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Unintentional Weight Loss Causes

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121. Evaluating the effectiveness of the Glasgow 2014 Commonwealth Games

. The consensus of opinion was that the HIA recommendations and other legacy reports and recommendations have not determined outcomes but rather have prioritised actions, added political weight to, and expedited projects that are and have been in the pipeline. Organisations spoke of using the recommendations and themes within the Framework as a justification for prioritising certain initiatives, and also as a source of additional funding streams. The HIA report in itself was also used by some stakeholders (...) and four Scottish Government themes. The consensus of opinion was that legacy reports and recommendations have not determined outcomes but rather have prioritised actions, added political weight to, and expedited projects that are and have been in the pipeline. Stakeholders suggested the HIA recommendations have been incorporated into policy but this is more likely to be a retro-fit exercise than genuine forethought. In general it is more likely that initiatives (the majority of which are pre-planned

2014 Glasgow Centre for Population Health

122. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada : Diabetes in the elderly

vulnerability. Frailty may have a biological basis and appears to be a distinct clinical syndrome. Many definitions of frailty have been proposed. The most commonly applied definition (Fried's Frailty Phenotype) suggests that a person is frail when 3 or more of the following criteria are present: unintentional weight loss (>4.5 kg in the past year), self-reported exhaustion, weakness (diminished grip strength), slow walking speed and low physical activity . Progressive frailty has been associated (...) this is controversial . Conversely, cognitive dysfunction in older people with diabetes has clearly been identified as a significant risk factor for the development of severe hypoglycemia . Nutrition and physical activity Nutrition education can improve metabolic control in ambulatory older people with diabetes . Although nutrition education is important, weight loss may not be, since moderate obesity is associated with a lower mortality in this population . Amino acid supplementation may improve glycemic control

2013 CPG Infobase

123. Professor Christopher Exley: The latest darling of the antivaccine movement

high” and “very high,” Exley claims that his research implicates aluminum as an etiological role in autism. Claiming that, before his current research, he had heard of claims that aluminum—or aluminum in vaccines—causes autism but had dismissed the science as not adequately strong to support a link, he then proclaims: I have to change my mind on both of these. I have to change my mind that aluminium has a role in autism and believe it now does…Now I’ve often said when asked “Should we stop using (...) money to fund this type of research. As I’ve before, Claire and Al Dwoskin, who founded the CMSRI, are fanatically antivaccine, and they use their foundation to fund causes related to their belief that vaccines cause autism. The CMSRI funds antivaccine research, and you can bet that the Dwoskins wouldn’t have funded Exley’s work if they didn’t think it would be used to implicate vaccines as a cause of autism and all the diseases and conditions that antivaxers blame vaccines for. England herself, I

2017 Respectful Insolence

124. Substance Abuse in Canada: The Effects of Cannabis Use during Adolescence (Report)

to patterns of heavy, compulsive use of psychoactive drugs and an inability to stop substance use, even though it is leading to severe, clinically relevant problems in multiple domains of a person’s life (e.g., when such use becomes physically hazardous; causes failure to fulfill obligations at work, school or home; or creates legal, social or interpersonal problems). Substance dependence: Also referred to as “drug or alcohol dependence,” substance dependence constitutes a cluster of cognitive (...) , this final section of the report outlines recommendations for research topics that will help improve prevention and treatment outcomes, as well as immediate actions that can be taken to inform cannabis-related policy and help reduce the harms associated with cannabis use during adolescence. While progress continues to be made in recognizing and understanding the causes, mechanisms and long-term effects of cannabis use in youth, many questions still need to be addressed. Future research should focus

2015 Canadian Centre on Substance Abuse

125. 2015 ACC/AHA Focused Update of Secondary Prevention Lipid Performance Measures

.” Unintentional nonadherence is thought to be a passive process on the part of the patient and may involve a lack of understanding of physical problems, resulting in an inability to follow treatment instructions, impaired manual dexterity, poor eyesight, or forgetfulness. In a recent systematic review and meta-analysis, it was noted that there is a statistically significant relationship between health literacy and medication adherence; however, the magnitude of effect was small when compared with other causes (...) reduction in all-cause mortality, which was largely attributable to significant reductions in deaths due to CAD and other cardiac causes. The majority of studies in the aforementioned report included patients with known ASCVD. Of the 26 RCTs included, 5 trials (39 612 subjects, all of whom had CAD) compared more versus less intensive statin regimens. The trials demonstrated that more intensive regimens produced a highly significant 15% further reduction in major vascular events, driven by reductions

2015 American Heart Association

126. Practice Advisory on Anesthetic Care for Magnetic Resonance Imaging

and pregnant non-MRI workers and found no significant difference in the relative risk of early delivery, low birth weight, or spontaneous abortions ( Category B2-E evidence ). Survey Findings. The consultants and ASA members strongly agree that all anesthesiologists should have general safety education on the unique physical environment of the MRI scanner. The ASA members agree and the consultants strongly agree that all anesthesiologists should have specific education regarding the features of individual (...) radiologist, and the device manufacturer). Other implanted electronic devices also pose a hazard in the MRI environment. These devices and associated wiring may transfer energy during the MRI scan, causing tissue damage, malfunction of the device, image artifacts, and device displacement. MRI may be performed on a limited basis for patients with certain implanted electronic devices ( e.g. , deep brain stimulators, vagal nerve stimulators, phrenic nerve stimulators, wire-containing thermodilution catheters

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2015 American Society of Anesthesiologists

127. Secondary Prevention After Coronary Artery Bypass Graft Surgery

of adverse cardiovascular outcomes. Postoperative antiplatelet agents and lipid-lowering therapy continue to be the mainstay of secondary prevention after coronary surgical revascularization. Other opportunities for improving long-term clinical outcomes after CABG include the aggressive management of hypertension and diabetes mellitus, smoking cessation, weight loss, and cardiac rehabilitation (CR). Secondary preventive therapies help maintain long-term graft patency and help patients obtain the highest (...) HDL was found to be a more potent CAD risk factor than high LDL. , Recent studies from the current era have shown that HDL levels are inversely related to cardiovascular events, even among patients receiving statin therapy and those with LDL levels aggressively treated to <70 mg/dL. In addition, moderate increases in HDL appear to be associated with regression of coronary atherosclerosis in statin-treated patients. Smoking cessation, weight loss, exercise, and moderate alcohol intake all modestly

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2015 American Heart Association

128. The Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anesthesia and Pain Medicine

information for practitioners of regional anesthesia and pain medicine regarding the etiology, differential diagnosis, prevention, and treatment of neurologic complications.” As before, the current practice advisory focuses on neurologic injuries apart from those caused by hemorrhagic or infectious complications or local anesthetic systemic toxicity, which are the subjects of other ASRA-sponsored practice advisories. This executive summary condenses findings and recommendations from subtopics (...) ) associated risk factors specific to the cohort studied, 4) robustness of data recording (eg, retrospective vs prospective; registries vs quality assurance databases vs insurance company records vs self-report; single institution vs continent-wide); and 5) discriminating the cause of injury (eg, anesthetic vs surgical vs patient vs a combination; transient vs permanent). | Incidence of Neuraxial Injury Neuraxial complications are extremely rare, but when they occur, they often result in life-altering

2015 American Society of Regional Anesthesia and Pain Medicine

129. Gastroesophageal Reflux Disease (GERD)

, aspiration pneumonia • Dysphonia • Recurrent or persistent cough • Gastrointestinal tract bleeding © World Gastroenterology Organization 2015 WGO Global Guidelines GERD 10 • Frequent nausea and/or vomiting • Persistent pain • Iron-deficiency anemia • Progressive unintentional weight loss • Lymphadenopathy • Epigastric mass • New-onset atypical symptoms at age 45–55 years. A lower age threshold may be appropriate, depending on local recommendations. • Family history of either esophageal or gastric (...) ? Lifestyle modifications (diet, weight loss) to minimize symptoms ? Continuous therapy for patients with (a) frequent symptoms, (b) stricture, (c) BE (to control symptoms) ? Consider H. pylori “test-and-treat” for patients on continuous PPI therapy ? Laparoscopic antireflux surgery for structural disease (hiatus hernia) or volume reflux causing regurgitation, aspiration, stricture, or persistent nocturnal symptoms despite PPI b.i.d. High resources ? MR-PPI o.d. for 8–12 weeks, then reassess ? MR-PPI

2015 World Gastroenterology Organisation

130. Acute Pain Management: Scientific Evidence

). ? Placebo effects occur in routine clinical care even when no placebo is given. The outcome of a treatment is attributable to both the treatment itself and the contextual (or placebo) component (N). ? Nocebo effects occur in routine clinical care and are seen as an increased pain response to a painful stimulus or the development of adverse effects not caused by, or separate from, the intervention ( N). ? Ethical harnessing of placebo and minimisation of nocebo effects will improve response to clinical

2015 Clinical Practice Guidelines Portal

131. Acute Pain Medicine in the United States: A Status Report

medicine encompasses the prevention, evaluation, diagnosis, treatment, and rehabilitation of painful disorders and notes that such disorders may arise from “a discrete cause, such as postoperative pain or pain associated with a malignancy, or may be a disorder in which pain constitutes the primary problem, such as neuropathic pain or headache .” By consensus, the panel observed that APM is not restricted to operating room practice and the discipline of APM assumes a diverse and multidisciplinary team (...) of opioid-use disorders following postoperative prescription opioid use is small. However, Wasan et al. and Ballantyne and LaForge conducted more recent reviews of the literature and concluded that the evidence for the earlier assertion was weak and that the real rates following surgery might be as high as 10% . This is particularly important, as prescription opioid abuse is a national crisis , costing in excess of $50 billion dollars per year , and prescription opioid overdose is now the leading cause

2015 American Academy of Pain Medicine

132. Atezolizumab (Tecentriq) - Non-Small-Cell Lung Carcinoma or Transitional Cell Carcinoma

of initial diagnosis, poor performance status (PS), and a history of unintentional weight loss. More than half of the patients with NSCLC are diagnosed with distant metastatic disease, which directly contributes to poor survival prospects. UC The overall 5-year survival rate for patients diagnosed with metastatic UC is approximately 5.5% (Surveillance, Epidemiology, and End Results [SEER] 2015). Poor prognostic factors for survival in patients with metastatic UC include advanced stage of disease (...) indication: Tecentriq is indicated for the treatment of adult patients with locally advanced or metastatic urothelial carcinoma after prior chemotherapy or who are considered cisplatin ineligible. 2.1.2. Epidemiology NSCLC Lung cancer remains the leading cause of cancer deaths worldwide in men and the second leading cause of cancer deaths worldwide in women. It accounted for approximately 13% of all new cancers in 2012 (Torre et al. 2015). Non-small cell lung cancer is the predominant subtype, accounting

2017 European Medicines Agency - EPARs

133. Clinical Handover in Acute and Children’s Hospital Services

associated with clinical handover whether as part of shift or inter-departmental clinical handover or communication of information in relation to the deterioration in a patient’s condition, are similar and include: • Inappropriate or delayed treatment being provided for patients including the delay in critical referrals which threaten the life, health or well being of patients in the acute hospital setting • Loss of trust and confidence amongst staff and patients in the performance of the healthcare (...) review methods with what is planned in the current review and helps avoid unintended and economically wasteful duplication of effort. 1.7 Grading of recommendations All decisions regarding the quality of evidence and the strength of recommendations were based on summaries of evidence from the literature review and the evidence was weighted according to the SIGN (2011) grading criteria. The basis for level of evidence and grade of recommendation are summarised in tables 1.8.1 and 1.8.2. Where existing

2015 National Clinical Guidelines (Ireland)

134. Clinical practice guideline on Systemic Lupus Erythematosus

and side effects of sun filters 312 Appendix 10. Topical corticosteroids 315 Appendix 11. Health needs and priorities of people with System Lupus Erythematosus 316 Appendix 12. Patient information 318 Appendix 13. Glossary 357 Appendix 14. Abbreviations, initials and acronyms 367 References 372CLINICAL PRACTICE GUIDELINE ON SYSTEMIC LUPUS ERYTHEMATOSUS 9 Presentation Documenting the variability of clinical practice, analysing the causes and adopting strategies aimed at eliminating it, have proved (...) suggest multidisciplinary management of pregnant woman with SLE by the obstetrician and the specialist in autoimmune diseases, with the participation of other specialists if considered necessary. v From the medical viewpoint, we suggest making one visit during the first trimster, every 4-6 weeks until week 26 of gestation, and every two weeks from week 27 until birth. This is subject to modifications according to obstetric and medical criteria. v During each visit, we suggest monitoring the weight

2015 GuiaSalud

135. Modification of lifestyle and nutrition interventions for management of early chronic kidney disease

) people should be encouraged to reduce their BMI to lower their risk of chronic kidney disease and end-stage renal disease (grade D). Maintenance of a health body weight (BMI 18.5–24.9 kg/m2; waist circumference 1.0 g/kg/day) is not recommended. No evidence was identified to show that phosphate restriction affects the progression of CKD. 3.7.2 For patients with stage 1-4 CKD and hypertension a reduction in sodium 30kg/m2 or unintentional weight loss of >10% in six months) should be referred (...) diabetes mellitus, hypertension, obesity and smoking (reviewed in Early CKD Guideline 2). Modification of lifestyle habits (e.g. healthy diet, physical exercise, smoking cessation, moderate alcohol consumption and weight loss in obese people) may therefore be of value in retarding the progression of CKD. In addition, restriction of dietary protein [1] and augmentation of fluid intake [2] have been recommended as a treatment for retarding CKD progression for over 50 years. The objective of the current

2013 KHA-CARI Guidelines

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

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 be necessary to validate an OAB diagnosis, exclude other disorders and fully inform the treatment plan. At the clinician’s discretion, a urine culture and/or post-void residual (...) 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-reported outcomes (PROs) can be a critical component of OAB management. Numerous questionnaire instruments have been

2014 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction

137. 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

138. 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

139. 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

140. 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

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