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101. Head injury

or lower limbs or abnormal reflexes. For a suspected basal skull fracture, which may present with: Clear fluid (possible cerebrospinal fluid) leaking from the ear(s) or nose. Periorbital haematoma(s) with no associated damage around the eyes. Bleeding from one or both ears; blood behind the ear drum (haemotympanum); new deafness in one or both ears. Battle's sign — bruising behind one or both ears over the mastoid process, suggesting fracture of the middle cranial fossa. For any neck tenderness

2016 NICE Clinical Knowledge Summaries

102. Earwax

history of ear surgery. A foreign body in the ear canal. Used ear drops, which have been unsuccessful, and irrigation is contraindicated. Had unsuccessful irrigation. Advice should be urgently sought from an Ear, Nose, and Throat specialist if: Severe pain, deafness, or vertigo occur during or after irrigation, or if a perforation is seen following the procedure. Infection is present and the external canal needs to be cleared of wax, debris, and discharge. Have I got the right topic? Have I got (...) for recommendation Basis for recommendation There is no evidence to suggest when earwax should be removed so this recommendation is based on expert opinion [ ; ; ; ; ]. If there is hearing loss and the tympanic membrane cannot be seen, then the wax should be removed as the majority of causes of conductive deafness are diagnosed by examining the tympanic membrane [ ]. Once the wax has been removed if hearing does not improve then alternative causes should be considered [ ]. Visualisation of the tympanic membrane

2016 NICE Clinical Knowledge Summaries

103. Otitis media with effusion

. Hearing loss is severe (61 dB or greater) and requires urgent referral within 2 weeks to exclude additional sensorineural deafness. Significant hearing loss persists on two documented occasions (usually following repeat testing after 6–12 weeks). The tympanic membrane is structurally abnormal (or there are other features suggesting an alternative diagnosis). There is a persistent, foul-smelling discharge suggestive of a possible cholesteatoma. Referral should be urgent (within 2 weeks). The child has

2016 NICE Clinical Knowledge Summaries

105. Giant cell arteritis

artery complications (such as aortic aneurysm, aortic dissection, large artery stenosis, and aortic regurgitation). Cardiovascular disease. Peripheral neuropathy. Depression. Confusion and encephalopathy. Deafness. Relapses are common and can occur if corticosteroid treatment is reduced or withdrawn too quickly. However, about 30–50% of people have spontaneous exacerbations of disease, especially during the first 2 years, that are independent of the corticosteroid regimen. Giant cell arteritis should (...) with osteoarthritis and 2.1 (95% CI 1.5 to 3.0) compared with people without osteoarthritis. Other complications include [ ; ] : Peripheral neuropathy. Depression. Confusion and encephalopathy (in about 30% of people). Deafness. Complications of long-term corticosteroid treatment (for example weight gain, bruising, osteoporosis and fractures, and diabetes). Prognosis What is the prognosis? Relapses are common and can occur if corticosteroid treatment is reduced or withdrawn too quickly [ ]. About 30–50% of people

2014 NICE Clinical Knowledge Summaries

106. Suspected neurological conditions: recognition and referral

neurological deficit such as vertical or rotatory nystagmus, new-onset unsteadiness or new-onset deafness: if the person has diabetes, check for and treat hypoglycaemia if the person does not have diabetes, or treating hypoglycaemia does not resolve the symptoms, and benign paroxysmal positional vertigo or postural hypotension do not account for the presentation, refer immediately to exclude posterior circulation stroke, in line with the NICE guideline on stroke and transient ischaemic attack in over 16s

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

107. Specialist neonatal respiratory care for babies born preterm

as presence or absence of condition, not severity): severe hearing impairment (for example, deaf) severe visual impairment (for example, blind). Specialist neonatal respiratory care for babies born preterm (NG124) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 22 of 53Non-in Non-invasiv vasive v e ventilation entilation Administration of respiratory support using a ventilator or flow driver, but not via an endotracheal

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

109. Screening, diagnosis and management of congenital hypothyroidism

(if hypoplasia), TG (if goiter, low TG level) PAX8 Normally located thyroid with abnormal perchlorate discharge test (ie, iodide organification defects) TPO, DUOX2/DUOXA2 +/– TG Normall y located thyroid on ultrasonography, with no iodide uptake on scintigraphy SCL5A5/NIS, TSH-R (if hypoplasia) Syndromic CH Deafness Normally located thyroid SCL26A4/PDS Short stature, obesity, hypocalcemia Normally located thyroid GNAS Cleft palate, ‘spiky’ hair Athyreosis (hypoplasia) FOXE1 (no mutations described

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2015 Pediatric Endocrine Society

111. Information for women considering preventive mastectomy

service provided by each State and Territory Cancer Council. The national phone number is 13 11 20. You can also request services in languages other than English. Breast Cancer Support Service Each State and Territory Cancer Council also provides a Breast Cancer Support Service. This free and con? dential service can be contacted by ringing the Cancer Council Helpline number on 13 11 20 or toll free on 1800 624 973. The TTY number for deaf or hearing-impaired people is 02 9334 1865. The Breast Cancer

2019 European Society of Endocrinology

114. Occupational Therapists' Use of Occupation Focused Practice in Secure Hospitals

, namely Ashworth, Broadmoor and Rampton, are located in England. Approximately 795 beds were commissioned by NHS England for England and Wales in 2014/15 (NHS England 2013a). Rampton includes the national services for women, deaf men, and men with a learning disability. The State Hospital, located in Scotland, provides the national service for Scotland and Northern Ireland and provides 140 beds for male patients, 12 of which are specifically for patients with a learning disability. These hospitals

2018 British Association of Occupational Therapists

115. Diagnosis and antenatal management of congenital cytomegalovirus infection

, a herpesvirus, is the most common viral infectionofthefetusandistheleadingnongeneticcauseof congenital deafness, 2 affecting nearly 40,000 infants each yearintheUnitedStates.Fetalinfectioncanresultinawide range of outcomes for children, from asymptomatic infec- tiontoseveredisabilityanddeath.Birthprevalencere?ects all neonatal infections detected at birth as a result of both primary and recurrent infections. Birth prevalence also var- ies geographically and is estimated to be 0.48-1.3% in the UnitedStates

2016 Society for Maternal-Fetal Medicine

116. Syphilis

such as unilateral sensori-neural deafness, ocular nerve palsies, uveitis and meningitis. • If untreated symptoms slowly resolve over a period of weeks. Note: Skin lesions may be extremely infectious so always use gloves during examination of any rash or genital lesion. Syphilis MANAGEMENT GUIDELINESSyphilis Management Guidelines page 3 of 4 Latent syphilis • This means syphilis with no clinical symptoms or signs. Early latent is defined as less than 2 years duration, and late latent beyond 2 years. • Some

2017 New Zealand Sexual Health Society

117. Sudden Hearing Loss

. Definitions of Common Terminology. Table 1. Definitions of Common Terminology. The SSNHL definition used throughout this guideline is ≥30-dB SNHL at 3 consecutive frequencies, based on its consistent use in the literature and National Institute on Deafness and Other Communication Disorders (NIDCD) criteria ; however, the GUG recognizes that in clinical practice, expanding the definition to cases with <30 decibels of hearing loss may be considered. The GUG recognizes that the NIDCD definition (...) the systematic review or to fill gaps when a review was not available. An information specialist conducted a systematic literature search using a validated filter strategy to identify CPGs, systematic reviews, and RCTs published since the prior guideline (2012). Search terms used were as follows: (“Hearing Loss, Sudden”[Mesh] OR “sudden hearing loss”[ti] OR “sudden deafness”[ti] OR “sudden sensorineural hearing loss”[ti] OR “idiopathic sudden hearing loss”[ti]). These search terms were used to capture all

2019 American Academy of Otolaryngology - Head and Neck Surgery

118. Management of Nasopharyngeal Carcinoma

NPC. The most common presenting symptoms of NPC are: 4-6, level III; 8, level III • neck lump/mass (42 - 80.8%) - always painless, can be unilateral or bilateral • nasal symptoms (26 - 49.8%) - blood-stained nasal dischar ge or saliva, unilateral nose block, epistaxis or bad breath • ear symptoms (11 - 48.4%) - ear block, deafness, tinnitus or pain; the symptoms are usually unilateral but can be bilateral as the disease progresses • ophthalmo-neurologic symptoms (11 - 14.6%) - unilateral head ache

2016 Ministry of Health, Malaysia

119. Consent for anaesthesia 2 revised edition 2006

of anaesthesia), disability (stroke, deafness and blindness) should be provided Consent A5 10/1/06 15:49 Page 14in written information, as should the very small risk of death. It is good practice to include an estimate of the incidence of the risk [22]. Anaesthetists must be prepared to discuss these risks at the pre-operative visit if the patient asks about them; • specific risks or complications that may be of increased significance to the patient, for example, the risk of vocal cord damage if the patient

2006 Association of Anaesthetists of GB and Ireland

120. Child maltreatment - recognition and management

of fractures or bleeding disorders. Family history of clotting disorders, metabolic disease, fractures, blue sclera, and deafness (to exclude osteogenesis imperfecta). Signs that may alert a clinician to the possibility of child maltreatment can include: Frequent attendance or unusual patterns of presentation to healthcare services, often due to injuries/features that may suggest physical or sexual abuse, neglect, or less commonly, fabricated or induced illness. For further information, see the sections

2019 NICE Clinical Knowledge Summaries

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