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Total 318 results found since Jan 2013.

Surgical Masks May Hide Neurological Diagnoses
We present a case that highlights one of the many ways in which the pandemic has negatively impacted the care of the non-COVID patient. A patient presented to the ED with a chief complaint of diffuse weakness and a new-onset cough on awakening. His daughter noted that he was slurring his words. An emergency medicine resident evaluated him, ordered laboratory studies, and decided to monitor the patient. The same resident later noted the patient veering to the left when walking, prompting a more detailed neurological examination. On removing the patient ’s facemask, a left lower facial weakness was evident. The resident ca...
Source: Case Reports in Neurology - September 30, 2022 Category: Neurology Source Type: research

‘A clear case of chronic aspiration of starch (potato)’
In June 2011 a 74 years old‐non smoker woman came to our attention complaining for months dyspnea and dry cough resistant to nonspecific antibiotic therapy (amoxicillin/clavulanic acid and levofloxacin, prescribed by her physician, for 10 days). She had no history of respiratory diseases; she had instead history of cerebri stroke (in March 2006), without neurological outcome, and throat cancer treated with radiotherapy 10 years before. When she came to our attention, physical examination showed dry crackles bilaterally in the lower lung fields. Pulmonary function test showed a mild restrictive respiratory pattern while t...
Source: The Clinical Respiratory Journal - April 11, 2013 Category: Respiratory Medicine Authors: A. Andreani, G. Cappiello, M. Valli, E. Businarolo, R. Melara, M. Giovannini, G. Rossi Tags: Forum Source Type: research

Short answer question case series: a dangerous cause of dyspnoea
Case vignette A 52-year-old man with hepatitis C and a remote history of recreational drug abuse presents with several days of shortness of breath, cough and malaise. He was seen at an outside hospital and diagnosed with pneumonia given his cough and shortness of breath. Subsequently, he was seen again and found to have a small abscess of his arm that was drained. On review of systems, he endorses nausea and generalised weakness but denies abdominal pain, chest pain, numbness, fever, headache or dizziness. On physical exam, he is afebrile but tachypnoeic, has decreased breath sounds at the bases, and has an appropriately h...
Source: Emergency Medicine Journal - July 19, 2013 Category: Emergency Medicine Authors: Woodfield, A., Runde, D., Jang, T. Tags: Poisoning/Injestion, Foodborne infections, Hepatitis and other GI infections, Pneumonia (infectious disease), TB and other respiratory infections, Cranial nerves, Headache (including migraine), Pain (neurology), Stroke, Drugs misuse (including addiction), Source Type: research

Applicability of the Two-Step Thickened Water Test in Patients With Poststroke Dysphagia: A Novel Assessment Tool for Paste Food Aspiration
This study evaluated the clinical usefulness of the newly developed Two-Step Thickened Water Test (TTWT) in identifying patients with poststroke dysphagia at risk of aspiration of paste food. The study subjects were 110 poststroke patients (mean age, 73 ± 10 years). The TTWT comprises a bedside pretest (tongue protrusion, vocalization, voluntary cough, and dry swallow) and a direct swallowing test using 4 mL of thickened water. Fiberoptic endoscopic evaluation of swallowing determined the subject's ability to swallow the paste food. Based on the test results and endoscopic evaluation, we calculated the TTWT's sensitivity ...
Source: Journal of Stroke and Cerebrovascular Diseases - June 21, 2012 Category: Neurology Authors: Ryo Momosaki, Masahiro Abo, Wataru Kakuda, Kazushige Kobayashi Tags: Original Articles Source Type: research

The Assassin: Chagas Cardiomyopathy
A 35-year-old Salvadoran woman had been hospitalized for heart failure multiple times over a 5-year period, yet the etiology of her disease remained elusive. She also had a history of stroke. Again, she presented to the emergency department with shortness of breath, chest pain, and fatigue. Although these symptoms were chronic, they had been increasing for 3 weeks prior to admission. The patient denied fevers, chills, cough, or gastrointestinal complaints. She had no history of smoking, alcohol consumption, or illicit drug use. Her medications included carvedilol, furosemide, and warfarin.
Source: The American Journal of Medicine - July 19, 2013 Category: Journals (General) Authors: Uppinder K. Mattu, Gagan D. Singh, Jeffrey A. Southard, Ezra A. Amsterdam Tags: Diagnostic dilemma Source Type: research

Stress cardiomyopathy following acute ischemic stroke during flexible bronchoscopy: a rare sequence of complications
We report three similar cases of cough-induced transdiaphragmatic intercostal hernia, highlighting the anatomic findings obtained with different imaging modalities (radiography, ultrasonography, CT, and magnetic resonance) in each of the cases.Hérnias intercostais transdiafragmáticas são eventos raros e são geralmente relacionadas a traumas abertos ou fechados, com risco de complicações. Relatamos três casos semelhantes, decorrentes de crises de tosse, destacando o aspecto das alterações anatômicas nos exames de imagem obtidos em cada situação (radiografia, ultrassonografia, TC e ressonância magnética)
Source: Jornal Brasileiro de Pneumologia - September 26, 2013 Category: Respiratory Medicine Source Type: research

Spontaneous intracranial hypotension: clinical features in eight cases
Conclusions SIH is an under–recognised but fairly common disorder. Clinical examination is usually normal, and confirmation of the diagnosis requires investigations and treatment not used routinely in the management of headache. Investigations, including contrast–enhanced neuroimaging, are often normal in the acute or chronic phase. Clinical history taking skills are therefore paramount in recognising this disorder. Characteristic features include a new daily persistent headache in a cranio–cervical distribution, with often bizarre sounding additional symptoms. Our results challenge the prevailing notions...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Anderson, J., Corkill, R. Tags: Headache (including migraine), Pain (neurology), Stroke, Ear, nose and throat/otolaryngology Association of British Neurologists (ABN) joint meeting with the Royal College of Physicians (RCP), London, 23-24 October 2013 Source Type: research

Stress cardiomyopathy following acute ischemic stroke during flexible bronchoscopy: a rare sequence of complications
We report three similar cases of cough-induced transdiaphragmatic intercostal hernia, highlighting the anatomic findings obtained with different imaging modalities (radiography, ultrasonography, CT, and magnetic resonance) in each of the cases.Hérnias intercostais transdiafragmáticas são eventos raros e são geralmente relacionadas a traumas abertos ou fechados, com risco de complicações. Relatamos três casos semelhantes, decorrentes de crises de tosse, destacando o aspecto das alterações anatômicas nos exames de imagem obtidos em cada situação (radiografia, ultrassonografia, TC e ressonância magnética)
Source: Jornal Brasileiro de Pneumologia - October 14, 2013 Category: Respiratory Medicine Source Type: research

In men and women with COPD the presence of urinary incontinence is associated with poorer quality of life
Commentary on: Hrisanfow E, Hägglund D. Impact of cough and urinary incontinence on quality of life in women and men with chronic obstructive pulmonary disease. J Clin Nurs 2013;22:97–105. Implications for practice and research The combination of coughing, as a result of chronic obstructive pulmonary disease (COPD), and urinary incontinence (UI), can adversely affect quality of life. Healthcare providers must actively screen for UI in patients who smoke, have a chronic cough and/or who are diagnosed with COPD, as early treatment may improve quality of life. Context It is estimated that worldwide, over 200 milli...
Source: Evidence-Based Nursing - December 10, 2013 Category: Nursing Authors: Newman, D. K. Tags: Primary health care, Stroke, Incontinence, Pregnancy, Reproductive medicine, Health education, Smoking, Tobacco use Primary healthcare Source Type: research

Polymethylmethacrylate cement pulmonary embolism and infarct
Discussion Pulmonary cement emboli can occur in up to 23% of percutaneous vertebroplasty.1 This procedure is widely used making emergency practitioner recognition of complications important. Most complications are related to leakage of the bone cement into the venous system. Pulmonary migration...
Source: Emergency Medicine Journal - February 13, 2014 Category: Emergency Medicine Authors: Stevens, A. C. Tags: Fractures, Drugs: cardiovascular system, Pain (neurology), Stroke, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests, Radiology (diagnostics), Ethics, Trauma Images in emergency medicine Source Type: research

The effects of a xanthan gum‐based thickener on the swallowing function of patients with dysphagia
ConclusionsResource ThickenUp Clear improves the safety of swallow without increasing residue providing a viscosity‐dependent therapeutic effect for patients with oropharyngeal dysphagia. At nectar viscosity, the effect is due to intrinsic texture properties, spoon‐thick viscosity adding changes in swallow physiology. NCT01158313.
Source: Alimentary Pharmacology and Therapeutics - March 13, 2014 Category: Drugs & Pharmacology Authors: L. Rofes, V. Arreola, R. Mukherjee, J. Swanson, P. Clavé Tags: Original Article Source Type: research

A Case of Sinus Arrest and Post-hiccup Cough Syncope in Medullary Infarction
We describe asymptomatic sinus arrest and post-hiccup cough syncope in a patient with medullary infarction. A 78-year-old woman developed arrhythmia, hiccup, and cough syncope attacks. Neurological examination was not remarkable. Cough syncope occurs after hiccup attacks. Bradycardia and decreased blood pressure were also present after the beginning cough. Holter 24-hour electrocardiography monitor exhibited 65 episodes of asymptomatic sinus arrest more than 3 seconds. Magnetic resonance imaging disclosed acute infarction in the bilateral medial regions and the right tegmentum of the upper and middle medulla oblongata. Ce...
Source: Journal of Stroke and Cerebrovascular Diseases - May 8, 2013 Category: Neurology Authors: Takanori Takazawa, Ken Ikeda, Osamu Kano, Takayuki Kabuki, Kiyokazu Kawabe, Yasuo Iwasaki Tags: Case Reports Source Type: research

Pheochromocytoma crisis resulting in acute heart failure and cardioembolic stroke in a 37-year-old man
A previously healthy, 37-year-old man presented to his primary care physician with new-onset hypertension, cough, and dyspnea. He was initially diagnosed with asthma and was treated with inhalation corticosteroids. Despite treatment, his symptoms worsened over a 3-month period. Although previously athletic, he developed exercise intolerance, orthopnea, and paroxysmal nocturnal dyspnea. His symptoms prompted admission to a community hospital to rule out pulmonary embolism. Contrast computed tomography of the chest instead demonstrated a 5.3 × 4.8-cm left adrenal tumor ().
Source: Surgery - January 9, 2013 Category: Surgery Authors: Jenny K. Cohen, Robin M. Cisco, Anouk Scholten, Elliot Mitmaker, Quan-Yang Duh Tags: Images in Surgery Source Type: research

Gastroesophageal Reflux in Chronic Cough and Cough Syncope and the Effect of Antireflux Treatment: Case Report and Literature Review.
CONCLUSION: For chronic cough and cough syncope of unknown cause, the GER assessment could be valuable. In treating well-selected GER-related chronic cough and cough syncope, PPI, SRF, and LF can be considered. Moreover, satisfactory restoration of physical and social functions could be achieved after effective antireflux therapy. PMID: 24842868 [PubMed - as supplied by publisher]
Source: The Annals of Otology, Rhinology, and Laryngology - May 19, 2014 Category: ENT & OMF Authors: Hu ZW, Wang ZG, Zhang Y, Tian SR, Wu JM, Zhu GC, Liang WT Tags: Ann Otol Rhinol Laryngol Source Type: research

Question 2: Should children who have a febrile seizure be screened for iron deficiency?
Clinical scenario You are a senior house officer working in a busy district general hospital in the UK. A 2-year-old child presents following a generalised tonic-clonic seizure that lasted around 1 min. He had recently been unwell with a cough and runny nose and was febrile at the time of the seizure. He now appears well and is running around the ward. You diagnose a simple febrile seizure secondary to a viral upper respiratory tract infection and, as it his first episode, admit him for observation. The local hospital protocol on the management of febrile seizures states no investigations are required. However, your r...
Source: Archives of Disease in Childhood - September 11, 2014 Category: Pediatrics Authors: King, D., King, A. Tags: ADC Archimedes, Epidemiologic studies, TB and other respiratory infections, Drugs: CNS (not psychiatric), Epilepsy and seizures, Infection (neurology), Stroke, Malnutrition, Child and adolescent psychiatry (paedatrics), Child health Source Type: research