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Cough fracture

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61. Bilateral Internal Superior Laryngeal Nerve Palsy of Traumatic Cervical Injury Patient Who Presented as Loss of Cough Reflex after Anterior Cervical Discectomy with Fusion (Full text)

cervical discectomy with fusion (ACDF). An 75-year-old man visited with cervical spine fracture and he underwent ACDF through a right side approach. During the post-operative days, he complained of high pitched tone defect, and occasional coughing during meals. With a suspicion of SLN injury and for the work up for the cause of aspiration, we performed several studies. According to the study results, he was diagnosed as right SLN and left ibSLN palsy. We managed him for protecting from silent (...) Bilateral Internal Superior Laryngeal Nerve Palsy of Traumatic Cervical Injury Patient Who Presented as Loss of Cough Reflex after Anterior Cervical Discectomy with Fusion Injury to the bilateral internal branch of superior laryngeal nerve (ibSLN) brings on an impairment of the laryngeal cough reflex that could potentially result in aspiration pneumonia and other respiratory illnesses. We describe a patient with traumatic cervical injury who underwent bilateral ibSLN palsy after anterior

2012 Journal of Korean Neurosurgical Society PubMed abstract

62. Rib Fracture

or 2 rib fractures rarely develop these complications. Symptoms and Signs Pain is severe, is aggravated by movement of the trunk (including coughing or deep breathing), and lasts for several weeks. The affected ribs are quite tender; sometimes the clinician can detect crepitance over the affected rib as the fracture segment moves during palpation. Diagnosis Usually chest x-ray Palpation of the chest wall may identify some fractures. Some clinicians feel clinical evaluation is adequate in healthy (...) can also depress respiration and worsen . Some clinicians prescribe NSAIDs simultaneously. To minimize pulmonary complications, patients should consciously and frequently (eg, hourly while awake) breathe deeply or cough. Holding (essentially splinting) the affected area with the flat palm of the hand or a pillow can minimize the pain during deep breathing or coughing. Patients are hospitalized if they have ≥ 3 fractures or underlying cardiopulmonary insufficiency. Immobilization (eg, by strapping

2013 Merck Manual (19th Edition)

63. Vertebral Compression Fractures

. There may be no preceding trauma or only minimal trauma (eg, a minor fall, sudden bending, lifting, coughing). Patients who have had an osteoporotic vertebral fracture are at higher risk of other vertebral and nonvertebral fractures. Occasionally, compression or other vertebral fractures result from significant force (eg, a motor vehicle crash, a fall from a height, a gunshot wound). In such cases, a is often also present, and the spine may be fractured in > 1 place. If the cause was a fall or jump from (...) Vertebral Compression Fractures Vertebral Compression Fractures - Injuries; Poisoning - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge

2013 Merck Manual (19th Edition)

64. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing

For people who present with signs or symptoms of PE, such as chest pain, shortness of breath or coughing up blood, assess their general medical history, do a physical examination and offer a chest X-ray to exclude other causes. [2012] [2012] Pulmonary embolism rule-out criteria (the PERC rule) Pulmonary embolism rule-out criteria (the PERC rule) 1.1.16 If clinical suspicion of PE is low [1] , consider using the pulmonary embolism rule- Venous thromboembolic diseases: diagnosis, management

2020 National Institute for Health and Clinical Excellence - Clinical Guidelines

65. Cerebral palsy in adults

outcomes. Osteopor Osteoporosis and fr osis and fractur acture risk e risk 1.4.2 Be aware that low bone mineral density is common in adults with cerebral palsy, particularly in people: with reduced mobility or reduced weight bearing taking anticonvulsants or proton pump inhibitors who have had a previous low-impact fracture. 1.4.3 Consider assessing for risk of fractures secondary to osteoporosis in adults with cerebral palsy. Risk factors to assess include: needing help with moving or having (...) to be moved, for example, hoisting history of falls low BMI history of low-impact fractures other medical factors, for example steroid use, that may adversely affect bone health. Cerebral palsy in adults (NG119) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 20 of 64For more information about assessment of fracture risk, see NICE's guideline on osteoporosis: assessing the risk of fragility fracture. 1.4.4 Consider a dual

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

66. Ivacaftor (combination with ivacaftor/tezacaftor, cystic fibrosis, 12 years and older, with F508del mutation, homozygous) - Addendum to Commission A19-70

of bronchiectasis 0 (0) 1 (0.5) Lung infection 0 (0) 1 (0.5) Respiratory, thoracic and mediastinal disorders 8 (4.4) 2 (1.1) Haemoptysis 5 (2.7) 2 (1.1) Cough 1 (0.5) 0 (0) Lung disorder 1 (0.5) 0 (0) Pneumomediastinum 1 (0.5) 0 (0) Pneumothorax 1 (0.5) 0 (0) Gastrointestinal disorders 4 (2.2) 3 (1.6) Distal intestinal obstruction syndrome 2 (1.1) 2 (1.1) Constipation 1 (0.5) 1 (0.5) Lower gastrointestinal haemorrhage 1 (0.5) 0 (0) Investigations 2 (1.1) 1 (0.5) Forced expiratory volume decreased 1 (0.5) 0 (0 (...) ) 0 (0) Acarodermatitis 0 (0) 1 (0.4) Bronchitis 0 (0) 1 (0.4) Bronchopulmonary aspergillosis allergic 0 (0) 1 (0.4) Gastroenteritis viral 0 (0) 1 (0.4) Influenza 0 (0) 1 (0.4) Nervous system disorders 3 (1.2) 1 (0.4) Benign intracranial hypertension 1 (0.4) 0 (0) Generalized tonic-clonic seizure 1 (0.4) 0 (0) Migraine 1 (0.4) 0 (0) Headache 0 (0) 1 (0.4) Respiratory, thoracic and mediastinal disorders 3 (1.2) 5 (1.9) Haemoptysis 3 (1.2) 3 (1.2) Cough 0 (0) 1 (0.4) Paranasal cyst 0 (0) 1 (0.4

2020 Institute for Quality and Efficiency in Healthcare (IQWiG)

67. Therapeutic guidelines for antiretroviral (ARV) treatment of adult HIV infection

Intermediate PI Darunavir/cobicistat + emtricitabine/tenofovir DF 2 Y Intermediate Drugs in bold italics are generic products aabacavir use contraindicated if HLA-B*5701 allele positive bregimen acceptable if baseline HIV plasma viral load 30 and 3 months (TAF is not licensed for individuals with eGFR 3 mg/mmol) • Persistent moderate to severe hypophosphatemia (serum phosphate 30 mg/mmol) • Documented osteoporosis (at least one T-score 10%) 10-year risk of major osteoporotic fracture as determined by FRAX (...) score (https://www.sheffield.ac.uk/FRAX/tool.aspx?country=19) • Fragility fracture (atraumatic fracture or fracture resulting from minimal trauma) • Documented osteomalacia (laboratory and/or imaging) THERAPEUTIC GUIDELINES FOR ANTIRETROVIRAL TREATMENT OF ADULT HIV INFECTION VI VERSION: DEC 2019 This page has been purposely left blank THERAPEUTIC GUIDELINES FOR ANTIRETROVIRAL TREATMENT OF ADULT HIV INFECTION 1 VERSION: DEC 2019 RETURN TO TABLE OF CONTENTS THERAPEUTIC GUIDELINES FOR ANTIRETROVIRAL

2020 CPG Infobase

68. Guidance for maternal medicine in the evolving coronavirus (COVID-19) pandemic

be ‘shielded’. 2 Where possible, pregnant women with all other respiratory conditions should be offered remote consultation. Pregnant women with underlying respiratory conditions who develop fever or cough should initially be reviewed remotely to assess the severity of their illness. Those considered to not be coping at home should be assessed in hospital for COVID-19 and other common differential diagnoses (See section 4). 3.5 Haematological Authors: Jahnavi Daru, Sue Pavord, Beverley Hunt, Susan Robinson (...) women presenting to acute services with symptoms which might be indicative of COVID-19 During the pandemic women will continue to present with symptoms warranting medical input, but medical teams may not be able to provide a prompt review. The investigation of potential COVID-19 in a pregnant woman should follow national guidelines for adults. 22 Women presenting with fever, cough, headache, shortness of breath or any other symptoms suggestive of COVID-19 should still be fully investigated according

2020 Royal College of Obstetricians and Gynaecologists

69. Clinical care of severe acute respiratory infections – Tool kit

of fever, cough Pneumonia, infection Pesticide exposure Poisoning Recent fall or other trauma Rib fracture, ail chest, pneumothorax, contusion, tamponade Known allergies, allergen exposure, bite or sting Allergic reaction Recent medication or dose change Allergic reaction or side e ect History of opioid or sedative drug use Overdose History of wheezing Asthma or COPD History of diabetes DKA History of tuberculosis or malignancy Pericardial tamponade, pleural e usion History of heart failure Pulmonary (...) technical guidance can be found at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical- guidance Transmission • The COVID-19 virus is a zoonotic virus, meaning that it can be transmitted between animals and humans. The intermediary animal host has not yet been identified. • The COVID-19 virus is spread between people mainly via inhalation of respiratory droplets from coughing or sneezing, but can also be passed through fomite/contact. • Nosocomial transmission can occur where

2020 WHO Coronavirus disease (COVID-19) Pandemic

70. Covid-19: Management of emergency department patients

/analgesia alone Upper limb fracture Fracture of the lower limb except femur, tibia, calcaneum Dislocation following reduction Minor stable vertebral fractures General surgery Renal biliary colic in whom pain is controlled Abdominal pain with normal CT and pain controlled Abscess not showing signs of sepsis Haematuria without clot retention, hypotension or anaemia 6 | Clinical guide for the management of emergency department patients during the coronavirus pandemic Bacterial infection News cough) have not improved in 7 days. They should seek help via the NHS 111 online coronavirus service or call 111 if they cannot

2020 Covid-19 Ad hoc guidelines

71. Chronic obstructive pulmonary disease (COPD)

Nicotine Cessation Guideline for recommendations on helping patients quit smoking. Screening Screening for COPD is not recommended in asymptomatic adults. COPD Diagnosis and Treatment Guideline 3 Diagnosis and Assessment COPD should be considered in any patient who has persistent dyspnea that worsens with exercise, chronic cough, wheezes, or sputum production, and/or a history of exposure to risk factors for the disease such as smoking and occupational or environmental exposures. Diagnosis of COPD (...) 0.70 or lower 80% or higher GOLD stage 2 = moderate 0.70 or lower 50–79.9% GOLD stage 3 = severe 0.70 or lower 30–49.9% GOLD stage 4 = very severe 0.70 or lower Lower than 30% 1 Patients who may be at risk of developing COPD include those who smoke or are exposed to pollutants; have cough, sputum, or dyspnea; and/or have a family history of respiratory disease. Methods for assessing symptoms COPD Assessment Test (CAT) The CAT is a validated tool for assessing the impact on COPD on wellbeing

2020 Kaiser Permanente Clinical Guidelines

72. The Vest for delivering high-frequency chest wall oscillation in people with complex neurological needs

for people with rib fractures, poor bone density or surgical sites or lines that would be affected by the position of The Vest on the chest wall. One specialist highlighted that HFCWO is a technique to help mobilisation of secretions and still needs an effective cough to clear secretions. If a person has an ineffective cough effort, The Vest would have to be used with assisted cough techniques and suction to clear the secretions. The specialists identified specific patient populations needing airway (...) (available in different styles and sizes), which gently compresses and releases the chest wall. This action is designed to mobilise mucus from smaller to larger airways, which can then be coughed up or removed by suction. The Vest has 3 programmes with different combinations of frequency, pressure and treatment time. A treatment session usually takes 10 to 30 minutes. The system can be used by the person having treatment, but people who are immobile may need help from a carer. Specialist commentators

2018 National Institute for Health and Clinical Excellence - Advice

73. Chronic obstructive pulmonary disease: fluticasone furoate, umeclidinium and vilanterol (Trelegy)

steroid effects were more common in the fluticasone furoate/vilanterol/umeclidinium and fluticasone furoate/vilanterol groups (8% and 7% respectively) compared with the umeclidinium/vilanterol group (5%), however no statistical analysis was conducted. However, the incidence of decreased bone mineral density and associated fractures was the same in all 3 groups (2% in each group). Lower respiratory tract infections (excluding pneumonia) had the same frequency of incidence in all 3 groups (5% in each

2018 National Institute for Health and Clinical Excellence - Advice

74. Optimisation of RIZIV – INAMI lump sums for incontinence

in the frail elderly and cognitive impaired. 2.3.2.1 Subtypes of incontinence: stress, urgency, mixed and other The SUI clinical subtype or the loss of urine on effort, exertion, sneezing or coughing (increasing intra-abdominal pressure) typically includes the younger and middle-aged female patient presenting during pregnancy or after childbirth. Urgency and mixed UI often presents in middle-aged women affected by bladder and or pelvic floor problems and middle-aged and older men. Urgency is defined (...) as the leakage of urine with or immediately preceded by urgency (a sudden compelling desire to urinate that is difficult to delay) whereas MUI is the leakage of urine associated with both urgency and exertion, effort, sneezing or coughing often accompanied by an overactive bladder (OAB), frequency and nocturia. The urgency and mixed types tend to suffer from higher volume leakage episodes. In men UUI is mostly represented (40-80%), followed by mixed forms of UI (10-30%), and SUI in less than 10

2020 Belgian Health Care Knowledge Centre

75. Glinides and glitazones in the treatment of type 2 diabetes

OR starlix) AND (diabetes mellitus OR type 2 diabetes OR type ii diabetes) AND (mortality OR morbidity OR cardiac OR heart OR cardiovascular OR fracture OR malignancy OR cancer OR stroke OR renal OR kidney OR microvascular OR macrovascular OR retinopathy OR nephropathy OR neuropathy OR myocardial infarction OR adverse event OR adverse events OR safety OR death OR blood pressure OR weight) 791 Embase (glinide OR glinides OR meglitinide OR meglitinides OR repaglinide OR nateglinide OR prandin OR GlucoNorm (...) OR Surepost OR EIPICO OR NovoNorm OR starlix) AND ('diabetes mellitus' OR 'type 2 diabetes' OR 'type ii diabetes') AND (mortality OR morbidity OR cardiac OR heart OR cardiovascular OR fracture OR malignancy OR cancer OR stroke OR renal OR kidney OR microvascular OR macrovascular OR retinopathy OR nephropathy OR neuropathy OR 'myocardial infarction' OR 'adverse event' OR 'adverse events' OR safety OR death OR blood pressure OR weight) AND [embase]/lim NOT ([embase]/lim AND [medline]/lim) NOT ('conference

2020 Swiss Federal Office of Public Health HTA

76. British guideline on the management of asthma

and asymptomatic • symptoms of wheeze, cough, breathlessness and chest tightness that vary over time • recorded observation of wheeze heard by a healthcare professional • personal/family history of other atopic conditions (in particular, atopic eczema/dermatitis, allergic rhinitis) • no symptoms/signs to suggest alternative diagnoses. ? In patients with a high probability of asthma: • record the patient as likely to have asthma and commence a carefully monitored initiation of treatment (typically six weeks (...) to consider in an initial structured clinical assessment Episodic symptoms (see sections 3.2.1 and 3.2.2) 13, 18, 19, 21, 22 62, 73, 74 More than one of the symptoms of wheeze, breathlessness, chest tightness and cough occurring in episodes with periods of no (or minimal) symptoms between episodes. Note that this excludes cough as an isolated symptom in children. 75 For example: • a documented history of acute attacks of wheeze, triggered by viral infection or allergen exposure with symptomatic

2019 SIGN

77. Cystic fibrosis: diagnosis and management

, such as: recurrent lower respiratory tract infections clinical or radiological evidence of lung disease (in particular bronchiectasis) persistent chest X-ray changes chronic wet or productive cough chronic sinus disease obstructive azoospermia (in young people and adults) acute or chronic pancreatitis malabsorption rectal prolapse (in children) pseudo-Bartter syndrome. 1.1.3 Refer people with suspected cystic fibrosis to a specialist cystic fibrosis centre if: they have a positive or equivocal sweat test result (...) of clinical history and medicines adherence, and a physical examination with measurement of weight and length or height Cystic fibrosis: diagnosis and management (NG78) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 15 of 43measurement of oxygen saturation taking respiratory secretion samples for microbiological investigations, using sputum samples if possible, or a cough swab or nasal pharyngeal aspirate (NPA) lung

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

78. Cerebral palsy in under 25s: assessment and management

by a speech and language therapist with training in assessing and treating dysphagia. 1.8.2 Refer the child or young person to a local specialist multidisciplinary team with training in assessing and treating dysphagia if there are clinical concerns about eating, drinking and swallowing, such as: coughing, choking, gagging, altered breathing pattern or change in colour while eating Cerebral palsy in under 25s: assessment and management (NG62) © NICE 2019. All rights reserved. Subject to Notice of rights (...) , drinking and swallowing difficulties or concerns about nutritional status low weight for age (below the 2nd centile) Cerebral palsy in under 25s: assessment and management (NG62) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 22 of 46history of low-impact fracture use of anticonvulsant medication. 1.12.2 Recognise that there is an increased risk of low-impact fractures in children and young people with cerebral palsy

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

80. Palliative Care for Adults

• Admission from long-term care facility or medical foster home • Elderly patient, cognitively impaired, with acute hip fracture • Metastatic or locally advanced incurable cancer • Chronic home oxygen use • Out-of-hospital cardiac arrest • Current or past hospice program enrollee • Limited social support (e.g., family stress, chronic mental illness) • No history of completing an advance care planning discussion /document a Primary Criteria are global indicators that represent the minimum that hospitals

2020 Institute for Clinical Systems Improvement

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