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Unintentional Weight Loss Causes

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181. Promoting Safety: Alternative Approaches to the Use of Restraints

needs and local circumstances. They neither constitute a liability nor discharge from liability. While every effort has been made to ensure the accuracy of the contents at the time of publication, neither the authors nor the Registered Nurses’ Association of Ontario give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of this work. Copyright (...) had just been released from restraints who subsequently died, with cause of death identified as acute pulmonary embolism. Contained in the report were the following recommendations associated with the creation of a guideline on the topic of restraints: Registered Nurses’ Association of Ontario (RNAO) 61. That the RNAO should develop a nursing best practice guideline for the use of restraints in psychiatric clients, in consultation with relevant stakeholders such as the Ontario Nurses’ Association

2012 Registered Nurses' Association of Ontario

182. Managing undernutrition in the elderly. Prevention is better than a cure

. obese as well as underweight elderly people can experience unintentional weight loss due to undernutrition (masked undernutrition). The risks associated with rapid loss of muscle mass remain in both groups of patients. 1,14 It is not possible to identify undernourished patients simply by their physical appearance, body mass index (bMI) or weight at a single time point, therefore systematic screening within general practice is a useful means of identifying those most at risk. Incorporating screening (...) . It is important to address all of these factors concurrently: addressing social factors without managing contributing medical factors and vice versa may not be fully effective. A multidisciplinary approach may assist in managing these patients. Identify ‘red flag’ conditions If a patient presents with undernutrition, the first objective in general practice is to assess for any potentially life- threatening or serious medical conditions (‘red flags’) that may have led to unintentional weight loss

2012 Clinical Practice Guidelines Portal

183. Treatment and recommendations for homeless people with Chronic Non-Malignant Pain

practice adaptations reflect their collective judgment about optimal pain management interventions for this population. The recommendations in this document specify what experienced clinicians know works best for patients experiencing homelessness, with the realistic understanding that limited resources, fragmented health care delivery systems, and loss to follow-up often compromise adherence to optimal clinical practices. We hope these recommendations provide helpful guidance to health care (...) ; Hwang et al., 2008; NCH, 2009; Griffith et al., 2010). Conditions of homelessness exacerbate suffering caused by pain and create barriers to pain management and treatment (Alford & Waldmann, 2004; Matter et al., 2009; Miaskowski et al., 2011). Numerous factors common to the experience of homelessness increase chronic pain or complicate management, including more frequent injuries, complex and poorly treated medical conditions, inadequate shelter, minimal social supports, lack of resources to pay

2011 National Health Care for the Homeless Council

184. Multidisciplinary Practical Guidelines for Gastrointestinal Access for Enteral Nutrition and Decompression From the Society of Interventional Radiology and American Gastroenterological Association (AGA) Institute, With Endorsement by Canadian Intervention

be started as the patient discon- tinues receiving clopidogrel. Clopidogrel therapy may be restarted the day after the procedure (28,31). Recommendations for a high-risk procedure in a patient with a high-risk condition are as follows. Warfarin should be stopped 5 days before the procedure. A therapeutic dose of low molecular weight heparin should be substituted, with the dose withheld on the morning of the procedure. That night, following the procedure, warfarin should be restarted at the full (...) . Clopidogrel: Withhold for 5 days before the procedure. 4. Aspirin: Do not withhold. 5. Low molecular weight heparin (therapeutic dose): Withhold one dose before the procedure. Antibiotic Prophylaxis Patients undergoing gastrostomy placement are often at increased risk for infection secondary to poor nutritional status, advanced age, comorbidi- ties, and immune compromise. Factors that increase risk for infection are patient-related (eg, diabetes, obesity, malnutrition, chronic steroid admin- istration

2011 Society of Interventional Radiology

185. Obesity

that intentional weight loss reduces mortality, whereas unintentional weight loss is associated with an increased risk of mortality. Due to an increased flux of cholesterol through the biliary system, weight loss may increase the chances of cholelithiasis developing. Diets with moderate amounts of fat that trigger gallbladder contraction may reduce this risk. Slow weight loss—e.g., 0.5– 1.0 kg/week—has been shown to prevent the formation of gallstones in patients with higher weight loss rates. Weight loss (...) apparent. In addition, smoking, weight change (weight gain and weight loss may be more detrimental than a stable weight) and unintentional weight loss may confound the estimation of health risks. Medical complications of obesity in the elderly are mainly associated with metabolic syndrome (with glucose intolerance, hypertension, dyslipidemia, and cardiovascular disease). Metabolic syndrome peaks at age 50–70 in males and age 60–80 in females, with an odds ratio (OR) of 5.8 in 65-year-old males and 4.9

2011 World Gastroenterology Organisation

186. Nutrition Screening, Assessment, and Intervention in Adult

Screening Tool 14 Appetite, unintentional weight loss Malnutrition Universal Screening Tool 15 BMI, change in weight Presence of acute disease Maastricht Index 16 Percentage ideal body weight Albumin, prealbumin, lym- phocyte count Nutrition Risk Classification 17 Weight loss, percentage ideal body weight, dietary intake Gastrointestinal function Nutritional Risk Index 18 Present and usual body weight Albumin Nutritional Risk Screening 2002 19 Weight loss, BMI, food intake Diagnosis (severity (...) in peer-reviewed publications and their fre- quent use by A.S.P.E.N. members and other healthcare professionals in clinical practice, academia, research, and Table 1. Selected Nutrition Screening and Assessment Instrument Parameters Instrument Anthropometry and/or Diet- Related Severity of Illness Other (Physical, Psychological Variables or Symptoms) Screening tools Birmingham Nutrition Risk Score 13 Weight loss, BMI, appetite, ability to eat Stress factor, (severity of diagnosis) Malnutrition

2011 American Society for Parenteral and Enteral Nutrition

187. From The Archives: The Skinny on Cachexia?Can it be Treated?

rheumatologic diseases (1). Cytokines are elevated in pro-inflammatory states and have been found to cause an activation of proteolysis and lipolysis (2, 3). Many tumors are known to produce their own cytokines, which were found to cause a decreased appetite and weight loss in animal models (4). The activity of the various cytokines involved produces a net negative energy balance in the patient suffering from a chronic disease. There are several other implicated hormonal factors that may induce cachexia (...) with a poor nutritional state will continue to be a difficult problem. Peer Review/Commentary by Theresa Ryan, MD Assistant Professor of Medicine, NYU Division of Medical Oncology: Anorexia-Cachexia Syndrome, or ACS, affects up to 80% of patients with advanced solid tumor malignancies. Although definitions vary, ACS is typically defined as a weight loss of > 5% of a patient’s pre-illness weight over a 2-6month period. ACS causes both physical and psychological distress and is associated with early

2011 Clinical Correlations

188. Preventing falls and harm from falls in older people

aged 65 years and older. However, this age limit need not be rigidly applied in implementing initiatives. A fall is defined as ‘a sudden, unintentional change in position causing an individual to land at a lower level, on an object, the floor, or the ground, other than as a consequence of a sudden onset of paralysis, epileptic seizure, or overwhelming external force’ xxviii . Strategies under the policy may focus on reducing falls and/ or on reducing the harm that occurs should a fall take place (...) . Harms caused by falls among older people include physical harm, such as fractures and traumatic brain injury and also negative psychological and functional impacts, such as loss of confidence in undertaking daily activities and inappropriate activity restriction. Obsolete Prevention of Falls and Harm from Falls among Older People 2011–2015 NSW Healt H Pa Ge 7 SECTION 3 Areas of action The following areas of action for NSW Health in prevention of falls among older people have been designed to provide

2011 Clinical Practice Guidelines Portal

189. Exercise and Sports Science Australia position statement on exercise and falls prevention in older people

Health, Injury Prevention Policy Unit; 2000. 7. Sjogren H, Bjornstig U. Unintentional injuries among elderly people: incidence, causes, severity, and costs. Acc Anal Prev 1989;21(3):233–42. 8. Carroll N, Slattum P, Cox F. The cost of falls among the community- dwelling elderly. J Manage Care Pharm 2005;11:307–16. 9. Scuffham P, Chaplin S, Legood R. Incidence and cost of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health 2003;57:740–4. 10. Tiedemann AC, Murray SM (...) or more times every year. 1 Falls can also result in disability, loss of mobility, reduced quality of life and fear of falling. 2 The rate of falling is even higher in residents of aged care facilities and in hospital patients. 3 Fall rates and the risk of multiple falls also increase signi?cantly with age. 4 Most falls result in only minor injuries, however * Corresponding author at: The George Institute for Global Health, PO Box M201, Missenden Rd, NSW 2050, Australia. E-mail address: atiedemann

2011 Clinical Practice Guidelines Portal

190. Limb Lengthening Using the PRECICETM Nail System: Complications and Results (PubMed)

posttraumatic (n = 5) and congenital (n = 4). The mean LLD was 36.4 ± 11.4 mm. The minimum follow-ups were 2 months (average, 5 months; range, 2 - 9 months).The mean distraction rate was 0.5 ± 0.1 mm/day. We observed in 7 patients differences in achieving the lengthening goals (average, 1.6 mm; range, -20.0 - 5.0 mm). Average lengthening was 34.7 ± 10.7 mm. All patients reached normal alignment and normal joint orientation. An unintentional loss of the achieved length during the consolidation phase (...) was noticed in patients with delayed bone healing in two cases. In the first case (loss of 20mm distraction) the nail could be redistracted and the goal length was achieved. In the second case (loss of 10mm distraction) the nail broke shortly after the diagnosis and the nail was exchanged.We report of loss of achieved length after lengthening with a telescopic nail. Weight bearing before complete consolidation of the regenerate might be a risk factor for that. Thorough examination of the limb length

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2016 Archives of trauma research

191. Robot Assisted Stereotactic Laser Ablation for a Radiosurgery Resistant Hypothalamic Hamartoma (PubMed)

. Recently, in children, stereotactic laser ablation has shown promise as a surgical technique that can combine the best features of both of these approaches for the treatment of HH. Here we present the first reported use of a frameless robot-assisted stereotactic system to treat an HH. The patient had failed two previous Gamma Knife radiosurgery treatments. Post-procedure he had a stable, but unintentional weight loss of 20 kg and a transient episode of hemiparesis the night of the operation. At six (...) Robot Assisted Stereotactic Laser Ablation for a Radiosurgery Resistant Hypothalamic Hamartoma Hypothalamic hamartomas (HH) are benign tumors that can cause significant morbidity in adults as a cause of epilepsy, particularly gelastic seizures. Open and endoscopic resections of HH offer good seizure control but have high rates of morbidity and are technically challenging. Stereotactic radiosurgery has been an alternative treatment; however, it results in comparably poor seizure control

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2016 Cureus

192. Hemophagocytic Lymphohistiocytosis in a Patient with Classical Hodgkin Lymphoma (PubMed)

clinicopathological features of HLH include fevers, cytopenias, hepatosplenomegaly, and hemophagocytosis in the bone marrow. Case Presentation. A previously healthy 28-year-old Caucasian male presented with a one-month history of persistent fever, night sweats, and unintentional weight loss. He was diagnosed with classical Hodgkin Lymphoma (HL) by core-needle biopsy of an axillary lymph node. Both bone marrow involvement by HL and hemophagocytosis were seen on subsequent bone marrow biopsy. Other findings (...) included pancytopenia, splenomegaly, and elevated serum ferritin. Extensive work-up for autoimmune and infectious etiologies was unremarkable. The patient had a complete response after chemotherapy with Adriamycin, bleomycin, vincristine, and dacarbazine. Conclusion. This report documents the exceedingly uncommon association between HLH and HL. HLH is a hyperinflammatory syndrome with high mortality, so it is imperative to identify and treat the underlying cause for secondary HLH. Malignancy-associated

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2016 Case reports in hematology

193. Comparing the Effectiveness of Two Dietary Interventions for Fecal Incontinence

: No Criteria Inclusion Criteria Experience at least 1 episode/week of unintentional loss of stool associated with diarrhea/loose stool (Bristol stool scale of 5 or greater). Subjects aged 18 and older meeting the Rome III criteria for Functional Fecal incontinence diagnostic criteria: Recurrent uncontrolled passage of fecal material in an individual and one or more of the following: Abnormal functioning of normally innervated and structurally intact muscles Minor abnormalities of sphincter structure (...) : December 11, 2018 See Sponsor: University of Michigan Collaborator: The Rome Foundation Information provided by (Responsible Party): Stacy Menees, University of Michigan Study Details Study Description Go to Brief Summary: Background: Fecal incontinence (FI) is a common complaint, and is often associated with diarrhea and urgency. Foods that are high in fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs) cause symptoms of diarrhea and urgency. Thus, assessing the impact of a low FODMAP

2016 Clinical Trials

194. Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS): A New Horizon for Surgical Critical Care and Induced Frailty

vulnerable when they experience: muscle weakness fatigue low physical activity, and unintentional loss in body weight, which has been agreed upon by a consensus of experts. Two additional non-intravenous contrasted CT scans will be obtained at 3 and 12 months as part of the study protocol to assess for interval change in SMI/sarcopenia. Objective mobility and activity monitoring will be performed to supplement assessment of frailty and disability. Wearable monitors (similar in size and appearance (...) will be determined as a combination of factors. An older adult is considered physically vulnerable when they experience: muscle weakness fatigue low physical activity, and unintentional loss in body weight, which has been agreed upon by a consensus of experts. This will be collected at baseline, 3, 6 and 12 months. Other: Modified Minnesota Leisure Time Activities A questionnaire used to assess physical activity will be administered at baseline, 3, 6 and 12 months. Other: Computed tomography morphometrics A CT

2016 Clinical Trials

195. SGLT2 Inhibition and Left Ventricular Mass

episodes any condition prohibiting MRI studies (e.g. metal implants, claustrophobia, body weight too high) including any suspected reaction after contrast agent application patient actively attempted to lose weight or experienced unintentional clinically significant weight loss during the last 3 months bariatric surgery or other gastrointestinal surgery procedures that induce chronic malabsorption treatment with any weight loss drug in the preceding 6 months planned significant changes of pre-study (...) weight loss. Finally, intramyocardial lipids are associated with impaired diastolic function in patients with type 2 diabetes mellitus. Myocardial insulin resistance may also contribute to heart failure, because genetic deletion of cardiac insulin receptors in mice worsens catecholamine-mediated myocardial injury. Heart failure risk may be further exacerbated through obesity-induced neurohumoral activation and systemic inflammation. Inflammatory cytokines are elevated in heart failure and modulate

2016 Clinical Trials

196. The ENRGISE Pilot Study

will be characterized with Fried criteria developed by Fried et al. that employ self-reported exhaustion, unintentional weight loss, low energy expenditure, slow gait speed, and weak grip strength. Those with >3 of the 5 factors are judged to be frail, those with 1 or 2 factors as pre-frail, and those with no factors as non-frail. Changes in the isometric hand grip strength will be performed at baseline, months 3, 6, 9, and 12, between the groups [ Time Frame: Changes from baseline to months 3, 6, 9, and 12 (...) -Mental State Exam (MMSE) score <24 (<23 for racial/ethnic minorities or participants with less than 9 years of education) Unable to communicate because of severe hearing loss or speech disorder Neurological conditions that are causing impaired muscle function or mobility (may include stroke with residual paresis, paralysis, neuropathy, Parkinson disease, or multiple sclerosis) Severe rheumatologic or orthopedic diseases, e.g., awaiting joint replacement, known active inflammatory or autoimmune

2016 Clinical Trials

197. Combination of PCI-32765 With Obinutuzumab in Untreated Follicular Lymphoma

not suitable for radiotherapy, or stage II bulky disease Age ≥ 18 years No prior lymphoma therapy Need for start of therapy as defined by: bulky disease at study entry according to the GELF criteria (nodal or extranodal mass >7 cm in its greater diameter) and/or B symptoms (fever, drenching night sweats, or unintentional weight loss of >10% of normal body weight over a period of 6 months or less) and/or hematopoietic insufficiency (granulocytopenia < 1.500/µl, Hb < 10 g/dl, thrombocytopenia < 100.000/µl (...) Functional Classification pulmonary (e.g. chronic lung disease with hypoxemia) endocrine (e.g. severe, not sufficiently controlled diabetes mellitus) renal insufficiency (unless caused by the lymphoma): creatinine > 2x normal value and/or creatinine clearance < 50 ml/min) impairment of liver function (unless caused by the lymphoma): transaminases > 3x normal or bilirubin > 2,0 mg/dl (unless caused by known Morbus Meulengracht [Gilbert-Meulengracht-Syndrome]) Positive test results for chronic HBV

2016 Clinical Trials

198. Efficacy Study of Thalidomide in Gastrointestinal Vascular Malformation Related Bleeding

treatment or surgery; Any significant "alarm symptoms" within the past 6 months, such as, unintentional weight loss, signs of gastrointestinal bleeding more than 2 weeks prior to enrolment, jaundice, or any other sign indicating serious or malignant disease; Malignancy or clinically significant cardiovascular, pulmonary, renal, pancreatic, hepatic disease, cirrhotic or portal hypertension gastropathy, rheumatologic disorders, uncontrollable diabetes mellitus or hypertension as judged by the investigator (...) red protrusions, with surrounding venous dilatation or patchy erythema with or without oozing; Exclusion Criteria: Less than 1 year of bleeding history; GI bleeding caused by Esophageal varices, Mallory Weiss syndrome, Zollinger-Ellison syndrome, Suspicion of gastric malignancy at baseline endoscopy, Post-Billroth-resection, Biliary disorders, Gastrointestinal tumors, Crohn's disease or Ulcerative colitis, Hemangioma or unknown source of GI bleeding; Bleeding that needs emergent endoscopic

2016 Clinical Trials

199. Metastatic Colon Cancer in an 18-Year-Old without Predisposing Factors (PubMed)

appendicitis, the working diagnosis may be considered to be anorexia. This case illustrates the importance of considering colon cancer among other disease entities as a cause of unintentional weight loss in adolescents. While this is a rare occurrence in the pediatric population, significant unintentional weight loss with altered bowel habits should prompt a search for underlying malignancy-even in the absence of a positive family history or predisposing cancer syndromes. (...) Metastatic Colon Cancer in an 18-Year-Old without Predisposing Factors While colorectal carcinoma is a common gastrointestinal cancer in adults, it is rare in pediatrics with an incidence of 1 : 1,000,000 and represents a fraction of neoplasms encountered in children. Malignant neoplasms represent a major cause of mortality in the pediatric age group. While presenting with weight loss, iron deficiency, rectal bleeding, abdominal pain, and change in bowel habits, or symptoms similar to acute

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2016 Case reports in pediatrics

200. Frailty and Mortality in Older Old With Severe Aortic Stenosis

, physical activity, fatigue, unintentional weight loss) and determination of inflammatory markers (C-reactive protein and interleukin-6). During follow-up, measures of functional impairment (basic and instrumental activities of daily living, walking speed and timed set up & go test), hospitalizations, death and quality of life will be determined. Condition or disease Intervention/treatment Aortic Stenosis Other: Frailty measurement Other: Comprehensive Geriatric Assessment Study Design Go to Layout (...) Pascual, Hospital de Meixoeiro Study Details Study Description Go to Brief Summary: BACKGROUND.- The frailty syndrome (FS) associates an increase in morbidity and mortality in the elderly patient. When severe and symptomatic, aortic stenosis (AS) is a disease with poor prognosis, the most frequent cause of heart surgery in the elderly and associates high health costs. No variables have been identified as determinants of morbidity and mortality of these patients and there are not algorithms developed

2016 Clinical Trials

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