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Gag Reflex

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121. A Randomized Trial of 4% Nebulized Lignocaine vs. 10% Lignocaine Spray in Patients Undergoing Flexible Bronchoscopy

lignocaine have similar efficacy as topical anaesthetics in fiberoptic bronchoscopy but patients preferred the nebulized route. Noitasaeng et.al. concluded in their study that spraying lidocaine took less time to start the procedure, with greater ease of instrumentation, less incidence of hypersecretion, less gag reflex, and smooth operation during the procedure but patients preferred nebulized lidocaine administration. At the investigators' center, it has been a routine practice to perform flexible

2017 Clinical Trials

122. Accuracy of the Sensory Test Using the Laryngopharyngeal Endoscopic Esthesiometer in Obstructive Sleep Apnea

has made more than 50 laryngopharyngeal sensory tests. Other: Laryngopharyngeal sensory test The sensory measurements will include thresholds for laryngeal adductor reflex, cough reflex, gag reflex, and psychophysical sensory thresholds at the velopharynx and hypopharynx. Non-expert rater Pulmonologist or Otolaryngologist inexperienced in laryngopharyngeal sensory evaluation: who has made minimum 5 and maximum 50 laryngopharyngeal sensory tests. Pulmonologist fellow who has completed the training (...) provided for a Pulmonologist Fellow in bronchoscopy and who has performed minimum 5 and maximum 50 laryngopharyngeal sensory testing. Other: Laryngopharyngeal sensory test The sensory measurements will include thresholds for laryngeal adductor reflex, cough reflex, gag reflex, and psychophysical sensory thresholds at the velopharynx and hypopharynx. Outcome Measures Go to Primary Outcome Measures : Laryngeal adductor reflex threshold [ Time Frame: 15 days ] Threshold at which the laryngeal adductor

2017 Clinical Trials

123. Effect of Allopurinol for Hypoxic-ischemic Brain Injury on Neurocognitive Outcome

or hyperexcitability) Severe muscular hypotonia or hypertonia, Absent or insufficient spontaneous respiration (e.g., gasping only) with need for respiratory support at 10 min postnatally Abnormal primitive reflexes (absent suck or gag or corneal or Moro reflex) or abnormal movements (e.g., potential clinical correlates of seizure activity) Exclusion criteria gestational age below 36 weeks birth weight below 2500 g postnatal age >30min at the end of screening phase severe congenital malformation or syndrome

2017 Clinical Trials

124. Oral Flurbiprofen Spray for Mucosal Graft Harvesting at the Palatal Area

on the experimental sites before, no smoking, no pregnancy or lactation. Exclusion Criteria: hypersensitivity to flurbiprofen, history of allergy to NSAIDs, having coagulation disorders, presence of gagging reflex. Contacts and Locations Go to No Contacts or Locations Provided More Information Go to Layout table for additonal information Responsible Party: Sıla Çağrı İşler, PhD, Gazi University ClinicalTrials.gov Identifier: Other Study ID Numbers: 36290600/66 First Posted: May 24, 2017 Last Update Posted: May 24

2017 Clinical Trials

125. Efficacy Study of the Medical Device TRP Snorlessâ„¢ in the Treatment of Snoring

fingers) Intolerable gag reflex Known nasal septal deviation Neck circumference > 46 cm Patient currently treated for OSA Patient with AHI≥30 events/hour or with AHI>15 and (SFI) Sleep Fragmentation Index > 20 Patient currently treated for central sleep apnoea Addiction to alcoholic beverages (5 drinks per day per NIAAA) Under constant pharmacological treatment for depression, anxiety, chronic pain, insomnia Hypertrophy of tonsils Macroglossia Hypertrophy of uvula Primary gastroesophageal reflux Any

2017 Clinical Trials

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

135. 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. 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

139. Emergency Airway Management Part 1: Optimizing the basics

) If simple airway positioning is not sufficient, insert an oropharyngeal or a nasopharyngeal airway. Frequently, more than one is required. It is reasonable to place 2 nasopharyngeal airways and an oropharyngeal airway at the same time time to facilitate bag valve mask ventilation. Oropharyngeal airway Ensure that an oropharyngeal airway is appropriate for the patient. The patient should be unconscious, without a gag reflex. To choose the correct sized airway, place one end at the tip of the chin (...) reserved for the end of algorithms, as rescue devices, they can also be used early in the algorithm as the primary means of ventilation. (Braude 2007; Mosier 2015) The LMA can only be placed in patients without airway reflexes – the same patients who will tolerate an oral airway. You can use medications to facilitate LMA placement. Darren Braude has described using classic RSI medications, but proceeding directly to an LMA rather than intubation as “rapid sequence airway”. (Braude 2007

2017 First10EM

140. 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

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