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Yellow Nail Syndrome

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141. 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: † 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

142. 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

143. 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

144. Multiple abscesses in the lower extremities caused by Trichophyton rubrum. Full Text available with Trip Pro

Multiple abscesses in the lower extremities caused by Trichophyton rubrum. Dermatophytes are keratinophilic fungi, that usually infect the hair, stratum corneum, and nails. However, dermatophytes occasionally invade the dermis, subcutaneous tissues, and internal organs, resulting in a condition called deep dermatophytosis. We report a case of an unusual presentation of Trichophyton rubrum infection causing multiple fungal abscesses in the lower extremities of an immunocompromised patient.A 66 (...) -year-old male who had been receiving immunosuppressive drugs for 7 years developed numerous subcutaneous nodules in the lower extremities. The yellow purulent fluid obtained from the cyst was positive for T. rubrum. Topical bifonazole cream was effective for tinea pedis, but oral Sporanox 400 mg/day was discontinued after 2 months because the patient died from pneumonia after hospitalization for a lumbar fracture.Although deep dermatophytosis is very rare, dermatomycosis should be considered in any

2019 BMC Infectious Diseases

145. Votrient (pazopanib hydrochloride)

in view of its observed benefits. The following matters need to be further investigated via post-marketing surveillance: (1) the occurrence of hepatic function disorder, hypertension, cardiovascular events (including venous thromboembolic events), hemorrhagic events, pneumothorax, thyroid function abnormal, gastrointestinal perforations and gastrointestinal fistula, proteinuria and nephrotic syndrome, wound healing delayed, infections, posterior reversible encephalopathy syndrome, and interstitial (...) lung disease and (2) further safety information on the product in the patients with hepatic impairment and patients with soft tissue sarcoma of tumor types not evaluated in clinical studies. As a result of its regulatory review, the Pharmaceuticals and Medical Devices Agency has concluded that the product may be approved for the following indications and dosage and administration, with the following conditions for approval. [Indications] Soft tissue sarcoma [Dosage and administration] The usual

2012 Pharmaceuticals and Medical Devices Agency, Japan

146. Giotrif - afatinib

with authorised orphan medicinal products because there is no authorised orphan medicinal product for a condition related to the proposed indication. New active Substance status The applicant requested the active substance afatinib contained in the above medicinal product to be considered as a new active substance in itself, as the applicant claims that it is not a constituent of a product previously authorised within the Union. Licensing status Giotrif has been given a Marketing Authorisation in the USA (...) in the clinical management of early stage NSCLC by establishing comprehensive, multi-modality treatment regimens; however, the prognosis for advanced disease has not improved substantially. With an overall 5-year survival rate of 9% to 13%, the treatment of NSCLC remains a highly unmet medical need. According to the European Society for Medical Oncology (ESMO) guidelines, first-line treatment with a tyrosine kinase inhibitor (TKI), erlotinib or gefitinib, should be prescribed to patients with tumours bearing

2013 European Medicines Agency - EPARs

147. Stivarga - regorafenib

maximum tolerated dose NSCLC non-small cell lung cancer NOAEL no observed adverse effect level OATP Organic anion-transporting polypeptide ORR objective response rate OS overall survival OVAT One Variable At a Time PK pharmacokinetics PFS progression free survival PR partial response RECIST response evaluation criteria in solid tumours RPES Posterior reversible encephalopathy syndrome SAE serious adverse event SD stable disease SJS Stevens-Johnson-Syndrome TEN Toxic epidermal necrolysis TG (...) Pursuant to Article 7 (EC) No 1901/2006, the application included an EMA Decision CW/1/2011 on the granting of a class waiver. Information relating to orphan market exclusivity 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

2013 European Medicines Agency - EPARs

148. Candida - skin

mucocutaneous disorders to invasive disseminated disease involving multiple organs. Candida albicans is the most common species that can cause infection in humans. Candidal skin infections are common and are more likely to occur where skin rubs on skin (such as between skin folds) and where heat and moisture lead to maceration and inflammation. The diagnosis of candidal skin infection is usually made as a result of typical presenting clinical features; investigations are usually unnecessary. An underlying (...) of the normal commensal flora of the human gastrointestinal tract and the vagina (in 13% of women) [ ] . It is not part of the normal skin flora, but there may be transient colonization of fingers or body folds. Colonization with Candida is usually asymptomatic. However, where mucosal barriers are disrupted or if the host's defences are lowered, it can cause infections (candidiasis) ranging from non-life threatening superficial mucocutaneous disorders to invasive disseminated disease involving multiple

2017 NICE Clinical Knowledge Summaries

149. Colic - infantile

for symptoms which cannot be managed in primary care. Have I got the right topic? Have I got the right topic? From birth to 6 months. This CKS topic covers the management of infantile colic with no obvious underlying cause. This CKS topic does not cover the management of other forms of colic, or colic associated with conditions such as constipation, cows' milk protein allergy, or gastro-oesophageal reflux disease. There are separate CKS topics on , , and . The target audience for this CKS topic (...) article on troublesome crying in infants notes that crying is the commonest trigger for physical maltreatment of an infant [ ]. Differential diagnosis 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 suddenly and recently: Intussusception or volvulus — suggested by bile-stained (green or yellow-green vomit), blood in the stool, and abdominal

2017 NICE Clinical Knowledge Summaries

150. Scabies

) — characterized by greasy, skin-coloured, brown or yellow-brown, hyperkeratotic papules in seborrhoeic regions, nail abnormalities, and mucous membrane changes. It is an inherited condition (autosomal dominant). Xerotic dermatitis — characterized by symmetric areas of dry skin with diffuse scale that worsens in severity distally. Basis for recommendation Basis for recommendation The information on diagnosing scabies is based on expert opinion in the British Association for Sexual Health and HIV (BASSH) UK (...) . Female sex. Crowded living conditions. Institutionalization. Crusted scabies is primarily seen in people who are immunosuppressed, such as those with AIDS, lymphoma, people receiving systemic or potent topical steroids, or organ transplant recipients. Crusted scabies can also occur in elderly people, those who are physically incapacitated, and people with Down's syndrome. [ ; ] Complications and prognosis Complications and prognosis Complications What are the complications? Complications of scabies

2017 NICE Clinical Knowledge Summaries

151. Mirabegron (Myrbetriq)

in the NDA, both with possible concomitant allergic phenomena. Both of these cases had confounding factors. In one of these cases, Stevens-Johnson syndrome with reported, along with increased serum ALT, AST and builirubin in a patient taking mirabegron 100 mg and an acetaminophen-containing herbal medication. The risk benefit analysis is, in my opinion, satisfactory for NDA approval. The data provided in the Sponsor’s submissions support adequate directions for use, including the data to describe (...) with renal impairment were compared pharmacokinetically to healthy control volunteers who were matched for sex, age and weight. Following single dose administration of 100 mg mirabegron in volunteers with mild renal impairment (estimated glomerular filtration rate [eGFR] 60 to 89 mL/min/1.73 m2 as estimated using the Modification of Diet in Renal Disease [MDRD] equation), mean mirabegron C max and AUC inf were increased by 6% and 31% relative to volunteers with normal renal function. In volunteers

2012 FDA - Drug Approval Package

152. Tavaborole in Difficult-to-Treat Onychomycosis Cases: A Post-hoc Assessment of Phase III Subjects. (Abstract)

Tavaborole in Difficult-to-Treat Onychomycosis Cases: A Post-hoc Assessment of Phase III Subjects. Toenail onychomycosis is a chronic fungal infection that often requires prolonged treatment in order to effectively manage pathogenic organisms and obtain a clear nail. Traditionally, certain clinical features of onychomycosis, including the presence of substantial lateral disease, focal fungal masses, yellow/brown streaks, and extensive nail involvement (ie, >50%), indicate a poor treatment (...) application of either tavaborole 5% solution or vehicle. Our post-hoc analysis identified 84 difficult-to-treat cases (tavaborole 5%; n=60; vehicle, n=24) in subjects with toenail onychomycosis due to Trichophyton rubrum or Trichophyton mentagrophytes. No subjects identified as difficult-to-treat and treated with vehicle achieved a complete cure, while 6 subjects treated with tavaborole 5% attained a completely clear nail and negative mycology. Similarly, 7 subjects treated with tavaborole 5% solution

2018 Journal of drugs in dermatology : JDD Controlled trial quality: uncertain

153. Topical Tavaborole in the Treatment of Onychomycosis Complicated by Dermatophytoma: A Post-hoc Assessment of Phase II Subjects. (Abstract)

Topical Tavaborole in the Treatment of Onychomycosis Complicated by Dermatophytoma: A Post-hoc Assessment of Phase II Subjects. Dermatophytoma is a little-known, difficult to treat fungal infection that complicates onychomycosis. First described by Roberts and Evans in the late 1990's, dermatophytoma presents as a dense concentration of fungal hyphae within or under the nail plate and is generally white or yellow/brown in color, and linear (streaks) or round (patches) in shape; primary (...) into the use of topical tavaborole for dermatophytoma, a condition previously thought to respond only to oral or combination therapy.

J Drugs Dermatol. 2018;17(3):347-354.


2018 Journal of drugs in dermatology : JDD Controlled trial quality: uncertain

154. Prevention of skin cancer

not only serve for the structured transfer of © German Guideline Program in Oncology | Evidence-based Guideline on Prevention of Skin Cancer | April 2014 1.9 Other documents relating to this guideline 9 knowledge, but can also play a part in formulating health system structures. Examples that may be mentioned here are those of evidence-based guidelines as a basis for compiling and updating Disease Management Programmes or the use of quality indicators derived from guidelines for certifying organ tumour (...) involved Representative German Society of Pathology (DGP) PD Dr. Christian Rose* German Society of Paediatric and Adolescent Medicine (DGKJ) Prof. Dr. Peter Höger German Society of Urology (DGU) Prof. Dr. Jürgen Gschwend German Working Party for the Assistance of Persons with Disabilities and Chronic Diseases and their Relatives (BAG Selbsthilfe) Christiane Regensburger Otorhinolaryngology, Oral and Maxillofacial Surgical Oncology Working Group (AHMO) Prof. Dr. Jochen A. Werner (retired), PD Dr

2014 German Guideline Program in Oncology

155. HIV, viral hepatitis and STIs - a guide for primary care

– A GUIDE FOR PRIMARY HEALTH CARE iii HIV , VIRAL HEPATITIS & STIs A GUIDE FOR PRIMARY CARE 2014 EDITION EXPERT REFERENCE GROUP (EDITORIAL OVERSIGHT) Dr Michael Burke Nepean Sexual Health & HIV Clinic Ms Tracey Cabrie Victorian Infectious Diseases Service, Melbourne Health Associate Professor Ben Cowie Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, University of Melbourne Professor Greg Dore The Kirby Institute, UNSW Australia Dr Seamus Duffy Tuggerah Medical Centre Dr (...) , Tracey Cabrie, Benjamin Cowie, Gregory Dore, Seamus Duffy, Gail Matthews, Ronald McCoy, Anna McNulty, Simone Strasser, Catriona Ooi, David Youds and Iryna Zablotska COPY EDITOR Mary Sinclair PRINTED BY TTR Print Management INCLUDES INDEX HIV (Viruses) – Handbooks, manuals, etc. HIV infections – Handbooks, manuals, etc. Hepatitis, Viral – Handbooks, manuals, etc. Sexually transmitted diseases – Handbooks, manuals, etc. 616.9792 © Australasian Society for HIV Medicine Inc. 2014 ABN 48 264 545 457 CFN

2014 Clinical Practice Guidelines Portal

156. List of cutaneous conditions

) (sandpapered nails, trachyonychia) ( cheveux incoiffable , pili trianguli et canaliculi, spun-glass hair) (woolly hair nevus) Conditions of the subcutaneous fat [ ] See also: Conditions of the are those affecting the layer of that lies between the and underlying . (Lawrence syndrome, Lawrence–Seip syndrome) (Dercum's disease) (alpha1-protease deficiency panniculitis, alpha1-proteinase deficiency panniculitis) (acquired partial lipodystrophy, cephalothoracic lipodystrophy, progressive lipodystrophy) (benign (...) deficiency) (hypodontia with nail dysgenesis, Witkop syndrome) (Treacher Collins–Franceschetti syndrome) (Bourneville disease, epiloia) (adult progeria) (craniocarpotarsal syndrome, distal arthrogryposis type 2, Freeman–Sheldon syndrome, Windmill–Vane–Hand syndrome) (4p- syndrome) (steroid sulfatase deficiency, X-linked recessive ichthyosis) (Cockayne syndrome complex) Infection-related [ ] See also: and Infection-related cutaneous conditions may be caused by , , , , or . Bacterium-related [ ] See also

2012 Wikipedia

157. Assessment and Management of Foot Ulcers for People with Diabetes, Second Edition

and a significant risk factor for chronic kidney disease for people with diabetes (Scottish Intercollegiate Guidelines Network [SIGN], 2010). It may also be a risk factor for retinopathy in type 1 diabetes. Smoking cessation reduces these risks and may optimize conditions for wound healing (SIGN, 2010).20 REGISTERED NURSES’ ASSOCIATION OF ONTARIO RECOMMENDATIONS Assessment and Management of Foot Ulcers for People with Diabetes, Second Edition Glycemic Control (Level of Evidence = Ib) Improved glycemic control (...) and depth of wound bed . Ia – IV ? 1 . 2 Assess bed of foot ulcer(s) for exudate, odour, condition of peri-ulcer skin and pain . IV ? 1 . 3 Assess affected limb(s) for vascular supply and facilitate appropriate diagnostic testing, as indicated . III – IV ? 1 . 4 Assess foot ulcer(s) for infection G using clinical assessment techniques, based on signs and symptoms, and facilitate appropriate diagnostic testing, if indicated . Ia ? 1 . 5 Assess affected limb(s) for sensory, autonomic and motor changes

2013 Registered Nurses' Association of Ontario

158. Oprah Winfrey for President? Does anyone remember all the pseudoscience and quackery she’s promoted?

this blog longer than seven years, because that’s the last time I wrote about Ms. Tinkham. Basically, Ms. Tinkham was diagnosed with breast cancer. Unfortunately, she was also inspired by Oprah and her promotion of The Secret to . It , though. It was of , whom you might remember as the man responsible for the “pH Miracle Living” quackery, where acid was The One True Cause of All Disease, particularly but also and , and who is now in . Tinkham was fortunate in that she did fairly well for three years (...) program said, “We don’t take positions on the opinions of our guests. Rather, we offer a platform for guests to share their first-person stories in an effort to inform the audience and put a human face on topics relevant to them.” When McCarthy’s views have been discussed on the air, statements from the Centers for Disease Control and Prevention and the American Academy of Pediatrics saying that there’s no scientific evidence of a vaccine-autism link have been read. Overall, Oprah had a malign

2018 Respectful Insolence

159. How “they” view “us”: Colton Berrett edition

the disconnect between how we view ourselves and how those whose misinformation we combat view us. Earlier this week, I wrote about the , the 17-year-old boy who four years ago developed transverse myelitis. The disease initially rendered him quadriplegic and landed him in the hospital for a month and a half. Prior to his illness, Colton was a highly active 13-year-old who enjoyed motocross and a variety of other sports. By all reports, he was happy, healthy, and on his way to a fantastic life. After his (...) is not a mistake. Michael J. Dochniak (MJD) Panacea writes, Researching a promising idea is not a mistake. MJD says, Orac has taught MJD that proving a negative is medically unethical, therefore, I’ve used common-sense teachings to induce exclusionary measures that may affect the disease/disorder incidence thereafter. In simplicity, stop what you’re doing and see what happens. I like Orac, although, once a decade. Panacea MJD: If that’s what you think Orac taught you, then you didn’t understand him

2018 Respectful Insolence

160. Diagnosis and Management of Hepatitis C Infection in Infants, Children, and Adolescents

of HCV infection in children, the diagnostic workup, monitoring and treatment of disease, and provides an update on future treatment options and areas of research. Key Words: chronic hepatitis, infectious hepatitis, interferon therapy, pediatric liver disease (JPGN 2012;54: 838–855) H epatitis C virus (HCV) is an RNA virus that affects>180 million individuals worldwide with a high propensity for chronic infection ( The overall prevalence of hepatitis C (...) of disclosure. What people with whom the HCV-infected child interacts should be told about the infection? What are the legal rights of the child and caregivers in regard to disclosure? The child with CHC is frequently stigmatized; how should this issue be addressed? Can the child with CHC play sports without disclosing the HCV status? Although children with CHC generally have a mild course of liver disease during childhood, there is still concern for cirrhosis, liver trans- plantation, and cancer

2012 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

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