence among 149 HIV- negative women without a history of cervical cancer and attending a colposcopy clinic. 34 HPV was found in 56% of the 96 anal samples (compared to 54% of 149 cervical samples). However

2019 Belgian Health Care Knowledge Centre

1536. Antibiotic Prophylaxis for Dental Patients at Risk for Infection

Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult, 8th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2016:1441-53. 23. Baddour LM, Epstein AE, Erickson CC, et al. Update on cardiovascular implantable electronic device infections and their management. Circulation 2010;121(3):458-77. 24. Lick SD, Edozie SN, Woodside KJ, Conti VR. Strepto- coccus viridans endocarditis from tongue piercing. J Emerg Med 2005;29(1):57-9. 25. Lockhart PB, Loven B, Brennan MT (...) . Background Bacteremia (bacteria in the bloodstream) is anticipated follow- ing invasive dental procedures and can lead to complications in an immunodeficient patient. 6,7 High risk cardiac disease, immunosuppression, and immunodeficiencies may compromise one’s ability to fight simple infection. The rationale for anti- biotic prophylaxis is to reduce or eliminate transient bacteremia caused by invasive dental procedures. 8 Antibiotic usage may result in the development of resistant organisms. 3,6,7,9-11

2019 American Academy of Pediatric Dentistry

1537. Mouth Care

be rinsed thoroughly after meals. Dentures should be left out of the mouth overnight and soaked. Refer to ‘Edentulous patients’ advice. Mouth care if receiving chemotherapy/radiotherapy– key differences See local cancer centre/cancer network policy. Patients may be advised to avoid antipyretic analgesics (paracetamol, aspirin) if at risk of neutropenia (can mask fever due to sepsis). Patients receiving head and neck radiotherapy should avoid oil-based products. Other specialist advice regarding oral (...) care during radiotherapy may also be given by the cancer centre. Caphosol® is a supersaturated calcium phosphate mouthrinse approved for restricted use for the prevention of oral mucositis in patients undergoing radiotherapy for head and neck cancer, and for patients undergoing chemotherapy. Consultation with a haematologist or oncologist is required before prescription. Oral Hygiene Care Table 1: Specific measures Version 1 May 2014 Dry/coated mouth care Oral care should be provided at least four

2018 Scottish Palliative Care Guidelines

1538. Diphenhydramine

Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Diphenhydramine Diphenhydramine Aka: Diphenhydramine (...) , Benadryl From Related Chapters II. Indications See for Allergy III. Dosing: Standard Adult: 25-50 mg PO/IV/IM q6h Child: 5 mg/kg/day divided qid (12.5 mg/5 ml) IV. Preparation: Diphenhydramine 1% (for Local Anesthesia) Dilute Diphenhydramine 5% in (1:4) Longer delay to onset of action than Shorter duration of action than Images: Related links (...) -hand side of this page. But if you still have questions please contact us via Top results for diphenhydramine 1. Diphenhydramine Diphenhydramine Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease

2018 Trip Latest and Greatest

1539. Surgery

. They are intended to provide information quickly to support time-sensitive decisions. Information is available to the topic (...) an Advice Statement to accompany all evidence reviews. Key points Head and neck cancer of unknown primary ? In small single-arm case series, tumour detection rates for transoral robotic surgery (TORS) tongue base mucosectomy or lingual tonsillectomy in patients with head and neck cancer of unknown primary ranged from 51% to 54%. The extent of prior investigation that defined head (...) and neck cancer of unknown primary varied between studies. No studies were identified that directly compared detection rates 2018 4. Breast surgery for metastatic breast cancer. BACKGROUND: Metastatic breast cancer is not a curable disease, but women with metastatic disease are living longer. Surgery to remove the primary tumour is associated with an increased survival in other types of metastatic cancer. Breast surgery is not standard treatment for metastatic disease, however several recent

2018 Trip Latest and Greatest

1540. Ranitidine

. But if you still have questions please contact us via Top results for ranitidine 1. Drug Interaction Between Clopidogrel and Ranitidine or Omeprazole in Stable Coronary Artery Disease: A Double-Blind, Double Dummy, Randomized Study. 27289472 2016 07 16 2017 01 17 2017 02 03 1179-187X 16 4 2016 Aug American journal of cardiovascular drugs : drugs, devices, and other interventions Am J Cardiovasc Drugs Drug Interaction Between Clopidogrel and Ranitidine or Omeprazole in Stable (...) 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

2018 Trip Latest and Greatest

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