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Ebell MH, Barry HC. Management of Sore Throat: Time to Update. Am Fam Physician 2024; 109:301-302. [PMID: 38648823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
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Hedin K. Sore throat-related infections - lessons learnt from non-pharmacological interventions and non-COVID-19 infections. Clin Microbiol Infect 2024; 30:18-19. [PMID: 37914084 DOI: 10.1016/j.cmi.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Affiliation(s)
- Katarina Hedin
- Futurum, Region Jönköping County, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden.
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Granjo Morais C, Martins A, Ganhão S, Aguiar F, Rodrigues M, Brito I. Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis recurrence temporally associated with allergen-specific immunotherapy in a female adolescent: a case report. Reumatismo 2023; 75. [PMID: 38115774 DOI: 10.4081/reumatismo.2023.1594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 10/01/2023] [Indexed: 12/21/2023] Open
Abstract
Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most common periodic fever syndrome in pediatric patients. It is clinically characterized by fever flares lasting 3-7 days, reappearing every 2-8 weeks with a distinctive clockwork regularity. PFAPA generally begins before 5 years of age and usually ceases 3-5 years after onset. Recurrences may be observed in adolescence and adulthood in up to 20% of cases. The authors aim to describe a case of PFAPA recurrence in adolescence temporally associated with allergen-specific immunotherapy (ASIT). A 16-year-old female patient was referred to the rheumatology unit due to recurrent episodes of fever one month after initiating ASIT for allergic rhinitis. These episodes occurred every 4 weeks and lasted 3 days. During these episodes, she also presented with a sore throat, tonsillar exudates, and cervical lymphadenopathy. Abortive treatment with oral prednisolone was attempted in these episodes, with complete resolution of fever after a single dose. After reviewing her medical background, she had previously experienced febrile episodes accompanied by aphthous ulcers and tonsillar exudates occurring every 7-8 weeks from age 2-7. The etiopathogenesis of PFAPA remains uncertain. Environmental triggers, particularly those with immunomodulator effects, may interfere with the immune responses responsible for PFAPA occurrence, but the mechanisms are still unclear. The authors describe the first report of the reappearance of PFAPA flares, possibly due to ASIT. Further studies are needed to fully clarify if ASIT constitutes a true environmental trigger of PFAPA.
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Affiliation(s)
- C Granjo Morais
- Department of Pediatrics, São João University Hospital Center, Porto.
| | - A Martins
- Department of Rheumatology, São João University Hospital Center, Porto.
| | - S Ganhão
- Pediatric and Young Adult Rheumatology Unit, São João University Hospital Center, Porto.
| | - F Aguiar
- Pediatric and Young Adult Rheumatology Unit, São João University Hospital Center, Porto.
| | - M Rodrigues
- Pediatric and Young Adult Rheumatology Unit, São João University Hospital Center, Porto.
| | - I Brito
- Pediatric and Young Adult Rheumatology Unit, São João University Hospital Center, Porto.
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Hausmann J, Dedeoglu F, Broderick L. Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis Syndrome and Syndrome of Unexplained Recurrent Fevers in Children and Adults. J Allergy Clin Immunol Pract 2023; 11:1676-1687. [PMID: 36958521 DOI: 10.1016/j.jaip.2023.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
Children and adults with autoinflammatory disorders, who often experience recurrent fevers, rashes, cold-induced symptoms, conjunctivitis, lymphadenopathy, recurrent infections, aphthous stomatitis, and abnormal blood cell counts, may present to the allergist/immunologist because the symptoms mimic allergies and disorders of immunity. In recent years, there has been increased recognition of non-monogenic autoinflammatory disorders, including periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome and syndrome of undifferentiated recurrent fevers. For many clinical practitioners, the natural history, diagnostic criteria, differential diagnoses, and preferred therapies remain challenging because of the presumed rarity of patients and the evolving field of autoinflammation. Here, we aim to provide a practical framework for the clinical allergist/immunologist to evaluate and treat this patient population.
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Affiliation(s)
- Jonathan Hausmann
- Department of Medicine, Harvard Medical School, Boston, Mass; Program in Rheumatology, Division of Immunology, Boston Children's Hospital, Boston, Mass; Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, Mass
| | - Fatma Dedeoglu
- Department of Medicine, Harvard Medical School, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - Lori Broderick
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, University of California-San Diego, La Jolla, Calif; Rady Children's Foundation, Rady Children's Hospital, San Diego, Calif.
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Tovmasyan AS, Filina EV, Golubeva LI, Golovatyuk AA, Ramazanov SR, Polyaeva MY, Kishinevskii AE, Shvedov NV, Mosin VV. [Chronic pharyngitis. Modern approaches to diagnosis and treatment]. Vestn Otorinolaringol 2023; 88:56-62. [PMID: 37450392 DOI: 10.17116/otorino20228803156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
The relevance of the problem of chronic inflammatory diseases of the pharynx is due to the significant prevalence of this pathology. Among all forms of chronic pharyngitis, the most adverse effect on the quality of life is observed in chronic athrophic pharyngitis. According to the literature, in this category of patients there are no clear criteria for assessing the functional state and morphological picture of the mucous membrane of the posterior pharyngeal wall. Most of the described signs of atrophic pharyngitis are insufficienyly informative, which necessitates further improvement of existing and possible search for new diagnostic methods. Many of the modern methods of treatment do not provide a lasting effect due to the presence of only a local effect on the altered mucous membrane of the posterior pharyngeal wall, without taking into account the changes that are caused by a violation of trophic processes in the tissue, which necessitates the search for new effective methods of treating this disease.The review article outlines modern ideas about the methods of diagnosis and treatment of chronic pharyngitis, presents promising areas in the treatment of patients with atrophic pharyngitis. In foreign countries, the term «chronic tonsillopharyngitis» is most often used. Due to the existing difference in terminology, the predominant part of the material on the problem of chronic pharyngitis is presented by domestic literature sources.
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Affiliation(s)
- A S Tovmasyan
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - E V Filina
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - L I Golubeva
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A A Golovatyuk
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - S R Ramazanov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - M Yu Polyaeva
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A E Kishinevskii
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - N V Shvedov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - V V Mosin
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
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van Dam-Kastelein J, Gorter-Houtman ND, Donker DW, Buwalda J, van Kempen PMW. [Acute sore throat, not always innocent]. Ned Tijdschr Geneeskd 2022; 166:D6897. [PMID: 36300468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Acute sore throat is one of the most common problems in general practice. It usually concerns a viral oropharyngeal infection, with good recovery within 10 days. In current guidelines, antibiotics are recommended only in exceptional situations. Although rare, potentially life-threatening complications can occur. Three case histories, on epiglottitis, peritonsillar abscess, and Lemierre syndrome, respectively, demonstrate that acute sore throat can result in severe illness. Early recognition of alarm symptoms, alertness on a complicated disease course, and clinical (re)evaluation (within 1-2 days), are essential. This contributes to the differentiation between a harmless and a serious course, given that serious conditions also have an innocent onset. We highly recommend to consult an ENT specialist when there is doubt about the seriousness of the disease, or correctness of therapy, so timely co-assessment, treatment or transfer can follow. ECMO can be a life-saving treatment when conventional therapy is insufficiently supportive.
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Affiliation(s)
- Jeanine van Dam-Kastelein
- Universitair Medisch Centrum Utrecht, afd. Intensive Care, Utrecht
- Contact: Jeanine van Dam-Kastelein
| | | | - Dirk W Donker
- Universitair Medisch Centrum Utrecht, afd. Intensive Care, Utrecht
| | - Joeri Buwalda
- Deventer Ziekenhuis, afd. Keel-, Neus-, Oorheelkunde en Heelkunde, Deventer
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Purrahman D, Poniatowski ŁA, Wojdasiewicz P, Fathi MR, Yousefi H, Lak E, Mahmoudian-Sani MR. The role of inflammatory mediators in the pathogenesis of periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome. Mol Biol Rep 2022; 49:8061-8069. [PMID: 35320440 DOI: 10.1007/s11033-022-07352-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION As a recurrent disease, periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is characterized by episodes of febrile attacks and is often prominent in children under five years of age. However, the etiology of this condition has not been fully understood yet. MATERIALS AND METHODS The search in the extensive literature of peer-reviewed articles published from the inception to December 2021 was conducted to identify the relevant studies, using the electronic databases of MEDLINE/PubMed, Embase, Scopus, the Cochrane Library, and the Web of Science. RESULTS The analysis of complex relationships indicates that inflammatory factors, such as various cytokines and acute-phase proteins (APPs), play leading roles in the pathogenesis of this disease. Accordingly, this article summarizes the current state of knowledge to explain the mechanisms involved in inflammatory responses among patients with PFAPA syndrome and investigate its role in the pathogenesis of this disease. Moreover, the possibilities for further implementation of new therapeutic strategies are pointed out. CONCLUSION It is concluded that some pathophysiological processes are associated with immune dysregulation, which itself may be secondary to environmental factors, genetic background, and underlying diseases, including latent infections that multiply inflammatory mediators. elevated inflammatory markers similarly play a significant part in the clinical outcomes of this condition, whose pyrogenic nature is the reason for the development of episodes of febrile attacks in the population of patients suffering from PFAPA syndrome.
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Affiliation(s)
- Daryush Purrahman
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Łukasz A Poniatowski
- Department of Neurosurgery, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Piotr Wojdasiewicz
- Department of Biophysics, Physiology and Pathophysiology, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Mohammad-Reza Fathi
- Department of Pediatric Neurology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Homayon Yousefi
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elena Lak
- Department of Internal Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad-Reza Mahmoudian-Sani
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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House SA, Hall M, Ralston SL, Marin JR, Coon ER, Schroeder AR, De Souza HG, Davidson A, Duda P, Ho T, Genies MC, Mestre M, Reyes MA. Development and Use of a Calculator to Measure Pediatric Low-Value Care Delivered in US Children's Hospitals. JAMA Netw Open 2021; 4:e2135184. [PMID: 34967884 PMCID: PMC8719236 DOI: 10.1001/jamanetworkopen.2021.35184] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE The scope of low-value care in children's hospitals is poorly understood. OBJECTIVE To develop and apply a calculator of hospital-based pediatric low-value care to estimate prevalence and cost of low-value services. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study developed and applied a calculator of hospital-based pediatric low-value care to estimate the prevalence and cost of low-value services among 1 011 950 encounters reported in 49 US children's hospitals contributing to the Pediatric Health Information System (PHIS) database. To develop the calculator, a multidisciplinary stakeholder group searched existing pediatric low-value care measures and used an iterative process to identify and operationalize relevant hospital-based measures in the PHIS database. Children with an eligible encounter in 2019 were included in the calculator-applied analysis. Two cohorts were analyzed: an emergency department cohort (with encounters resulting in emergency department discharge) and a hospitalized cohort. EXPOSURES Eligible condition-specific hospital encounters. MAIN OUTCOMES AND MEASURES The proportion and volume of encounters in which low-value services were delivered and their associated standardized costs. Measures were ranked by those outcomes. RESULTS There were 1 011 950 encounters eligible for 1 or more of 30 calculator-included measures in 2019; encounters were incurred by 816 098 unique patients with a median age of 3 years (IQR, 1-8 years). In the emergency department cohort, low-value services delivered in the greatest percentage of encounters were Group A streptococcal testing among children younger than 3 years with pharyngitis (3679 of 9785 [37.6%]), computed tomography scan for minor head injury (7541 of 42 602 [17.7%]), and bronchodilators for treatment of bronchiolitis (8899 of 55 616 [16.0%]). In the hospitalized cohort, low-value care was most prevalent for broad-spectrum antibiotics in the treatment of community-acquired pneumonia (3406 of 5658 [60.2%]), acid suppression therapy for infants with esophageal reflux (3814 of 7507 of [50.8%]), and blood cultures for uncomplicated community-acquired pneumonia (2277 of 5823 [39.1%]). Measured low-value services generated nearly $17 million in total standardized cost. The costliest services in the emergency department cohort were computed tomography scan for abdominal pain (approximately $1.8 million) and minor head injury (approximately $1.5 million) and chest radiography for asthma (approximately $1.1 million). The costliest services in the hospitalized cohort were receipt of 2 or more concurrent antipsychotics (approximately $2.4 million), and chest radiography for bronchiolitis ($801 680) and asthma ($625 866). CONCLUSIONS AND RELEVANCE This cross-sectional analysis found that low-value care for some pediatric services was prevalent and costly. Measuring receipt of low-value services across conditions informs prioritization of deimplementation efforts. Continued use of this calculator may establish trends in low-value care delivery.
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Affiliation(s)
- Samantha A. House
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
- Children’s Hospital at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | | | | | - Eric R. Coon
- Department of Pediatrics, University of Utah, Salt Lake City
| | | | | | | | - Patti Duda
- Children’s Hospital Association, Lenexa, Kansas
| | - Timmy Ho
- Division of Newborn Medicine, Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Marquita C. Genies
- Department of Pediatrics, Johns Hopkins Medical School, Baltimore, Maryland
| | - Marcos Mestre
- Department of Pediatrics, Division of Hospital Medicine, Nicklaus Children’s Hospital, Miami, Florida
| | - Mario A. Reyes
- Department of Pediatrics, Division of Hospital Medicine, Nicklaus Children’s Hospital, Miami, Florida
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Stein E, Pulle J, Zimmerman M, Otim I, Atala J, Rwebembera J, Oyella LM, Harik N, Okello E, Sable C, Beaton A. Previous Traditional Medicine Use for Sore Throat among Children Evaluated for Rheumatic Fever in Northern Uganda. Am J Trop Med Hyg 2020; 104:842-847. [PMID: 33319727 PMCID: PMC7941849 DOI: 10.4269/ajtmh.20-0288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 11/01/2020] [Indexed: 11/07/2022] Open
Abstract
Timely diagnosis of group A streptococcal (GAS) sore throat coupled with appropriate antibiotic treatment is necessary to prevent serious post-streptococcal complications, including rheumatic fever (RF) and rheumatic heart disease (RHD). Traditional medicine (TM) is a known common adjunct to formal medical care in sub-Saharan Africa. A better understanding of health-seeking behavior for sore throat both within and outside the formal medical system is critical to improving primary prevention efforts of RF and RHD. A prospective mixed-methods study on the use of TM for sore throat was embedded within a larger epidemiological study of RF in Northern Uganda. Children presenting with symptoms of RF were interviewed about recent TM use as well as health services use for sore throat. One hundred children with a median age of 10 years (interquartile range: 6.8-13 years) completed the TM interview with their parent/guardian as part of a research study of RF. Seventeen, or 17%, accessed a TM provider for sore throat as part of the current illness, and 70% accessed TM for sore throat in the past (73% current or past use). Of the 20 parents who witnessed the TM visit, 100% reported use of crude tonsillectomy. Penicillin was the most frequently prescribed medication by TM providers in 52% of participants who were seen by a TM provider. The use of TM among children presenting with symptoms of sore throat in northern Uganda is common and frequently used in tandem with diagnostic services offered through the formal healthcare system. Engagement with TM practitioners may provide an important avenue for designing effective primary prevention and management strategies of RF and reduce the global burden of RHD.
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Affiliation(s)
- Elizabeth Stein
- University of Washington School of Medicine, Seattle, Washington
- Children’s National Heart Institute, Children’s National Hospital, Washington, District of Columbia
| | - Jafesi Pulle
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | | | - Isaac Otim
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Jenifer Atala
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Joselyn Rwebembera
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Linda Mary Oyella
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Nada Harik
- Division of Infectious Diseases, Children’s National Hospital, Washington, District of Columbia
| | - Emmy Okello
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Craig Sable
- Children’s National Heart Institute, Children’s National Hospital, Washington, District of Columbia
| | - Andrea Beaton
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati Medical School, Cincinnati, Ohio
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Dolsan A, Bruneteau L, Roche C, Ferré F, Labaste F, Sommet A, Conil JM, Minville V. Comparison of intubating conditions after induction with propofol and remifentanil or sufentanil : Randomized controlled REMIDENT trial for surgical tooth extraction. Anaesthesist 2020; 69:262-269. [PMID: 32112114 DOI: 10.1007/s00101-020-00739-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/05/2019] [Accepted: 12/13/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to compare tracheal intubation conditions after induction of anesthesia with a bolus of propofol-sufentanil or propofol-remifentanil and a rapid induction technique. MATERIAL AND METHODS A total of 70 patients (American Society of Anesthesiologists (ASA) classification I‑II) undergoing outpatient surgery under general anesthesia with intubation for tooth extraction were randomly assigned to two groups in this double-blind study. Patients received either a bolus of remifentanil (3 μg/kg) or sufentanil (0.3 μg/kg) together with 2.5 mg/kg propofol for intubation. The primary outcome was the percentage of excellent intubation conditions and the secondary outcomes were the percentage of patients with a decrease of over 20% in mean arterial pressure (MAP) or heart rate (HR), time to achieve spontaneous respiration, time between the end of surgery and extubation and time to achieve an Aldrete score of 10. VAS pain score was >3 or having laryngeal pain 15 min after arriving in the postanesthesia care unit (PACU) were also analyzed. RESULTS Intubating conditions (perfect + good conditions) were significantly better with remifentanil than with sufentanil (88.5% vs. 68.6%; p = 0.01). When using remifentanil, the hemodynamic conditions were good. Using remifentanil did not significantly increase the pain score or the laryngeal pain in the recovery room. This was confirmed by no significant differences between the groups for morphine consumption. Remifentanil significantly decreased the time to achieve an Aldrete score of 10. CONCLUSION When intubation without muscle relaxants is required, intubating conditions are much better when a remifentanil bolus is used compared to a sufentanil bolus. The remifentanil/propofol rapid induction technique is a valuable technique to quickly intubate and achieve good conditions.
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Affiliation(s)
- A Dolsan
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, Avenue Jean Poulhès, 31432, Toulouse, France
| | - L Bruneteau
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, Avenue Jean Poulhès, 31432, Toulouse, France
| | - C Roche
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, Avenue Jean Poulhès, 31432, Toulouse, France
| | - F Ferré
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, Avenue Jean Poulhès, 31432, Toulouse, France
| | - F Labaste
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, Avenue Jean Poulhès, 31432, Toulouse, France
| | - A Sommet
- Laboratory of Medical and Clinical Pharmacology, Pharmacoepidemiology, Inserm U1027, Toulouse University, Faculty of Medicine, Toulouse, France
| | - J-M Conil
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, Avenue Jean Poulhès, 31432, Toulouse, France
| | - V Minville
- Department of Anaesthesiology and Intensive Care, Toulouse University Hospital, Avenue Jean Poulhès, 31432, Toulouse, France.
- INSERM, U1048, Université Paul Sabatier, Institute of Metabolic and Cardiovascular Diseases, I2MC, 31432, Toulouse, France.
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Malagón-Rojas JN, Mantziari A, Salminen S, Szajewska H. Postbiotics for Preventing and Treating Common Infectious Diseases in Children: A Systematic Review. Nutrients 2020; 12:E389. [PMID: 32024037 PMCID: PMC7071176 DOI: 10.3390/nu12020389] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/18/2020] [Accepted: 01/28/2020] [Indexed: 02/07/2023] Open
Abstract
Postbiotics have recently been tentatively defined as bioactive compounds produced during a fermentation process (including microbial cells, cell constituents and metabolites) that supports health and/or wellbeing. Postbiotics are currently available in some infant formulas and fermented foods. We systematically reviewed evidence on postbiotics for preventing and treating common infectious diseases among children younger than 5 years. The PubMed, Embase, SpringerLink, and ScienceDirect databases were searched up to March 2019 for randomized controlled trials (RCTs) comparing postbiotics with placebo or no intervention. Seven RCTs involving 1740 children met the inclusion criteria. For therapeutic trials, supplementation with heat-killed Lactobacillus acidophilus LB reduced the duration of diarrhea (4 RCTs, n = 224, mean difference, MD, -20.31 h, 95% CI -27.06 to -13.57). For preventive trials, the pooled results from two RCTs (n = 537) showed that heat-inactivated L. paracasei CBA L74 versus placebo reduced the risk of diarrhea (relative risk, RR, 0.51, 95% CI 0.37-0.71), pharyngitis (RR 0.31, 95% CI 0.12-0.83) and laryngitis (RR 0.44, 95% CI 0.29-0.67). There is limited evidence to recommend the use of specific postbiotics for treating pediatric diarrhea and preventing common infectious diseases among children. Further studies are necessary to determine the effects of different postbiotics.
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Affiliation(s)
- Jeadran N. Malagón-Rojas
- Doctorado en Salud Pública, Facultad de Medicina, Universidad El Bosque, 110121 Bogota, Colombia
- Instituto Nacional de Salud de Colombia, 111321 Bogota, Colombia
| | - Anastasia Mantziari
- Functional Foods Forum, Faculty of Medicine, University of Turku, 20520 Turku, Finland; (A.M.); (S.S.)
| | - Seppo Salminen
- Functional Foods Forum, Faculty of Medicine, University of Turku, 20520 Turku, Finland; (A.M.); (S.S.)
| | - Hania Szajewska
- Department of Paediatrics at the Medical University of Warsaw, 02091 Warsaw, Poland;
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Abstract
OBJECTIVE To assess the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis or tonsillitis in children and adults with chronic/recurrent tonsillitis. DESIGN Retrospective cohort study. SETTING Data were retrieved from the VEGA register, a comprehensive regional cohort in Sweden. PARTICIPANTS 1044 children (<15 years) and 2244 adults. INTERVENTION Tonsillectomy/adenotonsillectomy compared with no surgical treatment. MAIN OUTCOME MEASURES Changes in yearly mean rates of medical care visits due to pharyngitis/tonsillitis. RESULTS In children, there was a significant decrease in the yearly mean medical care visits rate from 1.93 (1.82 to 2.04) before surgery to 0.129 (0.099 to 0.165) after surgery, with a mean change of -1.80 (-1.90 to -1.69), p<0.0001. In patients who did not undergo surgery, the corresponding mean change was -1.51 (-1.61 to -1.41), resulting in a mean difference in the change in visit rates between the intervention and control groups of -0.283 (-0.436 to -0.135), p=0.0002. In adults, a significant decrease in the yearly mean medical care visit rate was observed from 1.45 (1.39 to 1.51) before surgery to 0.152 (0.132 to 0.173) after surgery, with a mean change of -1.30 (-1.36 to -1.24), p<0.0001, compared with -1.18 (-1.24 to -1.13) in the control group. The difference in the change in yearly mean visit rate between the surgical and non-surgical groups was -0.111 (-0.195 to -0.028), p=0.0097. The subgroup analysis showed a greater effect of surgery in children, in patients with a higher number of medical care visits before surgery and in the first year of follow-up. CONCLUSION In this cohort of patients moderately or less affected with chronic/recurrent tonsillitis, the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis and tonsillitis compared with no surgical treatment was low and of questionable clinical value.
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Affiliation(s)
- Eirik Østvoll
- Department of Otorhinolaryngology - Head and Neck Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
- Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Ola Sunnergren
- Department of Otorhinolaryngology, Ryhov County Hospital, Jönköping, Sweden
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Joacim Stalfors
- Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
- Sheikh Khalifa Medical City, Ajman, United Arab Emirates
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Abstract
For pediatric practitioners, acute otitis media (AOM) and group A streptococcal pharyngitis are two of the most common infections seen in ambulatory practices. The purpose of this article is to review these conditions with the focus of highlighting evidence-based guidelines. AOM in children is a visual diagnosis and not one that can be made on history alone. The American Academy of Pediatrics (AAP) guidelines have clear criteria to aid clinicians in how to diagnose AOM. The pneumatic otoscope is the standard tool used to diagnose otitis media, and the AAP guidelines stress developing proficiency in distinguishing a normal tympanic membrane from otitis media with effusion or AOM. There are several components to appropriate management (treatment) of AOM including analgesia, education, antibiotics, and the option (for some) for observation. Group A streptococcal pharyngitis is the most common bacterial cause of sore throat in children but still only accounts for a minority of cases. History and physical examination help determine who should be tested. Testing is required to determine who to treat. Up to 15% of children in the United States are carriers, so indiscriminate testing can lead to inappropriate antibiotic use. If a patient's test is positive, treatment is recommended and penicillin or amoxicillin are appropriate for most cases. [Pediatr Ann. 2019;48(9):e343-e348.].
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Abstract
Infection of the neck is a relatively common emergency department complaint. If not diagnosed and managed promptly, it may quickly progress to a life-threatening infection. These infections can result in true airway emergencies that may require fiberoptic or surgical airways. This article covers common, as well as rare but emergent, presentations and uses an evidence-based approach to discuss diagnostic and treatment modalities.
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Affiliation(s)
- Renjie Michael Li
- Department of Emergency Medicine, Loma Linda University Medical Center, 11234 Anderson Street MC A-108, Loma Linda, CA 92354, USA
| | - Michael Kiemeney
- Department of Emergency Medicine, Loma Linda University School of Medicine, 11234 Anderson Street MC A-108, Loma Linda, CA 92354, USA.
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Shakhova M, Loginova D, Meller A, Sapunov D, Orlinskaya N, Shakhov A, Khilov A, Kirillin M. Photodynamic therapy with chlorin-based photosensitizer at 405 nm: numerical, morphological, and clinical study. J Biomed Opt 2018; 23:1-9. [PMID: 29956507 DOI: 10.1117/1.jbo.23.9.091412] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/31/2018] [Indexed: 05/12/2023]
Abstract
Employment of chlorin-based photosensitizers (PSs) provides additional advantages to photodynamic therapy (PDT) due to absorption peak around 405 nm allowing for superficial impact and efficient antimicrobial therapy. We report on the morphological and clinical study of the efficiency of PDT at 405 nm employing chlorin-based PS. Numerical studies demonstrated difference in the distribution of absorbed dose at 405 nm in comparison with traditionally employed wavelength of 660 nm and difference in the in-depth absorbed dose distribution for skin and mucous tissues. Morphological study was performed at the inner surface of rabbit ear with histological examinations at different periods after PDT procedure. Animal study revealed tissue reaction to PDT consisting in edema manifested most in 3 days after the procedure and neoangiogenesis. OCT diagnostics was confirmed by histological examination. Clinical study included antimicrobial PDT of pharynx chronic inflammatory diseases. It revealed no side effects or complications of the PDT procedure. Pharyngoscopy indicated reduction of inflammatory manifestations, and, in particular cases, hypervascularization was observed. Morphological changes were also detected in the course of monitoring, which are in agreement with pharyngoscopy results. Microbiologic study after PDT revealed no pathogenic bacteria; however, in particular cases, saprophytic flora was detected.
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Affiliation(s)
- Maria Shakhova
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
- Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia
| | - Daria Loginova
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
- N.I. Lobachevsky State University of Nizhny Novgorod, Advanced School of General and Applied Physics, Russia
| | - Alina Meller
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
- Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia
| | - Dmitry Sapunov
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
- Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia
| | - Natalia Orlinskaya
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
- Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia
| | - Andrey Shakhov
- Institute of Applied Physics RAS, Nizhny Novgorod, Russia
- Nizhny Novgorod State Medical Academy, Nizhny Novgorod, Russia
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Rigante D, Gentileschi S, Vitale A, Tarantino G, Cantarini L. Evolving Frontiers in the Treatment of Periodic Fever, Aphthous Stomatitis, Pharyngitis, Cervical Adenitis (PFAPA) Syndrome. Isr Med Assoc J 2017; 19:444-447. [PMID: 28786261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Fevers recurring at a nearly predictable rate every 3-8 weeks are the signature symptom of periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis (PFAPA) syndrome, an acquired autoinflammatory disorder which recurs in association with at least one sign among aphthous stomatitis, pharyngitis, and/or cervical lymph node enlargement without clinical signs related to upper respiratory airways or other localized infections. The disease usually has a rather benign course, although it might relapse during adulthood after a spontaneous or treatment-induced resolution in childhood. The number of treatment choices currently available for PFAPA syndrome has grown in recent years, but data from clinical trials dedicated to this disorder are limited to small cohorts of patients or single case reports. The response of PFAPA patients to a single dose of corticosteroids is usually striking, while little data exist for treatment with cimetidine and colchicine. Preliminary interesting results have been published with regard to vitamin D supplementation in PFAPA syndrome, while inhibition of interleukin-1 might represent an intriguing treatment for PFAPA patients who have not responded to standard therapies. Tonsillectomy has been proven curative in many studies related to PFAPA syndrome, although the evidence of its efficacy is not widely shared by different specialists, including pediatricians, rheumatologists and otorhynolaryngologists.
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Affiliation(s)
- Donato Rigante
- Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico A. Gemelli, Rome, Italy
| | - Stefano Gentileschi
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases Behçet's Disease Clinic, University of Siena, Siena, Italy
| | - Antonio Vitale
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases Behçet's Disease Clinic, University of Siena, Siena, Italy
| | - Giusyda Tarantino
- Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico A. Gemelli, Rome, Italy
| | - Luca Cantarini
- Department of Medical Sciences, Surgery and Neurosciences, Research Center of Systemic Autoinflammatory Diseases Behçet's Disease Clinic, University of Siena, Siena, Italy
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Abstract
Background Efficiency and fiscal responsibility are important to the equal, safe, and effective delivery of care in the emergency department, where all presenting patients must be evaluated for emergent conditions. Health care professionals' understanding of the costs of care is a first step to developing rational approaches for the efficient distribution of the finite resources hospitals and emergency departments have at their disposal to reduce costs to patients and health care systems. Objective To determine emergency department health care professionals' knowledge of the costs to patients of routine care delivered in the emergency department. Methods An internet-based survey of currently practicing emergency medicine health care professionals with various levels of training (physicians, residents, physician assistants, and nurse practitioners) was conducted to evaluate their ability to identify the cost of care for 3 common presentations to the emergency department: abdominal pain, dyspnea, and sore throat. Results Four hundred forty-one emergency medicine health care professionals participated. In the 3 cases presented, correct costs were determined by 43.0%, 32.0%, and 40.1% of participants, respectively. Geographic region was not related to cost determination. Larger institution size was related to greater cost chosen (P=.01). Higher level of training was significantly correlated with perceived understanding of cost (P<.001); however, it was not related to accurate cost assessment in this study. Conclusion Emergency medicine health care professionals have an inadequate understanding of the costs associated with care routinely provided in the emergency department.
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Smilek P. [Sore throat treatment]. Cas Lek Cesk 2017; 156:203-204. [PMID: 28862011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The article deals with sore throat, gives definition of acute and chronic pain and describes their causes. Further describes possibilities of diagnosis with regard to differential diagnosis. Special attention is focused on differentiation between viral and streptococcal infection. Accented is the necessity of causal treatment and possibilities of supportive local treatment.Key words: sore throat, sore throat causes, sore throat diagnosis, causal treatment, local supportive treatment.
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20
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Vitale A, Orlando I, Lopalco G, Emmi G, Cattalini M, Frediani B, Galeazzi M, Iannone F, Rigante D, Cantarini L. Demographic, clinical and therapeutic findings in a monocentric cohort of adult patients with suspected PFAPA syndrome. Clin Exp Rheumatol 2016; 34:77-81. [PMID: 27791949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 06/01/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenopathy (PFAPA) syndrome is a non-Mendelian autoinflammatory disorder until now considered to be specifically limited to paediatric age. Recently, an increasing number of reports seems to suggest that PFAPA syndrome, diagnosed by the Marshall criteria revised by Thomas et al., can also affect adults. METHODS The Marshall/Thomas criteria have been applied to 989 adult patients presenting for recurrent fever episodes: all patients enrolled were reviewed for demographic, clinical, and therapeutic data. Infectious, neoplastic, autoimmune and other autoinflammatory diseases were ruled out. RESULTS We identified 30 adult patients (19 males, 11 females) with a suspected PFAPA syndrome: their mean age at disease onset was 33.75±14.01 years, mean age at diagnosis 39.1±14.39 years, and mean body temperature peak 39.5±0.7°C. In addition, the mean frequency of febrile episodes was 11.58±8.97 per year. More precisely, patients complained of pharyngitis (77%), cervical adenitis (73%), asthenia (63%), arthralgia (67%), oral aphthosis (50%), myalgia (54%), cephalalgia (43%), abdominal pain (27%), nausea/vomiting (17%), periorbital pain (17%), and arthritis (10%). Six out of 30 (20%) patients had suffered from PFAPA syndrome also during childhood, and the disease had reappeared in adulthood. CONCLUSIONS We provide the largest monocentric cohort of patients diagnosed with a suspected PFAPA syndrome in adulthood confirming that this syndrome can occur also during adulthood; moreover, due to the medical history of our patients and based on our experience, PFAPA syndrome might relapse during adulthood after a temporary remission reached in the course of paediatric age.
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Affiliation(s)
- Antonio Vitale
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - Ida Orlando
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - Giuseppe Lopalco
- Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari Aldo Moro, Bari, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Marco Cattalini
- Paediatric Clinic, University of Brescia and Spedali Civili di Brescia, Italy
| | - Bruno Frediani
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - Mauro Galeazzi
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - Florenzo Iannone
- Interdisciplinary Department of Medicine, Rheumatology Unit, University of Bari Aldo Moro, Bari, Italy
| | - Donato Rigante
- Institute of Paediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Luca Cantarini
- Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy.
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21
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Bonnecaze G, Vergez S, Serrano É. [Management of sore throat]. Rev Prat 2016; 66:e176. [PMID: 30512720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Guillaume Bonnecaze
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital Toulouse-Rangueil-Larrey, 31059 Toulouse, France
| | - Sébastien Vergez
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital Toulouse-Rangueil-Larrey, 31059 Toulouse, France
| | - Élie Serrano
- Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital Toulouse-Rangueil-Larrey, 31059 Toulouse, France
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22
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Affiliation(s)
- Katherine McMurray
- Palmetto Health Children's Hospital, Columbia, South Carolina; and Department of Pediatrics, University of South Carolina School of Medicine, Columbia, South Carolina
| | - Matthew Garber
- Palmetto Health Children's Hospital, Columbia, South Carolina; and Department of Pediatrics, University of South Carolina School of Medicine, Columbia, South Carolina
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Jonkman EJ, Eijkman MAJ. [Denistry in the Middle Ages in the low lands 8. "Eenre vrouw die hadde squinantie"]. Ned Tijdschr Tandheelkd 2015; 122:441. [PMID: 26397102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Hildreth AF, Takhar S, Clark MA, Hatten B. Evidence-Based Evaluation And Management Of Patients With Pharyngitis In The Emergency Department. Emerg Med Pract 2015; 17:1-17. [PMID: 26276908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 06/10/2015] [Indexed: 06/04/2023]
Abstract
Pharyngitis is a common presentation, but it can also be associated with life-threatening processes, including sepsis and airway compromise. Other conditions, such as thyroid disease and cardiac disease, may mimic pharyngitis. The emergency clinician must sort through the broad differential for this complaint using a systematic approach that protects against early closure of the diagnosis. This issue reviews the various international guidelines for pharyngitis and notes controversies in diagnostic and treatment strategies, specifically for management of suspected bacterial, viral, and fungal etiology. A management algorithm is presented, with recommendations based on a review of the best available evidence, taking into account patient comfort and outcomes, the need to reduce bacterial resistance, and costs.
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Affiliation(s)
- Amy F Hildreth
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA
| | - Sukhjit Takhar
- Attending Physician, Department of Emergency Medicine, Brigham and Women's Hospital, Instructor of Emergency Medicine, Harvard Medical School, Boston, MA
| | - Mark Andrew Clark
- Assistant Professor of Emergency Medicine, Program Director, Emergency Medicine Residency, Mount Sinai St. Luke's, Mount Sinai Roosevelt, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Benjamin Hatten
- Assistant Professor, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
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Liu J, Yan Z, Zhang M. [Clinical diagnosis and treatment of allergic pharyngitis]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 29:1401-1405. [PMID: 26685417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Although the concept of united airway disease has been widely accepted, most scholars emphasize only the effect of rhino-sinusitis while ignoring the pharyngeal factors to the lower airway, especially to the allergic pharyngitis (AP), which still lacks enough awareness. First of all, absence of unified diagnostic standard leads to the lack of epidemiological data, which, results in doctors' personal experience but no guideline in treatments. In addition, it is still not clear that the role of AP in the allergic airway diseases and its relationship with asthma. However, the number of patients with AP has been increasing obviously in daily clinic practice. Combined with the previous observation, this paper does a systematic review about the clinical problems of AP, expecting to give a hand to the clinical diagnosis and treatment of AP.
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Abstract
BACKGROUND Acute upper respiratory tract infections (URTIs), including the common cold and rhinosinusitis, are common afflictions that cause discomfort and debilitation and contribute significantly to workplace absenteeism. Treatment is generally by antipyretic and decongestant drugs and sometimes antibiotics, even though most infections are viral. Nasal irrigation with saline is often employed as an adjunct treatment for URTI symptoms despite a relative lack of evidence for benefit in this clinical setting. This review is an update of the Cochrane review by Kassel et al, which found that saline was probably effective in reducing the severity of some symptoms associated with acute URTIs. OBJECTIVES To assess the effects of saline nasal irrigation for treating the symptoms of acute URTIs. SEARCH METHODS We searched CENTRAL (2014, Issue 7), MEDLINE (1966 to July week 5, 2014), EMBASE (1974 to August 2014), CINAHL (1982 to August 2014), AMED (1985 to August 2014) and LILACS (1982 to August 2014). SELECTION CRITERIA Randomised controlled trials (RCTs) comparing topical nasal saline treatment to other interventions in adults and children with clinically diagnosed acute URTIs. DATA COLLECTION AND ANALYSIS Two review authors (DK, BM) independently assessed trial quality with the Cochrane 'Risk of bias' tool and extracted data. We analysed all data using the Cochrane Review Manager software. Due to the large variability of outcome measures only a small number of outcomes could be pooled for statistical analysis. MAIN RESULTS We identified five RCTs that randomised 544 children (three studies) and 205 adults (exclusively from two studies). They all compared saline irrigation to routine care or other nose sprays, rather than placebo. We included two new trials in this update, which did not contribute data of sufficient size or quality to materially change the original findings. Most trials were small and we judged them to be of low quality, contributing to an unclear risk of bias. Most outcome measures differed greatly between included studies and therefore could not be pooled. Most results showed no difference between nasal saline treatment and control. However, one larger trial, conducted with children, did show a significant reduction in nasal secretion score (mean difference (MD) -0.31, 95% confidence interval (CI) -0.48 to -0.14) and nasal breathing (obstruction) score (MD -0.33, 95% CI -0.47 to -0.19) in the saline group. However, a MD of -0.33 on a four-point symptom scale may have minimal clinical significance. The trial also showed a significant reduction in the use of decongestant medication by the saline group. Minor nasal discomfort and/or irritation was the only side effect reported by a minority of participants. AUTHORS' CONCLUSIONS Nasal saline irrigation possibly has benefits for relieving the symptoms of acute URTIs. However, the included trials were generally too small and had a high risk of bias, reducing confidence in the evidence supporting this. Future trials should involve larger numbers of participants and report standardised and clinically meaningful outcome measures.
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Affiliation(s)
- David King
- The University of QueenslandDiscipline of General Practice, School of MedicineHerstonBrisbaneQueenslandAustralia4029
| | - Ben Mitchell
- The University of QueenslandDiscipline of General Practice, School of MedicineHerstonBrisbaneQueenslandAustralia4029
| | | | - Geoffrey KP Spurling
- The University of QueenslandDiscipline of General Practice, School of MedicineHerstonBrisbaneQueenslandAustralia4029
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Sandberg JC, Grzywacz JG, Suerken CK, Altizer KP, Quandt SA, Nguyen HT, Bell RA, Lang W, Arcury TA. Older adults' use of care strategies in response to general and upper respiratory symptoms. J Appl Gerontol 2015; 34:NP41-61. [PMID: 24652871 PMCID: PMC4102662 DOI: 10.1177/0733464813478689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined the use of complementary and medical treatments, both individually and in combination, to address common general and upper respiratory symptoms. Data for the analysis were collected from a series of 18 daily diary questionnaires administered to community-living older African American and white adults living in rural counties in North Carolina. Participants reported symptoms experienced on each diary day and the treatment strategies they used each day in response to the particular symptom(s). Older adults used diverse categories of strategies to treat symptoms; treatment strategies were used inconsistently across symptoms. Use of only complementary strategies, only medical conventional strategies, or both complementary and medical strategies to treat any one symptom rarely corresponded to the use of the same strategy to address other symptoms. Future research would benefit from analyzing how older adults use health care strategies across symptom categories.
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Affiliation(s)
| | | | | | | | - Sara A Quandt
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ha T Nguyen
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ronny A Bell
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Wei Lang
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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[The effect and the analysis of the influence factors of sublingual immunotherapy on patients with pharyngitis and allergy to house dust mite]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:1511-3. [PMID: 25775760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To evaluate the effect of sublingual specific immunotherapy (SLIT) on patients with pharyngitis and allergy to house dust mite and to discuss the influence of different treatments, single and multiple allergen sensitization and genders on SLIT. METHOD We recorded the total medicine score (TMS) and self evaluation of 53 patients with pharyngitis and allergy to house dust mite before and 6 months after the treatment. Control group included 25 patients only treated with anti-allergic drugs. Treatment group included 28 patients accept SLIT. Based on different dosage regimens, treated patients were divided into SLIT group and comprehensive group; Based on the results of skin prick, treated patients were divided into dust mite group and multiple group; Based genders, treated patients were divided into male and female group. We compared the effective rate (ER)and decreasing percent of TMS (Dp-TMS) between control and treatment group, and also different groups in treatment group. RESULT The ER and Dp-TMS of treatment group is significantly higher than control group, (P < 0.01). The ER of SLIT and comprehensive group respectively is 72.73% and 76.47%without significant difference (P > 0.05). The ER and Dp-TMS of dust mite group and multiple group respectively is 61. 54%, 94. 46%,66. 67%, 71.25% without significant difference (P > 0.05). The ER and Dp-TMS of male and female respectively are 58.33%, 66.67%, 83.33%, 97.04% with significant difference (P > 0.05), while the Dp-TMS is not (P > 0.05). CONCLUSION The SLIT is effective to patients with pharyngitis and allergy to house dust mite; The therapeutic schedule, single and multiple allergen sensitization have no effects on SLIT in patients with pharyngitis and allergy to house dust mite. However, genders have influence on it.
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Shrank WH, Krumme AA, Tong AY, Spettell CM, Matlin OS, Sussman A, Brennan TA, Choudhry NK. Quality of care at retail clinics for 3 common conditions. Am J Manag Care 2014; 20:794-801. [PMID: 25365682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Evaluation of quality of care across retail clinics in a geographically diverse population has not been undertaken to date. We sought to evaluate and compare the quality of care for otitis media, pharyngitis, and urinary tract infection received in retail medical clinics in CVS pharmacies ("MinuteClinics" [MCs]), ambulatory care facilities (ACFs), and emergency departments (EDs). METHODS We used 14 measures constructed from RAND Corporation's Quality Assurance Tools and guidelines from the American Academy of Pediatrics, the American Academy of Family Physicians, and the Infectious Diseases Society of America. Our cohort was drawn from Aetna medical and prescription claims, 2009-2012. Members were matched on visit date, condition, and propensity score. Generalized estimating equations were used to compare quality across clinic type, overall, and by index condition. RESULTS We matched 75,886 episodes of care, of which 20,153 were eligible for at least 1 quality measure. MCs performed better than EDs and ACFs in 7 measures. In a multivariable model, MCs performed better than ACFs and EDs across all quality measures ([OR 0.42; 95% CI, 0.40-0.45; P < .0001; ACF vs MC] [OR 0.29; 95% CI, 0.27-0.31; P < .0001; ED vs MC]). Results for each condition were significant at P < .0001. CONCLUSIONS Quality of care for these conditions based on widely accepted objective measures was superior in MinuteClinics compared with ACFs and EDs.
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Mann D, Knaus M, McCullagh L, Sofianou A, Rosen L, McGinn T, Kannry J. Measures of user experience in a streptococcal pharyngitis and pneumonia clinical decision support tools. Appl Clin Inform 2014; 5:824-35. [PMID: 25298820 PMCID: PMC4187097 DOI: 10.4338/aci-2014-04-ra-0043] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 08/09/2014] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To understand clinician adoption of CDS tools as this may provide important insights for the implementation and dissemination of future CDS tools. MATERIALS AND METHODS Clinicians (n=168) at a large academic center were randomized into intervention and control arms to assess the impact of strep and pneumonia CDS tools. Intervention arm data were analyzed to examine provider adoption and clinical workflow. Electronic health record data were collected on trigger location, the use of each component and whether an antibiotic, other medication or test was ordered. Frequencies were tabulated and regression analyses were used to determine the association of tool component use and physician orders. RESULTS The CDS tool was triggered 586 times over the study period. Diagnosis was the most frequent workflow trigger of the CDS tool (57%) as compared to chief complaint (30%) and diagnosis/antibiotic combinations (13%). Conversely, chief complaint was associated with the highest rate (83%) of triggers leading to an initiation of the CDS tool (opening the risk prediction calculator). Similar patterns were noted for initiation of the CDS bundled ordered set and completion of the entire CDS tool pathway. Completion of risk prediction and bundled order set components were associated with lower rates of antibiotic prescribing (OR 0.5; CI 0.2-1.2 and OR 0.5; CI 0.3-0.9, respectively). DISCUSSION Different CDS trigger points in the clinician user workflow lead to substantial variation in downstream use of the CDS tool components. These variations were important as they were associated with significant differences in antibiotic ordering. CONCLUSIONS These results highlight the importance of workflow integration and flexibility for CDS success.
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Affiliation(s)
- D. Mann
- Department of Medicine, Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA, USA
| | - M. Knaus
- Department of Medicine, Hofstra North Shore-LIJ School of Medicine, Manhasset, NY, USA
| | - L. McCullagh
- Department of Medicine, Hofstra North Shore-LIJ School of Medicine, Manhasset, NY, USA
| | - A. Sofianou
- Department of Medicine, Division of General Internal Medicine, Mount Sinai School of Medicine, New York, NY, USA
| | - L. Rosen
- Department of Medicine, Hofstra North Shore-LIJ School of Medicine, Manhasset, NY, USA
| | - T. McGinn
- Department of Medicine, Hofstra North Shore-LIJ School of Medicine, Manhasset, NY, USA
| | - J. Kannry
- Department of Medicine, Division of General Internal Medicine, Mount Sinai School of Medicine, New York, NY, USA
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31
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Weber CS, Kleinjung T. [Common infections of the ear, nose, and throat]. Praxis (Bern 1994) 2014; 103:1001-1007. [PMID: 25146944 DOI: 10.1024/1661-8157/a001755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Infectious diseases of the ear, nose and throat are common reasons why patients visit their family physician. Therefore, the aim of this mini-review is to give an overview of the most important and frequent infectious diseases of the ear, nose and throat, the appropriate diagnostic measurements and therapy with relevance for the family physician. Most of these infectious diseases can be treated by the family physician and do not necessarily need to be seen by an ENT-specialist.
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Affiliation(s)
- Claudia Sandra Weber
- Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Universitätsspital Zürich
| | - Tobias Kleinjung
- Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Universitätsspital Zürich
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32
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Isomura I, Miyawaki S, Morita A. Pyoderma Gangrenosum Associated with Nasal Septal Perforation, Oropharyngeal Ulcers and IgA Paraproteinemia. J Dermatol 2014; 32:193-8. [PMID: 15863866 DOI: 10.1111/j.1346-8138.2005.tb00744.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2003] [Accepted: 10/12/2004] [Indexed: 11/29/2022]
Abstract
We report a case of pyoderma gangrenosum (PG) associated with nasal septal perforation, pharyngeal ulcers and IgA paraproteinemia. A 28-year-old woman first developed painful undermined ulcers on her perianal, inguinal and axillary areas when she was 22 years old. Histological findings from the cutaneous ulcers showed dermal and epidermal infiltrate of neutrophils, which was compatible with PG. Laboratory examinations did not detect any associations of systemic diseases other than polyclonal IgA paraproteinemia. Nasal fiberscopy revealed septal perforation and multiple ulcers on her pharynx. The biopsy specimen from the pharyngeal ulcers showed a polymorphous cellular infiltrate without necrotizing vasculitis or granuloma. However, there were no atypical lymphocytes that are typically seen in nasal NK/T lymphoma. By immunohistochemical analysis, the infiltrated lymphocytes were proved to be T cells and Epstein-Barr virus encoded RNA (EBER) was not detected. No pulmonary or renal lesions resembling Wegener's granulomatosis were found. Taken together, the nasal septal perforation was considered as nasal involvement of PG.
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Affiliation(s)
- Iwao Isomura
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
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33
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Cloutier L, Bisson P, Pinard J. [Sore throat says ahhhh!!! A targeted clinical exam]. Perspect Infirm 2014; 11:36-41. [PMID: 24672922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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34
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Vicedomini D, Lalinga G, Lugli N, D'Avino A. [Diagnosis and management of acute pharyngotonsillitis in the primary care pediatrician's office]. Minerva Pediatr 2014; 66:69-76. [PMID: 24608583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Acute pharyngotonsillitis is one of the most frequent causes of visits in the primary care pediatrician'office. Group A b-hemolytic streptococci (GABHS) or Streptococcus pyogenes causes 15-30% of cases of acute pharyngotonsillitis in pediatric age. Children with pharyngotonsillitis due to GABHS commonly present sore throat, fever more than 38 °C, tonsillar exudate, and tender cervical adenopathy, but the severity of illness ranges from mild throat pain to classic exudative tonsillitis with high fever. The McIsaac criteria is a clinical scoring system to predict the likelihood of streptococcal infection among children. This score is based on 5 clinical criteria: age 3-14 years, fever more than 38°C, tonsillar swelling or exudate, tender and enlarged anterior cervical lymph nodes, and absence of cough, but none of these findings is specific for GABHS pharyngotonsillitis. Culture of a throat swab on a blood agar plate (BAP) remains the gold standard for the diagnosis of acute streptococcal pharyngotonsillitis. Because of the major disadvantage of culturing throat swabs on BAP culture is the delay in obtaining the results (at least 1 day), in the past decades rapid antigen detection test (RAD) were introduced for the rapid identification of GABHS directly from throat swabs. Accurate diagnosis and treatment of GABHS pharyngotonsillitis provides positive benefits, including prevention of complications, such as acute rheumatic fever and peritonsillar abscess and reduce the acute morbidity associated with the illness. Conversely, improper diagnosis may result in negative consequences, including unnecessary antibiotic prescriptions that confer increased health care costs and contibute to the development of bacterial resistance.
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35
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Barton SJ. The proposed use of Defence Medical Information Capability Programme (DMICP) templates to improve patient care in the joint environment. J R Nav Med Serv 2014; 100:98-100. [PMID: 24881437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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36
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Banting J, Meriano T. Sore throat. J Spec Oper Med 2014; 14:124-128. [PMID: 25399381 DOI: 10.55460/7kvu-pp2l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 06/04/2023]
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37
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Block SL. Streptococcal pharyngitis: guidelines, treatment issues, and sequelae. Pediatr Ann 2014; 43:11-6. [PMID: 24450315 DOI: 10.3928/00904481-20131228-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Król P, Böhm M, Sula V, Dytrych P, Katra R, Nemcová D, Dolezalová P. PFAPA syndrome: clinical characteristics and treatment outcomes in a large single-centre cohort. Clin Exp Rheumatol 2013; 31:980-987. [PMID: 24237762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 04/11/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES This paper aims to describe clinical and laboratory features and disease outcome in a single-centre cohort of patients with PFAPA syndrome (Periodic Fever, Aphtous stomatitis, Pharyngitis, and Adenitis) and to test performance of diagnostic and therapeutic algorithms. METHODS Patients fulfilling criteria were selected from the fever clinic population. Prospective follow-up together with recruitment of newly diagnosed patients followed pre-defined guidelines. Diagnostic and therapeutic algorithms and definitions of outcome and therapy response were formulated. Paired blood samples during febrile and afebrile periods were compared. RESULTS Out of 176 patients referred for suspected periodic fever 125 children fulfilled criteria. Their age at onset was 23 months, median episode duration 3.5 days at 4-week intervals. Fever was associated with pharyngitis (91%), cervical adenitis (78%) and aphtae (41%). Among therapeutic options, episodic prednisone proved to be the most common first-line treatment. Administered to 77 patients, it reduced symptoms in 94%. Tonsillectomy led to the full symptom resolution in all 18 patients. Forty-six patients reached disease remission. CONCLUSIONS Distribution of typical symptoms, response to therapies and disease outcome in a large patient cohort were documented. We offer diagnostic and therapeutic algorithms that have proven effective during this prospective trial. Our findings support the general belief of benign nature of this aetiologically unclear condition, despite proportion of patients having persistent disease for years. Maintenance of normal findings in afebrile intervals, striking response to a single dose of prednisone and normal growth and development together with spontaneous tendency towards prolongation of afebrile intervals are important confirmatory features of PFAPA syndrome.
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Affiliation(s)
- Petra Król
- Department of Pediatrics and Adolescent Medicine, 1st Faculty of Medicine, Charles University in Prague, Czech Republic.
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39
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[Controlling sore throat pain and inflammation are the most important therapy goals]. MMW Fortschr Med 2013; 155:70-1. [PMID: 24288928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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40
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Gao ZY, Liu GT. [Verification and improvement of heaven-penetrating cooling needling at Yuji (LU 10) for pharyngitis]. Zhongguo Zhen Jiu 2013; 33:752. [PMID: 24195224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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41
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Zhang HR, Fu ZH, Gu YH. [Thirty-one cases of chronic pharyngitis treated by floating acupuncture]. Zhongguo Zhen Jiu 2013; 33:227-228. [PMID: 23713305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Abstract
Although sore throat is a very common complaint in the emergency department and is often associated with benign conditions, such as pharyngitis, it can be the early onset of something much more serious and even life threatening. A thorough history and examination are vital to the correct diagnosis but a high index of suspicion must be maintained to diagnose less common but serious pathology, such as epiglottitis and retropharyngeal abscess. Airway management is paramount to survival, and aggressive means should be taken early when epiglottitis is considered.
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Affiliation(s)
- Angela R Cirilli
- Department of Emergency Medicine, North Shore University Hospital, Long Island Jewish Hospital, 300 Community Drive, Manhasset, NY 11030, USA.
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43
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Rennie R, Crowson B. The management of upper respiratory tract infections. J R Nav Med Serv 2013; 99:97-105. [PMID: 24511790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Upper respiratory tract infections (URTIs), generally termed colds, sore throats and coughs, are common presentations in primary care. This article discusses the clinical picture, management, significant differential diagnosis, and specifically, when antibiotics may be required for an URTI.
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Affiliation(s)
- R Rennie
- Surgeon Lieutenant Commander R Rennie RN ST3 GPVT, Roborough Surgery, Plymouth
| | - B Crowson
- Surgeon Commander B Crowson RN MRCGP Defence Academy, Shrivenham
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44
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Aronsson B, Claesson K. [New treatment recommendations: Management of pharyngo-tonsillitis in ambulatory care]. Lakartidningen 2012; 109:2367. [PMID: 23367554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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45
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Kühlein T, Freund T. [Infections of the airways]. MMW Fortschr Med 2012; 154:51-56. [PMID: 23297541 DOI: 10.1007/s15006-012-1691-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Thomas Kühlein
- Abteilung Allgemeinmedizin und Versorgungsforschung Universitätsklinikum Heidelberg.
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46
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Hayashi T. [Diagnosis and treatment of PFAPA syndrome]. Nihon Jibiinkoka Gakkai Kaiho 2012; 115:1052-1053. [PMID: 24032170 DOI: 10.3950/jibiinkoka.115.1052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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47
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Zhang RY, He TY, Qin XG. [Targeted acupuncture for 34 cases of chronic pharyngitis]. Zhongguo Zhen Jiu 2012; 32:895-896. [PMID: 23259264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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48
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Zhong C, Zhang Y, Sun J. [Acupuncture and acupoint injection for 68 cases of chronic pharyngitis]. Zhongguo Zhen Jiu 2012; 32:946. [PMID: 23259282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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49
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Yang SH, Xie PC, Qin XL. [An instant pain-relief effect of balance acupuncture for relieving sore throat in acute pharyngitis patients]. Zhen Ci Yan Jiu 2012; 37:324-327. [PMID: 23140056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To observe the instant effect of "Balance Acupuncture" in relieving sore throat in patients with acute pharyngitis. METHODS A total of 74 acute pharyngitis patients with sore throat were randomly assigned to treatment group (Balance Acupuncture, n = 36) and placebo acupuncture group (sham acupoint, n = 38). Patients of the Balance Acupuncture group were treated by acupuncture stimulation of bilateral "Yantong" (sore throat) point (the mid-point of the second metacarpal bone on the radial side) and those of the sham acupoint group were treated by acupuncture stimulation of the sham point (the site 1 cm lateral to the mid-point between the ulnar endpoint of the cubic transverse striation and that of the wrist-palm transverse striation). After insertion, the acupuncture needle was manipulated repeatedly till "Deqi" for patients of the treatment group but not manipulated for patients of the placebo acupuncture group, then removed immediately. The VAS (Visual Analogue Scores) were assessed 1 min after the treatment in addition to safety index records. RESULTS Before the treatment, the VAS values of the treatment group and sham acupoint group were (5.25 +/- 1.51) points and (4.83 +/- 1.59) points, respectively, which had no significant differences between the two groups (P > 0.05). One minute after the treatment, VAS values of the treatment and sham acupoint groups were (2.11 +/- 1.88) points and (3.39 +/- 1.94) points, respectively, both decreasing significantly (P < 0.01). The effect of the former group was significantly superior to that of the sham acupoint group (P < 0.05). CONCLUSION Both Balance Acupuncture and sham-acupoint acupuncture treatments can relieve sore throat in acute pharyngitis patients, and the therapeutic effect of Balance Acupuncture treatment is obviously better.
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Affiliation(s)
- Shi-Hong Yang
- The Second Clinical Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510370, China.
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50
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Kyvsgaard N, Mikkelsen T, Korsholm J, Veirum JE, Herlin T. Periodic fever associated with aphthous stomatitis, pharyngitis and cervical adenitis. Dan Med J 2012; 59:A4452. [PMID: 22759839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is a non-hereditary idiopathic febrile syndrome belonging to the group of autoinflammatory diseases. PFAPA does not cause long-lasting sequelae. An early diagnosis provides treatment possibilities for the patient and comfort to the family. MATERIAL AND METHODS This study is a retrospective review of the medical records of patients diagnosed with PFAPA and admitted to our clinic from January 1999 to January 2010 (n = 31). RESULTS The study population (n = 31) consisted of 21 males and ten females: 30 Caucasians and 1 Asian. Normal growth was seen in 30 patients. The median age at onset was 33 months. The mean duration of fever episodes was 4.45 days (95% confidence interval (CI): 3.92-4.98 days), and the mean duration of intervals between fever episodes was 29.66 days (95% CI: 25.31-34.01 days). Concomitantly with the fever, all patients had characteristic symptoms. All patients were asymptomatic in between their fever episodes. Prodromal symptoms were seen in 12 patients. Oral prednisolone was used in 24 patients and caused immediate fever reduction in 87.5%. A reduction in the duration of the asymptomatic interval after treatment was seen in 75.0%. Tonsillectomy was performed in 20 of the 31 patients causing cessation of fever episodes in 70%. Fever episodes continued in 15%, and the postoperative status remained unknown in the last 15%. Spontaneous resolution was seen in four patients. The diagnostic delay had a median duration of 28 months (range 2-160 months). CONCLUSION The long diagnostic delay of PFAPA gives cause for concern and it indicates a need for greater awareness of the disease so that the diagnosis may be made earlier. FUNDING not relevant. TRIAL REGISTRATION not relevant.
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Affiliation(s)
- Nini Kyvsgaard
- Department of Paediatrics, Aarhus University Hospital, Skejby, Aarhus N, Denmark.
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