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Unintentional Weight Loss Causes

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121. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: AUA/SUFU Guideline

existed. See text and algorithm for definitions and detailed diagnostic, management and treatment frameworks. Guideline Statements Diagnosis 1. The clinician should engage in a diagnostic process to document symptoms and signs that characterize OAB and exclude other disorders that could be the cause of the patient's symptoms; the minimum requirements for this process are a careful history, physical exam, and urinalysis. Clinical Principle 2. In some patients, additional procedures and measures may (...) , but the majority of patients have symptoms for years. 15,16 To date, no population-based studies have directly examined epidemiologic differences across racial/ethnic groups. Patient-Reported Outcomes (PROs) and OAB. Since OAB is a symptom-based diagnosis, the quality of life (QOL) impact of the symptoms is a critical aspect of the condition. The degree of bother caused by OAB symptoms directly affects OAB care-seeking, treatment intensity and satisfaction with treatment. Therefore, assessment of patient

2014 American Urological Association

122. Treatment and recommendations for homeless people with Opioid Use Disorders

-medical interventions for this population. The recommendations in this document specify what experienced providers and recipients of homeless services believe works best, 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 professionals, and that they will contribute to improvements in both quality of care (...) providers and recipients gave generously of their time to formulate guidance for practitioners less experienced in the care of patients whose comorbidities and limited resources, both financial and social, are among the causes and consequences of homelessness. In addition, the Advisory Committee would like to thank the following individuals for reviewing and commenting on draft recommendations prior to publication: ? Diana Amodia MD, Medical Director, BAART Turk Street Clinic, San Francisco, California

2014 National Health Care for the Homeless Council

123. Guidelines for Insertion and Maintenance of Central Venous Access Devices in Children and Young People

of microorganisms causing catheter- related infection are the insertion site and the device hub. The microorganisms causing infections are usually Gram-positive bacteria residing on the patient’s skin, most often coagulase-negative staphylococci and Staphylococcus aureus. In addition, metastatic colonization of the device from a distant site of infection (Gastrointestinal and urinary tract, wound etc.) may occur. Figure 1. Sources of microbial contamination in patients with an IV catheter. Extraluminal sources (...) the area and the depth of the reservoir. It must sit flush against the skin surface. The length of the needle required may vary as the child gains or loses weight. The length of the needle used should be recorded on the patient’s documentation • Do not rock or tilt the needle as it may damage the septum • General observations of patients with these devices are outlined in Table 214 GENERAL PRINCIPLES FOR MANAGEMENT OF CVAD Dressing: A dressing will assist in anchoring the device during day to day

2014 Regulation and Quality Improvement Authority

124. Costs and impacts on the economy and productivity due to mental ill health

) in 2010 (Figure 1). 33 The DALY is calculated as the sum of the years of life lost due to premature mortality (YLL) in the population and the equivalent ‘healthy’ years lost due to disability (YLD) for incident cases of the health condition: one DALY is one year of healthy life lost due to premature death, prolonged illness or disability, or a combination of these factors. 34 Figure 1 provides a relative weighting of diseases by DALYs with cancer being the major disease group causing the greatest (...) group, Australia, 2003 34 Cause YLD % total YLL %total DALY %total Cancers 87,463 6.5% 411,953 32.2% 499,416 19.0% Cardiovascular disease 104,429 7.7% 369,365 28.9% 473,794 18.0% Mental disorders 327,391 24.2% 23,154 1.8% 350,545 13.3% Neurological and sense disorders 258,638 19.1% 54,127 4.2% 312,765 11.9% Chronic respiratory disorders 115,398 8.5% 71,339 5.6% 186,737 7.1% Diabetes mellitus 111,536 8.2% 32,295 2.5% 143,831 5.5% Unintentional injuries 41,263 3.0% 84,599 6.6% 125,862 4.8% Total

2013 Sax Institute Evidence Check

125. South Australian gastroenteropancreatic neuroendocrine tumours pathway

of hospital stay and poor coping skills. Each of these issues affects morbidity outcomes. Regular screening and ongoing monitoring for depression by health professionals as part of long-term follow-up care is required. Referral to a psychologist or psychiatrist may be appropriate. Body image Body image is the way a person feels about their appearance. Some cancer treatments can cause physical changes to a patient’s body, such as hair loss, scars from surgery, loss of a body part, changes to the skin (...) , weight gain or weight loss. Physical changes can result in poor body image. Patients should be provided with individualised and accurate information about any expected physical changes before treatment. Support and counselling by a specialist psychologist, psychiatrist or social worker may assist patients to make appropriate treatment decisions that incorporate the potential effect on their appearance. Sexuality Sexuality encompasses not only the physical aspects of sexual function, but also refers

2014 Clinical Practice Guidelines Portal

126. Australian and New Zealand Society for Geriatric Medicine position statement 22. Frailty in older people

, the FRAIL scale has recently been validated as predictive of mortality and disability in community- dwelling older Australian men 14 and women 15 . Slow gait speed in itself is strongly linked to functional decline and disability and has been used in isolation as a frailty measure 16 . The most well-known and widely used phenotype was defined by Fried et al. in 2001 and identifies frailty as the presence of = 3 of 5 criteria: unintentional weight loss of = 10lbs in the preceding year, self-reported (...) phenotypic tool is the Fried model which defines someone as frail if they meet 3 or more of 5 criteria: weight loss, exhaustion, weak grip strength, slow walking speed and low physical activity. The multidimensionality of frailty is embraced by tools such as the Edmonton Frailty Scale which derives a maximum score of 17 from assessments across 10 different domains. 4. Frailty can be conceptualised as the failure of a complex system. Deficits accumulate with the passage of time leading to a loss

2014 Clinical Practice Guidelines Portal

127. Chemical Exposures During Pregnancy

birth outcomes; pregnancy loss, preterm birth, low birth weight, congenital defects, childhood morbidity, obesity, cognitive dysfunction, impaired immune system development, asthma, early puberty, adult disease and mortality (cardiovascular effects and cancer). 5 In addition, impairment of fertility and fecundity in women 6 and impairment of testicular development and reproductive function in males, have been associated with fetal exposure to everyday chemicals in the environment. 7 Although (...) and choices during the planning and maintenance of pregnancy and breastfeeding. Examples of this are; refraining from smoking and drinking, and eating a balanced diet during pregnancy. 3. Increasing concerns over chemical exposure In recent years there has been increasing concern over the potential for exposure of environmental chemicals to the mother and baby to cause adverse health effects in the child. 4 Epidemiological research has linked exposure to some of these chemicals in pregnancy with adverse

2013 Royal College of Obstetricians and Gynaecologists

128. Eikenella corrodens endocarditis and liver abscess in a previously healthy male, a case report. (PubMed)

Eikenella corrodens endocarditis and liver abscess in a previously healthy male, a case report. Eikenella corrodens is one of the HACEK bacteria constituting part of the normal flora of the oropharynx, however, still an uncommon pathogen. We report a case of a large Eikenella corrodens liver abscess with simultaneously endocarditis in a previously healthy male.A 49-year-old Danish man was admitted because of one-month malaise, fever, cough and unintentional weight loss. On admission (...) slowly improved. He was discharged after 1.5 months of hospitalisation. On follow-up 2 months later, the patient was asymptomatic with normalized biochemistry and ultrasound showed complete regression of the abscess.This is the first case of documented Eikenella corrodens concurrent liver abscess and endocarditis. The case report highlights that Eikenella corrodens should be considered as a cause of liver abscess. Empirical treatment of pyogenic liver abscess will most often cover Eikenella corrodens

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2018 BMC Infectious Diseases

129. Impact of Dietary Intervention on Tumor Immunity: the DigesT Trial

-melanomatous skin cancer or curatively resected cervical cancer. Body Mass Index (BMI) < 20 Kg/m2. Anamnesis of alcohol abuse. Unintentional weight loss ≥ 5% in the last three months, unless the patient has a BMI > 25 Kg/m2 at study enrollment. Intentional weight loss is permitted if < 10% in the last three months and patient BMI is > 22 kg/m2. Severe heart, liver, pulmonary, kidney comorbidities. Current status of pregnancy or lactation, where pregnancy is defined as the state of a female after conception (...) fraction (LVEF) to less than 50%, as assessed by multigated radionuclide scintigraphic scan (MUGA) or echocardiography. Previous episodes of symptomatic hypotension causing unconsciousness. Baseline fasting plasma glucose ≤ 65 mg/dl. Ongoing therapy with systemic corticosteroids, or systemic corticosteroid therapy ≤ 2 weeks before study enrollment, or who have not recovered from side effects of such treatment. The following uses of corticosteroids are permitted: topical applications (e.g. for rash

2018 Clinical Trials

130. A Study of BNC105P Combined With Ibrutinib

leukemia and patients with Richter's transformation of CLL/SLL are NOT eligible. Active disease meeting at least 1 of the IWCLL 2008 criteria for requiring treatment: i) A minimum of any one of the following constitutional symptoms: Unintentional weight loss >10% within the previous 6 months prior to screening. Extreme fatigue (unable to work or perform usual activities). Fevers of greater than 100.5 F for ≥2 weeks without evidence of infection. Night sweats without evidence of infection. ii) Evidence (...) are not exclusions). Thrombotic events (pulmonary embolism; deep venous thrombosis) within 6 month prior to start of therapy. History of Human Immunodeficiency Virus (HIV) infection or active hepatitis B or C. Intravenous immunoglobulin (IVIG) can cause a false positive hepatitis B serology. If patients receiving routine IVIG have core antibody or surface antigen positivity without evidence of active viremia (negative hepatitis B DNA) they may still participate in the study, but should have hepatitis serologies

2018 Clinical Trials

131. Reducing SB in ALF and Its Affect on Cognitive Impairment, QoL, and Physical Functioning

cause of dependence and disability worldwide. With the nation's fastest growing demographic being adults over 65, the Lewy Body Dementia Association states that the current cost puts it higher than either heart disease or cancer; as the financial burden was estimated at $818 billion in 2015. Functional limitations such as a slower gait, muscle weakness (ex. grip strength), unintentional weight loss and self-reported exhaustion adds pressure on healthcare services. Older adults transitioning (...) benefits may come from the lower end of the PA spectrum; and there are no current guidelines for how long older adults should be sedentary. Research shows that large amounts of sedentary behaviour (SB) leads to an increased risk of all-cause mortality, independent from not meeting the PA guidelines (Ekelund et al., 2016). SB is defined as any waking behaviour characterized by an energy expenditure less than or equal to 1.5 metabolic equivalents while in a sitting or reclining posture. Alzheimer's

2018 Clinical Trials

132. Ibrutinib lead-in Followed by Venetoclax Plus Ibrutinib in Patients With RR CLL

or symptomatic lymphadenopathy Progressive lymphocytosis with an increase of ≥ 50% over a 2-month period, or lymphocyte doubling time of less than 6 months Disease-related symptoms as defined by any of the following: (a) Unintentional weight loss ≥ 10% within the previous 6 months. (b) Significant fatigue (i.e., ECOG PS 2 or worse; cannot work or unable to perform usual activities). (c) Fevers ≥38.0° C for 2 or more weeks without evidence of infection. (d) Night sweats for ≥ 1 month without evidence (...) . Progression-free survival (PFS) [ Time Frame: Day 169, 337, 505, 673, 841, yearly up to five years, end of trial treatment plus unscheduled (if progression is suspected) ] PFS is defined as the time from registration until progression according the iwCLL criteria or death from any cause, whichever occurs first. Patients not having an event at the time of analysis as well as patients starting a new antileukemic therapy in the absence of an event will be censored at the date of their last tumor assessment

2018 Clinical Trials

133. Safety and Efficacy of REGN2477+REGN1033 in Patients With Sporadic Inclusion Body Myositis

. Any condition that precludes adequate intake of energy and protein; malnutrition; presence of an eating disorder. Unintentional weight loss of ≥10% in the past 6 months (patient-reported) Hospitalization for heart failure in last year or New York Heart Association Class 4 History of hypertrophic cardiomyopathy Any drugs known to influence muscle mass and performance such as anabolic steroids or growth hormone within 6 weeks prior to screening Unable to fit on the site's DXA scanner table, within (...) . Ability to climb 4 steps of stairs unassisted (may use handrails) Willing and able to comply with clinic visits and study-related procedures Key Exclusion Criteria: Other neurological conditions (eg, hemiplegia post stroke, Parkinson's) or musculo-skeletal conditions (eg, severe osteoarthritis) causing mobility impairment Mini-Mental State Examination (MMSE) score <24 Ongoing, chronic, high-dose (>20 mg prednisone equivalent per day), systemic corticosteroid therapy within 6 weeks prior to screening

2018 Clinical Trials

134. Metformin Plus/Minus Fasting Mimicking Diet to Target the Metabolic Vulnerabilities of LKB1-inactive Lung Adenocarcinoma

adenocarcinomas must have been definitively treated and must have never recurred. Body Mass Index (BMI) < 20 Kg/m2. Anamnesis of alcohol abuse. Unintentional weight loss ≥ 5% in the last three months, unless the patient has a BMI > 25 Kg/m2 at study enrollment. Intentional weight loss is permitted if < 10% in the last three months only if patient BMI is > 22 kg/m2 and weight loss has completely stabilized in the last month. Current status of pregnancy or lactation, where pregnancy is defined as the state (...) be recapitulated in vivo by cyclic fasting or fasting-mimicking diet (FMD), can cause metabolic crisis in these neoplasms. In this trial, the investigators will assess for the first time the efficacy of combining standard-of-care platinum-based chemotherapy with metformin plus/minus FMD in patients with LKB1-inactive, advanced lung adenocarcinoma. Condition or disease Intervention/treatment Phase Advanced LKB1-inactive Lung Adenocarcinoma Drug: Metformin Hydrochloride Drug: Cisplatin Drug: Carboplatin Drug

2018 Clinical Trials

135. Ibrutinib and Obinutuzumab With or Without Venetoclax in Treating Older Patients With Untreated Chronic Lymphocytic Leukemia

nodes (>= 10 cm) or progressive or symptomatic lymphadenopathy Autoimmune anemia and/or thrombocytopenia that is poorly responsive to standard therapy Symptomatic or functional extranodal involvement (e.g. skin, kidney, lung, spine) Constitutional symptoms, which include any of the following: Unintentional weight loss of 10% or more within 6 months Significant fatigue Fevers > 100.5 degrees Fahrenheit (F) for 2 weeks or more without evidence of infection Night sweats >= 1 month without evidence (...) Given PO Other Names: ABT-0199 ABT-199 ABT199 GDC-0199 RG7601 Venclexta Outcome Measures Go to Primary Outcome Measures : Progression-free survival (PFS) [ Time Frame: From randomization date until the earlier of disease progression or death from any cause, assessed up to 10 years ] PFS will be compared between the experimental and control treatment strategy groups using a stratified log-rank test (stratified on Rai stage, intermediate versus [vs.] high, and del(17p13.1) by fluorescence in situ

2018 Clinical Trials

136. Drug Reduction in Older Patients: The DROP Trial

-VA healthcare settings. Other studies have shown that polypharmacy can lead to many harmful events among older community-dwelling and hospitalized populations including decreased medication taking, increased harm due to medications, and increased health care use and costs. Polypharmacy and a ways to measure drug burden have additionally been found to be associated with the development of the following geriatric syndromes: mild dementia, delirium, falls, loss of urine, and unintentional weight (...) into long-term care, hospice, or if the patient died. Presence or absence of one of these destinations is recorded. Unintentional weight loss (DETERMINE) [ Time Frame: baseline ] The investigators will use a structured interview to assess recent changes in weight and/or appetite and the 10-item "Determine Your Nutritional Health checklist", which yields a total nutritional risk score of: 0-2 ("low"), 3-5 ("moderate"), or > 6 ("high"). The DETERMINE checklist has been validated in a longitudinal study

2018 Clinical Trials

137. Human IL-15 (rhIL-15) and Obinutuzumab for Relapsed and Refractory Chronic Lymphocyte Leukemia

of the following: Unintentional weight loss greater than or equal to 10% within the previous 6 months. Significant fatigue (ie, ECOG performance scale 2 or worse; cannot work or unable to perform usual activities). Fevers 38.0 degree C for 2 or more weeks without evidence of infection. Night sweats for greater than or equal to 1 month without evidence of infection. greater than or equal to 18 years of age on day of signing informed consent NOTE: Because no dosing or adverse event data are currently available (...) and for the duration of study treatment, and for at least 18 months after the last dose of obinutuzumab. The effects of rhIL-15 and obinutuzumab on the developing human fetus are unknown. Additionally, CD20-depleting agents are known to produce opportunistic infections, causing fetal B-cell depletion in animal studies, and may be teratogenic. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. NOTE

2018 Clinical Trials

138. Exocrine pancreatic dysfunction is common in hepatocyte nuclear factor 1β-associated renal disease and can be symptomatic (PubMed)

elastase-1 deficiency is a common feature of HNF1B-associated renal disease even when diabetes is not present and pancreatic exocrine deficiency may be more symptomatic than previously suggested. Faecal elastase-1 should be measured in all patients with known HNF1B-associated disease complaining of chronic abdominal pain, loose stools or unintentional weight loss. The discovery of a low faecal elastase-1 concentration in individuals with developmental kidney disease of uncertain cause should prompt (...) %) patients with HNF1B-associated renal disease. A total of 8/29 (28%) had a measurement suggestive of exocrine pancreatic insufficiency at  <200 μg/g stool; of these, 3 suffered with abdominal pain, loose stools and/or unintentional weight loss. All three experienced symptomatic improvement and weight gain after commencing pancreatic enzyme replacement therapy. Faecal elastase-1 was low in 7/15 (47%) HNF1B patients without diabetes compared with 11/14 (79%) of those with diabetes (P  =  0.1).Faecal

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2018 Clinical kidney journal

139. Massive splenomegaly due to B-cell lymphoma: A case report (PubMed)

of disseminated diffuse large B - cell lymphoma, clinical stage IV, with massive splenomegaly. A 53 - year old man complaining of unintentional major weight loss, palpable abdominal mass in the left hemiabdomen and cervical lymphadenopathy, was admited to Department of abdominal surgery, UMC Ljubljana. Abdominal CT scan showed massive spleen, enlarged retroperitoneal and upper mediastinal lymph nodes and cervical lymphadenopathy. Splenectomy was performed and spleen was sent on histological analysis (...) Massive splenomegaly due to B-cell lymphoma: A case report Massive splenomegaly is indicated by spleen weight exceeding 1000 g and largest spleen dimension greater than 20 cm Poulin et al. (1998). In many cases, splenectomy is the treatment of choice for massive splenomegaly because it releases the pressure on adjacent organs and also provides a definitive histopathological diagnosis of the underlying cause Iriyama et al. (2010), Radhakrishnan (2018).Herein we present a clinical case

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2018 International journal of surgery case reports

140. Evaluation of Nursing Facility Resident Safety During Implementation of the INTERACT Quality Improvement Program. (PubMed)

analysis data, and monthly telephonic support.Minimum data set (MDS) data for unintentional weight loss, malnutrition, hip fracture, pneumonia, wound infection, septicemia, urinary tract infection, and falls with injury for the intervention year and the year prior; unintentional weight loss, dehydration, changes in rates of falls, pressure ulcers, severe pain, and unexpected deaths obtained from the NFs participating in the intervention through monthly telephone calls.No adverse effects on resident (...) nonsignificant reduction in hospitalizations.NFs with adequate on-site medical, radiography, laboratory, and pharmacy services, and capability for online training and data input were eligible.264 NFs randomized into intervention and comparison groups stratified by previous INTERACT use and self-reported hospital readmission rates.NFs randomized to the intervention group received INTERACT materials, access to online training and a series of training webinars, feedback on hospitalization rates and root-cause

2018 Journal of the American Medical Directors Association

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