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Pilot Study of a Nasal Airway Stent for the Treatment on Obstructive Sleep
Diso ep rde le rs S f & o T l h a e n r r a u p Hirata and Satoh, J Sleep Disord Ther 2015, 4:4 o y Journal of Sleep Disorders & Therapy J DOI: 10.4172/2167-0277.1000207 ISSN: 2167-0277 Research Article Open Access Pilot Study of a Nasal Airway Stent for the Treatment on Obstructive Sleep Apnea Yumi Hirata1* and Makoto Satoh2,3* 1Division of Sleep Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan 2International Institute for Integrative Sleep Medicine, University of Tsukuba, Japan 3Ibaraki Prefectural Center for Sleep Medicine and Sciences, Japan *Corresponding author: Makoto Satoh and Yumi Hirata, International Institute for Integrative Sleep Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan, Tel: +81 29 853 5643, fax: +81 29 853 5643; E-mail: [email protected], [email protected] Received date: May 26, 2015, Accepted date: Jun 27 2015, Published date: Jul 05, 2015 Copyright: © 2015 Hirata Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Study background: Obstructive sleep apnea (OSA) is a common disease characterized by repetitive upper airway obstruction during sleep. OSA is associated with an increased risk of cardiovascular morbidity. Continuous positive airway pressure (CPAP) has been established as a standard therapy for OSA, but it is not always tolerated by OSA patients. Objective: In a pilot study, we evaluated the therapeutic effects of the nasal airway stent (NAS), a new nasopharyngeal device placed in the nasopharynx, on OSA and snoring. -
The Nosebleed Feeling
February 2018 Academic Emergency Medicine Editor-in-Chief Pick of the Month The Nosebleed Feeling This month, I chose a paper about nosebleeds. (May I proffer from the outset, that I am avoiding the word “picked”). I admit that the problem of bleeding noses does not generate the enthusiasm of an ED thoracotomy, nor have the public health importance of opiate use. But what if I told you that your next patient is an unhappy bounce back epistaxis on Plavix? You are thinking “B-but, the other side has open beds!” Admit it. Nosebleeds are a pain for everyone. Especially the poor patient. That sentiment is why I picked--I mean, chose--the paper by Zahed et al, and why I also asked Michael Runyon to write a commentary about this paper (Topical tranexamic acid for epistaxis in patients on antiplatelet drugs: a new use for an old drug). The work by Zahed et al, may accomplish something that few papers do, and that is prompt an actual change in practice for a few folks. At the least, this paper should get your attention for a minute. Well, maybe it won’t get your attention. Maybe you’ve never experienced the nosebleed feeling. The nosebleed feeling is the dark sensation that creeps up inside you, as you witness the world’s worst parade. The world’s worst parade is led by the triage nurse, who strolls by first, holding paperwork in hand like a baton, glancing the rueful “you are screwed” glance your way. Marching onward to room 36, on your side of course, with the sorrowful procession in tow. -
Please Check All the Symptoms That Apply for the Past 3-6 Months. Patient Name
Review of Systems: Please check all the symptoms that apply for the past 3-6 months. Constitutional: Gastrointestinal: Dermatologic: o Loss of appetite o Blood in stool o Significant sun o Chills o Change in bowel habits exposure/sun burns o Fever o Difficulty swallowing o Change in moles o Weight gain o Abdominal pain o New skin lesions o Weight loss o Nausea o Night sweats o Vomiting Neurologic: Ophthalmologic: o Diarrhea o New headaches o Loss of vision o Constipation o Weakness on one side o Double vision o Gas and bloating o Seizures o Jaundice Ears, Nose & Throat: o Heartburn Psychological: o Nosebleed o Belching o Emotional abuse o Snoring o Stool incontinence o High stress level o Postnasal drip o Physical abuse o Hearing loss Urologic: o Sexual abuse o Voice changes o Difficulty urinating o Sleep disturbances o Blood in urine o Are you a worrier Cardiac: o Urinary urgency o Depression o Chest pain with activity o Painful urination o Do you feel anxious o Leg swelling o Frequent urination o Shortness of breath while o Recurrent urinary tract infections Endocrine: sleeping o Fatigue o Shortness of breath with Breast: o Heat intolerance activity o Breast lump o Racing heart o Chest pain o Nipple Discharge o Cold intolerance o Palpitations o Nipple inversion o Mammogram Allergy: Respiratory: o Sinus congestion o Chest pain with breathing Female Reproductive: o Stuffy nose o Shortness of breath o Sexually active o Itchy eyes o Cough o Regular periods LMP_________ o Runny nose o Wheezing o Irregular periods o Scratchy throat o Hot flashes o Decrease sex drive Hematologic\Lymphatic: Musculoskeletal: o Painful intercourse o Joint pain o Mood disturbances o Blood clots o Muscle pain o Excessive bleeding o Bone pain Male Reproductive: o Hepatitis exposure o Joint swelling o Difficulty with erection o HIV risk\exposure o Decrease sex drive o MRSA infections o Recent antibiotics o anemia o Swollen glands Patient name:___________________________________________________DOB:________________ Today’s date:____________________ . -
Information for the User FROVEX 2.5 Mg Film-Coated Tablets
Package leaflet: Information for the user If you have any doubt about taking other medicines with FROVEX 2.5 mg tablets, consult your doctor or pharmacist. FROVEX 2.5 mg film-coated tablets frovatriptan FROVEX with food and drink FROVEX 2.5 mg tablets can be taken with food or on an empty stomach, always with Read all of this leaflet carefully before you start taking this medicine because it an adequate amount of water. contains important information for you. - Keep this leaflet. You may need to read it again. Pregnancy and breast-feeding - If you have any further questions, ask your doctor or pharmacist. If you are pregnant or breast-feeding, think you may be pregnant or are planning to - This medicine has been prescribed for you only. Do not pass it on to others. It may have a baby, ask your doctor or pharmacist for advice before taking this medicine. harm them, even if their signs of illness are the same as yours. FROVEX 2.5 mg tablets should not be used during pregnancy or when breast feeding, - If you get any side effects, talk to your doctor or pharmacist. This includes any unless you are told so by your doctor. In any case, you should not breastfeed for 24 possible side effects not listed in this leaflet. See section 4. hours after taking FROVEX and during this time any breast milk expressed should be discarded. What is in this leaflet: 1. What FROVEX is and what it is used for Driving and using machines 2. What you need to know before you take FROVEX FROVEX 2.5 mg tablets and the migraine itself can cause drowsiness. -
The Hematological Complications of Alcoholism
The Hematological Complications of Alcoholism HAROLD S. BALLARD, M.D. Alcohol has numerous adverse effects on the various types of blood cells and their functions. For example, heavy alcohol consumption can cause generalized suppression of blood cell production and the production of structurally abnormal blood cell precursors that cannot mature into functional cells. Alcoholics frequently have defective red blood cells that are destroyed prematurely, possibly resulting in anemia. Alcohol also interferes with the production and function of white blood cells, especially those that defend the body against invading bacteria. Consequently, alcoholics frequently suffer from bacterial infections. Finally, alcohol adversely affects the platelets and other components of the blood-clotting system. Heavy alcohol consumption thus may increase the drinker’s risk of suffering a stroke. KEY WORDS: adverse drug effect; AODE (alcohol and other drug effects); blood function; cell growth and differentiation; erythrocytes; leukocytes; platelets; plasma proteins; bone marrow; anemia; blood coagulation; thrombocytopenia; fibrinolysis; macrophage; monocyte; stroke; bacterial disease; literature review eople who abuse alcohol1 are at both direct and indirect. The direct in the number and function of WBC’s risk for numerous alcohol-related consequences of excessive alcohol increases the drinker’s risk of serious Pmedical complications, includ- consumption include toxic effects on infection, and impaired platelet produc- ing those affecting the blood (i.e., the the bone marrow; the blood cell pre- tion and function interfere with blood cursors; and the mature red blood blood cells as well as proteins present clotting, leading to symptoms ranging in the blood plasma) and the bone cells (RBC’s), white blood cells from a simple nosebleed to bleeding in marrow, where the blood cells are (WBC’s), and platelets. -
L121 Session: L193 It Is Just a Nosebleed Isn't
Session: L121 Session: L193 It Is Just a Nosebleed Isn’t It? Anesthetic Considerations for Unsuspected Pulmonary Hypertension Shu Ming Wang, M.D. University of California Irvine Medical Center, Orange, CA Disclosures: This presenter has no financial relationships with commercial interests Stem Case and Key Questions Content A 6 year-old girl presents for emergency examination under anesthesia and control of epistaxis. History of present illness: The patient has uncontrolled epistaxis. What are the common causes of epistaxis? Past medical history: The patient has no significant medical history. Mom states that the patient has frequent nosebleeds that are easily stopped, but not this time. Mom also adds that the patient does not eat much, and usually is not very active because she gets tired easily. Is it common behavior for a 6 year-old child? Patient’s mom states that they recently immigrated to the United States. She was seen by pediatrician in the clinic 2 months prior and referred for further evaluation by a heart specialist because of murmur. Does every child with heart murmur required cardiologist consultation and evaluation? If not, who should be referred? Who should not. The appointment is scheduled in two weeks. The rest of the medical history is unremarkable, except that the patient has missed school due of inability to clear persistent cold. What are the common reasons for a child hard to recover from URI? Pre-op holding: Patient is tearing and clinging to her mom. Blood streak over lower face, bloody tissues and bloodstained clothing noted in the OR holding. The anesthesiologist attempts to perform a physical examination, but the child traumatized by previous attempts is extremely uncooperative, and now there is more bleeding. -
Factors Associated with Pleurisy in Pigs: a Case-Control Analysis of Slaughter Pig Data for England and Wales
Aus dem Zentrum für Klinische Tiermedizin der Tierärztlichen Fakultät der Ludwig-Maximilians-Universität München Arbeit angefertigt unter der Leitung von Prof. Dr. Mathias Ritzmann Angefertigt am Cambridge Infectious Diseases Consortium, University of Cambridge, Department of Veterinary Medicine, Cambridge, UK (Dr. A W (Dan) Tucker) Factors associated with pleurisy in pigs: A case-control analysis of slaughter pig data for England and Wales Inaugural-Dissertation zur Erlangung der tiermedizinischen Doktorwürde der Tierärztlichen Fakultät der Ludwig-Maximilians-Universität München Von Henrike Caroline Jäger aus Wiesbaden München 2012 Gedruckt mit der Genehmigung der Tierärztlichen Fakultät der Ludwig-Maximilians-Universität München Dekan: Univ.-Prof. Dr. Joachim Braun Berichterstatter: Univ.-Prof. Dr. Mathias Ritzmann Korreferent: Univ.-Prof. Dr. Dr. habil. Manfred Gareis Tag der Promotion: 9. Februar 2013 Meinem Vater Dr. med Sepp-Dietrich Jäger Table of Contents 4 TABLE OF CONTENTS I. INTRODUCTION ...................................................................................... 7 II. LITERATURE OVERVIEW .................................................................... 8 1. Anatomy and Physiology of the Pleura ....................................................8 2. Pleurisy ........................................................................................................9 2.1. Morphology ..................................................................................................9 2.2. Prevalence ..................................................................................................11 -
Nosebleed (Epistaxis): Learn About Causes and Treatment
© 2015 WebMD, LLC. All rights reserved. Nosebleed (Epistaxis) Nosebleed Overview Nosebleed Causes Nosebleeds in Children Nosebleed Symptoms When to Seek Medical Care Nosebleed Diagnosis Nosebleed Self-Care at Home Nosebleed Medical Treatment Nosebleed Follow-up Nosebleed Prevention Nosebleed Prognosis Read more on Nosebleeds from Healthwise Nosebleed Overview Nosebleeds (epistaxis, nose bleed) can be dramatic and frightening. Fortunately, most nosebleeds are not serious and usually can be managed at home, although sometimes medical intervention may be necessary. Nosebleeds are categorized based on where they originate, and are described as either anterior (originating from the front of the nose) or posterior (originating from the back of the nose). Anterior nosebleeds make up most nosebleeds. The bleeding usually originates from a blood vessel on the nasal septum, where a network of vessels converge (Kiesselbach plexus). Anterior nosebleeds are usually easy to control, either by measures that can be performed at home or by a health care practitioner. Posterior nosebleeds are much less common than anterior nosebleeds. They tend to occur more often in elderly people. The bleeding usually originates from an artery in the back part of the nose. These nosebleeds are more complicated and usually require admission to the hospital and management by an otolaryngologist (an ear, nose, and throat specialist). Nosebleeds tend to occur more often during winter months and in dry, cold climates. They can occur at any age, but are most common in children aged 2 to 10 years and adults aged 50 to 80 years. For unknown reasons, nosebleeds most commonly occur in the morning hours. Nosebleed Causes Most nosebleeds do not have an easily identifiable cause. -
What Is Pertussis (Whooping Cough)?
American Thoracic Society PATIENT EDUCATION | INFORMATION SERIES What Is Pertussis (Whooping Cough)? Pertussis is a very contagious respiratory infection commonly known as ‘whooping cough’. It is caused by a bacterium called Bordetella pertussis. The infection became much less common after a successful vaccine was developed and given to children to help prevent infection. However, in recent years, the number of people infected with pertussis has increased and now is at the highest rate seen since the 1950’s. There is concern that this is due mainly to people not taking the pertussis (whooping cough) vaccination and adults who have not had a booster and their immune protection has weakened with age. Whooping cough usually starts as a mild cold-like illness get in the air. If you are close enough, you can breathe in these (upper respiratory infection). The pertussis bacteria enter the droplets or they can land on your mouth, nose, or eye. You lungs and cause swelling and irritation in the airways leading can also get the infection if you kiss the face of a person with to severe coughing fits. At times, people with whooping pertussis or get infected nose or mouth secretions on your cough can have a secondary pneumonia from other bacteria hands and then touch your own face to rub your eyes or nose. while they are ill. Whooping cough can cause very serious A person with pertussis can remain contagious for many weeks illness. It is most dangerous in young babies and can result unless treated with an antibiotic. in death. It spreads very easily and people who have the infection can still spread it to others for weeks after they What are the symptoms of Pertussis infection? become sick. -
Medical Terminology Information Sheet
Medical Terminology Information Sheet: Medical Chart Organization: • Demographics and insurance • Flow sheets • Physician Orders Medical History Terms: • Visit notes • CC Chief Complaint of Patient • Laboratory results • HPI History of Present Illness • Radiology results • ROS Review of Systems • Consultant notes • PMHx Past Medical History • Other communications • PSHx Past Surgical History • SHx & FHx Social & Family History Types of Patient Encounter Notes: • Medications and medication allergies • History and Physical • NKDA = no known drug allergies o PE Physical Exam o Lab Laboratory Studies Physical Examination Terms: o Radiology • PE= Physical Exam y x-rays • (+) = present y CT and MRI scans • (-) = Ф = negative or absent y ultrasounds • nl = normal o Assessment- Dx (diagnosis) or • wnl = within normal limits DDx (differential diagnosis) if diagnosis is unclear o R/O = rule out (if diagnosis is Laboratory Terminology: unclear) • CBC = complete blood count o Plan- Further tests, • Chem 7 (or Chem 8, 14, 20) = consultations, treatment, chemistry panels of 7,8,14,or 20 recommendations chemistry tests • The “SOAP” Note • BMP = basic Metabolic Panel o S = Subjective (what the • CMP = complete Metabolic Panel patient tells you) • LFTs = liver function tests o O = Objective (info from PE, • ABG = arterial blood gas labs, radiology) • UA = urine analysis o A = Assessment (Dx and DDx) • HbA1C= diabetes blood test o P = Plan (treatment, further tests, etc.) • Discharge Summary o Narrative in format o Summarizes the events of a hospital stay -
Laryngotracheitis Caused by COVID-19
Prepublication Release A Curious Case of Croup: Laryngotracheitis Caused by COVID-19 Claire E. Pitstick, DO, Katherine M. Rodriguez, MD, Ashley C. Smith, MD, Haley K. Herman, MD, James F. Hays, MD, Colleen B. Nash, MD, MPH DOI: 10.1542/peds.2020-012179 Journal: Pediatrics Article Type: Case Report Citation: Pitstick CE, Rodriguez KM, Smith AC, Herman HK, Hays JF, Nash CB. A curious case of croup: laryngotracheitis caused by COVID-19. Pediatrics. 2020; doi: 10.1542/peds.2020-012179 This is a prepublication version of an article that has undergone peer review and been accepted for publication but is not the final version of record. This paper may be cited using the DOI and date of access. This paper may contain information that has errors in facts, figures, and statements, and will be corrected in the final published version. The journal is providing an early version of this article to expedite access to this information. The American Academy of Pediatrics, the editors, and authors are not responsible for inaccurate information and data described in this version. Downloaded from©2020 www.aappublications.org/news American Academy by of guest Pediatrics on September 30, 2021 Prepublication Release A Curious Case of Croup: Laryngotracheitis Caused by COVID-19 Claire E. Pitstick, DO, Katherine M. Rodriguez, MD, Ashley C. Smith, MD, Haley K. Herman, MD, James F. Hays, MD, Colleen B. Nash, MD, MPH Affiliations: Rush University Medical Center, Division of Pediatrics, Chicago, Illinois Address Correspondence to: Claire E. Pitstick, Department of Pediatrics, Rush University Medical Center, 1645 W Jackson Blvd Ste 200, Chicago, IL 60612 [[email protected]], 312-942-2200. -
Guidelines for Management of Common Ent Conditions in Primary Care
GUIDELINES FOR MANAGEMENT OF COMMON ENT CONDITIONS IN PRIMARY CARE 1 CONTENTS Page Introduction 3 How to use this guideline 3 On Call Arrangements for ENT 4 Pathways Nasal blockage / discharge +/-facial pain in adults 5 Nasal trauma (adults) 6 Hearing problems in children 7 Hearing problems in adults 8 Infectious sore throat in adults 9 Non-infectious sore throat in adults 10 Acute nose bleeds 11 Chronic recurrent nose bleeds 12 Vertigo 13 Hoarse voice in adults 14 Feeling of something stuck in the throat 15 Management of discharging ear 16 Primary care management of snoring in adults 17 Tonsil size grading 18 Examination of pharynx 19 Malocclusion examples 20 Appendices 21 Direct Access Audiology Leaflet Community Microsuction Service Case Studies Membership of the guideline development group Date of review 2 INTRODUCTION This guidance is intended to inform initial management of common ENT conditions and has been developed as a consensus between representatives from primary and secondary care, with reference to national guidelines, including from NICE and SIGN. It is intended to guide clinical management, but every patient should be assessed and managed individually. This guideline is intended for all clinicians in the Nottinghamshire area involved in managing patients with ENT conditions. HOW TO USE THE GUIDELINES The guideline is a set of flow charts covering a variety of ENT conditions. Each of these can be printed and laminated for easy reference if preferred. The BNF and the local Formulary should be referred to as appropriate.