Hoarseness, laryngitis and dysphonia

SICS Editore
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In the treatment of laryngitis the most important advice to the patient is voice rest, to avoid coughing, clearing one's throat and whispering. Voice rest does not necessitate total avoidance of talking, only significant restriction. Antibiotics are not indicated. It is important to keep the mucosa of the vocal cords moist (inhalation of a humidifying aerosol; steam inhalation). Patients in professions with heavy vocal loading should have a sufficiently long sick leave, at least one week, in acute hoarseness. Voice amplifier reduces vocal loading and is thus an efficient aid in the treatment of voice disorders. Indirect laryngoscopy must always be performed if the hoarseness is not associated with a respiratory infection, and in all patients with hoarseness lasting for more than two weeks. If the vocal cords cannot be fully visualized at indirect laryngoscopy the patient should be referred to a phoniatrician or an ENT specialist. Hoarseness in children is an indication for consultation by a phoniatrician or an ENT specialist (indirect laryngoscopy is difficult to perform).
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SICS Editore
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Published on
Oct 1, 2014
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Medical / Infectious Diseases
Medical / Oncology
Medical / Otorhinolaryngology
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The aim in the prevention and treatment of osteoporosis is to prevent fractures.In prevention of osteoporosis on the population level it is essential to ensure sufficient intake of calcium and vitamin D and to advise proper exercise habits as well as cessation of smoking. Diagnosis of osteoporosis is the responsibility of primary care. Bone density measurements should be targeted at risk groups (see table ). General, non-targeted DXA-screening is not indicated . Bone density measurements targeted at persons with increased risk are cost-effective and should be a part of the public health care. The treatment yields most benefit for those patients who already have a history of a low energy fracture, usually after a fall on flat ground. Patients who have experienced such a fracture should be referred to bone density measurement or directly to treatment. They have a 2–4-fold risk of refracture. Causes of secondary osteoporosis should be identified and treated accordingly (e.g. hyperparathyroidism, hyperthyroidism, Cushing's syndrome, hypogonadism, uraemia, coeliac disease, myeloma, glucocorticoid therapy, rheumatoid arthritis). Bisphosphonates are the first line drugs in the treatment and prevention. Oestrogen therapy is suitable also in the prevention and treatment of osteoporosis in women who have postmenopausal symptoms that require treatment and who have no arterial disease. The success of pharmacological treatment is assessed by bone density measurements and, on the population level, by the decrease in complications.
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