Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031350 (pharyngitis)
 2,405 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical features of 44 culture-confirmed cases of diphtheria involving the respiratory tract treated at the University of Washington and affiliated hospitals in Seattle over a five-year period were studied. Of 42 patients treated primarily in Seattle, five (11.9%) died; nonfatal, toxin-induced complications occurred in seven (16.7%). Airway obstruction was the most common cause of death in this series. Diphtheritic membrane (especially in the larynx), dyspnea, and leukocytosis were dire prognostic signs. We urge indirect laryngoscopyin all cases showing membrane formation; tracheotomy should be considered when laryngeal membrane is present. Diphtheria should be suspected in any patient with pharyngitis who has been in contact with endemic areas, especially when pharyngeal membrane is present.
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PMID:Clinical features of diphtheria in the respiratory tract. 49 Aug 6

The author presents the clinical history of 14 patients, from 21 to 48 years of age, 10 men and 4 women, with a final diagnosis of acute epiglottitis who were hospitalized at Gorgas Army Hospital or at the San Fernando Clinic. All the patients had pharyngitis and dysphagia, a few with nasal voice, stridor and difficulty breathing, as the chief complaint. All the patients were initially intubated orally for diagnostic purposes and immediately after nasotracheal intubation was done until the patient improved in 2 or 3 days (one patient remained intubated for 5 days). All patients were kept in the Intensive Care Unit and were treated with Ampicillin and Chloramphenicol IV and lately with a second generation cephalosporin (Cefamandole). The patients allergic to Penicillin were treated with Clindamycin and Chloramphenicol. Corticosteroids were not used in any of the patients. There were no sequelae and none of the patients expired.
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PMID:[Acute epiglottitis in adults]. 143 5

Forty-five acutely ill, coughing patients, three with acute dyspnea and cardiomegaly, and 37 control subjects were placed in lateral decubitus positions for auscultation of their dependent lungs to determine if this maneuver would elicit inspiratory crackles, signs of pneumonia. In the upright position, auscultation of the lungs was normal in all control subjects and in lateral decubitus positions their dependent lungs revealed transient late inspiratory crackles in seven of the 37 (18.9%), and transient inspiratory peeling sounds in two others (5.4%). Thirteen acutely ill, coughing patients, free of prior cardiac and pulmonary diseases, had persistent late inspiratory crackles induced in one or both dependent lungs when placed in lateral decubitus positions. These dependent lungs also revealed increased numbers of crackles in three patients, late inspiratory squeaks in four, and wheezes in three others. In the upright position, auscultation of the lungs was normal in 10 of these patients, and a few basilar crackles were heard in three others. All of these abnormal findings cleared after treatment with antibiotics. Thirty-one of 32 acutely ill, coughing patients with bronchitis, sinusitis, or pharyngitis were free of induced crackles in dependent lungs in lateral decubitus positions. However, placement of two other patients in these positions appeared to have elicited the inspiratory crackles of chronic pulmonary disease and early congestive heart failure. These observations suggest that placement of acutely ill, coughing patients into lateral decubitus positions for auscultation of the dependent lungs may be a valuable maneuver for diagnosis of pneumonia.
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PMID:Detection of pneumonia by auscultation of the lungs in the lateral decubitus positions. 280 64

We treated four adults whose upper airway was compromised due to acute epiglottitis. We also reviewed the English literature for all reports of this condition in adults (18 years and older). Among the 158 cases, the infectious etiology was identified in 29 (H. influenzae 20, Streptococcus pneumoniae six, H. parainfluenzae two, Streptococcus pyogenes one). In the remaining cases, the etiology was uncertain. Bacteremia was documented in 23/32 patients (71.9%), but extra-epiglottic infections were strikingly rare (X = six). The clinical manifestations were sore throat (100%), fever (88%), dyspnea (78%), dysphagia (76%), anterior neck cellulitis or tenderness (27%), hoarseness (21%), pharyngitis (20%) and anterior cervical lymphadenopathy (9%). Complete airway obstruction ensued in 23 out of the 119 subjects (18.3%) who had respiratory difficulty. Overall mortality rate was 17.6% but it was 6.4% among the patients who were semi-electively tracheostomized or endotracheally intubated. These findings illustrate that antibiotics therapy active against H. influenzae is required in the treatment of acute epiglottitis in adults. Additionally, airway patency should be established when inspiratory stridor appears assuring uncomplicated recovery.
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PMID:Acute epiglottitis in adults. 670 91

Patients with asthma-like symptoms may not have asthma but obstruction of the extrathoracic airway (EA). To evaluate if dysfunction of the EA causes asthma-like symptoms, we assessed bronchial and EA responsiveness to inhaled histamine in 441 patients who presented with at least one of three key symptoms--cough, wheeze, dyspnoea--but had neither documented asthma nor bronchial obstruction. The histamine concentrations causing a 20% fall in forced expiratory volume in 1 s (PC20FEV1) and a 25% fall in maximal mid-inspiratory flow (PC25MIF50) were used as respective thresholds of bronchial and EA responsiveness. Values 8 mg/mL or less indicated bronchial (B-HR) or EA hyper-responsiveness (EA-HR). The influence of concurrent upper respiratory tract diseases, such as post-nasal drip (PND), pharyngitis, laryngitis and sinusitis, was also assessed. We found four response patterns to the histamine challenge: EA-HR in 26.5% of the patients, B-HR in 11.1%, combined EA-HR and B-HR in 40.6%, and no-HR in 21.8%. Cough was reported by 79% of the patients, wheeze by 53%, and dyspnoea by 40%. Patients with cough as the sole presenting symptom (34.2%), as compared with those with wheeze and/or dyspnoea (20%), had significantly greater probability of having EA-HR (OR 5.35, 95% CI 3.25-8.82) and lower probability of having B-HR (OR 0.45, CI 0.28-0.70); patients with cough plus wheeze and/or dyspnoea (45.8%) had significantly greater probability of having both EA-HR and B-HR than either those with cough alone (OR 2.48, CI 1.49-4.13), or those with wheeze and/or dyspnoea but not cough (OR 1.74, CI 1.36-2.22). EA-HR alone or combined with B-HR was strongly associated with EA diseases, particularly pharyngitis and PND. Cough was significantly associated with PND, either when it was the sole symptom (OR 2.16, CI 1.14-4.09) or when it was combined with wheeze and/or dyspnoea (OR 3.53, CI 1.97-6.33). Our results suggest that extrathoracic airway dysfunction may account for asthma-like symptoms, particularly chronic cough. This abnormality seems to be sustained by chronic diseases of the upper respiratory tract.
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PMID:Are asthma-like symptoms due to bronchial or extrathoracic airway dysfunction? 767 38

Respiratory symptoms, recurrent infectious exacerbations, and progressive lung destruction in cystic fibrosis can be attributed to bacterial persistence and the accumulation of viscous purulent secretions in the airways. Purulent secretions contain high concentrations of extracellular DNA, a viscous material released by leukocytes. To evaluate the potential clinical utility of recombinant human DNase I (rhDNase or Pulmozyme), the human enzyme was cloned, sequenced, and expressed. In in vitro studies, rhDNase has been shown to reduce the viscoelasticity, reduce the adhesiveness, and improve the mucociliary transportability of cystic fibrosis sputum. In short-term phase 1 and phase 2 clinical trials, rhDNase has been shown to be safely tolerated and to improve the FEV1, FVC, and symptoms of dyspnea. A long-term placebo-controlled phase 3 study was performed in 968 adults and children (> or = 5 years) with cystic fibrosis to determine the effect of rhDNase on the risk of respiratory exacerbations requiring parenteral antibiotics and on the FEV1. Compared with placebo-treated patients, patients treated with rhDNase once daily or twice daily experienced a reduced risk of respiratory exacerbations by 28% (p = 0.04) and 37% (p = 0.01), respectively, and had a mean improvement in FEV1 of 5.8% (p < 0.01) and 5.6% (p < 0.01), respectively. Compared with placebo-treated patients, patients treated with rhDNase spent 2.7 fewer days receiving parenteral antibiotics (p = 0.04) and spent 1.3 fewer days in the hospital (p = 0.06) over the 6-month treatment period. Inhalation of rhDNase did not cause anaphylaxis but was associated with upper airway symptoms (ie, voice alteration, hoarseness, pharyngitis) that were generally mild and transient. In conclusion, aerosol administration of rhDNase was safely tolerated, reduced the risk of infectious exacerbations requiring parenteral antibiotics, and improved pulmonary function and patient well-being.
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PMID:Aerosolized recombinant human DNase I for the treatment of cystic fibrosis. 784 16

Necropsies performed between 1989 and 1995 on 15 African rope squirrels (Funisciurus substriatus) and 20 African ground squirrels (Xerus erythropus) from the Baltimore Zoo revealed 13 cases of gongylonemiasis. Nematodes were embedded in the epithelium of the esophagus, pharynx, buccal mucosa, and tongue, resulting in varying degrees of esophagitis, pharyngitis, stomatitis, and glossitis, respectively. Routine fecal examinations were negative, and the nematodes appeared to be unaffected by repeated treatments with ivermectin. Most of the affected animals had shown clinical signs of dyspnea and/or inanition and emaciation. Suppurative rhinitis was also a frequent finding at necropsy and was associated with the presence of the nematodes in eight animals. Dissection of whole nematodes from formalin-fixed specimens revealed morphologic features consistent with Gongylonema macrogubernaculum, a species previously only reported in nonhuman primates. The squirrels were housed in the same building with numerous primate species, and a review of pathology records revealed esophageal gongylonemiasis in three lion-tailed macaques (Macaca silenus), lingual gongylonemiasis in a spotnose monkey (Cercopithecus buettikoferi), and buccal gongylonemiasis in a brown-headed tamarin (Saguinus fuscicollis). Examination of whole nematodes dissected from one of the lion-tailed macaques also demonstrated the unique morphology of G. macrogubernaculum. Nematodes belonging to the species Gongylonema are acquired by ingestion of the intermediate host, the cockroach. This is the first report of G. macrogubernaculum in a nonprimate species and suggests that captive African squirrels can serve as reservoir hosts for this parasite in a zoo environment.
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PMID:Gongylonema macrogubernaculum in captive African squirrels (Funisciurus substriatus and Xerus erythropus) and lion-tailed macaques (Macaca silenus). 980 9

The aim of this study is to evaluate the prevalence of dermo-respiratory symptoms from lung-function spirometer values and serum IgE levels in farmers who have been exposed to pesticides in the United Arab Emirates (E.A.U.). The study was a comparison of 98 farmers with 98 non-farmers, the two groups were equivalent in age, sex and selected regions--the town of Al-Ain and in the Emirates of Dubai, Sharjah and Fujairah. Most of the farmers were illiterate or poorly educated (p < 0.0001). Most lived in prefabricated houses (50.5%). Use of chemical substances (70.9%) and a mixture of pesticides by the farmers (60.2%) was very high. The results revealed that the farmers had a very high prevalence of chronic dermo-respiratory symptoms. These differences are statistically significant when compared with the reference group, particularly for the following symptoms: cough (p < 0.003), pharyngitis (p < 0.0003), bronchitis (p < 0.02), asthma (p < 0.008), respiratory insufficiency (p < 0.006), pneumonia (p < 0.003), dyspnea (p < 0.006), nasal catarrh (p < 0.001), sinusitis (p < 0.05), pharyngeal irritation (p < 0.01), nasal irritation (dryness, sneezing and secretions) (p < 0.005), ocular irritation (p < 0.05), cutaneous pruritus (p < 0.002), and contact dermatitis (p < 0.02). The spirometer tests (all parameters together) measured in the farmers were significantly reduced by comparison with the reference group. In conclusion, the authors suggest that a high prevalence of dermo-respiratory symptoms, supported by reduced spirometer tests and high serum IgE, is associated with exposure to pesticides. These results are clearly useful for establishment of work-related reduced exposure in the future.
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PMID:Respiratory symptoms, skin disorders and serum IgE levels in farm workers. 1021 28

We report about a boy with Barth-syndrome (X-chromosomal cardioskeletal myopathy, neutropenia and abnormal mitochondria) and postinflammatorial pharyngeal stenosis. After a pseudomembranous pharyngitis he developed a dyspnea and an inability to swallow with a resultant aspiration pneumonia. After endoscopic diagnosis of scarred pharyngeal stenoses the child required a tracheostomy and a percutaneous endoscopic gastrostomy tube. Then the boy underwent transoral pharyngoplastic surgery. Thirty five months after pharyngoplasty transoral nutrition was feasible. The tracheostomy was closed and the gastrostomy tube was removed. Throughout a 40 month period of observation the child had no more complaints relating to the minor residual pharyngeal stenoses.
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PMID:Postinflammatorial stenoses of the pharynx in a child with Barth-syndrome. 1262 46

An open multi-centered veterinary clinical trial, comparing conditions before and after treatment with a herbal preparation, containing the powdered root of Echinacea purpurea, was conducted by 6 practicing veterinarians in Switzerland. The plant-based immune stimulant was administered to 41 dogs with manifestations of chronic and seasonal upper respiratory tract infections, including pharyngitis/tonsillitis, bronchitis and kennel cough. Each animal was at an individual stage of the disease, with various symptoms and different severity scores, at start of treatment. There was no control group. Echinacea powder (1:3) was administered with the food at a dose of 1.0 g/10 kg body weight once daily for 8 weeks. Overall efficacy showed significant improvement for 92% of 39 dogs after 4 weeks of treatment and this was confirmed after 8 weeks. Significant reductions of severity and resolution of typical clinical symptoms, of clear nasal secretions, enlargement of lymph nodes, dry cough, dyspnea and dry lung sounds, were evident after 4 weeks. Only two adverse effects, not suspected to be attributable to the study drug, were recorded. Because quality and stability of the Echinacea powder were defined, using an analytical standard and purity tests, these data suggest, that the Echinacea preparation can be recommended as a well tolerated alternative treatment of canine upper respiratory tract infections.
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PMID:Echinacea powder: treatment for canine chronic and seasonal upper respiratory tract infections. 1278 83


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