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Unintentional Weight Loss Causes


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21. 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

22. Unusual cause of chest pain: empyema necessitans and tubercular osteomyelitis of the rib in an immunocompetent man (PubMed)

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

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2016 BMJ case reports

23. Is MyPlate Approach to Helping Overweight Patients Lose Weight More Patient-centered?

to cause weight gain or prevent weight loss (e.g. corticosteroids, lithium, olanzapine, risperidone, clozapine) Unintentional weight loss within past 6 months (≥ 5% of body weight) Intentional weight loss within past 6 months (≥ 5% of body weight) Pregnant or nursing within past 6 months Plans to become pregnant within 18 months Another member of household is a study participant or trial staff member Problem alcohol use: Self reported average consumption of > 14 alcoholic drink per week or 5+ drinks (...) the last 6 months Serious medical condition likely to hinder accurate measurement of weight, or for which weight loss is contraindicated, or which would cause weight loss (e.g. End Stage Renal Disease on dialysis, cancer diagnosis or treatment within 2 yrs) Prior or planned bariatric surgery Use of prescription weight loss medication (including off label drugs e.g. topiramate, bupropion, byetta) or over-the-counter orlistat within 6 months Chronic use (at least past 6 months) of medications likely

2015 Clinical Trials

24. Body weight, anorexia, and undernutrition in older people. (PubMed)

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

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 ( (...) to Notice of rights ( 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. A review and meta-analysis of the effect of weight loss on all-cause mortality risk. (PubMed)

(healthy, unhealthy), baseline BMI (normal, overweight, obese), method used to estimate weight loss (measured weight loss, reported weight loss) and whether models adjusted for physical activity (adjusted data, unadjusted data) were used to classify subgroups for separate analysis. Intentional weight loss per se had a neutral effect on all-cause mortality (relative risk (RR) 1.01; P = 0.89), while weight loss which was unintentional or ill-defined was associated with excess risk of 22 to 39 (...) A review and meta-analysis of the effect of weight loss on all-cause mortality risk. Overweight and obesity are associated with increased morbidity and mortality, although the range of body weights that is optimal for health is controversial. It is less clear whether weight loss benefits longevity and hence whether weight reduction is justified as a prime goal for all individuals who are overweight (normally defined as BMI>25 kg/m2). The purpose of the present review was to examine the evidence

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2009 Nutrition research reviews

28. 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

29. 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

30. Type 2 diabetes in adults

/Supplement_1/S1 History and exam presence of risk factors asymptomatic candidal infections skin infections urinary tract infections fatigue blurred vision polydipsia polyphagia polyuria paraesthesias nocturia unintentional weight loss acanthosis nigricans older age overweight/obesity gestational diabetes pre-diabetes family history of type 2 diabetes African, Hispanic, or Native American ancestry physical inactivity polycystic ovary syndrome hypertension dyslipidaemia cardiovascular disease Diagnostic (...) antihyperglycaemic therapy for most patients. Glycaemic goals and treatment choices are individualised. Blood pressure control, lipid management, smoking cessation, and glycaemic management reduce the risk of macrovascular complications such as heart attack and stroke. Glycaemic control and blood pressure management reduce the risk of microvascular complications (neuropathy, nephropathy, retinopathy). Selected glucose-lowering drugs reduce all-cause and cardiovascular mortality. Definition Type 2 diabetes

2018 BMJ Best Practice

31. Coexisting severe mental illness and substance misuse: community health and social care services

are invited to the multi- agency and multidisciplinary meetings (see recommendation 1.3.9) and the discharge or transfer meeting. There is support to meet the person's housing needs. The discharge plan includes strategies for ongoing safety or risk management and details of how they can get back in contact with services. There are crisis and contingency plans in place if the person's mental or physical health deteriorates (including for risk of suicide or unintentional overdose). Providers share (...) the consequences of contact with statutory services. 1.6.5 Ensure any loss of contact or non-attendance at any appointment or activity is viewed by all practitioners involved in the person's care as a matter of concern. Follow-up actions could include: contacting the person to rearrange an appointment visiting the person at home contacting any other practitioners involved in their care, or family or carers identified in the person's care plan (see recommendation 1.2.4) contacting the person's care coordinator

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

32. Heart Disease and Stroke Statistics

. CVD prevalence excluding hypertension (CHD, HF, and stroke only) is 9.0% overall (24.3 million in 2016). In 2016, 2 744 248 resident deaths were registered in the United States. Ten leading causes accounted for 74.1% of all registered deaths. The 10 leading causes of death in 2016 were the same as in 2015; these include heart disease (No. 1), cancer (No. 2), unintentional injuries (No. 3), chronic lower respiratory diseases (No. 4), stroke (No. 5), Alzheimer disease (No. 6), DM (No. 7), influenza (...) and pneumonia (No. 8), kidney disease (No. 9), and suicide (No. 10). Seven of the 10 leading causes of death had a decrease in age-adjusted death rates. The age-adjusted death rates decreased 1.8% for heart disease, 1.7% for cancer, 2.4% for chronic lower respiratory diseases, 0.8% for stroke, 1.4% for DM, 11.2% for influenza and pneumonia, and 2.2% for kidney disease. The age-adjusted rate increased 9.7% for unintentional injuries, 3.1% for Alzheimer disease, and 1.5% for suicide. In 2016, ≈17.6 million

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2019 American Heart Association

33. Chest imaging

unintentional weight loss is to exclude an occult malignancy not detected by initial clinical evaluation and testing, usually in patients with abnormalities on baseline testing. Screening with CT is of limited value. Instead, diagnostic testing should be directed toward areas of concern based on the history and physical examination. 31 Age appropriate screening for malignancy (mammogram, pap smear) should also be encouraged. 32 The most common cause of malignancy in patients with unintentional weight loss (...) is gastrointestinal primary (47%), and gastrointestinal causes account for 45% of nonmalignant organic etiologies. 33 Therefore, endoscopy and/or colonoscopy should be considered for initial evaluation when there is evidence of a GI source. Imaging of the Chest Copyright © 2019. AIM Specialty Health. All Rights Reserved. 20 CT with contrast is sensitive for the detection of lymphoma, lung and genitourinary cancers, which are the next most common causes of malignancy in patients with unintentional weight loss

2019 AIM Specialty Health

34. Appropriate Use Criteria: Imaging of the Abdomen and Pelvis

a clinical diagnosis. While a commonly performed practice, there is conflicting evidence that abdominal radiography substantially aids the diagnosis of constipation with at best small likelihood ratios (1-1.2) based on well designed studies. 18 Constipation can have both functional and organic causes. When constipation is associated with red flag features such as failure to thrive, unexplained weight loss, or vomiting, referral to a pediatric gastroenterologist should be considered and additional testing (...) Lymphadenopathy 29 Pelvic floor disorders associated with urinary or bowel incontinence 29 Prostate cancer 29 Retroperitoneal conditions 30 Splenic hematoma 30 Splenomegaly 30 Sports hernia (athletic pubalgia) 30 Undescended testicle (cryptorchidism) 31 Imaging of the Abdomen and Pelvis Copyright © 2019. AIM Specialty Health. All Rights Reserved. 4 Nonspecific Signs and Symptoms 31 Abdominal pain 31 Azotemia 32 Lower extremity edema 32 Fever of unknown origin 32 Pelvic pain 32 Weight loss 33 Exclusions 33

2019 AIM Specialty Health

35. Hydralazine

, and unintentional weight loss. Five had polyarthralgias and 8 had lower extremity petechiae. All 12 patients were both ANA and ANCA positive 2018 7. Hydralazine Top results for hydralazine - Trip Database or use your Google+ account Liberating the literature My query is: English Français Deutsch Čeština Español Magyar Svenska ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words (...) Randomized Clinical Trial of Labetalol Versus Hydralazine for Severe Hypertension in Obstetric Patients (...) : No changes posted Full Text View Purpose Severe Hypertension in pregnancy demands urgent treatment because of high mortality & morbidity in obstetric patients. Hydralazine , the most commonly used agent, causes sudden hypotension and tachycardia. Labetalol because of combined α and β blocking effects lacks these side effects. Cochrane systematic review could include only three trials

2018 Trip Latest and Greatest

36. Fatigue

having tiredness lasting 1 month or longer, and 1.5% of people consult their GP with a new (...) symptom of tiredness each year. Tiredness can have a negative impact on work, family life, and social relationships. Red flags or alarm features in an adult with tiredness include: Significant unintentional weight loss (5% of body weight in 6–12 months). Lymphadenopathy suggestive of malignancy. Other symptoms and signs of malignancy, such as haemoptysis, dysphagia, rectal bleeding, breast lump (...) questions please contact us via Top results for fatigue 1. Tiredness / fatigue in adults Tiredness / fatigue in adults - NICE CKS Clinical Knowledge Summaries Share Tiredness / fatigue in adults - Summary Tiredness (or fatigue ) is often described as a lack of, or decreased, energy, and physical or mental exhaustion . Tiredness may be due to psychological, psychosocial, physical, or physiological causes or a combination of these. Between 10–18% of people in the UK report

2018 Trip Latest and Greatest

37. Placenta Praevia and Placenta Accreta: Diagnosis and Management

with placenta praevia or a low‐lying placenta as for any pregnant woman. Grade of recommendation: D General procedures for discussing and obtaining consent for caesarean section are described in detail in RCOG Consent Advice No. 7: Caesarean section . Evidence level 4 Women having a caesarean section for placenta praevia are at increased risk of blood loss of more than 1000 ml compared with women having a caesarean section for other indications (RR 3.97 #bib95% CI 3.24–4.85). Women with anterior placenta (...) are at increased risk of blood loss. Placenta praevia covering the internal cervical os and anterior placentation are independent risk factors (OR 4.1 and OR 3.5, respectively) for massive haemorrhage during caesarean section. A US case–control study from the National Institute of Child Health and Human Development (NICHD) Maternal‐Fetal Medicine Units (MFMU) Network Cesarean Section Registry has shown that maternal haemorrhagic morbidity is more common in women with praevia (19% versus 7%, adjusted RR 2.6

2018 Royal College of Obstetricians and Gynaecologists

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

, intervention, comparator and outcome PO by mouth PR per rectum p.r.n. as needed q1h every hour q4h every 4 hours q6h every 6 hours q8h every 8 hours q12h every 12 hours RCT randomized controlled trial RR relative risk SC subcutaneous SEAR South-East Asia Region SRE skeletal-related event TD transdermal WHO World Health Organization WPR Western Pacific Region9 EXECUTIVE SUMMARY INTRODUCTION Cancers are among the leading causes of morbidity and mortality worldwide, respon- sible for 18.1 million new cases (...) the evidence base. This pertains to antidepressants, anticonvulsants, opioid rotation and clinical regimens currently in established practice, but for which evidence of efficacy for cancer pain is lacking.14 WHO GUIDELINES FOR THE PHARMACOLOGICAL AND RADIOTHERAPEUTIC MANAGEMENT OF CANCER PAIN IN ADULTS AND ADOLESCENTS WHO GUIDELINES FOR THE PHARMACOLOGICAL AND RADIOTHERAPEUTIC MANAGEMENT OF CANCER PAIN IN ADULTS AND ADOLESCENTS 1. INTRODUCTION Cancers are among the leading causes of morbidity and mortality

2019 World Health Organisation Guidelines

39. Concise practice guidance on the prevention and management of accidental awareness during general anaesthesia

in cardiovascular instability, whereas dosing to lean body weight better preserves haemodynamic stability but increases the risk of AAGA. Dosing to adjusted body weight may offer a suitable compromise [24,25], supplemented by titrating the dose to hypnotic effect, aided by depth of anaesthesia monitoring where practical. At induction, the anaesthetist should always confirm loss of consciousness before administering NMBDs or before airway instrumentation by the following (notwithstanding RSI as discussed below (...) paralysis (interpreted as AAGA) associated with considerable distress and sequelae [2]. Syringes should be labelled, and managed in a way that prevents mis-identification [20]. Anaesthetists should ensure there are systematic processes in their own practice to prevent administration of NMBDs before induction of anaesthesia. If there is a near miss or actual maladministration in their own practice or in the department, they should manage the case expectantly (see below), reflect on the root causes

2019 Association of Anaesthetists of GB and Ireland

40. Urological Trauma

., et al. Terrorism in America. An evolving threat. Arch Surg, 1997. 132: 1059. 22. Frykberg, E.R. Medical management of disasters and mass casualties from terrorist bombings: how can we cope? J Trauma, 2002. 53: 201. 23. Jacobs, L.M., Jr., et al. An emergency medical system approach to disaster planning. J Trauma, 1979. 19: 157. 24. Eberle, B.M., et al. Thromboembolic prophylaxis with low-molecular-weight heparin in patients with blunt solid abdominal organ injuries undergoing nonoperative (...) fracture urethral injuries. Urology, 2014. 83: S48. 214. Barratt, R.C., et al. Pelvic fracture urethral injury in males-mechanisms of injury, management options and outcomes. Transl Androl Urol, 2018. 7: S29. 215. Mundy, A.R., et al. Urethral trauma. Part I: introduction, history, anatomy, pathology, assessment and emergency management. BJU Int, 2011. 108: 310. 216. Mundy, A.R., et al. Pelvic fracture-related injuries of the bladder neck and prostate: their nature, cause and management. BJU Int, 2010

2019 European Association of Urology

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