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Unintentional Weight Loss Causes

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

S16 Reducing the Risk of Developing Diabetes Management S20 Organization of Diabetes Care S26 Self-Management Education S31 Targets for Glycemic Control S35 Monitoring Glycemic Control S40 Physical Activity and Diabetes S45 NutritionTherapy S56 Pharmacotherapy inType 1 Diabetes S61 Pharmacologic Management of Type 2 Diabetes S69 Hypoglycemia S72 Hyperglycemic Emergencies in Adults S77 In-hospital Management of Diabetes S82 Weight Management in Diabetes S87 Diabetes and Mental Health S93 In?uenza (...) prevalence of diabetes in Canada was 6.8% of the populationd2.4 million Cana- dians (3)da 230% increase compared to prevalence estimates in 1998. By 2019, that number is expected to grow to 3.7 million (3). Diabetes is the leading cause of blindness, end stage renal disease (ESRD) and nontraumatic amputation in Canadian adults. Cardio- vascular disease is the leading cause of death in individuals with diabetesandoccurs2-to4-foldmoreoftenthaninpeoplewithout diabetes. People with diabetes are over 3 times

2013 CPG Infobase

162. Management of Hepatitis C

in children and infants 12 6.3 Natural history of HCV infection in children 13 6.4 Treatment of children with hepatitis C 13 7 Acute hepatitis C 14 7.1 Natural history 14 7.2 Post-exposure prophylaxis 14 7.3 Treatment of patients with acute hepatitis C 14 8 Assessment of liver disease 16 8.1 Clinical assessment 16 8.2 Fibrosis markers 16 8.3 Liver biopsy 16 9 Progression of untreated disease 18 9.1 Age, gender and ethnicity 18 9.2 Body weight 18 9.3 Tobacco smoking 19 9.4 Alcohol 19 9.5 Alanine (...) for treatment with pegylated IfN and weight-based ribavirin with the addition of a protease inhibitor as triple therapy. A All treatment-experienced patients infected with HCV genotype 1 should be considered for treatment with pegylated IfN and weight-based ribavirin with the addition of a protease inhibitor as triple therapy. B Treatment-naive patients co-infected with HIV and HCV genotype 1 who are unsuitable for treatment with a regimen which includes HCV protease inhibitors should be considered

2013 SIGN

163. 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

164. Frailty in the Older Person

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 exhaustion, weak grip strength, slow walking speed, low physical activity. 17 This phenotype has been validated as a predictor of adverse outcomes in large (...) status among older people. 2. “Frail” older people are at greatest risk of adverse outcomes (worsening disability, institutionalisation and death) and are more likely to present with a geriatric syndrome (particularly delirium and falls). 3. There are many validated tools to measure frailty as a clinical syndrome or phenotype. The most well-known and widely used 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

2014 Australian and New Zealand Society for Geriatric Medicine

165. Voncento - human coagulation factor VIII / human von willebrand factor

are low compared to the levels of VWF:Ag and characterized by absence of HMW multimers; reduced or normal level of FVIII:C. Type 2A VWD is an autosomal dominant disorder. Type 2B: Qualitatively defective VWF in which the levels of VWF:RCo and VWF:CB are low compared to the levels of VWF:Ag; increased affinity to platelet glycoprotein Iba results in loss of HMW multimers and thrombocytopenia; reduced or normal level of FVIII:C. Type 2B VWD is an autosomal dominant disorder. Type 2M: Qualitatively (...) defective VWF in which the levels of VWF:RCo and VWF:CB are low compared to the levels of VWF:Ag; no loss of HMW multimers, reduced or normal level of FVIII:C. Type 2M VWD is an autosomal dominant disorder. Type 2N: Qualitatively defective VWF in which there is a decreased affinity (abnormal binding) to FVIII; reduced level of FVIII:C. Type 2N VWD is an autosomal dominant disorder. Type 3: Severe deficiency of VWF characterised by VWF:RCo, VWF:Ag, and FVIII:C levels typically 1% to 5%. Depending

2013 European Medicines Agency - EPARs

166. Nexium Control - esomeprazole

-27 June 2013, the CHMP, in the light of the overall data submitted and the scientific discussion within the Committee, issued a positive opinion for granting a Marketing Authorisation to Nexium Control. Assessment report EMA/498929/2013 Page 10/70 2. Scientific discussion 2.1. Introduction Problem statement Gastroesophageal reflux disease (GERD) is defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Reflux of gastric content (...) in 10% to 20% of all adults and daily in 4% to 10% of all adults in the western countries. For many patients, acid regurgitation and heartburn can severely affect quality of life. Night-time heartburn may cause sleeping difficulties and impair next-day function. The impact on quality of life by GERD is comparable to that of more serious diseases, such as heart disease, diabetes, depression and arthritis (Wiklund et al 1998 1 , Lind et al 1999 2 , Gerson et al 2005 3 , Vakil et al 2006 4 , Jones et

2013 European Medicines Agency - EPARs

167. Abilify Maintena (aripiprazole)

for schizophrenia, such as extrapyramidal symptoms, weight gain, and cognitive impairment, also contribute to non-adherence 9 . 1 1) Messias E, Chen CY, Eaton WW. Epidemiology of schizophrenia: Review of findings and myths. Psychiatr Clin North Am. 2007;30:323-38; 2) McGrath J, Saha S, Chant D, Welham J. Schizophrenia: A concise overview of incidence, prevalence, and mortality. Epidemiol Rev. 2008;30:67-76. 2 1) Lieberman JA, Perkins D, Belger A, Chakos M, Jarskog F, Boteva K, et al. The early stages (...) was accepted for the reasons described above. In-process overfill is in place to compensate for loss of aripiprazole monohydrate due to adhesion of the drug substance to the filling lines. Overfill is also needed to compensate for the fact that after reconstitution some suspension cannot be withdrawn from the vial due to adhesion to the vial wall. The critical manufacturing steps (milling and lyophilisation), critical process parameters and control strategy have been adequately described and justified

2013 European Medicines Agency - EPARs

168. 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

169. Cancer Pain (PDQ®): Health Professional Version

, shoulders, thighs, legs, and feet. Weight bearing, walking, or tactile contact exacerbates the pain. Steroids may reduce the tendency to develop myalgia and arthralgias. Among hormonal therapies, aromatase inhibitors cause musculoskeletal symptoms, osteoporotic fractures, arthralgias, and myalgias.[ ] Dermatologic complications and chemotherapy EGFR inhibitors cause dermatitis with ensuing pain.[ ] Acute herpetic neuralgia occurs with a significantly increased incidence among cancer patients, especially (...) options. (Refer to the section of this summary for more information). Is the pain acute or chronic? Is it secondary to cancer, cancer treatment, other causes, or a combination? Is it somatic, visceral, neuropathic, or mixed? Is there an incidental component? Is there breakthrough pain? Determining whether the pain requires pharmacologic and/or other modalities of treatment. Pain is often multifactorial in nature, so factors that may modulate pain expression, such as psychological distress

2017 PDQ - NCI's Comprehensive Cancer Database

170. Nutrition in Cancer Care (PDQ®): Health Professional Version

can vary at presentation and through the continuum of cancer care. Many patients experience unintentional weight loss leading to a diagnosis of cancer.[ , ] Studies have reported malnutrition in 30% to 85% of patients with cancer.[ , ] Because there has previously been no universal definition of malnutrition, reports of malnutrition occurrence vary and may be under- or overreported in different populations. Historically, weight loss, low body mass index (BMI), and serum albumin levels have been (...) used as surrogate markers for malnutrition.[ , ] Emerging evidence supports that loss of lean body mass (sarcopenia) in patients with cancer is an independent risk factor for poorer outcomes; and that in the setting of obesity, unlike in other diseases where weight loss may be welcomed, inappropriate loss of weight may lead to loss of muscle mass and poorer outcomes.[ , , , ] However, there is no universal definition of sarcopenia, and there are no simple methods to identify the condition, limiting

2017 PDQ - NCI's Comprehensive Cancer Database

171. 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

172. 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

173. Power Threat Meaning Framework: innovative and important? #PTMFramework

solved the problem of psychiatric diagnosis; the DSM is, after all, not a static document. No decent mental health professional would say that the aetiology of mental health disorders is understood. We are in a reverse-therapeutic gap of sorts: we know what might work for certain conditions; but we don’t know the causes yet. And, just because biomarkers for psychiatric diagnoses have not yet been located, that does not mean they do not exist, or that we should stop looking for them. It is also (...) strange that both evidence-based medicine and outdated philosophies such as psychoanalysis and Foucauldian discourse are given the same weight in the Framework. Evidence-based medicine is just that: statistics have shown that it is effective for a high enough percentage of people to be useful. The same sorts of statistics can never be gathered for psychoanalysis. In terms of narratives, I agree that they can be useful. Looking at what happened can be helpful, up to a point. Many of us, however, find

2018 The Mental Elf

174. Poisoning or overdose

agonists and so-called 'legal highs'. 2,4-dinithrophenol. This is an industrial chemical. It is not a licensed medicine and is sometimes dangerously used for weight loss. There have been 11 deaths associated with this since 2008. Electronic nicotine delivery systems. Many electronic cigarettes (e-cigarettes) and their liquid refills contain nicotine, which is highly toxic. The majority of the reported exposures were accidental, with 37 percent involving children under five. Ingestion was the most (...) situations where poisoning is a possibility and information about toxidromes (the syndrome of signs and symptoms caused by certain classes of substances, usually in overdose) have been added. The assessment of a person who has been poisoned has been revised in line with expert opinion in review articles and in the British National Formulary. The recommendations on when to admit someone who has been poisoned have been revised in line with guidelines from the National Institute for Health and Clinical

2017 NICE Clinical Knowledge Summaries

175. 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

176. Composite Resin and Amalgam Dental Filling Materials: A Review of Safety, Clinical Effectiveness and Cost-effectiveness

health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report. Copyright: This report contains CADTH copyright material. It may be copied and used for non-commercial purposes (...) review failed to draw any conclusions about filling longevity due to various limitations in the included studies. 14 A probable cause of these limitations in the review might be the inclusion of low quality trials and pooling the results from trials of heterogeneous designs, both interventional randomized controlled trials (RCTs) and observational studies, without reporting stratified results by trial design or quality. Second, the use and handling proprieties of composite are operator sensitive

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

177. KHA-CARI adaptation of the KDIGO Guideline for the Care of Kidney Transplant Recipients

, the need for IS decreases overtime and it should be tailored accordingly: greater IS during the first weeks or months in order to improve acceptance to the graft and lower IS after months or a few years. (Evidence level C) D. Non-compliance with immunosuppressive drugs and its consequences (deterioration and loss of kidney function) have been clearly overlooked and its frequency is currently estimated at ~25% of the recipients. It could be one of the major causes of late graft failure. Therefore, every (...) in relation to diet and weight have been addressed separately in the KHA-CARI Nutrition in Kidney Transplant Recipients guideline and has not been addressed in the adaptation. Mental health. Relevant evidence from which to base recommendations and suggestions in relation to mental health in KTRs is limited and has therefore not been addressed in the adaptation. The transplant environment in Australia and New Zealand. There have been over 20,000 kidney transplant operations performed on approximately

2012 KHA-CARI Guidelines

178. Prevention, Diagnosis and Management of Colorectal Anastomotic Leakage

. There is experimental evidence of increased risk of AL for several immunosuppressant drugs used in patients who have undergone organ transplantation. This is consistent with reports of a higher AL rate in immunosuppressed patients after renal transplantation 20 .10 Table 1. Medication associated with increased risk of AL. Nutrition and Hypoalbuminaemia Malnutrition (defined as an unintentional loss of weight of >10% in the preceding 6 months), and a serum albumin concentration of 10% unintentional weight loss (...) . While the technique may not be supported by sufficient weight of clinical evidence (and clearly cannot provide reassurance regarding leakage caused by excessive tension or ischaemia), it seems sensible to recommend that all rectal anastomoses (and probably all left sided colonic anastomoses) for which a defunctioning proximal stoma is not being undertaken should routinely be tested for immediate “technical” defects by air insufflation (or a similar technique). The use of a defunctioning stoma

2016 Association of Coloproctology of Great Britain and Ireland

179. 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

180. 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

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