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Gag Reflex

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121. Clinical Predictors of Oro-esophageal Tube Feeding Success in Brain Injury Patients With Dysphagia Full Text available with Trip Pro

into two groups, based on the OE tube training success. Clinical factors assessed included age, cause of brain lesion, gag reflex, cognitive function and reasons for OE tube training failure.Of the 76 cases enrolled, 56 study patients were assigned to the success group, with the remaining 20 in the failure group. There were significant differences between these two groups in terms of age, gag reflex, ability to follow commands, and the score of Korean version of Mini-Mental Status Examination (K-MMSE (...) ). Location of the brain lesion showed a borderline significance. Multivariable analysis using logistic regression revealed that age, cause of brain lesion, gag reflex, and K-MMSE were the main predictors of OE tube training success.A younger age, impaired gag reflex and higher cognitive function (specifically a K-MMSE score ≥19.5) are associated with an increased probability of OE tube training success in dysphagic patients.

2017 Annals of rehabilitation medicine

122. Role of bromocriptine in multi-spectral manifestations of traumatic brain injury Full Text available with Trip Pro

cases of traumatic brain injury in minimally conscious state were enrolled in the study. After hemodynamic stability, bromocriptine was given at paediatric dose of 3.75 mg/d and adult dose of 7.5 mg/d. It was administered through a naso-gastric (NG) feeding tube in the patients with minimally conscious state, then changed to oral route after proper swallowing and good gag reflex were ensured in the patient. The drug was slowly reduced over three weeks after neurological improvement in the patients

2017 Chinese Journal of Traumatology

123. Collet-Sicard Syndrome With Hypoglossal Nerve Schwannoma: A Case Report Full Text available with Trip Pro

Collet-Sicard Syndrome With Hypoglossal Nerve Schwannoma: A Case Report Collet-Sicard syndrome is a rare syndrome that involves paralysis of 9th to 12th cranial nerves. We report an uncommon case of schwannoma of the hypoglossal nerve in a 39-year-old woman presented with slurred speech, hoarse voice, and swallowing difficulty. Physical examination revealed decreased gag reflex on the right side, decreased laryngeal elevation, tongue deviation to the right side, and weakness of right trapezius

2017 Annals of rehabilitation medicine

124. Optimal dose of succinylcholine for laryngeal mask airway insertion: systematic review, meta-analysis and metaregression of randomised control trials. Full Text available with Trip Pro

failure rate and its related coughing and gagging when compared with mini dose.The use of succinylcholine compared with none can facilitate LMA insertion and reduce insertion-related reflexes without significant postoperative myalgia. However, additional prospective studies with a larger sample size are required to fully evaluate the dose-dependent effect and complications of succinylcholine for LMA insertion.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article (...) that succinylcholine reduced the first-attempt LMA insertion failure rate (RR, 0.22; 95% CI 0.12 to 0.43), coughing and gagging (RR, 0.26; 95% CI 0.15 to 0.45) and laryngospasm (RR, 0.14; 95% CI 0.05 to 0.39). The use of succinylcholine did not result in a significant increase of postoperative myalgia (RR, 2.58; 95% CI 0.79 to 8.44) and did not reduce the risk of postoperative sore throat (RR, 0.76; 95% CI 0.55 to 1.03). Subgroup analysis further showed that low-dose succinylcholine reduced the LMA insertion

2017 BMJ open

125. The Middle Ear Cleft Status in a "Natural" Cohort With Eustachian Tube Dysfunction. (Abstract)

damage, requiring tracheotomy and gastrostomy. These patients were unable to swallow, produce valsalva, yawn, and needed oral suctioning. Examination included fiberoptic nasopharyngoscopy, gag reflex and soft palate assessments, otoscopy, and tympanometry.Nineteen patients (38 ears) were evaluated: 14 men and 5 women, aged 18 to 93 years (average 59). Duration of gastrostomy and tracheotomy were between 3 months and 18 years. All the patients lacked gag reflex, palatal movements, or supraglottic

2017 Otology and Neurotology

126. Lidocaine spray alone is similar to spray plus viscous solution for pharyngeal observation during transoral endoscopy: a clinical randomized trial. Full Text available with Trip Pro

and viscous solution (combination group, n = 170). We compared the number of pharyngeal observable sites (non-inferiority test), pain by visual analogue scale, observation time, and the number of gag reflexes between the two groups. Results The mean number of images of suitable quality taken at the observable pharyngeal sites in the spray group was 8.33 (95 % confidence interval [CI]: 7.94 - 8.72) per patient, and 8.77 (95 % CI: 8.49 - 9.05) per patient in the combination group. The difference (...) in the number of observable pharyngeal sites was - 0.44 (95 % CI: - 0.84 to - 0.03, P = 0.01). There were no differences in pain, observation time, or number of gag reflexes between the 2 groups. Subgroup analysis of the presence of sedation revealed no differences between the two groups for the number of pharyngeal observation sites and the number of gag reflexes. However, the number of gag reflexes was higher in the spray group compared to the combination group in a subgroup analysis that looked

2017 Endoscopy international open Controlled trial quality: predicted high

127. Meningitis (bacterial) and menigococcal septicaemia in under 16s: recognition, diagnosis and management

in the management of critically ill children. 1.4.37 Undertake tracheal intubation and mechanical ventilation for the following Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management (CG102) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 27 of 39indications: threatened (for example, loss of gag reflex), or actual loss of airway patency the need for any form of assisted

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

130. Apparent Life-Threatening Events In Children

Administration 4 Apparent Life-Threatening Events In Children Apparent Life-Threatening Events In Children Aka: Apparent Life-Threatening Events In Children , Apparent Life Threatening Event In Infant , ALTE , BRUE , Brief Resolved Unexplained Event From Related Chapters II. Definition Apparent Life-Threatening Event (ALTE) Sudden, brief episode with serious findings in an infant under age 1 year Presents with apnea, or pallor, limp, or gagging Brief Resolved Unexplained Event (BRUE) Replaces Apparent Life (...) . Causes ral ALTE after age 2 months predicts serious cause Idiopathic in 50% of cases No longer thought to be near-miss (older hypothesis) Gastrointestinal (50% of diagnosed cases) disorder (Gastric , ) Neurologic (30% of diagnosed causes) Disorder (e.g. s) Vasovagal reflex Structural Disease (Budd-Chiari Syndrome) Brain Mass (or other ) (e.g. ) or (e.g. ) Respiratory (20% of diagnosed causes) Infection (RSV, , ) Obstruction ( , vocal cord, foreign body) Laryngotracheomalacia Facial anomaly Cardiac (5

2018 FP Notebook

132. Yervoy - ipilimumab

responses to T- cell dependent antigens. The antigens used for this assessment were hepatitis B surface antigen (HBsAg) vaccine, a melanoma cell-based vaccine (Sk-mel), DNP (2,4-Dinitrophenyl)-Ficoll keyhole limpet hemocyanin (KLH) and simian immunodeficiency virus (SIV) DNA vaccines (purified plasmid DNA) expressing the proteins for the gag (pSIVgag), env (pSIVenv), and pol (pSIVpol) portions of SIV. In one study, the SKmel tumour line was transfected to express GM-CSF. Ipilimumab at 10 mg/kg (...) of the pivotal (GLP) repeat- dose toxicity studies in monkeys. No drug-related findings were observed in standard clinical evaluations of cardiovascular, respiratory or neurologic function (including behaviour, posture, coordination, neurologic exams that included peripheral and cranial nerve evaluations, peripheral reflexes, proprioception, or eye movements, and in the 1-month study, electrocardiograms) conducted in monkeys as part of the repeat-dose toxicity studies for up to 6 months with ipilimumab

2011 European Medicines Agency - EPARs

133. Palliative care - secretions

inflammation of the mucosa, which triggers copious mucus production [ ]. Gastric reflux may also cause pooling of fluid in the hypopharynx [ ]. Oropharyngeal or gastric contents may be aspirated into the larynx and lower respiratory tract. Factors predisposing to aspiration include impaired consciousness, old age, impaired cough or gag reflex, and structural diseases of the airway and upper gastrointestinal tract. People who aspirate may have recurrent episodes of choking, coughing, or pneumonia

2016 NICE Clinical Knowledge Summaries

136. Management of patients with stroke: Identification and management of dysphagia

on videofluoroscopy fail to cough. 26 Risk of aspiration is suggested by the following: 36,37 ? wet, hoarse voice ? weak voluntary cough ? any indication of reduced laryngeal function. Reduced conscious level is also an indicator of aspiration risk. 37 The gag reflex is unreliable and insensitive as an independent predictor 26 and should only be used as part of a more detailed assessment procedure (see section 3). 38 One screening study suggests that reduced pharyngeal sensation may be associated with aspiration

2010 SIGN

137. Vegetative State 2.0

be present. The movements can vary from fast to quite slow. They can be almost constantly present, or rarely seen. 3) Automatic chewing (lips typically closed) and swallowing are frequently present. 4) Blinking is a common finding (including blinking while the lids are closed). The patient who has an essentially preserved brain stem, intact cranial nerves and end organs, will have preserved pupillary, corneal, oculocephalic, vestibulo-ocular, gag and cough reflexes. With brain stem or cranial nerve (...) for the imagery tasks could have elicited some type of cortical response independent of awareness, some kind of a very sophisticated knee-jerk reflex. Ropper suggested that instead of cuing the patients with “playing tennis” versus “relax”, Monti’s team should have asked patients “imagine playing tennis” and compared with “imagine not playing tennis”. Perhaps nothing in clinical medicine is as complex as the assessment of consciousness, thus Allan Ropper, Andrew Billings, and others(3)(13)(14)(15) all hold

2011 Clinical Correlations

138. In any situation, listening is always best. Doctors should remember that.

. They are so big. I just have a hard time getting them down. So, I just gave up taking my pills.” I looked at him and smiled. “You do realize that you can cut those pills into halves and quarters?” He looked down. Obviously not. “Okay,” I said, “let’s come up with a plan that doesn’t require you to swallow big pills all the time. I know that it’s not easy when you have a strong gag reflex and have to take big pills. Let’s find something that works well for you.” He smiled broadly and seemed to relax. I

2017 KevinMD blog

139. Resuscitated from ventricular fibrillation: what is the ECG Diagnosis?

hour down time prior to being resuscitated. She has been without sedation for several hours and has no corneal or gag reflexes per the primary team. There is enough evidence to call into question her neurological viability at this time, thus a left heart catheterization would be of questionable utility.” Autopsy, day 7: Anoxic brain injury with total cerebral necrosis 99% stenosis of the proximal LAD, with acute transmural infarct of the anterior and anterolateral walls of the LV 75% stenosis LCx

2016 Dr Smith's ECG Blog

140. Cardiopulmonary Syndromes (PDQ®): Health Professional Version

judiciously and sparingly; they are unpleasant to the taste and obtund the gag reflex, and anaphylactic reactions to preservatives in these solutions have been documented. Opioid and nonopioid antitussives, such as dextromethorphan, may act synergistically, but further studies are required to confirm this hypothesis.[ ] Gabapentin was found to be efficacious compared with placebo for chronic refractory cough, although this study did not specifically include cancer patients.[ ] In cases of increased sputum

2014 PDQ - NCI's Comprehensive Cancer Database

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