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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 com. Cellulitis is an infection of the skin and underlying soft tissue. The infection is usually caused by bacteria, such as staphylococci ("Staph") or streptococci ("Strep"); these commonly live on the skin or inner surface of the nose or mouth among healthy people. For many people, these skin bacteria never cause infection.

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The clinical presentation of adrenal insufficiency is variable, depending on whether the onset is acute, leading to adrenal crisis, or chronic, with symptoms that are insidious and vague. The diagnosis of adrenal insufficiency depends upon a critical level of clinical suspicion. Measurements of serum cortisol within three hours after wakening ...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 …ETIOLOGY. Gallstones — Gallstones (including microlithiasis) are the most common cause of acute pancreatitis accounting for 40 to 70 percent of cases [ 1,3,15 ]. However, only 3 to 7 percent of patients with gallstones develop pancreatitis [ 16,17 ]. The mechanism by which the passage of gallstones induces pancreatitis is unknown.INTRODUCTION. —. Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. The clinical presentation of CAP varies, ranging from mild pneumonia characterized by fever and productive cough to severe pneumonia characterized by respiratory distress and sepsis.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 ).SoftBank-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...

Justin Bufkin of One Smile Closer shares how he started a photography business on the side. He shares tips on anyone can make money with photography. Part-Time Money® Make extra mo...Community-acquired pneumonia (CAP) is defined as an acute infection of the pulmonary parenchyma in a patient who has acquired the infection in the community, as distinguished from hospital-acquired (nosocomial) pneumonia (HAP). CAP is a common and potentially serious illness [ 1-3 ]. It is associated with considerable morbidity and mortality ...May 6, 2022 · 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. UpToDate® registrants and Individual subscribers can now answer their clinical questions anytime, anywhere by downloading this app onto an Android™ phone …Trusted for more than 30 years, UpToDate® is the clinical decision support resource that provides over 2 million medical professionals worldwide with the latest evidence-based information available across 25 specialties. With the ever-increasing complexity of diseases, medicine, and clinical practice in today's world, UpToDate is dedicated to ...Licensed to: UpToDate Marketing Professional Support Tag : [0502 - 104.224.13.121 - 80CD775346 - PR14 - UPT - 20240504-17:39:40UTC] - SM - MD - LG - XL LoadingMoved Permanently. The document has moved here.

Apr 15, 2024 · Nonsteroidal antiinflammatory drugs (NSAIDs) are medications used to relieve pain and to reduce inflammation. They are some of the most commonly used medications in adults. A variety of NSAIDs are available, including at least 20 in the United States and more elsewhere. Many are available as pills that can be purchased without a prescription ... 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.Symptoms and signs — Rhabdomyolysis is characterized clinically by the triad of myalgias, muscle weakness, and red to brown urine due to myoglobinuria [ 1 ]. Biochemically, several serum muscle enzymes are elevated, including CK. The degree of muscle pain and other symptoms varies widely. Most of the symptoms of rhabdomyolysis are nonspecific.Sign in with Microsoft. Sign in with Open Athens. Sign in Another Way. If your organization permits Single Sign-On (SSO) for UpToDate, you may use your email address here.An overview of the approach to the prevention and treatment of osteoporosis in postmenopausal women will be presented here. The diagnosis and evaluation of osteoporosis in postmenopausal women and the management of osteoporosis in other patient groups are discussed separately. (See "Clinical manifestations, diagnosis, and …Diarrheal disease is one of the top ten leading causes of death worldwide and is a particular concern for children younger than five years old in resource-limited settings [ 1 ]. Among adults in resource-abundant settings, diarrhea is often a "nuisance disease" in the healthy individual. Most cases of acute diarrhea in adults are of infectious ...

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Anaphylaxis is an acute, potentially life-threatening, systemic hypersensitivity reaction caused by the sudden release of mast cell mediators [ 1 ]. It most often results from immunoglobulin E (IgE) mediated reactions to foods, drugs, and insect stings, but any agent capable of inciting a sudden, systemic degranulation of mast cells can induce ... 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 sections associated with each, such as Practice Changing UpDates, What's New, Patient Education, Calculators, and Drug Information. Group A Streptococcus (GAS), or Streptococcus pyogenes, is the leading bacterial cause of tonsillopharyngitis in adults and children worldwide. GAS is one of the few causes of tonsillopharyngitis or pharyngitis for which antibiotic treatment is recommended. The treatment and prevention of group A streptococcal tonsillopharyngitis is reviewed here.INTRODUCTION. —. Status epilepticus is a medical and neurologic emergency that requires prompt evaluation and treatment. The rapid evaluation and treatment of convulsive status epilepticus is discussed below. The definition, classification, clinical features, and diagnosis of convulsive status epilepticus in adults are reviewed …Use the resource trusted by healthcare practitioners worldwide. Patients and their caregivers can learn more about a medical condition and explore treatment options using UpToDate, the same resource trusted by more than 2 million clinicians around the world. After you read the information in UpToDate, you will have the tools and the confidence ...

Clostridioides difficile infection (CDI) is one of the most common hospital-acquired (nosocomial) infections and is an increasingly frequent cause of morbidity and mortality among older adult hospitalized patients [ 1-3 ]. CDI is also increasingly diagnosed in younger patients and in the community.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.The Amazon deals keep rolling out in Cyber Week, with big discounts on Amazon digital media and magazine subscriptions. By clicking "TRY IT", I agree to receive newsletters and pro...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 …Hydroxocobalamin (vitamin B12a supplement and cyanide antidote): Pediatric drug information. Hydroxychloroquine: Pediatric drug information. Hydroxyprogesterone caproate (United States: Withdrawn from market): Pediatric drug information. Hydroxyurea (hydroxycarbamide): Pediatric drug information.CULLEN SMALL CAP VALUE FUND CLASS I- Performance charts including intraday, historical charts and prices and keydata. Indices Commodities Currencies StocksSymptoms and signs — Rhabdomyolysis is characterized clinically by the triad of myalgias, muscle weakness, and red to brown urine due to myoglobinuria [ 1 ]. Biochemically, several serum muscle enzymes are elevated, including CK. The degree of muscle pain and other symptoms varies widely. Most of the symptoms of rhabdomyolysis …Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials.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. UpToDate 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.

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)

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 and Prevention ...Here we discuss our approach to the adult with unexpected thrombocytopenia. This approach can be used by the primary care physician and the consulting hematologist. Separate topics discuss thrombocytopenia in other populations: Neonates – (See "Neonatal thrombocytopenia: Clinical manifestations, evaluation, and … Use the resource trusted by healthcare practitioners worldwide. Patients and their caregivers can learn more about a medical condition and explore treatment options using UpToDate, the same resource trusted by more than 2 million clinicians around the world. After you read the information in UpToDate, you will have the tools and the confidence ... 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.Hematuria is the medical term for red blood cells in the urine. Red blood cells in the urine can come from the kidney (where urine is made) or anywhere in the urinary tract ( figure 1 ). The urinary tract includes the ureters (the tubes that carry the urine from the kidneys to the bladder), the bladder (where urine is stored), the prostate (in ... 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. Apr 15, 2024 · Nonsteroidal antiinflammatory drugs (NSAIDs) are medications used to relieve pain and to reduce inflammation. They are some of the most commonly used medications in adults. A variety of NSAIDs are available, including at least 20 in the United States and more elsewhere. Many are available as pills that can be purchased without a prescription ... Acute treatment of migraine in adults without hemiplegic or brainstem aura. Algorithm 1. The abortive (symptomatic) therapy of migraine ranges from the use of simple analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen to triptans, antiemetics, calcitonin gene-related peptide (CGRP) antagonists, lasmiditan, …

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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 ).UpToDate, the evidence-based clinical decision support resource from Wolters Kluwer, is trusted at the point of care by clinicians worldwide.Atrial fibrillation (AF) is the most commonly treated cardiac arrhythmia. AF is generally associated with an irregularly irregular ventricular rhythm and absence of distinct P waves. This topic will provide a broad overview of the classification, clinical presentation, diagnosis, management, and sequelae of AF, including new-onset AF.For individuals and groups up to 19. Medical practices and other groups can place their UpToDate subscription orders together online, pay for them in a single transaction, and receive all the benefits of a personal subscription. Subscribe or view pricing for your group by selecting the “Purchase for Others” option. Subscribe Or See Pricing.Blood pressure is reported as the systolic pressure over diastolic pressure (eg, 120/70 or "120 over 70"). Untreated high blood pressure increases the strain on the heart and arteries, eventually causing organ damage. High blood pressure increases the risk of heart failure, heart attack (myocardial infarction), stroke, and kidney failure.Measures to cut down on leveraged crypto trades could entice institutional buyers and make bitcoin more useful as a currency. In an effort to curb cryptocurrency speculation, finan...The preventive treatment of episodic migraine headache in adults is reviewed here. The clinical features and management of chronic migraine (defined as ≥15 headache days per month) are discussed separately. (See "Chronic migraine" .) Other aspects of migraine are reviewed elsewhere.About UpToDate UpToDate is the evidence-based, point-of-care resource trusted for reliable clinical answers around the world. UpToDate incorporates the latest medical findings, the best available evidence, and practical recommendations for patient care — so whatever your clinical question, you can be sure to find the answers you need.Oct 25, 2023 · A table summarizing the emergency management of acute hyponatremia in adults is provided ( table 1 ). An alternative approach, recommended in by European organizations, is to treat with two 150 mL bolus infusions of 3 percent saline, each given over 20 minutes, measuring the serum sodium between infusions [ 28 ]. Please make your check payable to UpToDate. All checks must be in US dollars and drawn on a US bank. Please mail your payment to: UpToDate Inc. P.O. Box 412094. Boston, MA 02241-2094. Your order will be processed upon receipt of your completed order form and check. Average processing time is two to three business days. ….

Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinical radiographic syndrome of heterogeneous etiologies that are grouped together because of similar findings on neuroimaging studies. It is also often referred to as: To continue reading this article, you must sign in with your personal, hospital, or group practice subscription ...UpToDate offers a number of subscriptions and add-on products, allowing you to have the most up-to-date information and improve patient care. 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 sections associated with each, such as Practice Changing UpDates, What's New, Patient Education, Calculators, and Drug Information. 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...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. UpToDate is an online resource that helps you make informed decisions about medical care. Access the latest evidence, expert opinions, and patient education with your subscription. 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 ).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 ). Uptodate com, Nov 7, 2023 · Polycystic ovary syndrome (PCOS) is a condition that causes irregular menstrual periods, symptoms of excess androgens (acne, hirsutism, and scalp hair loss), and ovaries that appear "polycystic" on pelvic ultrasound. The condition occurs in approximately 5 to 10 percent of females. Many females with PCOS are overweight or obese, and they are at ... , 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 ..., 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., Angioedema is self-limited, localized subcutaneous (or submucosal) swelling, which results from extravasation of fluid into interstitial tissues. Angioedema may occur in isolation, accompanied by urticaria, or as a component of anaphylaxis. The clinical features, diagnosis, differential diagnosis, and management of angioedema will be …, UpToDate offers a number of subscriptions and add-on products, allowing you to have the most up-to-date information and improve patient care. , 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 ..., Jan 4, 2024 ... Outline · Constipation · - Osmotic laxatives · - Lubiprostone · - Guanylate cyclase agonists · - Sodium/hydrogen exchanger 3 (NHE..., Mar 28, 2024 · Generalized anxiety disorder (GAD) is characterized by excessive worry and anxiety that are difficult to control, cause significant distress and impairment, and occur on more days than not for at least six months [ 1 ]. GAD is a relatively common disorder, most often with an adult onset and chronic course [ 2-6 ]. , A table summarizing the emergency management of acute hyponatremia in adults is provided ( table 1 ). An alternative approach, recommended in by European organizations, is to treat with two 150 mL bolus infusions of 3 percent saline, each given over 20 minutes, measuring the serum sodium between infusions [ 28 ]., Licensed to: UpToDate Marketing Professional Support Tag : [0602 - 207.46.13.154 - FBF59F1322 - PR14 - UPT - 20240510-02:21:15UTC] - SM - MD - LG - XL Loading, Licensed to: UpToDate Marketing Professional Support Tag : [0602 - 207.46.13.154 - FBF59F1322 - PR14 - UPT - 20240510-02:21:15UTC] - SM - MD - LG - XL Loading , Windows/Mac OS X: Free remote desktop application CrossLoop—which we've mentioned once or twice before—has just released a Mac version, which means simple, cross-platform remote su..., Oct 11, 2023 · 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 uncovering ... , For individuals and groups up to 19. Medical practices and other groups can place their UpToDate subscription orders together online, pay for them in a single transaction, and receive all the benefits of a personal subscription. Subscribe or view pricing for your group by selecting the “Purchase for Others” option. Subscribe Or See Pricing., Dissolved CO 2 + H 2 O ↔ H 2 CO 3 ↔ HCO 3- + H +. The ratio between these reactants can be expressed by the Henderson-Hasselbalch equation. By convention, the pKa of 6.10 is used when the denominator is the concentration of dissolved CO 2, and this is proportional to the pCO 2 (the actual concentration of the acid H 2 CO 3 is very …, Normally during sleep, air moves in and out through the nose, throat, and lungs at a regular rhythm. In a person with sleep apnea, air movement is periodically reduced or stopped. There are two types of sleep apnea, obstructive sleep apnea and central (non-obstructive) sleep apnea; some forms of apnea involve both types (a “mixed” apnea)., UpToDate is a trusted online resource that provides reliable and current information on various medical topics. Whether you are a physician, a patient, or a student, you can sign in with your email, username, or organization account to access UpToDate's evidence-based answers to your clinical questions. , 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 ..., Nov 10, 2023 · Pneumococcal vaccination is indicated for adults with risk factors for pneumococcal disease or for severe adverse outcomes should disease occur. Pneumococcal vaccination is also a routine part of infant and childhood immunization schedules worldwide. This topic will review types of pneumococcal vaccines, indications and approach to vaccine ... , INTRODUCTION. The best strategy for management of acute exacerbations of asthma is early recognition and intervention, before attacks become severe and potentially life threatening. Detailed investigations into the circumstances surrounding fatal asthma have frequently revealed failures on the part of both patients and clinicians to recognize ..., Neurofibromatosis type 1 (NF1), previously known as von Recklinghausen disease, is the most common type. The hallmarks of NF1 are the multiple café-au-lait macules and associated cutaneous neurofibromas. The condition is called segmental NF1 when clinical features are limited to one area of the body due to somatic mosaicism of a …, Art, as we all know, is about following a set number of rules handed to you by another person. In the latest New York Magazine cover story, art critic Jerry Saltz lists 33 steps to..., Google today introduced a new mobile management and security solution, Android Enterprise Essentials, which, despite its name, is actually aimed at small to medium-sized businesses..., Here we discuss our approach to the adult with unexpected thrombocytopenia. This approach can be used by the primary care physician and the consulting hematologist. Separate topics discuss thrombocytopenia in other populations: Neonates – (See "Neonatal thrombocytopenia: Clinical manifestations, evaluation, and …, INTRODUCTION. —. Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. The clinical presentation of CAP varies, ranging from mild pneumonia characterized by fever and productive cough to severe pneumonia characterized by respiratory distress and sepsis., Licensed to: UpToDate Marketing Professional Support Tag : [0602 - 207.46.13.154 - FBF59F1322 - PR14 - UPT - 20240510-02:21:15UTC] - SM - MD - LG - XL Loading, 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., 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. , Previously unidentified systemic and extrapulmonary manifestations of disease may also be present in this group. These may include fatigue, malaise, weight loss, exertional dyspnea, skin rashes, peripheral lymphadenopathy, nephrolithiasis, uveitis, palpitations, and syncope and Bell palsy, among others., Mar 19, 2024 · Acute pancreatitis is an acute inflammatory process of the pancreas. Overall mortality rates in acute pancreatitis are approximately 2 percent, but can be as high as 30 percent in patients with persistent organ failure (severe acute pancreatitis) [ 1 ]. This topic reviews the management of acute pancreatitis. , 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., 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., Intravenous thrombolysis can be administered up to 4.5 hours after symptom onset, and mechanical thrombectomy can be administered up to 24 hours after symptom onset. (See "Approach to reperfusion therapy for acute ischemic stroke" and "Intravenous thrombolytic therapy for acute ischemic stroke: Therapeutic use" and "Mechanical …