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Yellow Nail Syndrome

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101. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update Full Text available with Trip Pro

ulceration due to poor arterial blood flow to the hand Check nail beds, fingers and hand for unusual skin changes Aneurysm Abnormal areas of dilatation with overlying skin thinning Listen with a stethoscope Low-pitch continuous diastolic and systolic Low-pitch continuous diastolic and systolic High-pitch discontinuous systolic only Steal syndrome AVF may have a very strong bruit Feel with your fingers Thrill at the arterial anastomosis and throughout the entire outflow vein that is easy to compress (...) , and vascular access coordinator (VAC). Chronic Kidney Disease Nomenclature Used by KDOQI Prognosis of Chronic Kidney Disease by Glomerular Filtration Rate and Albuminuria Categories Green: low risk (if no other markers of kidney disease, no chronic kidney disease [CKD]); Yellow: moderately increased risk; Orange: high risk; Red, very high risk. Figure reproduced from Inker et al Inker L.A. Astor B.C. Fox C.H. et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation

2019 National Kidney Foundation

102. Colic - infantile: What is the differential diagnosis of infantile colic?

information. Gastro-oesophageal reflux disease (GORD). See the CKS topic on for more information. Cows' milk protein allergy (CMPA) or transient lactose intolerance (rare). See the CKS topic on for more information. Seizures, infantile spasms (rare). See the CKS topic on for more information. Congenital or metabolic disorders, chromosomal abnormalities (rare). Basis for recommendation The information on differential diagnosis is based on the National Institute for Health and Care Excellence (NICE (...) Colic - infantile: What is the differential diagnosis of infantile colic? Differential diagnosis | Diagnosis | Colic - infantile | CKS | NICE Search CKS… Menu Differential diagnosis Colic - infantile: What is the differential diagnosis of infantile colic? Last revised in June 2017 What is the differential diagnosis of infantile colic? Be aware that signs of organic disease in infants can be non-specific. Other possible causes of excessive, inconsolable crying include: If symptoms started

2019 NICE Clinical Knowledge Summaries

103. Neratinib (Nerlynx) - Breast cancer, breast neoplasms

efficacy 113 2.5.4. Conclusions on the clinical efficacy 118 2.6. Clinical safety 119 2.6.1. Discussion on clinical safety 136 2.6.2. Conclusions on the clinical safety 139 2.7. Risk Management Plan 139 2.8. Pharmacovigilance 142 2.9. New Active Substance 142 Assessment report EMA/CHMP/525204/2018 Page 3/169 2.10. Product information 142 2.10.1. User consultation 142 2.10.2. Additional monitoring 142 3. Benefit-Risk Balance 142 3.1. Therapeutic Context 142 3.1.1. Disease or condition 142 3.1.2 (...) 3.8. Conclusions 147 4. Recommendations 147 5. Re-examination of the CHMP opinion of 22 February 2018 148 5.1. Risk Management Plan 155 5.2. Pharmacovigilance 159 5.3. Product information 159 5.3.1. User consultation 159 5.3.2. Additional monitoring 159 6. Benefit-risk balance following re-examination 159 6.1. Therapeutic Context 159 6.1.1. Disease or condition 159 6.1.2. Available therapies and unmet medical need 160 6.1.3. Main clinical studies 160 6.2. Favourable effects 160 6.3. Uncertainties

2018 European Medicines Agency - EPARs

104. Prevention and Management of Dermatological Toxicities Related to Anticancer Agents: ESMO Clinical Practice Guidelines Full Text available with Trip Pro

) and to cope with the disease itself [ Jordan K. Aapro M. Kaasa S. et al. European Society for Medical Oncology (ESMO) position paper on supportive and palliative care. Ann Oncol. 2018; 29 : 36-43 ]. The skin and its appendages, hair and nails are an integral component of overall health, appearance and sense of self. These dermatological structures may be altered in cancer patients as a result of the disease itself (i.e. paraneoplastic dermatoses), as part of inherited cancer syndromes, or as a consequence (...) , these guidelines will focus on papulopustular exanthema, hand-foot syndrome (HFS), pruritus, nail changes (paronychia, onycholysis) and alopecia. Acneiform rash (Papulopustular exanthema) Incidence Papulopustular eruption (acneiform rash) is characterised by an eruption consisting of papules and pustules typically appearing in the face, scalp and upper chest and back [ Lacouture M.E. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer. 2006; 6 : 803-812 ]. It represents the most frequent AEs

2020 European Society for Medical Oncology

105. CRACKCast E196 – Monitoring the Emergency Patient

for an arterial line. Persistent or recurrent hemodynamic instability Monitoring of conditions or treatments that result in large fluid or blood pressure shifts Frequent arterial blood sampling Expected inaccuracies in noninvasive blood pressure management (e.g. because of obesity or dysrhythmias) [4] What is the Beer-Lambert Law and how does it allow us to measure pulse oximetry? Rosen’s trivia at its finest. The concentration of an absorbing substance can be determined if the characteristic wavelength (...) who is mechanically ventilated, potentially indicating the presence of hypoxia, hypercarbia, or insufficient anesthesia. Phase 4-5: Diminishing CO2 due to inspiration. If there is an ETT cuff leak, you can see this area blending in with the expiratory phase (Phase 1-2). [7] List 5 uses for ETCO2. Uses for ETCO2 monitoring include, but are not limited to: Rapid assessment of critically-ill patients Just like you learned in medical school, every critically ill patient needs to have their ABC’s

2018 CandiEM

106. Guidelines of care for the management of cutaneous squamous cell carcinoma Full Text available with Trip Pro

, x Kristi Schmitt-Burr Affiliations Basal Cell Carcinoma Nevus Syndrome Life Support Network, Burton, Ohio r x Kristi Schmitt-Burr Affiliations Basal Cell Carcinoma Nevus Syndrome Life Support Network, Burton, Ohio , x Aleksandar Sekulic Affiliations Mayo Clinic, Phoenix, Arizona , MD, PhD s x Aleksandar Sekulic Affiliations Mayo Clinic, Phoenix, Arizona , x Paul Storrs Affiliations Private practice, Chicago, Illinois , MD h x Paul Storrs Affiliations Private practice, Chicago, Illinois , x Joyce (...) techniques and histopathologic assessment, tumor staging, surgical and nonsurgical management, follow-up and prevention of recurrence, and management of advanced disease. The primary focus of these recommendations is on evaluation and management of primary cSCC and localized disease, but where relevant, applicability to recurrent cSCC is noted, as is general information on the management of patients with metastatic disease. Key words: , , , , , , , , , Abbreviations used

2018 American Academy of Dermatology

107. Nappy rash: What else might it be?

Nappy rash: What else might it be? Differential diagnosis | Diagnosis | Nappy rash | CKS | NICE Search CKS… Menu Differential diagnosis Nappy rash: What else might it be? Last revised in July 2018 What else might it be? Alternative conditions that may present similarly to nappy rash include: Allergic contact dermatitis This occurs when the skin is sensitized to a specific irritant or allergen following exposure, and it has a characteristic pattern of distribution affecting skin areas exposed (...) yellow, greasy scale seen in other sites may not be seen in the nappy area or flexures. It most commonly starts between the second week and sixth month of life. See the CKS topic on for more information. Psoriasis Infantile psoriasis is uncommon, and when it occurs it most typically affects the inguinal folds and gluteal cleft. The rash presents as bright red, well-defined symmetrical plaques which are typically without the silvery white scale which may be seen at other sites, such as the scalp

2018 NICE Clinical Knowledge Summaries

108. Fungal skin infection - body and groin : What else might it be?

Fungal skin infection - body and groin : What else might it be? Differential diagnosis | Diagnosis | Fungal skin infection - body and groin | CKS | NICE Search CKS… Menu Differential diagnosis Fungal skin infection - body and groin : What else might it be? Last revised in May 2018 What else might it be? Other conditions that may present similarly to fungal infection of the body include: Discoid eczema — itchy plaques of papules or vesicles tend to occur symmetrically on the limbs. Less likely (...) versicolor — well-demarcated multiple round or oval macules of variable colours most commonly on the back, chest, and upper arms. Surface may have a fine scale. May be more noticeable in the summer months if patches fail to tan. Lesions may fluoresce a bright yellow-green or gold colour on Wood lamp examination. See the CKS topic on for more information. Psoriasis — chronic plaque psoriasis typically presents as monomorphic, erythematous plaques covered by adherent silvery-white scale, usually

2018 NICE Clinical Knowledge Summaries

109. Anaemia - B12 and folate deficiency: What are the signs and symptoms of vitamin B12 or folate deficiency anaemia?

anaemia and without low serum levels of vitamin B12. Symptoms of vitamin B12 and folate deficiency include: Cognitive changes. Dyspnoea. Headache. Indigestion. Loss of appetite. Palpitations. Tachypnoea. Visual disturbance. Weakness, lethargy. People with pernicious anaemia may present with symptoms of associated disorders, for example, myxoedema, other thyroid disorders, vitiligo, stomach cancer, or Addison's disease. Signs of vitamin B12 and folate deficiency include: Anorexia. Angina (in older (...) people). Angular cheilosis. Brown pigmentation affecting nail beds and skin creases (but not mucous membranes). Congestive heart failure (in older people). Episodic diarrhoea. Glossitis — red smooth and shiny tongue, perhaps with ulcers. Heart murmurs. Liver enlargement. Mild jaundice — a lemon-yellow tint. Mild pyrexia. Oropharyngeal ulceration. Pallor of mucous membranes or nail beds. Tachycardia. Weight loss. Neurological complications associated with vitamin B12 deficiency include: Loss

2018 NICE Clinical Knowledge Summaries

110. Psoriasis: How should I classify psoriasis?

% and 35% respectively), and may affect all parts of the nail and surrounding structures. Nail changes can occur with any type of psoriasis, and are particularly common in people with psoriatic arthritis (up to 90% of people are affected). The incidence of nail involvement increases with the duration of psoriasis. Nail pitting (depressions in the nail plate) is the most common finding. Discolouration (for example the 'oil drop sign') — orange-yellow discolouration of the nail bed. Subungual (...) (a potentially life-threatening ) Rapidly developing widespread erythema, followed by the eruption of white, sterile non-follicular pustules which coalesce to form large lakes of pus. Lesions associated with systemic illness, such as fever, malaise, tachycardia, weight loss, and arthralgia. Usually presents in people with existing or previous chronic plaque psoriasis, but can also occur in people without a history of psoriasis. Localized (palmoplantar) pustular psoriasis Lesions on the palms and soles

2018 NICE Clinical Knowledge Summaries

111. Scabies: What else might it be?

of linear burrows. For more information, see the CKS topic on . Other dermatological conditions, including: Acropustulosis — suggested by a recurrent, self-limited, pruritic, vesiculopustular eruption of the palms and soles, occurring in infants aged 2–3 years. Atopic eczema — suggested by a dry, itchy, red rash that often starts in childhood. For more information, see the CKS topic on . Bullous pemphigoid — a blistering disease of elderly people, which often starts with pruritus and an urticaria-like (...) . Urticaria pigmentosa — suggested by numerous reddish-brown or pale, monomorphic maculopapules, plaques, or nodules appearing symmetrically anywhere on the body, except the face, head, palms, or soles. The differential diagnoses of crusted scabies include: Psoriasis — characterized by red, scaly, sharply-demarcated, indurated plaques, present, particularly over the extensor surfaces and scalp. Dariers's disease (Keratosis follicularis) — characterized by greasy, skin-coloured, brown or yellow-brown

2018 NICE Clinical Knowledge Summaries

112. Prevalence of developmental defects of enamel among children with intellectual disability – A systematic review Full Text available with Trip Pro

, and neural crest. Ectoderm is the outer layer of the embryo, and it forms from the embryo’s epiblast. It develops into the surface ectoderm, neural crest, and neural tube. Surface ectoderm develops into epidermis, hair, nails, lens of the eye, and tooth enamel. The neural crest of the ectoderm develops into peripheral nervous system, adrenal medulla, and dentin of teeth. The neural tube of the ectoderm develops into brain, spinal cord, motor neurons, and retina. [ ] If any defects occurs in the formation (...) of ectoderm derivatives, its effects will be evident in the respective organs developed from the germ layer. This could be explained by the fact that all these organs develop from the same germ layer. One such defect could be intellectual disability (ID) and enamel defect. ID is defined as a group of developmental conditions characterized by significant impairment of cognitive functions which are associated with limitations of learning, adaptive behavior, and skills. [ ] Overall, In India, the prevalence

2020 Journal of Global Oral Health

113. Primary Biliary Cholangitis

wellastheNationalInstitutesofHealthwebsite(https://livertox. can be helpful for assessing a patient’s risk pro?le for DILI. Previous surgery and blood transfusions should be listed. Physical examination should include screening for hepato- and splenomegaly as well as extrahepatic signs of advanced liver disease, such as icterus of sclera, skin and mucous membranes, xanthelasma, palmar and plantar erythema, nail abnormalities, or scratch lesions particularly on the arms and legs. Abdominal ultrasound is the ?rst recommended (...) contain at least 11 portal ?elds. Biopsy ?ndings can be classi?ed under: (i) Disorders involving the bile ducts such as chronic non- suppurative cholangitis or ?brosing obliterative cholangi- tis, as well as less frequent cholangiopathies (Table 3). (ii) Disordersnotinvolvingbileducts,suchasavarietyofstor- age,in?ltrativeorin?ammatoryliverdiseases,granuloma- tous diseases, nodular regenerative hyperplasia, peliosis, sinusoidal dilatation and cirrhosis of different cause. (iii) Hepatocellular

2017 European Association for the Study of the Liver

114. Approaches to promote handwashing and sanitation behaviour change in low? and middle?income countries: a mixed method systematic review Full Text available with Trip Pro

, CONDITION OR ISSUE Diarrhoeal diseases are the second highest cause of death in low income countries and the fifth highest cause of death in the world (WHO, 2011). In an update of the Global Burden of Disease study it was shown that unsafe water, sanitation and handwashing caused nearly 5% of DALYs (Disability‐Adjusted Life Years) for males and females in poor communities (GBD Risk Factor Collaborators, 2015). Water, Sanitation and Hygiene (WASH) interventions consist of (1) water supply (water quantity (...) Citations: Linked article: . Give access Share full text access Please review our and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Shareable Link Use the link below to share a full-text version of this article with your friends and colleagues. Copy URL Share a link Share on What are the main findings of this review? Community‐based approaches which include a sanitation component can increase handwashing with soap

2017 Campbell Collaboration

115. Antiocoagulation - oral

. Rivaroxaban has also been approved as an option for prophylaxis of atherothrombotic events (with aspirin alone, or with aspirin and clopidogrel, or ticlodipine) for people with coronary heart disease and after an acute coronary syndrome in people with elevated cardiac biomarkers. It is also indicated for people with symptomatic peripheral artery disease at high risk of ischaemic events. Unlike warfarin, apixaban, dabigatran, edoxaban and rivaroxaban do not require regular international normalized ratio (...) Antiocoagulation - oral Prodigy Toggle navigation Topics Specialities A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Allergies Cancer Cardiovascular Child health Drugs and devices Ear, nose and throat Endocrine and metabolic Eyes Gastroenterology Gastrointestinal Haematology Immunizations Infections and infestations Injuries Kidney disease and urology Men's health Mental health Musculoskeletal Neurological Oral health Palliative care Poisoning Pregnancy Preventative medicine Respiratory

2017 Prodigy

116. Bruising

, or exacerbated by, an underlying bleeding disorder or medical condition, including: Vascular disorders (for example senile or simple purpura). Platelet disorders (for example idiopathic thrombocytopenic purpura, leukaemia, or liver disease). Coagulation disorders (for example haemophilia, vitamin K deficiency, or von Willebrand disease). Drugs (such as corticosteroids, warfarin, and alcohol). The presence of a bleeding disorder or underlying medical condition does not rule out non-accidental injury (...) and abdominal pain). [ ; ; ] Vascular disorders Senile purpura A common and benign condition, resulting from impaired collagen production and capillary fragility in elderly people. Manifests as bruises which are usually bilateral on the extensor surfaces of the hands, forearms, face, and neck, which fade to a brownish colour over several months. Simple purpura ('easy bruising syndrome') A benign disorder typically occurring in otherwise healthy women, usually in their twenties or thirties. Manifests

2017 Prodigy

117. Scabies

to excoriation or secondary bacterial infection; -other lesions: vesicles (usually at the start of a burrow), nodules (firm, 0.5 cm in diameter, usually on the male genitalia, groin, buttocks), wheals; -poor hygienic conditions may result in secondary bacterial infection; -irritant or allergic contact eczema can be induced following topical treatment. 2. Crusted scabies (the term “Norwegian scabies” should no longer be used) [1], [4], [13] -occurs in patients with severe immune deficiency due to disease (e.g (...) a yellow-to-brown, thick, verrucous aspect; -diffuse non-crusted scabies with involvement of the back may also occur [12]; -bacterial secondary infection can result in malodorous skin lesions. Diagnosis Diagnosis is suspected on the characteristics of itch (generalised, intense at night), clinical findings and suggestive history (e.g. positive context for contamination, disease observed in close contacts). Definitive diagnosis is supported by a positive microscopic examination of skin scrapings which

2017 European Dermatology Forum

118. Androgenetic Alopecia

, Belgium 9 Department of Dermatology, University of Bologna, Italy 10 Department of Dermatology and Allergy, Division of Evidence based Medicine, Charité – Universitätsmedizin, Berlin, Germany ABSTRACT Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80% Caucasian (...) follicle in predisposed men and women. Its aetiology is multifactorial and polygenic (13). Men Androgenetic alopecia in men is an androgen-dependent trait (14). Evidence from genetic disorders and from clinical trials of 5a-reductase inhibitors has shown that dihydrotestosterone (DHT) is the androgen chiefly responsible for the follicular pathology although the molecular and cellular events are only partially understood. DHT probably acts primarily on dermal papilla, the predominant site of androgen

2017 European Dermatology Forum

119. Pityriasis versicolor: Scenario: Management

antifungal shampoos are based on expert opinion in clinical guidance Evidence-based Danish guidelines for the treatment of Malassezia-related skin diseases [ ], Fungal skin and nail infections: diagnosis and laboratory investigation [ ], Antifungal agents for common outpatient paediatric infections [ ], and Pityriasis versicolor [ ]; expert opinion in a dermatology textbook [ ]; and a review article [ ]. Ketoconazole shampoo or selenium sulphide shampoo as an alternative are widely recommended (...) antifungal treatment before considering oral antifungal treatment is based on the expert opinion of previous external reviewers of this CKS topic. Oral antifungal treatment The recommendations on oral antifungal treatment are based on clinical guidance Evidence-based Danish guidelines for the treatment of Malassezia-related skin diseases [ ] and Fungal skin and nail infections: diagnosis and laboratory investigation [ ], expert opinion in a dermatology textbook [ ], a review article

2017 NICE Clinical Knowledge Summaries

120. Appropriate Use of Drug Testing in Clinical Addiction Medicine

Paperacknowledgedthatmorespecificclinical guidancewas needed and would be forthcoming from ASAM. In the White Paper, ASAM advocates for the use of ‘‘smarter’’ drug testing as follows: Smarter drug testing means the increased use of random testingratherthanthemorecommonscheduledtesting,and itmeanstestingnotonlyurinebutalsoothermatricessuchas blood,oralfluid(saliva),hair,nails,sweatandbreathwhen those matrices match the intended assessment process. In addition, smarter testing means testing based upon clinical (...) importantly, it will improve patient care. At the same time, it will reduce waste and fraud. How to Use This Document Unlike clinical guidelines that typically focus on either more generalized or disease-specific recommendations, this appropriateness document determines when, where, and how often a drug test should be performed for the identification, diagnosis, treatment, and recovery of patients with, or at risk for, addiction. Providers This document contains practical information to guide

2017 American Society of Addiction Medicine

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