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Unintentional Weight Loss Causes

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21. Unusual cause of chest pain: empyema necessitans and tubercular osteomyelitis of the rib in an immunocompetent man Full Text available with Trip Pro

Unusual cause of chest pain: empyema necessitans and tubercular osteomyelitis of the rib in an immunocompetent man A 33-year-old man, born in India but resident in the UK for 5 years, presented to the emergency department with a 4-week history of a dry cough and right-sided pleuritic chest pain. He reported systemic features, including fever and unintentional weight loss. His medical history included vitamin D deficiency. He had travelled to India 10 months previously and denied any exposure

2016 BMJ case reports

22. Megestrol Acetate With or Without Mirtazapine in Treating Cancer Patients With Weight Loss or Loss of Appetite

confirmed solid malignancy Patient must be >=18 years old. Patient must have shown unintentional weight loss of >= 5% in 6 weeks dating back from time of consent or >= 10% in 6 months dating back from time of consent Patient must have a poor appetite (defined as a score of =< 14 on the Simplified Nutritional Appetite Questionnaire (SNAQ) Prior diagnostic or therapeutic surgery is allowed as long as the wound has fully healed, the patient has fully recovered from the procedure, and at least 4 weeks have (...) Megestrol Acetate With or Without Mirtazapine in Treating Cancer Patients With Weight Loss or Loss of Appetite Megestrol Acetate With or Without Mirtazapine in Treating Cancer Patients With Weight Loss or Loss of Appetite - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved

2011 Clinical Trials

23. Body weight, anorexia, and undernutrition in older people. (Abstract)

people. When excessive, the loss of lean muscle tissue results in sarcopenia, which is associated with poor health outcomes. Unintentional weight loss in older people may be a result of protein-energy malnutrition, cachexia, the physiological anorexia of aging, or a combination of these. The physiological anorexia of aging is a decrease in appetite and energy intake that occurs even in healthy people and is possibly caused by changes in the digestive tract, gastrointestinal hormone concentrations (...) Body weight, anorexia, and undernutrition in older people. Ideal body weight for maximum life expectancy increases with advancing age. Older people, however, tend to weigh less than younger adults, and old age is also associated with a tendency to lose weight. Weight loss in older people is associated with adverse outcomes, particularly if unintentional, and initial body weight is low. When older people lose weight, more of the tissue lost is lean tissue (mainly skeletal muscle) than in younger

2013 Journal of the American Medical Directors Association

24. This doctor stopped telling patients to lose weight. Here’s why.

, and that even dangerous methods of weight loss are worth the risk. More disturbingly, we may ignore unintentional weight loss in our patients — and they may do the same — even though this can be an ominous sign. Marjorie Williams, a reporter for the Washington Post, about the weight loss she not only ignored but celebrated: “I was too happy enjoying this unexpected gift to question it even briefly: the American woman’s yearning for thinness is so deeply a part of me that it never crossed my mind (...) the nutritionist. A few months later, she came back to check her progress. She had lost weight, about five pounds, but was concerned because her heart “felt like it was racing.” After I questioned her extensively, she told me she was using a weight loss drug she bought from a friend. She wasn’t sure what was in it, but I knew similar drugs had been found to contain amphetamines. She agreed to throw the drug away. She regained the weight. Since then, I have worried that telling patients to lose weight

2016 KevinMD blog

25. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management

for adults.] 1.6.6 Screening should assess body mass index (BMI) and percentage unintentional weight loss. It should also consider the time over which a nutrient intake has been unintentionally reduced and/or the likelihood of future impaired nutrient intake. The Malnutrition Universal Screening T ool (MUST), for example, may be used to do this. [2008] [2008] [This recommendation is adapted from the NICE guideline on nutrition support for adults.] 1.6.7 When screening for malnutrition and the risk (...) of strok Prompt recognition of symptoms of stroke and tr e and transient ischaemic attack ansient ischaemic attack 1.1.1 Use a validated tool, such as FAST (Face Arm Speech T est), outside hospital to screen people with sudden onset of neurological symptoms for a diagnosis of stroke or transient ischaemic attack (TIA). [2008] [2008] 1.1.2 Exclude hypoglycaemia in people with sudden onset of neurological symptoms as the cause of these symptoms. [2008] [2008] 1.1.3 For people who are admitted

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

26. Renal replacement therapy and conservative management

and skills in this area. 1.7.3 Re-assess dietary management and fluid allowance when: a person's circumstances change (for example, when switching RRT modality), or biochemical measures or body composition measures (for example, unintentional weight loss) indicate, or the person (or, where appropriate, their family members or carers) asks. Renal replacement therapy and conservative management (NG107) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms (...) to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 10 of 33Fatigue Insomnia Itching Lethargy Pain Poor appetite Swelling T aste changes Thirst Weakness Weight loss/gain Gastro-intestinal/urological Abdominal cramps Change in bowel or urinary habits Nausea Musculoskeletal Muscle cramps Restless legs Neurological Cognitive impairment Dizziness Headaches Psychological/behavioural Anxiety Body image concerns Depression Mood disturbances/fluctuations Sexual dysfunction

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

27. British guideline on the management of asthma

, predominant cough Gastro-oesophageal reflux Orthopnoea, paroxysmal nocturnal dyspnoea, peripheral oedema, pre- existing cardiac disease Cardiac failure Crackles on auscultation Pulmonary fibrosis With airflow obstruction Significant smoking history (ie, >30 pack-years), age of onset >35 years COPD Chronic productive cough in the absence of wheeze or breathlessness Bronchiectasis*; inhaled foreign body*; obliterative bronchioitis; large airway stenosis New onset in smoker, systemic symptoms, weight loss (...) treatment Severe/life-threatening asthma attack Severe/life-threatening asthma attack ‘Red flags’ and indicators of other diagnoses Prominent systemic features (myalgia, fever, weight loss) Failure to thrive Unexpected clinical findings (eg crackles, clubbing, cyanosis, cardiac disease, monophonic wheeze or stridor) Unexplained clinical findings (eg focal signs, abnormal voice or cry, dysphagia, inspiratory stridor) Persistent non-variable breathlessness Symptoms present from birth or perinatal lung

2019 SIGN

28. Obinutuzumab for untreated advanced follicular lymphoma

sites, especially if lymph nodes cause problems because of their location, or if people have fever, night sweats or unintentional weight loss. The committee concluded that people with symptomatic disease reflect the relevant population to consider in this appraisal. Obinutuzumab for untreated advanced follicular lymphoma (TA513) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 25Rituximab plus chemother (...) of this submission by the evidence review group (ERG). See the committee papers for full details of the evidence. Clinical need in advanced follicular lymphoma P People with follicular lymphoma want further options for treatment eople with follicular lymphoma want further options for treatment 3.1 Follicular lymphoma progresses slowly over many years, often without symptoms. The patient experts noted that, despite this, knowing that the disease will eventually progress can cause considerable distress. People

2018 National Institute for Health and Clinical Excellence - Technology Appraisals

29. Management of Poisoning

It is estimated that 350,000 people died worldwide from unintentional poisoning in 2002. 1 In Singapore, injuries (including poisoning) ranked as the ? fth leading cause of death and the leading cause of hospitalisation from 2007 to 2009. The pattern of poisoning has changed as the public is now exposed to other new drugs and chemicals. New antidotes and therapies have also been developed for the management of such poisoning, and are now available to health professionals. The Ministry of Health released its (...) as unopposed alpha agonism may worsen accompanying hypertension (pg 57). Grade D, Level 3 D Physostigmine should be considered for treating tachycardia resulting from pure anticholinergic poisoning (pg 58). Grade D, Level 3 Executive summary of key recommendations2 GPP Lidocaine is the drug of choice for most ventricular arrhythmias due to drug toxicity (pg 58). GPP C Sodium bicarbonate should be used in impaired conduction defect caused by sodium channel blocking agents such as tricyclic antidepressants

2020 Ministry of Health, Singapore

30. What works to improve early grade literacy in Latin America and the Caribbean? A systematic review and meta?analysis Full Text available with Trip Pro

all countries in this graph with equal weight Source: from Are Latin American children's reading skills improving? Highlights of the second and third regional comparative and explanatory studies (SERCE & TERCE). Washington, DC: American Institutes for Research; p. 15. Reprinted with permission However, we still find great disparities among the poor, rural, indigenous, and other disadvantaged groups in the region. In addition, one in four third graders performed so poorly that they were categorized (...) levels include level 1 and below. (2) The mean score for the region includes all countries except for Cuba, El Salvador, and Honduras with equal weights. (3) Cuba's and El Salvador's scores are from 2006 Source: from Are Latin American children's reading skills improving? Highlights of the second and third regional comparative and explanatory studies (SERCE & TERCE). Washington, DC: American Institutes for Research; p. 19. Reprinted with permission There are many reasons to explain the poor literacy

2019 Campbell Collaboration

31. Citizen engagement in public services in low? and middle?income countries: A mixed?methods systematic review of participation, inclusion, transparency and accountability (PITA) initiatives Full Text available with Trip Pro

or monitoring results, and working through local community organisations were identified as further facilitating factors that strengthened the weight of citizens’ voices and their power to hold service providers to account. Rights information interventions were more likely to be successful where they targeted the provision of services that citizens access through interactions with service provider staff; created a sense of common knowledge about people's rights to the service amongst both citizens (...) motivation to stimulate behaviour changes amongst service providers to improve service delivery quality. This is particularly critical in CBNRM, to ensure interventions do not do unintentional harm by increasing the burden on communities for resource management without enabling them to realise full access to the benefits in return. Interventions that do not incorporate specific measures to facilitate the inclusion of vulnerable groups may not realise equitable outcomes for those groups in the short‐term

2019 Campbell Collaboration

32. Staff and associate specialist (SAS) grade handbook

the recent reclassification. Addiction used in this chapter relates to an end-stage SUD. The inability to abstain and impaired control refer to the loss of control in addiction, the broken promises of ‘I’ll just have one’, etc. Characteristically, there is a history of multiple failed attempts at controlled drinking or stopping for a month, but after the first drink has been taken again, control over not drinking any more is lost and the seemingly irrational compulsion to continue is overwhelming

2020 Association of Anaesthetists of GB and Ireland

33. Productive healthy ageing: interventions for quality of life

of malnutrition – including those with limited income, poor appetite, poor dentition, mobility issues or disabilities that make it difficult to buy and/or prepare food, mental health issues, dysphagia, as well as people who are socially isolated, have a chronic illness, have experienced unintentional weight loss or changes in appetite, or are experiencing physiological changes (such as decreased bone mass, immune dysfunction, anaemia and poor wound healing). 21 ? Undernutrition can lead to nutrient (...) ? If you think a person may be malnourished: o Encourage a balanced diet, including frequent meals and snacks. o Encourage them to make an appointment with an appropriate health care professional, such as a registered dietitian. o Talk to them about their eating habits and weight/recent weight loss - ask them questions to open up the conversation, eg “Tell me what you had to eat yesterday”. o Encourage them to attend social events which include meals, such as lunch clubs. Some examples are hosted

2019 Public Health England

34. Haemodialysis

[tiab] OR dialysis[tiab]) followed by title/abstract-filtered topic terms (“dialysis dose”, Kt/V, augmented, intensive, conservative, incremental, pregnancy, membrane, hydration, “dry weight”, “fluid overload”, dialysate, potassium, bicarbonate, buffer, phosphate, “dialyser reaction”, hypersensitivity, “blood loss”, “needle dislodgment”, exsanguination, “home haemodialysis”, “nocturnal haemodialysis”, exercise, “physical training”) followed by negative terms (e.g. to exclude animal studies and acute (...) , with low ultrafiltration rates and regular clinical assessment, anticipating the typical change in weight during pregnancy. [2C] 3. Membrane flux and haemodiafiltration We recommend that patients with minimal residual function should be treated with high-flux dialysers. [1B] We suggest that haemodiafiltration may be considered as a treatment for intra-dialytic hypotension refractory to other measures, and for dialysis patients with favourable prognosis who are unable or unlikely to be transplanted. [2B

2019 Renal Association

35. Society of Interventional Radiology Quality Improvement Standards on Percutaneous Ablation in Renal Cell Carcinoma Full Text available with Trip Pro

and reporting criteria--a 10-year update. J Vasc Interv Radiol . 2014 ; 25 : 1691–1705 | | | | | 29 ). Certainly, multiphasic, contrast-enhanced imaging (eg, US, CT, MR imaging) is preferred to unenhanced techniques ( x 46 Iannuccilli, J.D., Grand, D.J., Dupuy, D.E., and Mayo-Smith, W.W. Percutaneous ablation for small renal masses-imaging follow-up. Semin Intervent Radiol . 2014 ; 31 : 50–63 | | | 46 ). • Overall survival: Length of patient survival, regardless of cause of death. Overall survival should (...) Radiol . 2014 ; 25 : 1691–1705 | | | | | 29 ). • Cancer-specific survival: Length of patient survival when cause of death is related to the malignancy. Cancer-specific survival should be calculated both from the time of initial cancer diagnosis and from the start of IGTA therapy ( x 29 Ahmed, M., Solbiati, L., Brace, C.L. et al. Image-guided tumor ablation: standardization of terminology and reporting criteria--a 10-year update. J Vasc Interv Radiol . 2014 ; 25 : 1691–1705 | | | | | 29 ). • Time

2020 Society of Interventional Radiology

36. Palliative Care for Adults

• Introduced when disease progresses despite therapy Heart Disease • Stage III or IV heart failure despite optimal medical management • Angina refractory to medical or interventional management • Frequent emergency department visits or hospital admissions • Frequent discharges from implanted defibrillators despite optimal device and antiarrhythmic management Pulmonary Disease • Oxygen-dependent, O 2 sats less than 88% on room air • Unintentional weight loss • Dyspnea with minimal to moderate exertion (...) Annotationswww.icsi.org Institute for Clinical Systems Improvement 14 Palliative Care for Adults Sixth Edition /January 2020 Debility/Failure to Thrive • Greater than three chronic conditions in patient over 75 years old • Functional decline • Weight loss • Patient/family desire for low-yield therapy • Increasing frequency of outpatient visits, emergency department visits, hospitalizations Cancer • Uncontrolled symptoms due to cancer or treatment • Introduced at time of diagnosis – if disease likely incurable

2020 Institute for Clinical Systems Improvement

37. KDOQI Clinical Practice Guidelines for Nutrition in CKD

cholesterol HGS Handgrip Strength HOMA-IR Homeostatic Model Assessment of Insulin Resistance HR Hazard ratio hsCRP High sensitivity C-reactive protein IBW Ideal body weight IDPN Intradialytic parenteral nutrition IL-6 Interleukin IMT Intima media thickening IV Intravenous Guideline on Nutrition in CKD Page 6 KA Ketoacid KAA Ketoacid analogue KDIGO Kidney Disease: Improving Global Outcomes KDQOL-SF Kidney disease quality of life short form KDOQI Kidney Disease Outcomes Quality Initiative KQ Key question (...) as it remains the gold standard for measuring body composition despite being influenced by volume status (OPINION). Body Composition and Body Weight/BMI 1.1.4 In adults with CKD 1-5D and post-transplant, it reasonable to consider assessing body composition in combination with body weight/BMI at the first visit and to monitor overall nutrition status periodically over time (OPINION). Guideline on Nutrition in CKD Page 26 Frequency of Body Weight/BMI and Body Composition Assessment 1.1.5 In adults with CKD 1

2020 National Kidney Foundation

38. Public health guidance on HIV, hepatitis B and C testing in the EU/EEA

of life. One QALY equates to one year of life in perfect health. For an individual requiring an intervention, QALY would be the weighted value of each year remaining to the patient with a quality of life score (on a 0 to 1 scale). In cost- effectiveness studies, QALYs are used to assess the effectiveness of a new intervention against baseline intervention. Rapid diagnostic test (RDT): Test that provides result with a short turnaround time, typically with oral fluid or finger prick blood sample. RDTs (...) ADVICE Public health guidance on HIV, hepatitis B and C testing in the EU/EEA – An integrated approach 5 2 Background 2.1 Burden of disease 2.1.1 Hepatitis B and C HBV and HCV can both cause acute and chronic hepatitis, potentially leading to the development of cirrhosis, liver cancer and death. In the EU/EEA, an estimated 4.7 million people are chronically infected with HBV and 3.9 million with HCV [14]. Many of these infections go undiagnosed, as chronic infection is frequently asymptomatic. Both

2019 European Centre for Disease Prevention and Control - Public Health Guidance

39. Management of Type 2 Diabetes Mellitus

, a fasting plasma glucose (FPG) or oral glucose tolerance test (OGTT) may also be used to diagnose diabetes. The diagnosis can be made if a fasting glucose level is greater than or equal to 126 mg/dL (7.0 17 UMHS Management of Type 2 Diabetes Mellitus June, 2017 mmol/l), but should be confirmed on a separate day. Diabetes may also be diagnosed on the basis of symptoms (polydipsia, polyuria, unintentional weight loss) and elevated glucose level (= 200 mg/dL), but should also be confirmed on a separate day (...) diet, exercise, and weight loss), acarbose, and metformin have all been shown to reduce the progression of pre-diabetes to diabetes. Diagnosis. The American Diabetes Association (ADA) has added HbA1c as a screening as well as diagnostic test for diabetes. While some disagreement exists concerning the specific level that defines type 2 diabetes, the current ADA definition is that diabetes is diagnosed if A1c is 6.5% or higher. This cut point is specific but not sensitive and thus individuals

2020 University of Michigan Health System

40. Guidelines For Professional Ultrasound Practice

for the Provision of an Ultrasound Service’. https://www.rcr.ac.uk/publication/standards-provision-ultrasound-service It provides guidance on topics that were not included in the joint RCR/SCoR Standards document and provides further detailed advice on some areas of practice that were. There can be overlap between the terms ‘Standards’, ‘ Guidelines’ and ‘Protocols’ and this can cause confusion. For the purposes of this document, the definitions used are the same as those in the above 2014 Royal College

2019 British Medical Ultrasound Society

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