MEDICAL: DISEASES : PHYSICAL EXERCISE AND FITNESS : CHILDREN: A Teen's Muscle Soreness Turned Out to Be This Life-Threatening Condition

classic Classic list List threaded Threaded
1 message Options
Reply | Threaded
Open this post in threaded view
|

MEDICAL: DISEASES : PHYSICAL EXERCISE AND FITNESS : CHILDREN: A Teen's Muscle Soreness Turned Out to Be This Life-Threatening Condition

David P. Dillard
Administrator



*


*



MEDICAL: DISEASES :

PHYSICAL EXERCISE AND FITNESS :

CHILDREN:

A Teen's Muscle Soreness Turned Out to Be This Life-Threatening Condition

*

*


A Teen's Muscle Soreness Turned Out to Be This Life-Threatening Condition

By Rachael Rettner, Senior Writer

June 4, 2018 05:22pm ET

https://www.livescience.com/62738-teen-muscle-soreness-rhabdomyolysis.html


*


*


  A Texas teen who felt extremely sore after a hard gym workout turned out
to have a rare and potentially life-threatening condition called
rhabdomyolysis. But how do you tell the difference between run-of-the-mill
soreness and rhabdomyolysis?

.

The teen, Jared Shamburger, had recently signed up for a gym membership
with his family, according to local news outlet KTRK. His older brother
and dad had been weightlifting for years, and Shamburger wanted to "catch
up" with them. "I have to go hard fast," Shamburger, who is 17, told KTRK.

.

But after a 90-minute weightlifting session, Shamburger said he felt
particularly sore. "Everything hurt. It hurt to the touch. It was
swollen," he said.

.

When the teen's soreness and swelling didn't go away, his mom, Judy
Shamburger, looked up his symptoms online, and realized her son might have
rhabdomyolysis. Her suspicion was right. The teen was diagnosed with the
condition, sometimes referred to as "rhabdo," and hospitalized for five
days, KTRK reported.

*

snip

*

Shamburger is expected to make a full recovery, KTRK reported.

*

*


Rhabdomyolysis - Wikipedia

https://en.wikipedia.org/wiki/Rhabdomyolysis

Rhabdomyolysis is a condition in which damaged skeletal muscle breaks down
rapidly.[3] Symptoms may include muscle pains, weakness, vomiting, and
confusion.[3][4] There may be tea-colored urine or an irregular
heartbeat.[3] Some of the muscle breakdown products, such as the protein
myoglobin, are harmful to the kidneys and may lead to kidney failure.[3]

The muscle damage is most often the result of a crush injury, strenuous
exercise, medications, or drug abuse.[3] Other causes include infections,
electrical injury, heat stroke, prolonged immobilization, lack of blood
flow to a limb, or snake bites.[3] Some people have inherited muscle
conditions that increase the risk of rhabdomyolysis.[3] The diagnosis is
supported by a urine test strip which is positive for "blood" but the
urine contains no red blood cells when examined with a microscope.[3]
Blood tests show a creatine kinase greater than 1,000 U/L, with severe
disease being above 5,000 U/L.[5]

The mainstay of treatment is large quantities of intravenous fluids.[3]
Other treatments may include dialysis or hemofiltration in more severe
cases.[4][6] Once urine output is established sodium bicarbonate and
mannitol are commonly used but they are poorly supported by the
evidence.[3][4] Outcomes are generally good if treated early.[3]
Complications may include high blood potassium, low blood calcium,
disseminated intravascular coagulation, and compartment syndrome.[3]

Rhabdomyolysis occurs in about 26,000 people a year in the United
States.[3] While the condition has been commented on throughout history,
the first modern description was following an earthquake in 1908.[7]
Important discoveries as to its mechanism were made during the Blitz of
London in 1941.[7] It is a significant problem for those injured in
earthquakes and relief efforts for such disasters often include medical
teams equipped to treat survivors with rhabdomyolysis.[7]

Contents

     1 Signs and symptoms
     2 Causes
         2.1 Genetic predisposition
     3 Mechanism
     4 Diagnosis
         4.1 General investigations
         4.2 Complications
         4.3 Underlying disorders
     5 Treatment
         5.1 Electrolytes
         5.2 Acute kidney impairment
         5.3 Other complications
     6 Prognosis
     7 Epidemiology
     8 History
     9 Etymology and pronunciation
     10 Other animals
     11 References
     12 External links


*

*


Rhabdomyolysis

Medline Plus

https://medlineplus.gov/ency/article/000473.htm

Rhabdomyolysis
Email this page to a friend Print Facebook Twitter Google+

Rhabdomyolysis is the breakdown of muscle tissue that leads to the release
of muscle fiber contents into the blood. These substances are harmful to
the kidney and often cause kidney damage.
Causes

When muscle is damaged, a protein called myoglobin is released into the
bloodstream. It is then filtered out of the body by the kidneys. Myoglobin
breaks down into substances that can damage kidney cells.

Rhabdomyolysis may be caused by injury or any other condition that damages
skeletal muscle.

Problems that may lead to this disease include:

     Trauma or crush injuries
     Use of drugs such as cocaine, amphetamines, statins, heroin, or PCP
     Genetic muscle diseases
     Extremes of body temperature
     Ischemia or death of muscle tissue
     Low phosphate levels
     Seizures or muscle tremors
     Severe exertion, such as marathon running or calisthenics
     Lengthy surgical procedures
     Severe dehydration

Muscle DisordersMuscle DisordersRead more
NIH MedlinePlus MagazineNIH MedlinePlus MagazineRead more
Health Topics A-ZHealth Topics A-ZRead more
A.D.A.M Quality Logo

Symptoms

Symptoms may include:

     Dark, red, or cola-colored urine
     Decreased urine output
     General weakness
     Muscle stiffness or aching (myalgia)
     Muscle tenderness
     Weakness of the affected muscles

Other symptoms that may occur with this disease:

     Fatigue
     Joint pain
     Seizures
     Weight gain (unintentional)

Exams and Tests

A physical exam will show tender or damaged skeletal muscles.

The following tests may be done:

     Creatine kinase (CK) level
     Serum calcium
     Serum myoglobin
     Serum potassium
     Urinalysis
     Urine myoglobin test

This disease may also affect the results of the following tests:

     CK isoenzymes
     Serum creatinine
     Urine creatinine

Treatment

You will need to get fluids containing bicarbonate to help prevent kidney
damage. You may need to get fluids through a vein (IV). Some people may
need kidney dialysis.

Your health care provider may prescribe medicines including diuretics and
bicarbonate (if there is enough urine output).

Hyperkalemia and low blood calcium levels (hypocalcemia) should be treated
right away. Kidney failure should also be treated.
Outlook (Prognosis)

The outcome depends on the amount of kidney damage. Acute kidney failure
occurs in many people. Getting treated soon after rhabdomyolysis will
reduce the risk of permanent kidney damage.

People with milder cases may return to their normal activities within a
few weeks to a month. However, some people continue to have problems with
fatigue and muscle pain.
Possible Complications

Complications may include:

     Acute tubular necrosis
     Acute renal failure
     Harmful chemical imbalances in the blood
     Shock (low blood pressure)

When to Contact a Medical Professional

Call your provider if you have symptoms of rhabdomyolysis.
Prevention

Rhabdomyolysis can be avoided by:

     Drinking plenty of fluids after strenuous exercise.
     Removing extra clothes and immersing the body in cold water in case of
heat stroke.

Images

     Male urinary systemMale urinary system

References

O'Connor FG, Deuster PA. Rhabdomyolysis. In: Goldman L, Schafer AI, eds.
Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders;
2016:chap 113.

Parekh R. Rhabdomyolysis. In: Walls RM, Hockberger RS, Gausche-Hill M,
eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed.
Philadelphia, PA: Elsevier; 2018:chap 119.

Uduman J, Singasani R. Rhabdomyolysis. In: Ferri FF, ed. Ferri's Clinical
Advisor 2018. Philadelphia, PA: Elsevier; 2018:1122-1124.
Review Date 8/1/2017

Updated by: Walead Latif, MD, nephrologist and Clinical Associate
Professor, Rutgers Medical School, Newark, NJ. Review provided by VeriMed
Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical
Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial
team.


A.D.A.M., Inc. is accredited by URAC, also known as the American
Accreditation HealthCare Commission (www.urac.org). URAC's accreditation
program is an independent audit to verify that A.D.A.M. follows rigorous
standards of quality and accountability. A.D.A.M. is among the first to
achieve this important distinction for online health information and
services. Learn more about A.D.A.M.'s editorial policy, editorial process
and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and
subscribes to the principles of the Health on the Net Foundation
(www.hon.ch).

The information provided herein should not be used during any medical
emergency or for the diagnosis or treatment of any medical condition. A
licensed physician should be consulted for diagnosis and treatment of any
and all medical conditions. Call 911 for all medical emergencies. Links to
other sites are provided for information only -- they do not constitute
endorsements of those other sites. Copyright 1997-2018, A.D.A.M., Inc.
Duplication for commercial use must be authorized in writing by ADAM
Health Solutions.


*


*


Rhabdomyolysis

PUBMED Health

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024696/

Rhabdomyolysis

Rhabdomyolysis is a condition in which damaged skeletal muscle tissue
breaks down rapidly. Breakdown products of damaged muscle cells are
released into the bloodstream. Some of these, such as the protein
myoglobin, are harmful to the kidneys and may lead to kidney failure.

PubMed Health Glossary
(Source: Wikipedia)


About Rhabdomyolysis

Rhabdomyolysis is an extremely rare but serious side effect where muscle
tissue gradually breaks down in certain muscles. This can lead to
permanent paralysis, and the breakdown products can cause serious kidney
damage.

In studies, rhabdomyolysis was found to occur in 1 out of 10,000 people
who took statins for longer periods of time.

Signs of this side effect include muscle ache and dark-colored urine, so
it is important to seek medical advice if you have these symptoms.
Institute for Quality and Efficiency in Health Care (IQWiG)


ults: 1 to 20 of 60

Is continuous renal replacement therapy beneficial for people with
rhabdomyolysis?

Rhabdomyolysis is a potentially life-threatening condition where damaged
muscle tissue breaks down quickly, and products of damaged muscle cells
are released into the bloodstream. Of these products, a protein called
myoglobin is harmful to kidney health and can lead to acute kidney injury.
There is some evidence to suggest that continuous renal replacement
therapy (CRRT) may provide benefits for people with rhabdomyolysis.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: June 15, 2014

Rhabdomyolysis in bariatric surgery: a systematic review

BACKGROUND: Rhabdomyolysis (RML) is a rare complication of bariatric
surgery. A systematic review was performed to identify risk factors and
patient outcomes in morbidly obese patients undergoing bariatric surgery
who develop RML.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2013

Prevention of kidney injury following rhabdomyolysis: a systematic review

OBJECTIVE: To conduct a systematic literature review to evaluate
evidence-based recommendations for the prevention of
rhabdomyolysis-associated acute renal failure (ARF).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2013

Statin-induced rhabdomyolysis: a comprehensive review of case reports

PURPOSE: To identify case reports of statin-induced rhabdomyolysis and
summarize common predisposing factors, symptoms, diagnostic findings,
functional outcomes, characteristics, treatment, and rehabilitation.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2014

Utility of urine myoglobin for the prediction of acute renal failure in
patients with suspected rhabdomyolysis: a systematic review

This review concluded that there was inadequate evidence to evaluate use
of urine myoglobin as a predictor of acute renal failure in patients with
suspected rhabdomyolysis. There were limitations in the review and
included studies, but the overall conclusion reflected the evidence
presented.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2009

Systematic review and meta-analysis of clinically relevant adverse events
from HMG CoA reductase inhibitor trials worldwide from 1982 to present

PURPOSE: Our objective was to determine the association of clinically
relevant adverse events from a systematic review and meta-analysis of
statin randomized controlled trials (RCT).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2007

Statin Use for the Prevention of Cardiovascular Disease in Adults: A
Systematic Review for the U.S. Preventive Services Task Force [Internet]

Cardiovascular disease (CVD) is the leading cause of mortality and
morbidity in the United States but is potentially preventable with statin
therapy. The U.S. Preventive Services (USPSTF) commissioned this review to
inform the development of new recommendations on use of statin therapy for
prevention of CVD in adults.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).
Version: November 2016
Show search results within this document

Efficacy of statins for primary prevention in people at low cardiovascular
risk: a meta-analysis

The review concluded that both low- and high-potency statins were
efficacious in preventing death and cardiovascular-related morbidity in
people at low risk of cardiovascular events, although the number needed to
treat to prevent one adverse outcome was relatively high for any statin.
The authors' conclusions reflect the evidence available and appear likely
to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2011

Adverse events associated with individual statin treatments for
cardiovascular disease: an indirect comparison meta-analysis

The use of statin therapy for cardiovascular disease was associated with a
relatively low risk of adverse events. High risk of bias within the
studies, high clinical and methodological heterogeneity between the
studies, and a discrepancy between the initial outcomes stated and those
actually reported suggest that the authors' conclusions and
recommendations may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2012

Intensive statin therapy in acute coronary syndromes and stable coronary
heart disease: a comparative meta-analysis of randomised controlled trials

This review concluded that intensive-dose statin therapy reduced all-cause
mortality in patients with recent acute coronary syndrome but not in
patients with stable coronary heart disease, compared with moderate-dose
statin therapy. The review was well-conducted and these conclusions are
likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2007

Lipid Modification: Cardiovascular Risk Assessment and the Modification of
Blood Lipids for the Primary and Secondary Prevention of Cardiovascular
Disease

This guideline updates for primary prevention, the NICE technology
appraisal, Statins for the prevention of cardiovascular events (TA94,
2007) and reviews and updates the recommendations made in the NICE
guideline Lipid Modification (CG67, 2008) for primary and secondary
prevention of cardiovascular disease (CVD). The scope for this guideline
was limited to the identification and assessment of CVD risk and to the
assessment and modification of lipids in people at risk of CVD, or people
with known CVD. The guideline development group wishes to make clear that
lipid modification should take place as part of a programme of risk
reduction which also include attention to the management of all other
known CVD risk factors.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).
Version: July 2014
Show search results within this document

Aerobic training for McArdle disease

McArdle disease is a rare disease of muscle metabolism. Affected people
cannot use a starch-like substance called glycogen which is stored in
muscle and used for energy at the beginning of activity and during
strenuous exercise. The effects of the condition are fatigue and cramping
within a few minutes of starting an activity, which can potentially lead
to acute muscle damage. After about seven or eight minutes of exercise the
muscle can start to use alternative sources of energy from fats and sugars
supplied from the liver and so the symptoms ease. This phenomenon is
called the 'second wind'. In healthy people, aerobic training is known to
improve the ability of muscle to burn fats for energy during exercise. In
theory then, aerobic training could be beneficial to people with McArdle
disease, as their muscles might be trained to use fats earlier and more
efficiently during exercise. The purpose of this review was to identify
any randomised controlled trials of aerobic training and assess its
effects in people with McArdle disease. There were no randomised
controlled trials of aerobic training in people with McArdle disease.
There were, however, three small uncontrolled studies (the largest
included nine participants). The studies showed that it is possible for
people with McArdle disease to undergo exercise training and there were no
harmful effects. Whether or not training is beneficial for people with
McArdle disease needs further investigation, with randomised controlled
trials including larger numbers of people with the condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: December 7, 2011

Statins for acute ischemic stroke

Stroke is a major public health problem than can cause death and severe
disability. A limited number of drugs are available for treating patients
with stroke. Statins, a group of drugs commonly used to reduce cholesterol
levels, are known to be safe and effective when given to patients with an
acute heart attack. Therefore, they may also be beneficial in patients
with acute stroke. We identified eight relevant trials of statins in acute
stroke involving 625 participants. Unfortunately, insufficient information
was available to establish whether statins are safe and beneficial for
patients with acute ischemic stroke

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: August 10, 2011

Drug Class Review: HMG-CoA Reductase Inhibitors (Statins) and Fixed-dose
Combination Products Containing a Statin: Final Report Update 5 [Internet]

In the United States, coronary heart disease and cardiovascular disease
account for nearly 40% of all deaths each year. Coronary heart disease
continues to be the leading cause of mortality and a significant cause of
morbidity among North Americans. In 2006, coronary heart disease claimed
607 000 lives, translating into about 1 out of every 5 deaths in the
United States. High levels of cholesterol, or hypercholesterolemia, are an
important risk factor for coronary heart disease. The
3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors, also
known as statins, are the most effective class of drugs for lowering serum
low-density lipoprotein cholesterol concentrations. They are first-line
agents for patients who require drug therapy to reduce serum low-density
lipoprotein cholesterol concentrations. The purpose of this review is to
compare the benefits and harms of different statins in adults and children
with hypercholesterolemia.

Drug Class Reviews - Oregon Health & Science University.
Version: November 2009
Show search results within this document

Single-dose oral celecoxib for postoperative pain

Acute pain is often felt soon after injury. Most people who have surgery
have moderate or severe pain afterwards. People with pain are used to test
pain killers. They have often had wisdom teeth removed. The pain is often
treated with pain killers given by mouth. Results can then be applied to
other forms of acute pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: October 22, 2013

Lipid-lowering agents for nephrotic syndrome

Nephrotic syndrome is a relatively rare disease in which the kidneys leak
protein into the urine. A common early sign is swelling in the feet and
face. Other signs and symptoms of nephrotic syndrome include low levels of
protein in the blood, and high levels of fats in the blood, particularly
cholesterol and triglycerides.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: December 10, 2013

Drug and nutritional treatment for McArdle disease

We reviewed the evidence about the effects of drug and nutritional
treatment for McArdle disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: November 12, 2014

Statins can help reduce risk of death in people with chronic kidney
disease who do not need dialysis

Adults with chronic kidney disease (CKD) have high risks of developing
complications from heart disease. It is thought that statin treatment
lowers cholesterol and reduces risk of death and complications from heart
disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: May 31, 2014

Screening for Lipid Disorders in Adults: Selective Update of 2001 US
Preventive Services Task Force Review [Internet]

Both the US Preventive Services Task Force (USPSTF) and the National
Cholesterol Education Program (NCEP ATP III) have issued recommendations
on screening for dyslipidemia in adults. To guide the USPSTF in updating
its 2001 recommendations, we reviewed evidence relevant to discrepancies
between these recommendations.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).
Version: June 2008
Show search results within this document

The harmful health effects of recreational ecstasy: a systematic review of
observational evidence

Street drugs known as ecstasy have been sold for about 20 years in the UK.
The active substance that such tablets contain  or purport to contain  is
3,4-methylenedioxymethamphetamine (MDMA). Shortly after consumption, MDMA
releases chemicals in the brain that tend to bring about a sense of
euphoria, exhilaration and increased intimacy with others. It is thought
to be the third most commonly used illegal drug in the UK after cannabis
and cocaine, with estimates suggesting that between 500,000 and 2 million
tablets are consumed each week. Most people who take ecstasy also use
other legal and illegal drugs, sometimes at the same time. Ecstasy is
commonly taken in nightclubs and at parties and is very often associated
with extended sessions of dancing.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR
Journals Library.
Version: 2009




A systematic review and economic evaluation of statins for the prevention
of coronary events

This study evaluated the use of a group of statins, atorvastatin,
fluvastatin, pravastatin, rosuvastatin and simvastatin, for the prevention
of cardiovascular events.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR
Journals Library.
Version: 2007

Lipid Screening in Childhood and Adolescence for Detection of Familial
Hypercholesterolemia: A Systematic Evidence Review for the U.S. Preventive
Services Task Force [Internet]

Familial hypercholesterolemia (FH) is an inherited disorder of lipoprotein
metabolism characterized by highly elevated total cholesterol (TC)
concentrations early in life, independent of environmental influences.
Around 1 in 200 to 1 in 500 persons in North America and Europe are
estimated to have heterozygous FH. When untreated, FH is associated with a
high incidence of premature clinical atherosclerotic cardiovascular
disease.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).
Version: August 2016
Show search results within this document

Daptomycin for Methicillin-Resistant and Methicillin-Sensitive
Staphylococcus Aureus Infection: A Review of Clinical Effectiveness,
Cost-Effectiveness and Guidelines [Internet]

The aim of this review is to summarize evidence on the comparative
clinical and cost effectiveness of daptomycin to other antibiotics for the
treatment of bacteremia and other infections caused by methicillin
susceptible staphylococcus aureus (MSSA) or methicillin resistant
staphylococcus aureus (MRSA), and to summarize evidence-based guidelines
regarding the use of daptomycin for MRSA and MSSA bacteremia or infection.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency
for Drugs and Technologies in Health.
Version: January 21, 2016
Show search results within this document

Lipid Screening in Childhood for Detection of Multifactorial Dyslipidemia:
A Systematic Evidence Review for the U.S. Preventive Services Task Force
[Internet]

For purposes of this report, multifactorial dyslipidemia refers to
dyslipidemias involving elevated total cholesterol (TC) or low-density
lipoprotein cholesterol (LDL-C) that are not familial hypercholesterolemia
(FH). There is evidence that elevated TC and LDL-C concentrations in
childhood, and especially adolescence, are associated with markers of
atherosclerosis in young adults.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).
Version: August 2016
Show search results within this document

Screening for Dyslipidemia in Younger Adults: A Systematic Review to
Update the 2008 U.S. Preventive Services Task Force Recommendation
[Internet]

This review updates prior reviews on screening for lipid disorders in
adults, and will be used by the U.S. Preventive Services Task Force
(USPSTF) to update its 2008 recommendation. Unlike prior USPSTF reviews,
this one focuses on screening in younger adults, defined as adults ages 21
to 39 years, as there is more uncertainty about the need to perform lipid
screening in this population than in older adults.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).
Version: November 2016
Show search results within this document

Chronic Kidney Disease (Partial Update): Early Identification and
Management of Chronic Kidney Disease in Adults in Primary and Secondary
Care

The Renal National Service Framework (NSF), and the subsequent NICE
Clinical Practice Guideline for early identification and management of
adults with chronic kidney disease (CKD) in primary and secondary care
(CG73), served to emphasise the change in focus in renal medicine from
treatment of established kidney disease to earlier identification and
prevention of kidney disease.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).
Version: July 2014
Show search results within this document

Guidelines for the Prevention, Care and Treatment of Persons with Chronic
Hepatitis B Infection

These are the first World Health Organization (WHO) guidelines for the
prevention, care and treatment of persons living with chronic hepatitis B
(CHB) infection, and complement similar recently published guidance by WHO
on the prevention, care and treatment of infection due to the hepatitis C
virus (HCV).

World Health Organization.
Version: March 2015
Show search results within this document

Management of Gout [Internet]

To review the evidence base for treating patients with gout, both acute
attacks and chronic disease. The review specifically focuses on the
management of patients with gout in the primary care setting.

Comparative Effectiveness Reviews - Agency for Healthcare Research and
Quality (US).
Version: March 2016
Show search results within this document

Spinal Injury: Assessment and Initial Management

The scope of this guideline is the assessment, imaging and early
management of spinal injury and does not address rehabilitation. It is
important to recognise that early management is intrinsically connected to
rehabilitation and some later complications may be avoided with changes in
early care. Early and ongoing collaborative multidisciplinary care across
a trauma network is vital in ensuring that the patient with a spinal
injury receives the best possible care.

NICE Guideline - National Clinical Guideline Centre (UK).
Version: February 2016
Show search results within this document

Major Trauma: Assessment and Initial Management

This guideline provides guidance on the assessment and management of major
trauma, including resuscitation following major blood loss associated with
trauma. For the purposes of this guideline, major trauma is defined as an
injury or a combination of injuries that are life-threatening and could be
life changing because it may result in long-term disability. This
guideline covers both the pre-hospital and immediate hospital care of
major trauma patients but does not include any management after definitive
lifesaving intervention. It has been developed for health practitioners
and professionals, patients and carers and commissioners of health
services.

NICE Guideline - National Clinical Guideline Centre (UK).
Version: February 2016
Show search results within this document

Fractures (Complex): Assessment and Management

Two of the five guidelines in the NICE Trauma Suite relate to fractures.
These are titled non-complex and complex fractures. In broad terms the
non-complex fractures are those likely to be treated at the receiving
hospital, whereas the complex fractures require transfer or the
consideration of transfer of the injured person to a specialist centre.

NICE Guideline - National Clinical Guideline Centre (UK).
Version: February 2016
Show search results within this document

Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel,
trabectedin and gemcitabine for advanced recurrent or refractory ovarian
cancer: a systematic review and economic evaluation

The study was unable to compare the clinical and cost-effectiveness of
platinum-based therapies with non-platinum-based therapies for platinum
sensitive ovarian cancer. In people with platinum-sensitive disease,
paclitaxel plus platinum could be considered cost-effective compared with
platinum therapies alone at a threshold of 30,000 per additional
quality-adjusted life-year. In people with disease which is resistant or
refractory to platinum it is unlikely that topotecan would be considered
cost-effective compared with pegylated liposomal doxorubicin
hydrochloride.

Health Technology Assessment - NIHR Journals Library.
Version: January 2015
Show search results within this document

Alcohol Use Disorders: Diagnosis and Clinical Management of
Alcohol-Related Physical Complications [Internet]

Alcohol is the most widely used psychotropic drug in the industrialised
world; it has been used for thousands of years as a social lubricant and
anxiolytic. In the UK, it is estimated that 24% of adult men and 13% of
adult women drink in a hazardous or harmful way. Levels of hazardous and
harmful drinking are lowest in the central and eastern regions of England
(2124% of men and 1014% of women). They are highest in the north (2628% of
men, 1618% of women). Hazardous and harmful drinking are commonly
encountered amongst hospital attendees; 12% of emergency department
attendances are directly related to alcohol whilst 20% of patients
admitted to hospital for illnesses unrelated to alcohol are drinking at
potentially hazardous levels. Continued hazardous and harmful drinking can
result in dependence and tolerance with the consequence that an abrupt
reduction in intake might result in development of a withdrawal syndrome.
In addition, persistent drinking at hazardous and harmful levels can also
result in damage to almost every organ or system of the body.
Alcohol-attributable conditions include liver damage, pancreatitis and the
Wernickes encephalopathy. Key areas in the investigation and management of
these conditions are covered in this guideline.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).
Version: 2010
Show search results within this document

The Management of Lower Urinary Tract Symptoms in Men [Internet]

The guideline covers men (18 and over) with a clinical working diagnosis
of lower urinary tract symptoms (LUTS). Options for conservative,
pharmacological, surgical, and complementary or alternative treatments are
considered in terms of clinical and cost effectiveness.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).
Version: 2010
Show search results within this document

Reslizumab (Cinqair) [Internet]

Asthma is a common chronic respiratory disorder characterized by
reversible airway obstruction, pulmonary inflammation, airway
hyper-responsiveness, and airway remodelling., Patients with asthma
typically present with paroxysmal or persistent symptoms of wheezing,
dyspnea, chest tightness, sputum production, and coughing that are
associated with airflow limitation and airway hyper-responsiveness to
endogenous and exogenous stimuli (e.g., exercise; viral respiratory
infections; or exposure to certain allergens, irritants, or gases). Severe
eosinophilic asthma is an asthma phenotype characterized by the presence
of eosinophils in the airways and sputum, despite compliance with
conventional asthma therapy. Severe asthma can have a profound effect on
patients day-to-day lives, such as limiting physical activity, reducing
performance at work or school, restricting social interactions, and
leading to stigma. It may also necessitate frequent physician and
emergency room visits.

Common Drug Review - Canadian Agency for Drugs and Technologies in Health.
Version: April 2017
Show search results within this document

When To Suspect Child Maltreatment

This guidance provides a summary of the clinical features associated with
maltreatment (alerting features) that may be observed when a child
presents to healthcare professionals. Its purpose is to raise awareness
and help healthcare professionals who are not specialists in child
protection to identify children who may be being maltreated. It does not
give healthcare professionals recommendations on how to diagnose, confirm
or disprove child maltreatment.

NICE Clinical Guidelines - National Collaborating Centre for Women's and
Children's Health (UK).
Version: July 2009
Show search results within this document

Identification and Management of Familial Hypercholesterolaemia (FH)
[Internet]

While the NHS in England and Wales has made spectacular progress in
improving the secondary prevention of cardiovascular disease, we now need
to work harder to identify those who are at particularly high risk of
myocardial infarction.

NICE Clinical Guidelines - National Collaborating Centre for Primary Care
(UK).
Version: August 2008
Show search results within this document

Lomitapide (Juxtapid) [Internet]

The objective of this review is to evaluate the beneficial and harmful
effects of lomitapide added to other lipid-lowering therapy in patients
with homozygous familial hypercholesterolemia (HoFH).

Common Drug Review - Canadian Agency for Drugs and Technologies in Health.
Version: July 2015
Show search results within this document

Optimal strategies for monitoring lipid levels in patients at risk or with
cardiovascular disease: a systematic review with statistical and
cost-effectiveness modelling

The study found that regular lipid monitoring in individuals with and
without cardiovascular disease is likely to be beneficial to both patients
and to the health service, and frequent monitoring strategies appear to be
cost-effective.

Health Technology Assessment - NIHR Journals Library.
Version: December 2015
Show search results within this document

Noninvasive Testing for Coronary Artery Disease [Internet]

This report evaluates the current state of evidence regarding
effectiveness and harms of noninvasive technologies for the diagnosis of
coronary artery disease (CAD) or dysfunction that results in symptoms
attributable to myocardial ischemia in stable symptomatic patients who
have no known history of CAD.

Comparative Effectiveness Reviews - Agency for Healthcare Research and
Quality (US).
Version: March 2016
Show search results within this document




Major Trauma: Service Delivery

A trauma service provides care for people who have sustained physical
injuries. These injuries are often the result of an accident but can be
sustained in other circumstances. Injuries range from minor to serious
life-threatening trauma. The scope of this guidance is the delivery of
services for people with major trauma in the initial phase of care,
exploring areas of uncertainty and variation.

NICE Guideline - National Clinical Guideline Centre (UK).
Version: February 2016
Show search results within this document

Fractures (Non-Complex): Assessment and Management

Two of the five guidelines in the NICE trauma suite relate to fractures.
These are titled non-complex and complex fractures. In broad terms,
non-complex fractures are those likely to be treated at the receiving
hospital, whereas complex fractures require transfer or the consideration
of transfer of the injured person to a specialist.

NICE Guideline - National Clinical Guideline Centre (UK).
Version: February 2016
Show search results within this document

Antisocial Behaviour and Conduct Disorders in Children and Young People:
Recognition, Intervention and Management

Antisocial behaviour and conduct disorders are the most common reason for
referral to child and adolescent mental health services and have a
significant impact on the quality of life of children and young people and
their parents and carers. Rates of other mental health problems (including
antisocial personality disorder) are considerably increased for adults who
had a conduct disorder in childhood. This new NICE guideline seeks to
address these problems by offering advice on prevention strategies, as
well as a range of psychosocial interventions.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health
(UK).
Version: 2013
Show search results within this document

Meta-analysis of safety of the coadministration of statin with fenofibrate
in patients with combined hyperlipidemia

Addition of fenofibrate to statin therapy might represent a viable
treatment option for patients whose high risk for coronary heart disease
is not controlled by a statin alone. However, safety of coadministration
of statin with fenofibrate has been a great concern. The present study
tested the safety of coadministration of statin with fenofibrate. We
systematically searched the literature to identify randomized controlled
trials examining safety of coadministration of statin with fenofibrate. A
meta-analysis was performed to estimate safety of coadministration of
statin with fenofibrate using fixed-effects models. There were 1,628
subjects in the identified 6 studies. Discontinuation attributed to any
adverse events (4.5% vs 3.1%, p = 0.20), any adverse events (42% vs 41%, p
= 0.82), adverse events related to study drug (10.9% vs 11.0%, p = 0.95),
and serious adverse events (2.0% vs 1.5%, p = 0.71) were not significantly
different in the 2 arms. Incidence of alanine aminotransferase and/or
aspartate aminotransferase =3 times upper limit of normal in the
combination therapy arm was significantly higher than in the statin
monotherapy arm (3.1% vs 0.2%, p = 0.0009). In the 6 trials with 1,628
subjects no case of myopathy or rhabdomyolysis was reported. In
conclusion, statin-fenofibrate combination therapy was tolerated as well
as statin monotherapy. Physicians should consider statin-fenofibrate
combination therapy to treat patients with mixed dyslipidemia.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2012

Efficacy and safety evaluation of intensive statin therapy in older
patients with coronary heart disease: a systematic review and
meta-analysis

PURPOSE: To reveal and evaluate the efficacy and safety of intensive
statin therapy in older patients (age = 65 years) with coronary heart
disease (CHD).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2013

A systematic review and economic evaluation of statins for the prevention
of coronary events

OBJECTIVES: To evaluate the clinical effectiveness and cost-effectiveness
of statins for the primary and secondary prevention of cardiovascular
events in adults with, or at risk of, coronary heart disease (CHD).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2007

Risks associated with statin therapy: a systematic overview of randomized
clinical trials

This review evaluated the risk of adverse events among patients taking
statins. The authors concluded that statin therapy in carefully selected
patients is associated with low adverse event rates in clinical trials.
The reliability of the results is unclear given the lack of detail about
the review process and potential for bias.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2006

Primary prevention of cardiovascular mortality and events with statin
treatments: a network meta-analysis involving more than 65,000 patients

This review concluded that statin treatment used for the primary
prevention of cardiovascular disease was effective in reducing
cardiovascular death and other major cardiovascular events. The conduct
and reporting of the review were good and the conclusions are likely to be
reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2008

Intensive statin therapy compared with moderate dosing for prevention of
cardiovascular events: a meta-analysis of >40,000 patients

This review found that intensive dosing with statins for prevention of
cardiovascular events was associated with significant reductions in
non-fatal events. The review was well conducted and the authors'
conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2011

Efficacy and safety of cholesterol-lowering treatment: prospective
meta-analysis of data from 90 056 participants in 14 randomised trials of
statins

This prospective meta-analysis of individual patient data concluded that
statin therapy can safely reduce the 5-year incidence of major coronary
events, coronary revascularisation and stroke by about 20% per mmol/L
reduction in cholesterol, largely irrespective of lipid profile or other
characteristics. The authors' conclusions reflect the evidence presented
and are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2005

Meta-analysis of drug-induced adverse events associated with
intensive-dose statin therapy

The authors concluded that intensive-dose statin therapy significantly
reduced the risk of a serious cardiovascular event but increased the risk
of a statin-induced adverse event, compared with moderate dose therapy.
The reliability of these conclusions is uncertain due to methodological
weaknesses in the review such as failure to assess study validity or check
for heterogeneity between the studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2007

Efficacy and safety of statin treatment for cardiovascular disease: a
network meta-analysis of 170 255 patients from 76 randomized trials

This review concluded that statin therapies offered clear benefits in
reducing cardiovascular outcomes across broad populations. The review
appeared generally well conducted. The authors conclusions appear likely
to be reliable, although it should be borne in mind that subgroup analysis
by population type was conducted only for the primary outcome of
cardiovascular disease mortality.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2011

The effect of early, intensive statin therapy on acute coronary syndrome:
a meta-analysis of randomized controlled trials

This review investigated the effects of early intensive statin therapy for
acute coronary syndrome. It concluded that early treatment reduces
cardiovascular events with benefits observed after 6 months, but an
analysis of individual patient data is needed to confirm these findings.
The pooled results should be regarded with some caution because of
limitations such as the variation between study results.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2006

Efficacy and safety of more intensive lowering of LDL cholesterol: a
meta-analysis of data from 170 000 participants in 26 randomised trials

This meta-analysis of individual patient data found that reducing
low-density lipoprotein cholesterol with statins reduced the annual rate
of heart attack, revascularisation and stroke by about 20% for each
1mmol/litre reduction achieved. These conclusions reflected the strong
evidence presented and are likely to be reliable and applicable to a wide
range of patients.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2010

Meta-analysis of cardiovascular outcomes trials comparing intensive versus
moderate statin therapy

The authors concluded that intensive statin treatment offers greater
benefits than standard-dose treatment, mainly for nonfatal cardiovascular
events. The review appears to support the authors' conclusions, but the
poor reporting of review methods and the lack of an assessment of study
quality mean that the reliability of the conclusions is uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2006

The clinical and cost-effectiveness of intensive versus standard lipid
lowering with statins in the prevention of cardiovascular events amongst
patients with acute coronary syndromes: a systematic review

Early intensive lipid lowering with high-dose/potency statins for high
risk acute coronary syndrome (ACS) patients significantly reduced the risk
of death or major cardiovascular event in comparison with standard lipid
lowering regimens. The authors' conclusion is reasonable, but perhaps
should be tempered as it was primarily based on one large trial and
generalisability beyond that intervention might be premature.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2007

Strength of evidence for perioperative use of statins to reduce
cardiovascular risk: systematic review of controlled studies

This review determined the evidence on the use of statins during the
peri-operative period to reduce the risk of cardiovascular events. The
authors concluded that there was insufficient evidence for routine
administration of statins to reduce peri-operative cardiovascular risk.
Given the limitations of the evidence base, this conclusion seems
reasonable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2006

Effects of early treatment with statins on short-term clinical outcomes in
acute coronary syndromes: a meta-analysis of randomized controlled trials

This review assessed the effects of starting statin therapy within 14 days
of the onset of acute coronary syndrome. The authors concluded that early
statin therapy does not reduce death, myocardial infarction or stroke up
to 4 months, but may reduce unstable angina. This was a well-conducted and
clearly reported review and the authors' conclusions are likely to be
reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2006

Comparison of sequential rosuvastatin doses in hypercholesterolaemia: a
meta-analysis of randomised controlled trials

This review provided evidence for improved efficacy, as assessed by
surrogate markers, in treating patients with hypercholesterolaemia with
each sequential titration of rosuvastatin and a generally consistent
tolerability profile across the dose range. The authors' conclusions
reflect the evidence presented, but the lack of validity assessment and
lack of reporting of some data made the reliability of the conclusions
uncertain.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2010

Systematic review: comparative effectiveness and harms of combinations of
lipid-modifying agents and high-dose statin monotherapy

This review concluded that there was insufficient evidence to support the
benefit for mortality, myocardial infarction, stroke, and
revascularisation procedures of statin combination therapy over high-dose
monotherapy in high-risk patients needing intensive lipid-lowering
therapy. The authors' conclusion reflected the evidence presented, but the
reliability is potentially compromised by search restrictions and unclear
quality of included studies.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed
Reviews [Internet] - Centre for Reviews and Dissemination (UK).
Version: 2009



Results: 10

Is continuous renal replacement therapy beneficial for people with
rhabdomyolysis?

Rhabdomyolysis is a potentially life-threatening condition where damaged
muscle tissue breaks down quickly, and products of damaged muscle cells
are released into the bloodstream. Of these products, a protein called
myoglobin is harmful to kidney health and can lead to acute kidney injury.
There is some evidence to suggest that continuous renal replacement
therapy (CRRT) may provide benefits for people with rhabdomyolysis.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: June 15, 2014

When is it worth taking statins to lower high cholesterol?

High cholesterol levels could mean an increased risk of cardiovascular
disease. Certain medications called statins lower the amount of
cholesterol in the blood. They can prevent related medical conditions and
increase life expectancy. Whether or not it's worth taking them will
depend on what other risk factors you have, though. If the risk of
cardiovascular disease can't be reduced enough through general measures,
treatment with medication can be considered. Whether treatment with
medication is a good idea will mostly depend on individual risk factors
and how you yourself view the pros and cons of the treatment. The main
factor is whether you have already had cardiovascular disease, such as
coronary artery disease. That may greatly increase the risk of a heart
attack or stroke. This risk can be reduced using medication. When deciding
whether or not to have a certain treatment, it can help to find out about
the advantages and disadvantages of the treatment. Various groups of drugs
can be used for the treatment of high cholesterol. But only one group of
drugs, known as statins, has been well studied in people who have never
had a heart attack, stroke or other type of cardiovascular disease. Many
different statins have been approved in Germany, including atorvastatin,
fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin and
simvastatin.

Informed Health Online [Internet] - Institute for Quality and Efficiency
in Health Care (IQWiG).
Version: September 7, 2017

Medication for the long-term treatment of coronary artery disease

The long-term treatment of coronary artery disease (CAD) mainly involves
taking medication. Various medications can relieve the symptoms and lower
the risk of complications. In order to prevent the development of related
medical conditions, all people who have coronary artery disease (CAD) are
advised to take two types of medication: Antiplatelets to prevent blood
clots, and statins to protect the blood vessels. Beta blockers are
sometimes taken too, to reduce the heart's workload, particularly in
people who have heart failure or high blood pressure. Good-quality studies
have proven that these medications can lower the risk of complications
such as heart attacks or strokes. People who have certain other medical
conditions too may take other medications such as ACE inhibitors. But even
the very best treatment with medications will offer only limited
protection from heart disease. All medications can have side effects. Yet
it is often possible to avoid them by adjusting the dose or by choosing a
different medication in the same group of drugs. The side effects often go
away after a while too, once the body has got used to the medication. The
risk of side effects may increase when two or more medications are taken
together, because they may interact. It is therefore important to tell
your doctor what medication you are already taking. Generally speaking,
the more risk factors someone has, the more likely it is that he or she
will benefit from medication. The important thing is to continue to take
your medication and to take it regularly  its protective effect lasts only
as long as it is taken.

Informed Health Online [Internet] - Institute for Quality and Efficiency
in Health Care (IQWiG).
Version: July 27, 2017

Aerobic training for McArdle disease

McArdle disease is a rare disease of muscle metabolism. Affected people
cannot use a starch-like substance called glycogen which is stored in
muscle and used for energy at the beginning of activity and during
strenuous exercise. The effects of the condition are fatigue and cramping
within a few minutes of starting an activity, which can potentially lead
to acute muscle damage. After about seven or eight minutes of exercise the
muscle can start to use alternative sources of energy from fats and sugars
supplied from the liver and so the symptoms ease. This phenomenon is
called the 'second wind'. In healthy people, aerobic training is known to
improve the ability of muscle to burn fats for energy during exercise. In
theory then, aerobic training could be beneficial to people with McArdle
disease, as their muscles might be trained to use fats earlier and more
efficiently during exercise. The purpose of this review was to identify
any randomised controlled trials of aerobic training and assess its
effects in people with McArdle disease. There were no randomised
controlled trials of aerobic training in people with McArdle disease.
There were, however, three small uncontrolled studies (the largest
included nine participants). The studies showed that it is possible for
people with McArdle disease to undergo exercise training and there were no
harmful effects. Whether or not training is beneficial for people with
McArdle disease needs further investigation, with randomised controlled
trials including larger numbers of people with the condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: December 7, 2011

Statins for acute ischemic stroke

Stroke is a major public health problem than can cause death and severe
disability. A limited number of drugs are available for treating patients
with stroke. Statins, a group of drugs commonly used to reduce cholesterol
levels, are known to be safe and effective when given to patients with an
acute heart attack. Therefore, they may also be beneficial in patients
with acute stroke. We identified eight relevant trials of statins in acute
stroke involving 625 participants. Unfortunately, insufficient information
was available to establish whether statins are safe and beneficial for
patients with acute ischemic stroke

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: August 10, 2011

Single-dose oral celecoxib for postoperative pain

Acute pain is often felt soon after injury. Most people who have surgery
have moderate or severe pain afterwards. People with pain are used to test
pain killers. They have often had wisdom teeth removed. The pain is often
treated with pain killers given by mouth. Results can then be applied to
other forms of acute pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: October 22, 2013

Lipid-lowering agents for nephrotic syndrome

Nephrotic syndrome is a relatively rare disease in which the kidneys leak
protein into the urine. A common early sign is swelling in the feet and
face. Other signs and symptoms of nephrotic syndrome include low levels of
protein in the blood, and high levels of fats in the blood, particularly
cholesterol and triglycerides.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: December 10, 2013

Drug and nutritional treatment for McArdle disease

We reviewed the evidence about the effects of drug and nutritional
treatment for McArdle disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: November 12, 2014

Statins can help reduce risk of death in people with chronic kidney
disease who do not need dialysis

Adults with chronic kidney disease (CKD) have high risks of developing
complications from heart disease. It is thought that statin treatment
lowers cholesterol and reduces risk of death and complications from heart
disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries
[Internet] - John Wiley & Sons, Ltd.
Version: May 31, 2014

Comparing Statins and Combination Drugs

How do statins and combination drugs compare in lowering "bad" cholesterol
(LDL-c)?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology
Information (US).
Version: November 1, 2010


https://www.ncbi.nlm.nih.gov/pubmedhealth/c/pmh_cons/?term=rhabdomyolysis



*


*


What's to know about rhabdomyolysis?

Last reviewed Wed 5 July 2017

By Jennifer Huizen

Medical News Today

https://www.medicalnewstoday.com/articles/318224.php


Article Contents

What is rhabdomyolysis?

Causes

Symptoms

Diagnosis

Treatment

Preventing rhabdomyolysis


*


*



Rhabdomyolysis

Updated: Nov 10, 2017

  Author

Eyal Muscal, MD, MS Assistant Professor, Section of Pediatric Immunology,
Allergy, and Rheumatology, Department of Pediatrics, Baylor College of
Medicine, Texas Children's Hospital

Eyal Muscal, MD, MS is a member of the following medical societies: Alpha
Omega Alpha, American College of Rheumatology

Disclosure: Nothing to disclose.
Coauthor(s)

Marietta Morales De Guzman, MD Associate Professor, Section of Immunology,
Allergy and Rheumatology, Department of Pediatrics, Baylor College of
Medicine; Clinic Chief, Pediatric Rheumatology Center, Texas Children's
Hospital

Marietta Morales De Guzman, MD is a member of the following medical
societies: American Academy of Pediatrics, American College of
Rheumatology, Texas Pediatric Society

Disclosure: Nothing to disclose.
Chief Editor

Lawrence K Jung, MD Chief, Division of Pediatric Rheumatology, Children's
National Medical Center

Medscape

https://emedicine.medscape.com/article/1007814-overview

In most cases, the history reflects the inciting cause (though in some, it
is nonspecific and thus diagnostically unreliable). Possible causes
include the following:

     Alcohol use and resultant unresponsiveness

     Illicit drug use

     Use of prescribed medications

     Heatstroke

     Infection

     Trauma

     Metabolic disorders

     Inflammatory myopathies

Initial physical findings may be nonspecific. The following may be noted:

     Muscular pain and tenderness

     Decreased muscle strength

     Soft tissue swelling

     Skin changes consistent with pressure necrosis

     Hyperthermia, hypothermia, and electrical injuries

     Crush injuries or deformities in long bones


*


*


Rhabdomyolysis and Acute Kidney Injury | NEJM

https://www.nejm.org/doi/full/10.1056/nejmra0801327

by X Bosch - ?2009 - ?Cited by 847 -
May 18, 2011 - Review Article from The New England Journal of Medicine
Rhabdomyolysis and Acute Kidney Injury.


*


*


Rhabdomyolysis - Mayo Clinic - YouTube
Video for rhabdomyolysis
? 2:25

https://www.youtube.com/watch?v=Hy0uEPo8-7w

Jun 22, 2011 - Uploaded by Mayo Clinic
Earlier this year, thirteen football players from the University of Iowa
were hospitalized with Rhabdomyolysis ...


*


*


Database Search Results for Rhabdomyolysis


Google Scholar


https://scholar.google.com/scholar?hl=en&as_sdt=0%2C39&q=rhabdomyolysis+&btnG=


Google Books


https://www.google.com/search?tbm=bks&q=rhabdomyolysis+


Penn State Summon Search


https://tinyurl.com/ybqpxcub


     Book / eBook (6,085) Include Exclude
     Book Chapter (4,393) Include Exclude
     Book Review (2,524) Include Exclude
     Conference Proceeding (428) Include Exclude
     Dissertation/Thesis (701) Include Exclude
     Electronic Resource (3) Include Exclude
     Government Document (6) Include Exclude
     Journal / eJournal (32) Include Exclude
     Journal Article (43,115) Include Exclude
     Magazine (3) Include Exclude
     Magazine Article (2,273) Include Exclude
     Manuscript (15) Include Exclude
     Market Research (5) Include Exclude
     Newsletter (3,344) Include Exclude
     Newspaper Article (10,196) Include Exclude
     Pamphlet (4) Include Exclude
     Paper (13) Include Exclude
     Patent (93) Include Exclude
     Poster (2) Include Exclude
     Presentation (2) Include Exclude
     Publication (3) Include Exclude
     Reference (1,534) Include Exclude
     Report (237) Include Exclude
     Research Guide (2) Include Exclude
     Special Collection (2) Include Exclude
     Streaming Audio (1) Include Exclude
     Streaming Video (3) Include Exclude
     Student Thesis (2) Include Exclude
     Technical Report (24) Include Exclude
     Trade Publication Article (239) Include Exclude
     Transcript (118) Include Exclude
     Web Resource (174) Include Exclude



Google Domain Limited Web Search (GOV)

https://tinyurl.com/ydcy7paf


Google Domain Limited Web Search (PUBMED)

https://tinyurl.com/yax8zk5m


Google Domain Limited Web Search (SCIENCEDIRECT)

https://tinyurl.com/y8xbtthl



.



.



WEBBIB1718

http://tinyurl.com/yaevofzf


.


.



Sincerely,
David Dillard
Temple University
(215) 204 - 4584
[hidden email]


*

*

RESEARCH GUIDE DIRECTORY
https://sites.google.com/site/researchguideresourcesongsites/

Net-Gold
https://groups.io/g/Net-Gold
http://listserv.temple.edu/archives/net-gold.html
https://groups.io/org/groupsio/Net-Gold/archives

Google Sites Research Guides AND Discussion Group Directory
http://tinyurl.com/ngda2hk

OR

https://sites.google.com/site/researchguidesonsites/

FAKE NEWS
https://sites.google.com/site/fakenewsresearchguide/

RESEARCH PAPER WRITING
https://sites.google.com/site/howtowriteasuperresearchpaper/

EMPLOYMENT
https://sites.google.com/site/employmentsources/

INTERNSHIPS
https://sites.google.com/site/internshipsarticles/home/internships-main-sitemap

Social Work and Social Issues Discussion Group
https://groups.io/g/social-work

Tourism Discussion Group
https://groups.io/g/Tourism

Blog
https://educatorgold.wordpress.com/

Articles by David Dillard
https://sites.google.com/site/daviddillardsarticles/

Twitter: davidpdillard

SPORT-MED
https://www.jiscmail.ac.uk/lists/sport-med.html
http://listserv.temple.edu/archives/sport-med.html
https://groups.io/g/SportMed/topics