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Yellow Nail Syndrome

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121. British Association of Dermatologists guidelines for the management of pemphigus vulgaris

to the lack of diagnostic criteria, and inclusion of all subtypes of pemphigus and of other blistering disorders such as bullous pemphigoid, which have a better prognosis. However, not all cases of PV have such a dismal prognosis. Studies differentiating the clinical phenotypes have shown a lower mortality in patients with predominantly mucosal PV (1–17%) compared with those with mucocuta- neous PV (8–42%). 10–12 Mucocutaneous PV tends to be a more severe disease, proving slower to respond to treatment (...) become frontrunners are the Pemphigus Disease Area Index (PDAI) and the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS), 31–34 each taking 2–5 min to complete. 32,34 These have also been validated for use in oral PV but are inferior to another system, the Oral Disease Severity Score, which may be combined with ABSIS or PDAI in patients with skin or extraoral mucosal sites. 35 It is recommended that disease severity is scored in routine clinical practice. It is essential in clinical trials

2017 British Association of Dermatologists

122. CRACKCast E139 – Frostbite

and associated conditions Quantity of exposed surface area Heat loss—conductive, evaporative Aerosol propellants Cardiovascular Hypotension Atherosclerosis Arteritis Raynaud’s syndrome Cold-induced vasodilation Anemia Sickle cell disease Diabetes Vasoconstrictors, vasodilators [5] Describe the pre-hospital and ED management of frostbite Priorities Prevent re-freeze injury & thaw Analgesia Wound care Tetanus prophylaxis Consider if there is a role for thrombolytic therapy (IV or IA) Post-thaw wound care (...) and progresses to pain and edema Can last days 3. Hyperemia: Hot, red and prolonged cap refill Vasomotor paralysis Severe pain, hyperalgesia Edema and bullae formation Can last weeks to months 4. Post-hyperemia Normal appearance unless tissue lost May have chronic pain [4] Chilblains (Perino) Due to repetitive exposure to cold conditions or in someone with underlying disease Look like cold sores that appear within 24 hrs after exposure to cold Face, hands, feet, tibia Risk groups: Young women, Raynaud’s

2017 CandiEM

123. Biologic therapy for psoriasis

at localised sites and associated with significant functional impairment and/or high levels of distress (for example nail disease or involvement of high-impact and difficult-to-treat sites such as the face, scalp, palms, soles, flexures and genitals) áá R5 Consider biologic therapy earlier in the treatment pathway (for example, if methotrexate has failed, is not tolerated or is contra-indicated) in people with psoriasis that fulfils the disease severity criteria and who also have active psoriatic arthritis (...) the presence of psoriatic arthritis (in consultation with an adult or paediatric rheumatologist) outcomes to previous treatments for psoriasis Other factors person's age past or current co-morbid conditions (for example, inflammatory bowel disease, cardiovascular disease) conception plans body weight the person's views and any stated preference on administration route or frequency adherence áá R15 Be aware that the recommended first-line choice of biologic therapy will not be appropriate for every

2017 British Association of Dermatologists

124. Prevention, Diagnosis & Management of infective endocarditis

emboli despite adequate antimicrobial therapy Semi-elective (after 2 weeks of antimicrobials) PVE and relapsing infection Elective (after 6 weeks of antimicrobials) Well-tolerated chronic severe valvular regurgitation with controlled infection SUMMARY OF THE CLINICAL PRACTICE GUIDELINES FOR THE PREVENTION, DIAGNOSIS AND MANAGEMENT OF INFECTIVE ENDOCARDITIS20 IE in specific conditions There are important considerations for IE in congenital heart disease (CHD), CIED and transcatheter valve implants (...) > Immunocompromised patients • Fever is usually very high in acute IE • Anaemia • In subacute cases this may be anaemia of chronic disease or microcytic anaemia Peripheral • Splinter haemorrhages • Nail beds of the fingers or toes • Examine all digits of upper and lower limbs • Exclude workplace trauma • Osler’s nodes > Painful subcutaneous nodules (red-purple, slightly raised, tender lumps and with a pale centre) • Pulps of the fingers or toes • Pain precedes the development of the visible lesion by up to 24

2017 Ministry of Health, Malaysia

125. Effect of nail polish and henna on oxygen saturation determined by pulse oximetry in healthy young adult females. (Abstract)

Effect of nail polish and henna on oxygen saturation determined by pulse oximetry in healthy young adult females. The purpose of this study was to determine the effect of different colour nail polishes and henna on the measurement of oxygen saturation and the differences among the measurements of three pulse oximetry devices.33 healthy females with a mean age of 19±1.0 years and no complaints or known disease were included into the study. All the participants applied henna to one (...) of their fingers a day before the study. Just before the study, one finger was left empty as control and the other fingers were dyed using various colours of nail polish (red, blue, beige, purple, brown, white, pink, green, colourless polish, light blue, light green and yellow). There were more than eight colour nail polishes and some fingers were used for the other colours after being completely cleaned. The same brand nail polishes were used for the study. Oxygen saturation measurements were done using three

2010 Emergency Medicine Journal

126. Otezla - apremilast

implicated in psoriasis and psoriatic arthritis (PsA) (Schafer, 2010). The proinflammatory mediators that are upregulated in PsA include the cytokines TNF-a, IL-1,IL-6, and IL-8, and the chemokines monocyte chemotactic protein-1 (MCP-1) and macrophageinflammatory protein-1 beta (MIP-1ß) (CC-10004-PSA-002-PD). Based on these effects, apremilast is being developed for use in the treatment of various immune-mediated inflammatory conditions such as psoriasis, PsA, rheumatoid arthritis (RA), Behçet disease (...) arthritis Otezla, alone or in combination with Disease Modifying Antirheumatic Drugs (DMARDs), is indicated for the treatment of active psoriatic arthritis (PsA) in adult patients who have had an inadequate response or who have been intolerant to a prior DMARD therapy (see section 5.1). Psoriasis Otezla is indicated for the treatment of moderate to severe chronic plaque psoriasis in adult patients who failed to respond to or who have a contraindication to, or are intolerant to other systemic therapy

2015 European Medicines Agency - EPARs

127. Antiretroviral / HIV Drug Dosing for Paediatrics

/effective if >25kg; Reduce in renal failure With or without food. Can be crushed and mixed with small amount of water or food. Nausea, diarrhoea, headache, fatigue. Abacavir (ABC) Ziagen ® (ViiV) Child: (=3months) 8mg/kg BD or 16mg/kg OD. Well tolerated round up doses. Max dose: 600mg per day Paed dosing for 300mg tab: (14-19kg) ? ½ tab BD or 1tab OD, (>20-24kg) ½ tab AM + 1 tab PM or 1½ tab OD, (>25kg) ? 1 tab BD or 2 tabs OD Adult: (=12 yrs): 300mg BD or 600mg OD Tab: 300mg (yellow) scored Liq: 20mg (...) /20ml vial) Do not give with stavudine. With or without food. Capsules can be opened and dissolved in water. Granulocytopenia and/or anaemia, nausea, headache, myopathy, hepatitis, nail pigmentation, neuropathy. Emtricitabine (FTC) Emtriva ® (Gilead) Child: (= 4months) 6mg/kg OD of the oral solution. (max. dose 240mg OD) Adult: Capsule (=33kg) 200mg OD; oral solution: 240mg OD Cap: 200mg (blue/white)=240mg liq Liq: 10mg/ml - Fridge (Discard 45 days after opening) - not bioequivalent to caps

2015 The Children's HIV Association

128. Avibactam sodium / ceftazidime (Avycaz)

-Disease Interactions 145 7.5.5 Drug-Drug Interactions 145 7.6 Additional Safety Evaluations 145 7.6.1 Human Carcinogenicity 145 7.6.2 Human Reproduction and Pregnancy Data 146 7.6.3 Pediatrics and Assessment of Effects on Growth 146 7.6.4 Overdose, Drug Abuse Potential, Withdrawal and Rebound 147 7.7 Additional Submissions / Safety Issues 147 8 POSTMARKET EXPERIENCE 149 9 APPENDICES 151 9.1 Literature Review/References 151 9.2 Labeling Recommendations 151 9.3 Advisory Committee Meeting 153 REFERENCES (...) found that while a 2 g ceftazidime + 0.5 g avibactam dose is optimal and that the 30-minute infusion may not achieve adequate probability of joint PK/PD target attainment for organisms with higher minimum inhibitory concentrations (MICs). The simulations demonstrated that this would be better achieved by a 2-hour infusion. The drug product is white to yellow powder in 20 mL (nominal capacity), sterile vials. The qualitative and quantitative composition of the drug product is presented in Table 2

2015 FDA - Drug Approval Package

129. Breastfeeding Healthy Term Infants

in postpartum care section, 2 – 24 hours) Positions appropriate for breastfeeding for mother and infant Principles for enabling the infant to latch-on effectively Removing the infant from the breast Hand expression of colostrum/breastmilk • Potential contraindications to breastfeeding Contraindications are rare and breastfeeding is recommended during most maternal infectious diseases, antimicrobial therapy, or immunizations. Contraindications are: Permanent conditions: Mothers advised (...) Discharge 16 72 hours to 7 days and beyond 16D. Breastfeeding Challenges in the Postpartum Period 17 Infant Challenges Near -T erm Infant 17 Hypoglycemia 18 Neonatal Jaundice 18 Ankyloglossia (tongue tie) 19 Maternal Challenges Breast Fullness 19 Breast Engorgement 19 Areolar Engorgement 20 Plugged or Blocked Duct 20 Milk Blister or Blocked Nipple Pore 20 Overabundance of Breastmilk 20 Mastitis 21 Breast Abscess 22 Inverted or Flat Nipples 22 Nipple pain 22 Maternal conditions (such as Vasospasm

2015 British Columbia Perinatal Health Program

130. Langerhans Cell Histiocytosis Treatment (PDQ®): Patient Version

and symptoms may be caused by lesions in the CNS or by CNS . Liver and spleen Signs or symptoms of LCH that affects the or may include: Swelling in the abdomen caused by a buildup of extra . Trouble breathing. Yellowing of the skin and whites of the eyes. Itching. Easy bruising or bleeding. Feeling very tired. Lung Signs or symptoms of LCH that affects the may include: Collapsed lung. This condition can cause chest pain or tightness, trouble breathing, feeling tired, and a bluish color to the skin. Trouble (...) of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken. : A series of questions and tests to check the brain, , and function. The exam checks a person's mental status, coordination, and ability to walk normally, and how well the muscles, senses, and reflexes work. This may also be called a neuro exam or a neurologic exam. : A procedure in which a sample of is drawn and checked for the following

2018 PDQ - NCI's Comprehensive Cancer Database

131. Childhood Hematopoietic Cell Transplantation (PDQ®): Health Professional Version

A, von Stackelberg A, Schrappe M, et al.: Allogeneic hematopoietic SCT in children with ALL: current concepts of ongoing prospective SCT trials. Bone Marrow Transplant 41 (Suppl 2): S71-4, 2008. [ ] Bertaina A, Merli P, Rutella S, et al.: HLA-haploidentical stem cell transplantation after removal of αβ+ T and B cells in children with nonmalignant disorders. Blood 124 (5): 822-6, 2014. [ ] Handgretinger R, Chen X, Pfeiffer M, et al.: Feasibility and outcome of reduced-intensity conditioning (...) Risk of graft rejection Low Low–moderate Moderate–high Moderate–high Moderate–high Time to immune reconstitution a Rapid (6–12 mo) Moderate (6–18 mo) Slow (6–24 mo) Slow (6–24 mo) Slow (9–24 mo) b Risk of acute GVHD Moderate Moderate Moderate Low Low Risk of chronic GVHD High Moderate Low Low Low BM = bone marrow; EBV-LPD = Epstein-Barr virus–associated lymphoproliferative disorder; GVHD = graft-versus-host disease; HCT = hematopoietic cell transplantation; PBSCs = peripheral blood stem cells

2018 PDQ - NCI's Comprehensive Cancer Database

132. Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition

. The injury occurs as a result of intense and/or prolonged pressure or pressure in combination with shear G . The tolerance of soft tissue for pressure and shear may also be affected by microclimate G , nutrition, perfusion, co-morbidities and condition of the soft tissue. ” (National Pressure Ulcer Advisory Panel [NPUAP], 2016, para 3). Within the context of this Guideline, the interprofessional team refers to a team consisting of regulated health-care providers who provide wound care (i.e., pressure (...) in this Guideline overlap with wound care best practices in specialized populations (e.g., pediatric, spinal cord injury, bariatric, critically ill, older adults, individuals in the operating room, and individuals in palliative care settings), they do not fully encompass the comprehensive care required by these sub-groups. Th us, these specialized populations are considered to be outside the scope of this Guideline. For additional information on pressure injury management in these populations, please refer

2016 Registered Nurses' Association of Ontario

133. CRACKCast E005 – Patient Monitoring

CRACKCast E005 – Patient Monitoring CRACKCast E005 - Patient Monitoring - CanadiEM CRACKCast E005 – Patient Monitoring In , by Adam Thomas September 15, 2016 This episode of CRACKCast covers Rosen’s Chapter 005, Patient Monitoring. Proper management of any acutely ill patient requires accurate monitoring. This involves understanding of the strengths and limitations to the monitoring modalities at the emergency physician’s disposal. Shownotes – Link 1) List 6 situations when pulse oximetry (...) will falsely read as high So when is pulse oximetry not useful? Three settings: 1) Methemoglobinemia cyanide poisoning antimalarials benzocaine post methylene blue infusion 2) Carboxyhemoglobinemia CO poisoning 3) Poor light penetration dark nail polish low perfusion states dark skinned patients 2) List 10 situations when capnography is useful Capnography can be qualitative or quantitative: End-tidal CO2 measurement Colorimetry (qualitative) Uses a breath by breath assessment purple = <4 mmhg CO2 tan = 4

2016 CandiEM

134. Diagnosis and Management of Aplastic Anaemia

and exclude clonal evolution to myelodysplastic syndrome (MDS) or paroxysmal nocturnal haemoglobinuria (PNH), as this will influence the choice of conditioning. It is also vital not to miss constitutional AA so as to avoid (i) serious (and potentially lethal) toxicity from the transplant and (ii) inappropriate selection of a sibling donor. Grade 1C The Haematopoietic Cell Transplant Co‐morbidity Index or equivalent assessment should be documented. Grade 2B Alternatives to HSCT, including IST, should (...) putative drugs should be discontinued and the patient should not be re‐challenged. If a possible drug association is suspected, this must be reported to the Medicines and MHRA using the Yellow Card Scheme ( ). There is usually no hepatosplenomegaly or lymphadenopathy (except in infection). In young adults the presence of short stature, skin hyper/hypo pigmented areas and skeletal abnormalities, particularly affecting the thumb is suggestive of FA (Shimamura & Alter, ). The triad of nail dystrophy

2015 British Committee for Standards in Haematology

135. Nonimmune hydrops fetalis

of these are disorders associated with lymphatic dysfunction, such as Noonan and multiple pterygium syndrome, both of which frequently present with cystic hygroma; idiopathic chylothorax, in which a local pleuromediastinal lymph vessel disturbance occurs as the possible pathogenic mechanism; yellow nail syn- drome, a dominantly inherited congen- ital lymphedema syndrome; and congenitalpulmonary lymphangiectasia. Familial recurrence in some of these cases suggests a hereditary maldevelop- ment of lymphatic vessels (...) an- tigen A, also called anti-Ro, or the combinationantiSSA/RoorantiRo/SSA antibodies associated with maternal autoimmune disease. It may also result from structural abnormalities affecting cardiac conduction, as with endocardial cushion defects in the setting of a het- erotaxy syndrome. Once third-degree atrioventricular block has developed, treatment with corticosteroid therapy hasnotbeenshowntobebene?cial,and inthesettingofhydropstheprognosisis poor. 22 For thisreason, in-uterotherapy for fetal

2015 Society for Maternal-Fetal Medicine

136. Masican - masitinib

Performance Liquid Chromatograph HR Hazard ratio MTD Maximum tolerated dose OS Overall Survival PD Progressive disease PDGFR Platelet-derived growth factor receptor PFS Progression Free Survival P-gp Permeability glycoprotein PR Partial Response SAE Serious adverse events SD Stable Disease / Standard Deviation TKI Tyrosine Kinase Inhibitor t max Time to maximum concentration Vd Volume of distribution WT Wild Type Assessment report EMA/303044/2014 Page 6/77 1. Background information on the procedure 1.1 (...) Similarity Pursuant to Article 8 of Regulation (EC) No. 141/2000 and Article 3 of Commission Regulation (EC) No 847/2000, the applicant did not submit a critical report addressing the possible similarity with authorised orphan medicinal products because there is no authorised orphan medicinal product for a condition related to the proposed indication. Applicant’s requests for consideration Conditional Marketing Authorisation The applicant requested consideration of its application for a Conditional

2014 European Medicines Agency - EPARs

137. Masiviera - masitinib

ECOG Eastern Cooperative Oncology Group EGFR Human epidermal growth factor EMA European medicine agency F Bioavailability FGFR3 fibroblast growth factor receptor 3 HR Hazard ratio KPS Karnofsky Performance Status M+G Masitinib + gemcitabine mITT modified Intent To Treat M-RECIST Modified Response Evaluation Criteria In Solid Tumours NA Not applicable or not assessable NOAEL No observable adverse effect level OS Overall Survival PD Progressive disease PDGF Platelet-derived growth factor PDAC (...) Serious adverse events SD Stable Disease t1/2 half life TKI Tyrosine Kinase Inhibitor Tmax Time to maximum concentration TTP Time to progression ULN Upper limit of normal VAS Visual analogue scale Vd Volume of distribution WT Wild Type EMA/CHMP/327108/2014 Page 7/71 1. Background information on the procedure 1.1. Submission of the dossier The applicant AB Science submitted on 30 August 2012 an application for Marketing Authorisation to the European Medicines Agency (EMA) for Masiviera, through

2014 European Medicines Agency - EPARs

138. Guidelines for the treatment of malaria. Third edition

admission. The differential diagnosis of fever in a severely ill patient is broad. Coma and fever may be due to meningoencephalitis or malaria. Cerebral malaria is not associated with signs of meningeal irritation (neck stiffness, photophobia or Kernig’s sign), but the patient may be opisthotonic. As untreated bacterial meningitis is almost invariably fatal, a diagnostic lumbar puncture should be performed to exclude this condition. There is also considerable clinical overlap between septicaemia (...) , pneumonia and severe malaria, and these conditions may coexist. When possible, blood should always be taken on admission for bacterial culture. In malaria-endemic areas, particularly where parasitaemia is common in young age groups, it is difficult to rule out septicaemia immediately in a shocked or severely ill obtunded child. In all such cases, empirical parenteral broad-spectrum antibiotics should be started immediately, together with antimalarial treatment. 7.4 | TREATMENT OF SEVERE MALARIA

2015 World Health Organisation Guidelines

139. Diagnosis and Management of Acute Pulmonary Embolism

, chest pain may have a typical angina character, possibly re?ecting RV ischaemia and requiring differential diagnosis with acute coronary syndrome (ACS) or aortic dissection. Dyspnoea may be acute and severe in central PE; in small peripheral PE, it is often mild and may be transient. In patients with pre-existing heart failure or pulmonary disease, worsening dyspnoea may be the only symptom indicative of PE. Figure1 Key factors contributing to haemodynamic collapse in acute pulmonary embolism (...) . Adam Torbicki, Department of Pulmonary Circulation and Thromboembolic Diseases, Medical Centre of Postgraduate Education, ECZ-Otwock, Ul. Borowa 14/18, 05-400 Otwock, Poland. Tel:+48 22 7103052, Fax:+48 22 710315. Email: adam.torbicki@ecz-otwock.pl. † Representing the European Respiratory Society Other ESC entities having participated in the development of this document: ESC Associations: Acute Cardiovascular Care Association (ACCA), European Association for Cardiovascular Prevention

2014 European Society of Cardiology

140. National hepatitis B testing policy

with a person with HBV infection, have a higher risk of acquiring hepatitis B. The virus can be transmitted by sharing personal or sharp objects such as razors, toothbrushes, ear-rings and nail clippers; it cannot be transmitted by casual contact through kissing, touching or sharing food utensils. Because HBV has the potential given the right environmental conditions to survive for at least 7 days on surfaces and objects contaminated with traces of blood, these objects remain infectious for a long time (...) Society for HIV Medicine, Viral Hepatitis and Sexual Health Medicine (ASHM). The views expressed in this Testing Policy are not necessarily those of the Commonwealth. The Commonwealth and the Blood Borne Virus and Sexually Transmissible Infections Standing Committee of the Australian Health Protection Committee do not accept any liability for any injury, illness, damage or loss incurred by any person arising from the use of or reliance on the information or advice that is provided in this Testing

2015 Clinical Practice Guidelines Portal

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