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Evidence-based medicine (EBM) is the care of patients using the best available research evidence to guide clinical decision-making ( figure 1) [ 1,2 ]. The value of EBM is heightened in light of the following considerations: The volume of evidence available to guide clinical decisions continues to grow at a rapid pace ( figure 2)

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Mar 28, 2024 · Choice of initial therapy in most patients — The three primary options for antihypertensive drug therapy in most patients include an ACE inhibitor (or ARB), a calcium channel blocker, or a thiazide diuretic (preferably a thiazide-like diuretic) [ 3 ].

The pharmacology, efficacy, contraindications, and side effects of metformin for the treatment of diabetes will be reviewed here. A general discussion of initial treatment of type 2 diabetes and the role of metformin in the prevention of diabetes, in the treatment of polycystic ovary syndrome, and in gestational diabetes are reviewed separately.American Association of Nurse Practitioners (AANP) UpToDate is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 051212. For each hour of participation with the UpToDate program, NPs can claim 1.0 contact hour.The signs and symptoms of anemia include paleness, weakness, and fatigue. Impaired kidney function — The excess proteins and high blood calcium levels associated with MM can damage the kidneys. Kidney function is abnormal at diagnosis in about half of individuals with multiple myeloma.Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options.For over 30 years, clinicians around the world have trusted the evidence-based content in the UpToDate® clinical decision support (CDS) system to help make crucial care decisions when it matters most. Founded by clinicians for clinicians, and backed by an expert editorial team in over 25 specialties, UpToDate provides the latest medical ...

Licensed to: UpToDate Marketing Professional Support Tag : [1102 - 40.77.189.15 - 7D44A5896D - PR14 - UPT - 20240511-08:06:01UTC] - SM - MD - LG - XL LoadingJun 6, 2016 · Intrauterine tamponade (with a balloon, packing, or vacuum) may be used to manage patients with postpartum hemorrhage (PPH) resulting from uterine atony that is not controlled by uterotonic medications and uterine massage. However, outcome data regarding vacuum-induced tamponade are limited. Other manifestations include lower abdominal pain and cramping, low-grade fever, nausea, and anorexia [ 2,5 ]. Diarrhea may be associated with mucus or occult blood, but melena or hematochezia are rare. Fever is associated with CDI in about 15 percent of cases; temperature >38.5°C may occur in the setting of nonsevere or severe CDI.Anemia definitions — Anemia is defined for patient care as a reduction in one or more of the major red blood cell (RBC) measurements obtained as a part of the complete blood count (CBC): hemoglobin concentration, hematocrit, or RBC count. A low hemoglobin concentration and/or low hematocrit are the parameters most widely used to diagnose …Multiple antibiotic regimens have been evaluated for Helicobacter pylori ( H. pylori) therapy [ 1-6 ]. However, few regimens have consistently achieved high eradication rates. There are also limited data on H. pylori antibiotic resistance rates to guide therapy. The treatment regimen that is selected must consider local antibiotic resistance ...

EVALUATION AND DIAGNOSIS. The history and physical examination in patients presenting with a severely elevated blood pressure (or an acute rise in blood pressure over a previously normal baseline, even if the presenting pressure is <180/120 mmHg) should determine whether any of the following are present [ 1,5 ]: Acute head …Oral options include penicillin V potassium, amoxicillin, cephalexin, and cefadroxil. Parenteral options include cefazolin, nafcillin, and flucloxacillin. (See 'Treatment of erysipelas' above.) Duration of antibiotic therapy – We suggest five to six days of therapy rather than longer durations ( Grade 2C ).Mar 15, 2023 · Vaginal yeast infections (also called yeast vaginitis or vaginal candidiasis) are a common problem in women. The most common symptoms are itching and irritation of the vulva and around the opening of the vagina. Vaginal yeast infections usually occur as infrequent episodes, but can recur frequently and may cause chronic persistent symptoms. Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options.

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Immune thrombocytopenia (ITP) is an acquired thrombocytopenia characterized by immune-mediated destruction of platelets and/or impairment of platelet production; terminology is summarized in the table ( table 1 ). ITP is a diagnosis of exclusion; there are no reliable laboratory tests to confirm the diagnosis.UpToDateUpToDate, electronic clinical resource tool for physicians and patients that provides information on Adult Primary Care and Internal Medicine, Allergy and Immunology, Cardiovascular Medicine, Emergency Medicine, Endocrinology and Diabetes, Family Medicine, Gastroenterology and Hepatology, Hematology, Infectious Diseases, Nephrology and Hypertension, Neurology, Obstetrics, Gynecology, and Women ...Clinical Criteria Caprini risk assessment model for venous thromboembolism in adult general surgical patients (Caprini risk score)* Child Pugh score for severity of liver disease in adults (SI units)*UpToDate is an online clinical resource tool for physicians and patients that provides information on various specialties and topics. Click on one of the specialties to see …

For over 30 years, clinicians around the world have trusted the evidence-based content in the UpToDate® clinical decision support (CDS) system to help make crucial care decisions when it matters most. Founded by clinicians for clinicians, and backed by an expert editorial team in over 25 specialties, UpToDate provides the latest medical ..."I want African realities to be explored by Africans." Chimamanda Adichie is vocal about many things and African literature ranks highly on that list. The Nigerian author, in a vid...Spontaneous bacterial peritonitis (SBP) is defined as an ascitic fluid infection without an evident intra-abdominal surgically treatable source [ 1 ]. The presence of SBP, which almost always occurs in patients with cirrhosis and ascites, is suspected because of suggestive signs and symptoms, such as fever, abdominal pain, or altered mental ...UpToDate is a trusted source of clinical information for health professionals. However, the page you are looking for can't be found. Try searching for a different topic or language.UpToDate contributors generally avoid use of NSAIDs, or use them with particular caution and at reduced doses, in older adults and patients (regardless of age) with existing or increased risk for cardiovascular, GI, or kidney disease. Concurrent gastroprotection (eg, a proton pump inhibitor) may be warranted.Second dose of a 2023-2024 COVID-19 vaccine for individuals 65 years and older (April 2024) In the United States, a single dose of an updated 2023-2024 formula COVID-19 vaccine is recommended for all immunocompetent adults and adolescents, regardless of prior vaccination history. In February 2024, the Centers for Disease Control …"I want African realities to be explored by Africans." Chimamanda Adichie is vocal about many things and African literature ranks highly on that list. The Nigerian author, in a vid...Osteoporosis is caused by the cumulative effect of bone resorption in excess of bone formation. Bisphosphonates inhibit bone resorption with relatively few side effects. As a result, they are widely used to prevent osteoporotic fractures. The use of bisphosphonates for the management of osteoporosis will be reviewed here.General symptoms — Thyroid hormone normally stimulates the metabolism, and most of the symptoms of hypothyroidism reflect slowing of metabolic processes. General symptoms may include fatigue, sluggishness, slight weight gain, and intolerance of cold temperatures. Skin — Hypothyroidism can decrease sweating.

Immune thrombocytopenia (ITP) is an acquired thrombocytopenia characterized by immune-mediated destruction of platelets and/or impairment of platelet production; terminology is summarized in the table ( table 1 ). ITP is a diagnosis of exclusion; there are no reliable laboratory tests to confirm the diagnosis.

The pericardium is a fibroelastic sac made up of visceral and parietal layers separated by a (potential) space, the pericardial cavity. In healthy individuals, the pericardial cavity contains 15 to 50 mL of an ultrafiltrate of plasma. Diseases of the pericardium present clinically in one of several ways: Acute and recurrent pericarditis.Oral options include penicillin V potassium, amoxicillin, cephalexin, and cefadroxil. Parenteral options include cefazolin, nafcillin, and flucloxacillin. (See 'Treatment of erysipelas' above.) Duration of antibiotic therapy – We suggest five to six days of therapy rather than longer durations ( Grade 2C ).What's New. Our editors select a small number of the most important updates and share them with you via What's New. See these updates by clicking on the specialty you are interested in below. You may also enter "What's new" in the search box. Find Out What's New In:Jun 6, 2016 · Intrauterine tamponade (with a balloon, packing, or vacuum) may be used to manage patients with postpartum hemorrhage (PPH) resulting from uterine atony that is not controlled by uterotonic medications and uterine massage. However, outcome data regarding vacuum-induced tamponade are limited. Other manifestations include lower abdominal pain and cramping, low-grade fever, nausea, and anorexia [ 2,5 ]. Diarrhea may be associated with mucus or occult blood, but melena or hematochezia are rare. Fever is associated with CDI in about 15 percent of cases; temperature >38.5°C may occur in the setting of nonsevere or severe CDI.Estrogen is an appropriate treatment for prevention of osteoporosis in young women whose ovaries do not make estrogen. This treatment may be given as a skin patch or orally, such as in the form of birth control pills. (See "Patient education: Absent or irregular periods (Beyond the Basics)" .)The clinical approach to S. aureus bacteremia consists of careful history and physical examination, infectious disease consultation, and diagnostic evaluation including echocardiography and additional imaging as needed. History and physical examination. History – A careful history and physical examination is essential.Powerful and practical clinical knowledge at your fingertips, a personal subscription to UpToDate provides consistent, convenient access to enhance your daily medical practice. UpToDate helps you stay current on the latest evidence-based recommendations across 25 specialties to find answers to your clinical questions. Subscribe.

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Bushmills, in Northern Ireland, is known for the famous whiskey distillery of the same name in the town. But there's more to it than that. In Northern Ireland nothing says cozy lik...INTRODUCTION. Vitamin D is a fat-soluble vitamin. Very few foods naturally contain vitamin D (fatty fish are the exception), so dermal synthesis is the major natural source of the vitamin. Vitamin D from the diet or dermal synthesis is biologically inactive and requires enzymatic conversion to active metabolites ( figure 1 ).Nausea, the unpleasant sensation of being about to vomit, can occur alone or can accompany vomiting (the forceful expulsion of gastric contents), dyspepsia, or other gastrointestinal symptoms. Nausea can occur without vomiting and, less commonly, vomiting occurs without nausea. Nausea is often more bothersome and disabling than …Jan 25, 2023 · The azoles that are available for systemic use can be classified into two groups: the triazoles (fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole) and the imidazoles (ketoconazole). An overview of the use of azole agents for the treatment of various systemic fungal infections will be reviewed here. UpToDateSoftBank-backed South Korean on-demand laundry service startup Laundrygo raises Series C funding led by private equity firm H&Q Korea. Mom-and-pop stores and franchises — mostly of...Display complete list of interactions for an individual item by clicking item name. Add another item to analyze for potential interactions. NOTE: This tool does not address chemical compatibility related to I.V. drug preparation or administration. View interaction detail by clicking on link (s) below.The subacute and long-term assessment and management of patients who have suffered a stroke includes physical therapy and testing to determine the precise etiology of the event so as to prevent recurrence. The acute management differs. Immediate goals include minimizing brain injury, treating medical complications, and moving toward …The management of bowel obstruction depends upon the etiology, severity, and location of the obstruction. The goals of initial management are to relieve discomfort and restore normal fluid volume, acid-base balance, and electrolytes. Bowel compromise (ischemia, necrosis, or perforation) and a surgically correctable cause of SBO (eg ... ….

"I want African realities to be explored by Africans." Chimamanda Adichie is vocal about many things and African literature ranks highly on that list. The Nigerian author, in a vid...Shingles, also known as herpes zoster, is a painful rash caused by varicella-zoster virus (the same virus that causes chickenpox). After a person has had chickenpox, the virus continues to reside in the body, causing no symptoms. Later in life, it can become active again, causing the shingles rash. The term "shingles" comes from the Latin word ...Display complete list of interactions for an individual item by clicking item name. Add another item to analyze for potential interactions. NOTE: This tool does not address chemical compatibility related to I.V. drug preparation or administration. View interaction detail by clicking on link (s) below.OS X Mountain Lion brought with it a world of new keyboard shortcuts and trackpad gestures that make working with your Mac faster and easier. We're still getting used to many of th...UpToDate personal subscriptions support physicians with evidence-based clinical recommendations. With so much change in the world of patient care, it is clear that access to continuously updated and reliable data is critical for both provider and patient satisfaction. UpToDate® connects you to the most current medical research and findings ...From the laboratory to your medicine cabinet, the process of researching and developing a drug is long, complicated and costly. From the laboratory to your medicine cabinet, the pr...Moved Permanently. The document has moved here.Use the resource trusted by healthcare practitioners worldwide. Patients and their caregivers can learn more about a medical condition and explore treatment options …PARENTERAL DRUGS. A variety of parenteral and oral antihypertensive drugs are available for use in these patients ( table 1) [ 1-7 ]. Few studies have compared these agents with one another, and all are tolerated reasonably well [ 8,9 ]. Thus, the drug of choice is often dictated by the type of hypertensive emergency and the local hospital ... Uptodate com, With so much change in the world of patient care, it is clear that access to continuously updated and reliable data is critical for both provider and patient satisfaction. …, Type 2 diabetes mellitus is a disorder that is known for disrupting the way your body uses glucose (sugar); it also causes other problems with the way your body stores and processes other forms of energy, including fat. All the cells in your body need sugar to work normally. Sugar gets into the cells with the help of a hormone called insulin., A smart device with cutting-edge smart technology that helps you master your smoking habit and reduce cigarette consumption. A smart device with cutting-edge smart technology that ..., UpToDate, electronic clinical resource tool for physicians and patients that provides information on Adult Primary Care and Internal Medicine, Allergy and Immunology, Cardiovascular Medicine, Emergency Medicine, Endocrinology and Diabetes, Family Medicine, Gastroenterology and Hepatology, Hematology, Infectious Diseases, Nephrology and Hypertension, Neurology, Obstetrics, Gynecology, and Women ..., "I want African realities to be explored by Africans." Chimamanda Adichie is vocal about many things and African literature ranks highly on that list. The Nigerian author, in a vid..., Aug 25, 2022 · Enterococcal species can cause a variety of infections, including urinary tract infections, bacteremia, endocarditis, and meningitis. The antimicrobial agents available for treatment of enterococcal infection are reviewed here, followed by treatment approaches for clinical syndromes caused by enterococci. Other issues related to enterococci are ... , Indices Commodities Currencies Stocks, UpToDate: Trusted, evidence-based solutions for modern healthcare. Dedicated to continuously innovating to meet the needs of the rapidly changing medical landscape, the UpToDate® suite offers clinical, drug, patient and member content to support health professionals wherever care takes place. Subscribe To UpToDate., Apr 1, 2024 · For over a century, open appendectomy was the only standard treatment for appendicitis. Contemporary management of appendicitis is more sophisticated and nuanced: laparoscopic appendectomy has surpassed open appendectomy in usage, some patients with perforated appendicitis may benefit from initial antibiotic therapy followed by interval ... , NORTHERN TRUST EAFE INDEX FUND - NON-LENDING- Performance charts including intraday, historical charts and prices and keydata. Indices Commodities Currencies Stocks, Licensed to: UpToDate Marketing Professional Support Tag : [0602 - 104.224.13.115 - E553BA549D - PR14 - UPT - 20240416-14:45:43UTC] - SM - MD - LG - XL Loading, What's New. Our editors select a small number of the most important updates and share them with you via What's New. See these updates by clicking on the specialty you are interested in below. You may also enter "What's new" in the search box. Find Out What's New In:, These include fever of unknown origin, bacteremic seeding of heart valves and prosthetic devices, preterm birth of low birth weight children, and an increased risk for coronary heart disease and cerebrovascular events. The complications, diagnosis, and treatment of odontogenic infections will be reviewed here., Type 2 diabetes mellitus is a disorder that is known for disrupting the way your body uses glucose (sugar); it also causes other problems with the way your body stores and processes other forms of energy, including fat. All the cells in your body need sugar to work normally. Sugar gets into the cells with the help of a hormone called insulin., Treatment of osteomyelitis includes consideration of issues related to debridement, management of infected foreign bodies (if present), antibiotic selection, and duration of therapy; these issues are discussed in the following sections. General issues related to treatment of osteomyelitis are discussed here., Trusted expert editorial content. The heart of UpToDate is over 7,400 expert clinicians, editors, and reviewers who review and assemble the latest evidence-based clinical, …, Enterococcal species can cause a variety of infections, including urinary tract infections, bacteremia, endocarditis, and meningitis. The antimicrobial agents available for treatment of enterococcal infection are reviewed here, followed by treatment approaches for clinical syndromes caused by enterococci. Other issues related to enterococci are ..., Conjunctivitis, also called "pink eye," is defined as an inflammation of the conjunctiva. The conjunctiva is the thin membrane that lines the inner surface of the eyelids and the whites of the eyes (called the sclera) ( figure 1 ). Conjunctivitis can affect children and adults. The most common symptoms of conjunctivitis include a red eye and ..., UpToDate contributors generally avoid use of NSAIDs, or use them with particular caution and at reduced doses, in older adults and patients (regardless of age) with existing or increased risk for cardiovascular, GI, or kidney disease. Concurrent gastroprotection (eg, a proton pump inhibitor) may be warranted., Pneumonia can be caused by a variety of microorganisms, including viruses, bacteria, and, less commonly, fungi. The most common bacterial cause of pneumonia in the United States is a type of bacteria called Streptococcus pneumoniae (also called pneumococcus). Other bacteria can cause pneumonia as well., The four essential components of asthma management are patient education, minimizing exposure to asthma triggers, monitoring for changes in symptoms or lung function, and pharmacologic therapy. This overview topic presents the goals and components of asthma management. It is applicable to both children and adults., Oct 6, 2023 · PARENTERAL DRUGS. A variety of parenteral and oral antihypertensive drugs are available for use in these patients ( table 1) [ 1-7 ]. Few studies have compared these agents with one another, and all are tolerated reasonably well [ 8,9 ]. Thus, the drug of choice is often dictated by the type of hypertensive emergency and the local hospital ... , UpToDate is an online platform that offers evidence-based clinical information and decision support for health care professionals and patients. To use UpToDate, you need to create an account or log in with your credentials., Oct 6, 2023 · PARENTERAL DRUGS. A variety of parenteral and oral antihypertensive drugs are available for use in these patients ( table 1) [ 1-7 ]. Few studies have compared these agents with one another, and all are tolerated reasonably well [ 8,9 ]. Thus, the drug of choice is often dictated by the type of hypertensive emergency and the local hospital ... , Management of patients with nausea and vomiting of pregnancy (NVP) depends upon symptom severity, the impact of symptoms on health and quality of life, and the safety of treatment for both mother and fetus. NVP is typically a self-limited condition and not associated with adverse pregnancy outcomes. Treatment approaches …, The azoles that are available for systemic use can be classified into two groups: the triazoles (fluconazole, itraconazole, voriconazole, posaconazole, and isavuconazole) and the imidazoles (ketoconazole). An overview of the use of azole agents for the treatment of various systemic fungal infections will be reviewed here., If your organization permits Single Sign-On (SSO) for UpToDate, you may use your email address here. If not, please enter your Username. Close Subscribe. Subscribe. UpToDate offers a number of subscriptions and add-on products, allowing you to have the most up-to-date information and improve patient care. About Us ..., INTRODUCTION. Acute pulmonary embolism (PE) is a common and sometimes fatal disease. The approach to the evaluation should be efficient while simultaneously avoiding the risks of unnecessary testing so that therapy can be promptly initiated and potential morbidity and mortality avoided []., , Licensed to: UpToDate Marketing Professional Support Tag : [0602 - 207.46.13.154 - FBF59F1322 - PR14 - UPT - 20240510-02:21:15UTC] - SM - MD - LG - XL Loading, The pharmacology, efficacy, contraindications, and side effects of metformin for the treatment of diabetes will be reviewed here. A general discussion of initial treatment of type 2 diabetes and the role of metformin in the prevention of diabetes, in the treatment of polycystic ovary syndrome, and in gestational diabetes are reviewed separately., UpToDate contains a number of patient education articles that discuss breast cancer. The purpose of this overview is to provide a guide to the issues and questions that arise in women with newly diagnosed breast cancer. This topic can serve as a "road map" to the patient education articles that are relevant to your particular situation., UpToDate, electronic clinical resource tool for physicians and patients that provides information on Adult Primary Care and Internal Medicine, Allergy and Immunology, Cardiovascular Medicine, Emergency Medicine, Endocrinology and Diabetes, Family Medicine, Gastroenterology and Hepatology, Hematology, Infectious Diseases, Nephrology and Hypertension, Neurology, Obstetrics, Gynecology, and Women ...