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aspirin and Reye syndrome

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121. Measles

? Other causes of rash are much more likely in people who have previously had measles or who have been fully immunized. Infections that may be misdiagnosed as measles include: Parvovirus B19 , the virus that causes fifth disease (erythema infectiosum, also known as slapped cheek syndrome). This is a mild self-limiting illness that, in addition to a bright red rash on the cheeks, may cause a red, lacy rash on the rest of the body which can be mistaken for measles. However, there are no Koplik's spots (...) , and conjunctivitis. These symptoms, in addition to the appearance of a characteristic maculopapular rash (with or without Koplik's spots), are highly suggestive of measles. Other infections that may be misdiagnosed as measles include: Parvovirus B19, the virus that causes fifth disease (slapped cheek syndrome). Streptococcal infection (for example scarlet fever). Herpes virus type 6 (roseola infantum). Rubella. Early meningococcal disease. If a diagnosis of measles is suspected, it is essential to notify

2018 NICE Clinical Knowledge Summaries

122. Feverish children - management

to this. It is theorized that fever may inhibit bacterial and viral replication and strengthen the body's immune response to pathogens. In a minority of children, fever may be due to a non-infectious condition such as Kawasaki disease or malignancy. [ ; ; ; ] Prevalence How common is it? A UK prospective cohort study (1991–1997) of pre-school children (n = 13,617) found that febrile illness is very common in young children, with cough, cold, earache, and fever being the most common symptoms presenting to healthcare (...) the effectiveness of paracetamol versus ibuprofen in the management of febrile children noted that 'distress' is not well defined in the literature, and parents' perception of distress is subjective and may vary considerably [ ]. The recommendation not to use aspirin as an antipyretic in children under 16 years of age is based on the fact that aspirin-containing preparations are contraindicated in this age-group due to an associated increased risk of Reye's syndrome. It may be initiated by a specialist

2018 NICE Clinical Knowledge Summaries

123. Acne clinical guideline Full Text available with Trip Pro

testing in evaluating patients with adult acne and acne vulgaris in adolescents to adults? What is the effectiveness and what are the potential side effects of topical agents in the treatment of adult acne and acne vulgaris in adolescents to adults, including: • Retinoids and retinoid-like drugs • Benzoyl peroxide • Topical antibiotics • Salicylic/azelaic acids • Sulfur and resorcinol • Aluminum chloride • Zinc • Combinations of topical agents What is the effectiveness and what are the potential side (...) of dapsone 5% gel in female vs male patients with facial acne vulgaris: gender as a clinically relevant outcome variable. J Drugs Dermatol . 2012 ; 11 : 1417–1421 | Salicylic acid B II x 87 Shalita, A.R. Treatment of mild and moderate acne vulgaris with salicylic acid in an alcohol-detergent vehicle. Cutis . 1981 ; 28 : 556–558 ( 561 ) | 87 Systemic antibiotics Tetracyclines (eg, tetracycline, doxycycline, and minocycline) A I, II x 88 Garner, S.E., Eady, A., Bennett, C., Newton, J.N., Thomas, K

2016 American Academy of Dermatology

124. Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration

evaluate the impact of these practices. Studies with observational findings and case reports suggest that certain patient or clinical characteristics ( e.g. , obesity, obstructive sleep apnea, coexisting disease) may be associated with respiratory depression when neuraxial opioids are used ( Category B1/B4-H evidence ). Survey Findings. Both the consultants and the ASA members strongly agree that (1) a focused history and physical examination should be conducted before administering neuraxial opioids (...) , (2) particular attention should be directed toward signs, symptoms, or a history of sleep apnea; co-existing diseases or conditions; current medications; and adverse effects after opioid administration, and (3) a physical examination should include, but is not limited to, baseline vital signs, airway, heart, lung, and cognitive function. Recommendations for Identification of Patients at Increased Risk of Respiratory Depression Conduct a focused history and physical examination before

2016 American Society of Anesthesiologists

125. Management of Intra-Abdominal Infection : guidelines by the Surgical Infection Society Full Text available with Trip Pro

, but consider use of these approaches as options in critically ill patients and those at risk for infection with resistant gram-negative pathogens (Grade 2-B). 10. Duration of antimicrobial therapy The duration of antimicrobial therapy in the patient with IAI needs to be specific for each clinical condition. Specific recommendations include: • Do not use antibiotic agents to prevent infection in patients with severe or necrotizing pancreatitis (Grade 1-B). • Consider deferral of antibiotic therapy in lower (...) the treatment of patients with IAI are provided in this guideline. Executive Summary Intra-abdominal infection (IAI) is a common disease process managed by surgical practitioners. The Surgical Infection Society (SIS) developed and disseminated guidelines for the management of these infections in 1992 [ ], in 2002 [ , ], and most recently in 2010 as a joint guideline with the Infectious Diseases Society of America (IDSA) [ ]. Since the 2010 guideline, additional challenges have arisen in the management

2016 Surgical Infection Society

126. Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications Full Text available with Trip Pro

by increased morbidity and mortality and is now the third or fourth most common life-threatening infection syndrome, after sepsis, pneumonia, and intra-abdominal abscess. Globally, in 2010, IE was associated with 1.58 million disability-adjusted life-years or years of healthy life lost as a result of death and nonfatal illness or impairment. Epidemiological surveys from France and the International Collaboration on Endocarditis have confirmed that the epidemiological profile of IE has changed substantially (...) , Michael H. Gewitz , Matthew E. Levison , Ann F. Bolger , James M. Steckelberg , Robert S. Baltimore , Anne M. Fink , Patrick O’Gara and Kathryn A. Taubert Originally published 15 Sep 2015 Circulation. 2015;132:1435–1486 You are viewing the most recent version of this article. Previous versions: Abstract Background— Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex

2016 Infectious Diseases Society of America

127. Practice Guidelines for Obstetric Anesthesia Full Text available with Trip Pro

that platelet count and fibrinogen values are associated with the frequency of postpartum hemorrhage ( Category B2 evidence ). Other observational studies and case reports suggest that a platelet count may be useful for diagnosing hypertensive disorders of pregnancy, such as preeclampsia; hemolysis, elevated liver enzymes, and low platelet count syndrome; and other conditions associated with coagulopathy ( Category B3/B4-B evidence ). Survey Findings: The consultants and ASA members strongly agree (...) , comparative studies are insufficient to directly evaluate the impact of these practices. Studies with observational findings suggest that certain patient or clinical characteristics ( e.g. , hypertensive disorders of pregnancy such as preeclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome, obesity, and diabetes mellitus) may be associated with obstetric complications ( Category B2/B3-H evidence ). Survey Findings: The consultants and ASA members both strongly agree (1

2016 American Society of Anesthesiologists

128. Management of fever in children

for prescribing antipyretics are as follows: • select the first-line medication based on contraindications, warnings and precautions for use; • use a single substance in monotherapy for the first 24 hours. There is no preventive treatment for febrile seizures. Prescribing aspirin (acetylsalicylic acid) is not recommended in case of fever in children, due to a very rare but potentially fatal risk of Reye’s syndrome. On its own, a poorly tolerated fever, despite proper treatment for at least 24 hours (...) with caution in case of suspected bacterial infection; - gastrointestinal adverse effects: rare but sometimes fatal cases of gastrointestinal bleeding and gastric or oesophageal ulcerations; - renal adverse effects: rare cases of acute renal failure; - effects on haemostasis: the reversible action of NSAIDs on blood platelets leads to a risk of prolonged bleeding time; - others: skin allergic reactions, severe skin conditions, meningeal syndromes, bronchospasms and hyperkalaemia have also been reported.

2016 HAS Guidelines

129. Pediatric Pulmonary Hypertension: ATS/AHA Clinical Practice Guidelines

transient improve- ments in Pao 2 may be observed in the short term, no studies have demonstrated long-term benefit. Prolonged alkalosis may Table 8. Genetic Syndromes Associated With an Increased Incidence of PH PH with or without CHD Down syndrome DiGeorge syndrome Scimitar syndrome Noonan syndrome Dursun syndrome Cantu syndrome PH without CHD SCD Adams-Oliver syndrome Neurofibromatosis Autoimmune polyendocrine syndrome Gaucher disease Glycogen storage disease I and III Mitochondrial disorders (MELAS (...) / Downloaded from by guest on March 15, 2016 http://circ.ahajournals.org/ Downloaded from 2 Circulation November 24, 2015 1. Introduction 1.1. Rationale and Goals This guidelines document addresses approaches to the evalu- ation and treatment of pulmonary hypertension (PH) in chil- dren, defined as a resting mean pulmonary artery pressure (mPAP) >25 mm Hg beyond the first few months of life. This document focuses on childhood disorders of PH result- ing from pulmonary vascular disease (PVD) and includes PH

2015 American Thoracic Society

130. Pediatric Pulmonary Hypertension Full Text available with Trip Pro

Neurofibromatosis Autoimmune polyendocrine syndrome Gaucher disease Glycogen storage disease I and III Mitochondrial disorders (MELAS) CHD indicates congenital heart disease; MELAS, mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes; PH, pulmonary hypertension; and SCD, sickle cell disease. Downloaded from http://ahajournals.org by on March 27, 2019Abman et al Pediatric Pulmonary Hypertension 2057 paradoxically worsen pulmonary vascular tone, reactivity, and permeability edema 203 (...) the first few months of life. This document focuses on childhood disorders of PH result- ing from pulmonary vascular disease (PVD) and includes PH related to cardiac, lung, and systemic diseases, as well as idio- pathic pulmonary artery hypertension (IPAH). IPAH is a pul- monary vasculopathy that remains a diagnosis of exclusion, specifically indicating the absence of diseases of the left side of the heart or valves, lung parenchyma, thromboembolism, or other miscellaneous causes. The term PVD is also

2015 American Heart Association

131. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice Full Text available with Trip Pro

protocols can reduce the risk of allogenic blood transfusions. , Cardiovascular risk reduction It is not the intent of this manuscript to discuss in detail perioperative cardiovascular strategies to reduce cardiovascular risk. These interventions are extensively discussed in the recent ACC/AHA 2014 guidelines. Asthma, COPD and diabetes Chronic conditions such as asthma, chronic obstructive airways disease , diabetes mellitus malnutrition - and frailty should be optimized prior to surgery. Summary (...) and recommendation : cessation of smoking and alcohol intake at least 4 weeks before surgery is recommended. Encouraging patients is not enough; pharmacological support and individual counselling should be offered to every patient who smokes and to alcohol abusers undergoing elective surgery. Optimization of medical conditions, such as cardiovascular diseases, anaemia, chronic obstructive airways disease, diabetes, nutritional status and frailty and should follow international recommendations. Recommendation

2015 ERAS Society

132. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations Full Text available with Trip Pro

disturbances and delayed convalescence. Fitness can be subdivided into coexisting medical problems and physical fitness. Pre‐existing health factors such as myocardial infarction, heart failure, stroke, peripheral vascular disease and impaired kidney function can increase the risk of post‐operative complications. There is also sufficient evidence that patients with poor physical conditions and low anaerobic threshold have greater post‐operative morbidity and mortality. In patients with cardiopulmonary (...) . Pre‐existing factors can contribute to POCD, such as advanced age, metabolic syndrome, education, vascular dementia and attention deficit disorders. Sleep disruption, poor analgesia, anaesthetic medications such as benzodiazepines can further exacerbate POCD. Due to the complexity of the pathogenic mechanism and the multifactorial nature of POD and POCD, attempts are made to identify vulnerable patients and interventions which promote resolution of neuroinflammation. In this context, strategies

2015 ERAS Society

133. Revised ATA guidelines for the management of medullary thyroid carcinoma

duty to warn in the prenatalcontextaswell.ThecourtsheldinMolloyv.Meier,a case concerning Fragile X syndrome, that physicians have a duty to warn of genetic harms and to inform patients of all available prenatal medically appropriate options (122). Failuretowarninaprenatalcontextcouldleadtoallegations of wrongful conception, wrongful life, or even wrongful birth,inwhichcasetheparentsortheoffspringcouldsuethe physician for damages related to a foreseeable and serious genetic disease or condition (...) criteria described for FMTC (2,57–59). Currently,theopinionofmostclinicalinvestigatorsisthat FMTC should not be a freestanding syndrome; rather it should represent a variant along the spectrum of disease ex- pression in MEN2A. The Task Force agrees that FMTC should not be de?ned as a form of hereditary MTC distinct from MEN2A and MEN2B (2,49). Rather it should be rec- ognizedasavariantofMEN2Atoincludefamilieswithonly MTC who meet the original strict criteria for FMTC, small

2015 Pediatric Endocrine Society

134. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer

. Nikiforov, 6 Furio Pacini, 7 Gregory W. Randolph, 8 Anna M. Sawka, 9 Martin Schlumberger, 10 Kathryn G. Schuff, 11 Steven I. Sherman, 12 Julie Ann Sosa, 13 David L. Steward, 14 R. Michael Tuttle, 15 and Leonard Wartofsky 16 Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association’s (ATA’s) guidelines for the management of these disorders were revised in 2009, signi?cant scienti?c advances have (...) of the scienti?c or medical content of the manuscript was dictated by the ATA. THYROID Volume 26, Number 1, 2016 ª American Thyroid Association ª Mary Ann Liebert, Inc. DOI: 10.1089/thy.2015.0020 1 of differentiated thyroid cancer include those related to surveillance for recurrent disease using imaging and serum thyroglobulin, thyroid hormone therapy, management of recurrent and metastatic disease, consideration for clinical trials and targeted therapy, as well as directions for future research. Conclusions

2015 Pediatric Endocrine Society

135. Guidelines for the treatment of malaria. Third edition

and can be given orally or as a suppository. Ibuprofen (5 mg/kg bw) has been used successfully as an alternative in the treatment of malaria and other childhood fevers, but, like aspirin and other non-steroidal anti-inflammatory drugs, it is no longer recommended because of the risks of gastrointestinal bleeding, renal impairment and Reye’s syndrome. 4 | Treatment of uncomplicated Plasmodium falciparum malaria 44 Guidelines for the treatment of malaria 3 RD EDITION4.7.3 | USE OF ANTI - EMETICS (...) 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

2015 World Health Organisation Guidelines

136. Acute Pain Management: Scientific Evidence

Pharmacological treatment 352 8.8.5 Guillain-Barre syndrome 354 8.8.6 Procedure-related pain 354 8.9 Acute pain management in emergency departments 355 8.9.1 Systemic analgesics 355 8.9.2 Analgesia in specific conditions 357 8.9.3 Nonpharmacological management of pain 359 8.10 Prehospital analgesia 360 8.10.1 Assessment of pain in the prehospital environment 361 8.10.2 Systemic analgesics 361 8.10.3 Anxiolytics 364 8.10.4 Regional analgesia 364 8.10.5 Nonpharmacological management of pain 364 8.10.6 Analgesia (...) and implementation of clinical practice guidelines . https:// www.nhmrc.gov.au/guidelines-publications/cp30 Accessed 29 August 2014. painaustralia (2010) National Pain Strategy. Available from Painaustralia at: www.painaustralia.org.au Accessed 24 October 2015. Reardon DP , Anger KE, Szumita PM (2015) Pathophysiology, assessment, and management of pain in critically ill adults. Am J Health Syst Pharm 72(18):1531–43. Shipton EA (2014a) The transition of acute postoperative pain to chronic pain: Part 1 - Risk

2015 Clinical Practice Guidelines Portal

137. Antithrombotics: indications and management

reported, although the mechanisms and incidence are disputed. 19 3.1.3 CONTRAINDICATIONS Contraindications to aspirin include: known allergy to the drug; use other than as an antiplatelet in children and adolescents under 16 years (risk of Reye’s syndrome); active peptic ulceration; history of recent gastrointestinal bleeding; history of recent intracranial bleeding; and bleeding disorders including haemophilia, von Willebrand’s disease, severe thrombocytopenia (eg platelets 1g/day); concomitant use (...) . In the same Cochrane review no RCT on the use of aspirin or other antiplatelet agents in patients with essential thrombocythaemia was identified although aspirin is in common usage in this condition. 200 See section 15.4 for the management of myeloproliferative disorders in pregnancy. 12 • Myeloproliferative disorders4 3 4 1 ++ 3 1 + 4 Antithrombotics: indications and management 38 | 13 Other indications for anticoagulant therapy 13.1 DISSEMINATED INTRAVASCUl AR COAGUl ATION Experimental studies have

2012 SIGN

138. RACIN in Patients With Advanced TIL-negative Solid Tumors

will be treated with the MTD or RP1bD dose of RT and will follow the same schema of treatment used in the Phase Ia cohort (5 cycles). At the end of the 5th cycle, patients eligible for nivolumab maintenance, will be treated with nivolumab at 240 mg Q2W until progression or excessive toxicity; ASA will be maintained according to tolerability. Condition or disease Intervention/treatment Phase Solid Tumor, Adult Combination Product: Low dose irradiation + Nivolumab + Ipilimumab + Aspirin Phase 1 Study Design Go (...) Cooperative Oncology Group (ECOG) clinical performance status: 0-1 for all patients, independently of the number of previous lines of therapy. Life expectancy of ≥ 12 weeks Patients with Glycose-6-Phosphate Dehydrogenase (G6PD) deficiency or any other hereditary coagulation disorder are excluded, as well as patients with clinical history of Reye syndrome Adequate serology defined by the following laboratory results obtained during pre-screening period (day-28 to day-14). Seronegative for HIV infection

2018 Clinical Trials

139. Assessment of Viral Shedding Week Following Administration of Live Attenuated Influenza Vaccine in Children

contra-indication, which must be discussed with the CI to confirm patient suitability Children/adolescents who are clinically immunodeficient due to conditions or immunosuppressive therapy such as: acute and chronic leukaemias; lymphoma; symptomatic HIV infection; cellular immune deficiencies; and high-dose corticosteroids*. Children / adolescents younger than 18 years of age receiving salicylate therapy because of the association of Reye's syndrome with salicylates and wild-type influenza infection (...) by a single dose of LAIV. Parents will then be asked to take nasal swabs at home on days 1, 2, 3, 4, 5, 6, 7, 8, with further nasal swab, blood test and oral fluid collection in hospital 4 weeks later, in order to assess for immune responses to LAIV. Condition or disease Intervention/treatment Phase Influenza Vaccines Biological: Live attenuated influenza vaccine (LAIV) Phase 4 Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 30

2018 Clinical Trials

140. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

, and scopes of clinical practice. Selected organizations and professional societies with related interests and expertise are invited to participate as partners or collaborators. Individualizing Care in Patients With Associated Conditions and Comorbidities—The ACC and AHA recognize the complexity of managing patients with multiple conditions, compared with managing patients with a single disease, and the challenge is compounded when CPGs for evaluation or treatment of several coexisting illnesses (...) . Role of Natriuretic Peptides in Perioperative Risk of HF 16 2.3. Cardiomyopathy 16 2.4. Valvular Heart Disease: Recommendations 18 2.4.1. Aortic Stenosis: Recommendation 18 2.4.2. Mitral Stenosis: Recommendation 19 2.4.3. Aortic and Mitral Regurgitation: Recommendations 20 2.5. Arrhythmias and Conduction Disorders 21 2.5.1. Cardiovascular Implantable Electronic Devices: Recommendation 22 2.6. Pulmonary Vascular Disease: Recommendations 23 2.7. Adult Congenital Heart Disease 24 3. Calculation

2014 Society for Cardiovascular Angiography and Interventions

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