Otology
Adnan Darr, Karan Jolly, Jameel Muzaffar in ENT Vivas, 2023
Contraindications: Bone disease where skull is too thin to support BAHA implant e.g. osteogenesis imperfecta<3 yrs. Usually 4–5 yrs to allow optimal bone thickness of 4 mm Two-stage procedure with sleeper screw with 3-month interval to reduce OI failureMicrotia: Consider post-aural flaps, MDT for positioning, delay after 6 yrs (95% adult size)Chronic skin disordersRelative contraindications: Psychiatric disease or psychological immaturityAlcohol/drug abuse
Critical Care and Anaesthesia
Tjun Tang, Elizabeth O'Riordan, Stewart Walsh in Cracking the Intercollegiate General Surgery FRCS Viva, 2020
What are the contraindications for siting an epidural?The contraindications may be divided into absolute and relative:Absolute: Sepsis at planned siteCoagulopathyRaised ICPPatient refusalRelative AnticoagulationSystemic sepsisPrevious spinal surgeryPlanned ITU sedationAortic stenosis (cannot tolerate resulting hypotension)
Radionuclide scanning in the diagnosis and treatment of endocrine disorders
Philip E. Harris, Pierre-Marc G. Bouloux in Endocrinology in Clinical Practice, 2014
Life expectancy >3 months, tumor uptake on the OctreoScan should be at least as high as normal liver uptake and inoperable disease.48 Contraindications (both relative and absolute): Pregnancy and breastfeedingRenal impairmentImpaired hematological functionSevere hepatic impairmentSevere cardiac impairment
Current advances in the management of cluster headaches
Published in Expert Opinion on Pharmacotherapy, 2021
Theodoros Mavridis, Marianthi Breza, Christina Deligianni, Dimos D. Mitsikostas
Ergot derivatives such as oral ergotamine and intranasal or intravenous dihydroergotamine (DHE) have been used as a treatment for CH bouts but with little evidence of clear efficacy. The initial dose of oral ergotamine is 2 mg sublingual and can be repeated every 30 minutes with a max dose of 6 mg daily. Intranasal DHE has a level U recommendation from the AHS [29], denoting insufficient evidence to make. Intravenous DHE has shown better results for inpatient management of the refractory episodic CH [40]. The initial dose of DHE is 1 mg IV bolus and can be repeated after 1 hour with a max dose of 3 mg per day. Ergots can also induce medication overuse headache (MOH) with very low doses and their use must be limited to less than 10 days per month. Contraindications are coronary artery disease due to the constriction of the coronal vessels [41], arterial hypertension, and cerebrovascular diseases. Due to their impact on the vascular system, they should not be used in combination with other vasoconstrictor drugs. Other contraindications include Raynaud disease, renal or hepatic failure, pregnancy, and lactation [27,36].
Non-interventional observational study broadens positive benefit-risk assessment of an immunomodulating herbal remedy in the common cold
Published in Current Medical Research and Opinion, 2019
Hans-Heinrich Henneicke-von Zepelin, Petra Nicken, Belal Naser, Jennifer-Christin Kuchernig, Nicole Brien, Annette Holtdirk, Jörg Schnitker, Klaus-Ulrich Nolte
Esberitox Compact is used for supportive therapy of viral common colds. One tablet contains 16 mg of a native dry extract (drug extract ratio 4–9:1) from Baptisia tinctoria root, Echinacea purpurea root/Echinacea pallida root, and Thuja occidentalis tips and leaves at a ratio of 4.92:1.85:1.85:1. The extraction solvent is ethanol 30% (V/V). This product holds a marketing authorization from the relevant regulatory authorities who received the dossier on its pharmaceutical quality. The recommended dosage is one tablet three times daily for adults and adolescents (≥12 years). Contraindications are hypersensitivity to any of the active substances or excipients and pre-existing illnesses like progressive systemic diseases, autoimmune diseases, acquired immunodeficiency, immunosuppression or hematological diseases of the white blood cell system. The patients were referred to the PIL (therein, for example, treatment duration of up to 10 days is recommended) but were not given any further instructions (Supplemental data B). A real-life setting was intended.
The role of pleurodesis in respiratory diseases
Published in Expert Review of Respiratory Medicine, 2018
Rachel M. Mercer, Maged Hassan, Najib M. Rahman
There are no absolute contraindications, but a number of factors must be considered in certain groups. Many centers which provide lung transplantation services advice against pleurodesis, especially chemical pleurodesis, for patients who are likely to need lung transplantation in the future. This is due to adhesions being thought to cause an increased risk of bleeding and operative complications. A small study of 48 patients failed to show increased adverse outcomes in patients who had undergone previous pleural interventions, including chemical pleurodesis, compared to those who had no history of pleural intervention [5]. This has been borne out in numerous other small studies [6,7], although there are no studies which report the outcomes after chemical pleurodesis in isolation. Many transplant centers no longer view talc pleurodesis as an absolute contraindication.
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