How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

521 results for

Unintentional Weight Loss Causes

by
...
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

61. Exam Series: Guide to the Knee Exam

, tender to palpation. May mimic a joint effusion or a septic knee. Ultrasound may help differentiate between bursitis and a joint effusion. Aspiration is required if there is any suspicion of infection. Systemic disease (ex. Rheumatoid Arthritsi) Known history of disease of systemic symptoms including fever, chills, night sweats, fatigue, or unintentional weight loss. Insidious onset pain with morning stiffness. Often associated with effusions and Baker’s cysts. Bony erosions, typically first seen (...) to form an overall impression of the case. History of Presenting Illness: Understanding the mechanism of injury is essential in the assessment of knee pain. An acute and traumatic etiology suggests a structural cause of pain. It is also important to determine whether the patient has been able to weight bear, as this guides imaging decisions. Pain characteristics: Identify the onset, position (anterior vs. posterior, medial vs. lateral), quality, radiation, severity, and duration of the pain

2018 CandiEM

62. Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments: A Scientific Statement From the American Heart Association

studies using BMI versus waist-to-hip ratio (WHR). One limitation of relying on BMI is that it does not take into account the distribution of body fat differentials, which may be better assessed with WHR. The MASALA study done in the United States showed that compared with NHWs, South Asians were less physically active and had lower adiponectin and higher resistin levels. South Asians had lower BMI, body weight, and waist circumference compared with all other racial/ethnic minority groups except (...) , although variations across the genome and patterns within that variation are complex and different in these subgroups, the majority of studies have suggested that the underlying biological pathways are actually similar. Thus, although the genetics of CVD in ethnic subpopulations can be characterized by allelic heterogeneity (in which different variants in the same genetic locus cause the same phenotype), the genes and resulting biology are common, with differences in risk reflecting differences

Full Text available with Trip Pro

2018 American Heart Association

63. Health Literacy and Cardiovascular Disease: Fundamental Relevance to Primary and Secondary Prevention: A Scientific Statement From the American Heart Association

in relation to obesity and diet. Community- and school-based educational programs provide avenues for educating youth in communities vulnerable to limited health literacy. The life course impact of limited health literacy on obesity merits examination. Making weight loss, exercise, and diet education programs accessible and available to individuals with limited health literacy is essential. Interventions and programs that incorporate mobile health offer novel opportunities but must be developed so (...) had adjusted IRR of 0.73 (95% CI, 0.39–1.36) favoring multisession vs single-session group. Wu et al Multisite RCT 595 S-TOFHLA Ambulatory Hospitalization, mortality 12 mo Limited HL, all-cause hospitalization and mortality IRR of 1.43 (95% CI, 1.00–2.05). Mixon et al Prospective cohort 471 S-TOFHLA Hospitalization Medication errors NA Higher HL (OR, 0.84; 95% CI, 0.74–0.95) and subjective numeracy (OR, 0.77; 95% CI, 0.63–0.95) reduced medication error. McNaughton et al Retrospective, hospital

Full Text available with Trip Pro

2018 American Heart Association

64. Evaluation and Treatment of Hirsutism in Premenopausal Women

therapy) resulted in weight loss, a decrease in serum testosterone and fasting insulin concentrations, and a small improvement in Ferriman–Gallwey scores when compared with minimal or no treatment—mean difference, −1.19 [95% confidence interval (CI) (−2.35 to −0.03)] ( ). However, lifestyle changes should not be considered a primary therapy for hirsutism, as their impact is not clinically significant, particularly when compared with OCs ( ). Our approach is consistent with the Endocrine Society (...) of at least 6 months before making changes in dose, switching to a new medication, or adding medication. (2 |⊕OOO) 3.8. In patients with severe hirsutism causing emotional distress and/or in those women who have used oral contraceptives in the past and have not experienced sufficient improvement, we suggest initiating combination therapy with an oral contraceptive and antiandrogen (2 |⊕⊕OO). However, we suggest against combination therapy as a standard first-line approach. (2 |⊕⊕OO) Other drug therapies

Full Text available with Trip Pro

2018 The Endocrine Society

65. Breastfeeding Programs and Policies, Breastfeeding Uptake, and Maternal Health Outcomes in Developed Countries

or breastfeeding for longer durations may be associated with lower rates of breast cancer, epithelial ovarian cancer, hypertension, and type 2 diabetes, but not fractures. Because of heterogeneity and inconsistent results, we found insufficient evidence on whether breastfeeding is associated with postpartum depression, cardiovascular disease, or postpartum weight change. x Conclusions. The body of evidence for breastfeeding programs and policies was diverse in terms of interventions and settings. Current (...) cannot determine cause-and-effect relationships. xi Contents Evidence Summary 1 Chapter 1. Introduction 1 Background 1 Existing Guidelines 2 Rationale for Evidence Review 3 Key Questions 3 Analytic Framework 4 Organization of This Report 4 Chapter 2. Methods 5 Protocol Review 5 Literature Search Strategy 5 Search Strategy 5 Inclusion and Exclusion Criteria 5 Study Selection 7 Data Extraction 7 Risk of Bias Assessment of Individual Studies 8 Risk of Bias Assessment of Systematic Reviews 8 Data

2018 Effective Health Care Program (AHRQ)

66. Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions

contributed to an estimated death of 1825 students through unintentional injuries (eg, motor vehicle collisions), , and about 1 in 4 students report that alcohol use contributes to missing or falling behind in classes, low grades, and poor performance on examinations and papers. , In 2010, excessive alcohol use cost the United States an estimated $249 billion in loss in workplace productivity, health care expenses, criminal justice expenses, and motor vehicle collisions. Alcohol use during pregnancy can (...) result in preterm birth and low birth weight. It is a major preventable cause of birth defects and developmental disabilities, including fetal alcohol spectrum disorders, and affects development of the fetal brain, endocrine system, gastrointestinal tract, heart, kidney, and liver. The 2011-2013 Behavioral Risk Factor Surveillance System survey shows that 1 in 10 pregnant women aged 18 to 44 years reported consuming alcohol in the previous month, and 3.1% participated in binge drinking. Scope

2018 U.S. Preventive Services Task Force

67. Evaluation and Treatment of Hirsutism in Premenopausal Women

therapy) resulted in weight loss, a decrease in serum testosterone and fasting insulin concentrations, and a small improvement in Ferriman–Gallwey scores when compared with minimal or no treatment—mean difference, −1.19 [95% confidence interval (CI) (−2.35 to −0.03)] ( ). However, lifestyle changes should not be considered a primary therapy for hirsutism, as their impact is not clinically significant, particularly when compared with OCs ( ). Our approach is consistent with the Endocrine Society (...) of at least 6 months before making changes in dose, switching to a new medication, or adding medication. (2 |⊕OOO) 3.8. In patients with severe hirsutism causing emotional distress and/or in those women who have used oral contraceptives in the past and have not experienced sufficient improvement, we suggest initiating combination therapy with an oral contraceptive and antiandrogen (2 |⊕⊕OO). However, we suggest against combination therapy as a standard first-line approach. (2 |⊕⊕OO) Other drug therapies

Full Text available with Trip Pro

2018 The Endocrine Society

68. Management of Pregnancy

schedules. Federal laws addressing breastfeeding in the workplace exist but are relatively new.[ ] 11 In contrast, the infant mortality rate has declined 15% between 2005 and 2015, from 6.86 infant deaths per 1,000 live births to 5.82.[ ] The Centers for Disease Control and Prevention (CDC) indicated the following were the five leading causes of infant death in 2014:[ ] 12 13 • Birth defects • Preterm birth or low birth weight • Maternal complications of pregnancy • Sudden infant death syndrome (SIDS (...) ) • Unintentional injuries (e.g., accidental suffocation) From 2005 to 2014, congenital malformations remained the leading cause of infant death, although congenital malformations declined by 11% during that period. Preterm birth rates rose over 20% from 1990 (10.6%) through 2006 (12.8%). The preterm birth rate then declined from 2007 through 2014 from 10.4% to 9.6%, but increased slightly to 9.6% in 2015. Increases in preterm births were seen among non- Hispanic black and Hispanic women.[ ] 14 Cesarean birth

2018 VA/DoD Clinical Practice Guidelines

69. Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

with prior opioid exposure. Such findings emphasize the importance of preprocedural pain assessment and preemptive analgesia, when appropriate, for procedures known to cause pain . Indeed, severe procedural pain is associated with severe adverse events (e.g., tachycardia, bradycardia, hypertension, hypotension, desaturation, bradypnea, and ventilator distress) ( ) that may be prevented with appropriate pain assessment and preemptive analgesia. Evidence Gaps: Future research should include the following (...) in Supplemental Table 5 (Supplemental Digital Content 7, ), and the psychometric scores and the quality of evidence supporting each pain scale are described in Supplemental Table 6 (Supplemental Digital Content 8, ). The CPOT and the BPS remain the most robust scales for assessing pain in critically ill adults unable to self-report. Each has very good psychometric properties with scores of 16.7 and 15.1, respectively. The BPS-NI obtained a psychometric weighted score of 14.8. Although both the BPS

2018 Society of Critical Care Medicine

70. When and how to treat hyponatremia in the ED

polydipsia, and water intoxication (intentional or unintentional). In infants and children, GI fluid loss and unintentional ingestion of excessive water are most common 5 . Besides thiazide and SSRIs, medications that can cause hyponatremia include other anti-depressants, anti-psychotics, anti-epileptics, and NSAIDs 1 . Why does this matter? Pathophysiology and Complications of Hyponatremia Left untreated, hyponatremia can be a life-threatening condition. Hypotonic plasma leads to a shift of water from (...) Additional testing can be performed to identify whether the hyponatremia is hypo-, hyper-, or euvolemic. which is crucial in identifying the underlying etiology and guide treatment. Failure to identify the underlying cause of hyponatremia can lead to therapy that harms the patients 4 . Hypovolemic Euvolemic Hypervolemic Definition Loss of sodium and relatively lesser loss of body water Normal total body sodium and excess total body water Increased sodium with relatively greater increase in body water

2018 CandiEM

71. Improving Quality of Life: Substance Use and Aging

services. This chapter provides an overview of some of the harmful consequences of substance use among the aging population, including hospitalization, falls, vehicular accidents, cognitive impairment, depression, substance withdrawal and death, including by suicide. Mortality rates are much higher among older adults who have substance use disorders. Because the use of alcohol and medication, whether prescribed or misused, causes greater harm in older adults than illicit drugs, this chapter focuses (...) on the term as clinical indicators and outcomes. Whenever the sources use these terms, they are reflected in the text of the report by being included in quotation marks to indicate they come from another source. These terms are left intact to preserve the integrity of the original research being cited. Addiction: 1 A health condition characterized by compulsive drug use, despite harmful consequences. Someone suffering from addiction is unable to consistently abstain from substance use, even when it causes

2018 Canadian Centre on Substance Abuse

72. Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients

) to classify prescription opioid analgesic abuse as an epidemic. This appears to be due in large part to individuals using a prescription drug non-medically, most often an opioid an- algesic. Drug-induced deaths have rapidly risen and continue to be one of the leading causes of death in Americans. In 2011, the Office of National Drug Control Policy established a multifaceted approach to address prescription drug abuse, including Prescrip- tion Drug Monitoring Programs (PDMPs) that allow practitioners

2018 American Academy of Pain Medicine

73. Imaging Guidelines

patients presenting with an altered or depressed mental status, a history of loss of consciousness, or significant post-traumatic amnesia need a head CT scan. z A negative initial head CT scan in a patient not on anticoagulant therapy has a negative predictive value of greater than 99.97 percent for the need of any subsequent neurosurgical intervention, allowing safe discharge from the emergency department (ED). z A repeat head CT is needed in 6-12 hours when a patient of any age has a persistently (...) altered mental status. Urgent repeat head CT scanning is needed for the patient of any age with any worsening changes on neurologic exam. z Patients with supra-therapeutic international normalized ratio (INR) or thrombocytopenia may benefit from repeat head CT, despite a normal initial head CT, if they take oral anticoagulant or antiplatelet drugs. z Indications for head CT in children should follow the PECARN decision guide. Children with non-frontal soft tissue hematoma or brief loss

2018 American College of Surgeons

74. 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

2018 European Association of Urology

75. British guideline on the management of asthma

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, haemoptysis Lung cancer*; sarcoidosis* * may also be associated with non-obstructive spirometry 3.3.4 INTERMEDIATE PROBABILITY OF ASTHMA BASED ON INITIAL STRUCTURED CLINICAL ASSESSMENT Adults and children who (...) 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 problem Chronic sputum production Excessive vomiting or posseting Unexplained restrictive spirometry Severe upper respiratory tract

2016 SIGN

76. Spotlight: Subacute Endocarditis: The Great Masquerader

with hypertension, hypothyroidism and no known history of valvular heart disease presented to his primary care doctor with one month of generalized weakness and unintentional weight loss. The patient felt unwell, with neck and shoulder pain. He reported fever to 102 degrees Fahrenheit and cough at home. The patient had a dental procedure one month prior to admission. His blood work revealed white blood cells of 13.6mg/dL, hemoglobin of 13mg/dL, iron 27 ug/dl, TIBC 306 ug/dL with ferritin >800 ug/L and ESR 101mm (...) the risk of embolization with improvement in symptoms. The cause of his endocarditis was thought to be secondary to the dental procedure months before diagnosis; teeth #14 and #19 were found to have extensive carious lesions requiring extraction prior to surgery. Discussion : Why does Streptococcus viridans have a predilection toward heart valves in bacteremia? In population studies, viridans group Streptococcus is among the most common cause of endocarditis. Both host and bacterial factors contribute

2017 Clinical Correlations

77. Glasgow Coma Scale for Field Triage of Trauma: A Systematic Review

and Definitions Appendix G. Strength of Evidence Table Appendix H. Head-to-Head Studies for Predictive Utility Appendix I. Indirect Studies for Predictive Utility Appendix J. Studies of Reliability and Ease of Use Appendix K. Quality Assessment of Studies of Predictive Utility Appendix L. Quality Assessments of Studies of Reliability and Ease of Use xi Executive Summary Background Unintentional injuries are the leading cause of death among people in the United States ages 1 to 44, and the third leading cause (...) among people ages 45 to 64. 1 Among all age groups, motor vehicle crashes are the first or second leading cause of unintentional injury death. 2 In 2011, there were approximately 40,000,000 emergency department (ED) visits for injuries; of these approximately 2.5 million were due to trauma complications and unspecified injuries. 3 Approximately 18 percent of patients seen in the ED for an injury were transported by emergency medical services (EMS) personnel. 4 Traumatic brain injury (TBI

2017 Effective Health Care Program (AHRQ)

78. Food Deserts and Food Swamps: A Primer

-processed food consumed, the poorer the diet quality and the higher risk of developing nutrition-related chronic conditions .8,9 Our long-term diet patterns are a determinant of health outcomes such as the development of nutrition-related chronic conditions, e.g., excess weight gain, cardiovascular disease, type 2 diabetes and some types of cancer. 10 Some symptoms of poor mental health such as depression and anxiety have also been linked to suboptimal diet patterns. 11-13 FOOD DESERTS AND FOOD SWAMPS (...) and cancer in Canada were $19.8 billion in 2015. 16 Inadequate vegetable and fruit consumption alone costs 3.3 billion per year through a mix of direct healthcare costs and losses in productivity. 16 What Factors Influence Food Choices? Income is a primary determinant of diet quality. In 2012, almost 13% of Canadian households experienced food insecurity, 19 defined as “inadequate or insecure access to food because of financial constraints.” 20 Not having enough money makes it difficult

2017 National Collaborating Centre for Environmental Health

79. CrackCAST E129 – Bacteria

for the primary location of infection. Cutaneous diphtheria can occur as a primary skin infection or as a secondary infection of a preexisting wound. Circulating exotoxin causes the systemic symptoms of diphtheria, most profoundly affecting the nervous system, heart, and kidneys. Progression of symptoms/signs: Generic URTI symptoms Low grade fever and sore throat are the most frequent presenting complaints. Weakness, dysphagia, headache, voice changes, and loss of appetite ⅓ develop cervical lymphadenopathy (...) , an important , is deficient Asplenia chronic alcohol abuse, active and passive smoking, Corticosteroid use recent respiratory illness. Clinical presentation- All of the major pathophysiologic events of meningococcal sepsis are caused by the host’s inflammatory response to the organism causing functional and histologic damage to the microvasculature, resulting in increased vascular permeability, pathologic vasoconstriction and vasodilation, loss of thromboresistance, DIC, and profound myocardial dysfunction

2017 CandiEM

80. CRACKCast E125 – Electrolyte Disorders

. Ion exchange resin 1. Emergently in cardiac arrest, urgently in renal failure; may delay if renal function is normal 2. In patients with rhabdomyolysis or tumor lysis syndrome with intact urine output, not effective acutely [4] What are the five most common causes of hypokalemia? Most common cause in the outpatient world = thiazide diuretics. The five most common causes of hypokalemia are: renal losses, increased nonrenal losses (sweating, diarrhea, vomiting, laxatives) decreased potassium intake (...) , with simultaneous oral and IV replacement. [7] What are the three main types of hypernatremia? Give 3 examples of each. By far, the most common cause is a patient with an altered thirst mechanism (elderly, disabled patient) without access to free water. Hypernatremia can be divided into three physiologic pairings: hypernatremia with dehydration and low total body sodium, hypernatremia with low total body water and normal total body sodium, hypernatremia with increased total body sodium [1] Double loss

2017 CandiEM

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>