Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report recurrence of Kawasaki disease in a 20-year-old man eighteen years after the primary episode. Athough sixty-nine cases have been reported among adults in the literature, this represents only the second case of Kawasaki disease recurring in an adult patient after childhood presentation. Our patient presented with the characteristic mucocutaneous features, fever, arthralgia, epigastric pain and cholecystitis. His presentation was complicated by arthralgias and abnormal liver function tests, which are more common in the adult patient. The diagnosis was made based on clinical findings after the exclusion of other causes of persistent febrile illness. He was successfully treated with high dose aspirin and intravenous immunoglobulin therapy. Despite a second presentation of Kawasaki disease our patient did not have any demonstrable coronary arterial involvement. Although typically a self-limiting disease, cardiac complications can cause significant morbidity and mortality in those not treated with aspirin and IVIG. This report serves to highlight that late recurrence of Kawasaki disease may develop in adults many decades after the initial presentation. A twenty-year-old male, presented to the Emergency department with a one-week history of general malaise. He complained of sore throat, 5-day history of fever (39 degree celsius), epigastric discomfort, rash, nausea, vomiting, generalised arthralgia and myalgia. He was jaundiced with dark urine and pale stools. He had been commenced on oral penicillin three times a day for possible streptococcal infection after the rash had occurred. Past medical history was notable for a previous episode of Kawasaki disease (KD) at 2 years of age, after which there were no adverse sequelae, a history of asthma and non-alcoholic fatty liver disease.
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PMID:Recurrence of Kawasaki disease in an adult patient with cholecystitis. 1749 41

The purpose of this quality improvement study was to describe families' responses regarding the adequacy of the preoperative preparation provided in the Preoperative Assessment Clinic, and the necessity of two follow-up phone calls after pediatric ambulatory surgery for tonsillectomy with or without adenoidectomy (T+/-A). Using a questionnaire developed for the study, 90 families were contacted by phone on the first postoperative day and, of them, 73 were contacted a second time between the ninth and twelfth postoperative days. Families' responses were reported in four categories: (1) concerns, (2) use of resources, (3) adequacy of the preoperative teaching, and (4) necessity of the two postoperative phone calls. Results showed that, at the first phone call, a sore throat was reported as the most important concern followed by a decreased oral intake (ie, fluid, food, medicine), vomiting, and fever or "perceived fever." During the second phone call, a sore throat remained the most important concern followed by a decreased intake. Earache was the third highest concern and vomiting was then reported of concern by a minority of families. The most frequently consulted resource person for concerns was the physician on call for the otolaryngology service. Eighty-seven percent of families felt the preoperative preparation was adequate. For reasons of instructional and/or emotional support, 94% of families who responded reported that the first phone call was necessary and 68% reported that the second call was as well.
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PMID:Follow-up phone calls after pediatric ambulatory surgery for tonsillectomy: what can we learn from families? 1766 96

In a randomised double blind prospective study, we tested the hypothesis that postoperative pain is lower in patients who receive an ProSeal LMA laryngeal mask airway compared with a tracheal tube. One hundred consecutive female patients (ASA I-II, 18-75 years) undergoing laparoscopic gynaecological surgery were divided into two equal-sized groups for airway management with the ProSeal LMA or tracheal tube. Anaesthesia management was identical for both groups and included induction of anaesthesia using propofol/fentanyl, and maintenance with propofol/remifentanil, muscle relaxation with rocuronium, positive pressure ventilation, gastric tube insertion, dexamethasone/tropisetron for anti-emetic prophylaxis, and diclofenac for pain prophylaxis. All types of postoperative pain were treated using intravenous patient-controlled analgesia (PCA) morphine. Patients and postoperative staff were unaware of the airway device used. Data were collected by a single blinded observer. We found that pain scores were lower for the ProSeal LMA at 2 h and 6 h but not at 24 h. Morphine requirements were lower for the ProSeal LMA by 30.4%, 30.6% and 23.3% at 2, 6 and 24 h, respectively. Nausea was less common with the ProSeal LMA than with the tracheal tube at 2 h and 6 h but not at 24 h. There were no differences in the frequency of vomiting, sore throat, dysphonia or dysphagia. We conclude that postoperative pain is lower for the ProSeal LMA than the tracheal tube in females undergoing gynaecological laparoscopic surgery.
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PMID:A study of airway management using the ProSeal LMA laryngeal mask airway compared with the tracheal tube on postoperative analgesia requirements following gynaecological laparoscopic surgery. 1769 18

A 12-year-old boy presented with fever and sore throat of 6 days duration followed by vomiting and altered sensorium. He had received 4 doses of antirabies vaccine following a dog bite 4 weeks back. Rabies immunoglobulin was not given. History of hydrophobia and aerophobia were strikingly absent. The possibilities of rabies encephalitis and vaccine induced acute disseminated encephalomyelitis (ADEM) were considered. MRI brain showed exclusive grey matter changes characteristic of rabies. The diagnosis was further confirmed by serological tests.
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PMID:Rabies encephalitis. 1792 63

The clinical experience of Professor OUYANG Qun in using single acupoint includes treatment of Meniere's syndrome with Baihui (GV 20), optic neuritis with "Fengyan" (Extra point), painful heel with Xiaguan (ST 7), lymphoid tuberculosis with Quchi (LI 11), acute sore throat with Kongzui (LU 6), painful diseases with "Luolingwu" (Extra point), chest distress with "Kuanxiong" (Extra point), hordeolum with Feishu (BL 13), headache in menstrual period with Xuehai (SP 10), frozen shoulder with Tiaokou (ST 38), toothache with Waihuaijian (Extra point), occipital pain with Chengshan (BL 57) and vomiting with Yongquan (KI 1).
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PMID:[Professor OUYANG Qun's clinical experience on application of single point]. 1808 52

The insertion of a laryngeal mask airway (LMA) may result in postoperative sore throat. The choice of induction drug on airway morbidity after LMA insertion may be important. We performed this study to compare the incidence of postoperative pharyngeal morbidity after the insertion of a LMA in 340 patients administered either 2 mg/kg propofol (group P) or thiopental 5 mg/kg (group T) for induction of anesthesia. Patients were maintained at 1-2 minimum alveolar anesthetic concentration sevoflurane in 50% oxygen/air. Spontaneous or assisted spontaneous ventilation was maintained. An investigator blinded to group allocation visited patients at 2, 12, and 24 h postoperatively. Adverse responses were noted (yes/no) at each time point including sore throat, sore mouth, sore jaw, hoarseness, dysphonia, and dysphagia. At 2 h postoperatively, the incidence of sore throat, dysphagia, and postoperative nausea and vomiting in group T was higher than in group P (24% vs 13% for sore throat, 15% vs 3% for dysphagia, 20% vs 11% for nausea, 14% vs 6% for vomiting, P < 0.05). The number-needed-to-treat to prevent sore throat and dysphagia was 10 and 8, respectively (95% confidence intervals, 5-43). We concluded that, when propofol, rather than thiopental, is used for the induction of anesthesia, it results in a lower incidence of early pharyngeal morbidity and postoperative nausea and vomiting after the insertion of a LMA.
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PMID:Propofol causes less postoperative pharyngeal morbidity than thiopental after the use of a laryngeal mask airway. 1871 36

A 15-year-old girl was admitted with a high fever and progressive malaise, vomiting, anorexia and abdominal complaints. She previously had a sore throat and unilateral painful swollen lymph nodes in the neck. Laboratory investigation indicated a bacterial infection. Blood cultures were taken. There was infiltrate in the left lung. Pneumonia complicated with sepsis was suspected and ceftriaxone was started. The patient's condition deteriorated. Computed tomography (CT) scan showed progressive infiltrates in both lungs and pleural effusion. Blood culture led to the diagnosis. After changing antibiotics the patient slowly improved. Antibiotics were continued for several weeks.
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PMID:A previously healthy 15-year-old girl with high fever and progressive dyspnoea. 1825 50

A 13-year-old otherwise healthy premenarchal girl presented with acute onset of painful vulvar ulcerations. One day before developing vulvar ulcerations, she experienced flu-like symptoms, including a low-grade fever, cough, sore throat, and myalgia. Results of a throat swab were positive for influenza A infection (polymerase chain reaction [PCR] assay), and the patient was treated with oseltamivir. The patient's constitutional symptoms improved slightly, but within 2 days after her initial presentation, she returned to her primary care provider and described 24 hours of dysuria and vulvar swelling. She had a history of herpes labialis (cold sores) and rare episodes of minor oral aphthae (canker sores) that occurred less than twice a year. The patient denied a history of sexual activity, sexual abuse, or physical trauma. Physical examination showed ulceration and swelling of the labia minora, and the patient received an empiric dose of acyclovir (200 mg 4 times daily) for presumed autoinoculated herpes simplex virus (HSV) infection. An ulcer swab was performed, and urinalysis revealed no evidence of infection. Two days later, the patient presented to the emergency department with increasing vulvar pain and vaginal discharge. The previous ulcer swab findings were negative for HSV (PCR assay), and consequently, acyclovir was discontinued after 1 day of therapy. She received topical viscous lidocaine and an empiric dose of oral fluconazole. The lidocaine provided temporary symptomatic relief. Results of DNA amplification studies were negative for Chlamydia trachomatis and Neisseria gonorrhoeae. A potassium hydroxide preparation was negative for fungi, and an ulcer swab for bacterial culture revealed usual flora. Of note, the PCR assay for Epstein-Barr virus was not performed on ulcer cells. The patient was referred to the department of dermatology, and results of a physical examination showed copious white mucoid discharge and a 2-cm ulceration of the left labia minora (Figure, panel A). Two smaller pinpoint ulcerations and swelling of the left labia minora were also noted. The lesions were clinically indistinguishable from the genital aphthous ulcers of patients with complex aphthosis (recurrent, severe aphthous ulcers on oral or genital mucosa). A diagnosis of ulcus vulvae acutum was made, and treatment was started with clobetasol 0.05% ointment (4 times daily) and lidocaine gel as needed. Four days later, the patient reported marked symptomatic improvement. Physical examination showed near resolution of the large vulvar ulceration (Figure, panel B). The patient tapered use of clobetasol ointment over the next several days until the ulcerations healed completely. Two months after her initial episode, the patient again had 3 small vulvar erosions after symptoms that included low-grade fever, malaise, and vomiting. She did not receive oseltamivir for this illness; clobetasol ointment was applied 4 times daily, and the vulvar erosions ameliorated within a few days. Her constitutional symptoms resolved without treatment. The patient has not experienced any further episodes of vulvar ulcerations in the 18 months after the most recent treatment.
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PMID:Ulcus vulvae acutum in a 13-year-old girl after influenza A infection. 1832 8

Nausea and vomiting during the infusion of cryopreserved peripheral blood stem cells (PBSC) are common. The aim of this study was to explore the effect of lollipop with strawberry aroma on the infusion-related nausea and vomiting of cryopreserved autologous PBSCs. We compared 2 groups of adult patients receiving lollipop with strawberry aroma during cryopreserved PBSC infusions or not to assess the incidences of nausea and vomiting occurring during infusions. All patients received granisetron 3 mg i.v. twice a day, and lorazepam 1 mg every 4 hours orally for prophylaxis of the nausea and vomiting during conditioning phase and infusion day. Before infusion, all patients were premedicated with pheniramine maleate 45.5 mg i.v. and paracetamol 500 mg orally. The patients had no evidence of nausea or vomiting prior to cryopreserved PBSC infusions. The patients with ongoing nausea or vomiting owing to conditioning regimens and/or receiving additional antiemetics were excluded from the study. One hundred fifty-eight patients who consecutively underwent autologous stem cell transplantation for malignancy were included in the study. The first 110 patients (median age: 42.5, range: 17-75) were observed for the infusion related adverse effects only. The consecutive 48 patients (median age: 48, range: 18-80) were given a lollipop with strawberry aroma during cryopreserved PBSC infusions and observed for the infusion-related adverse effects. The 2 groups were comparable with respect to age, sex, diagnosis, stem cell collection methods, conditioning regimens administered, total mononuclear cell dose infused, number of total nucleated cells (TNCs) infused, number of CD34+ cells infused, number of bags infused, total volume infused, amount of dimethylsulfoxide (DMSO), and infusion rate. Patients who received a lollipop with a strawberry aroma during infusions had significantly less nausea (6.3%, n = 3 versus 21.8%, n = 24, P = .02) and vomiting (2%, n = 1 versus 13.6%, n = 15, P = .04) than the ones who did not (observation only group). Other infusion-related adverse events were as follows; hypoxia, cough, dyspnea, abdominal cramping, tachycardia, hiccup, fever, chills, chest pain, hypotension, hypertension, agitation, sore throat, and arrhythmia. Incidences of each of these adverse events were <5% in both groups and were comparable. The use of a lollipop with a strawberry aroma during infusion of cryopreserved autologous PBSCs may be promising in reduction of infusion-related nausea and vomiting, with an easy administration at a very cheap cost.
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PMID:The lollipop with strawberry aroma may be promising in reduction of infusion-related nausea and vomiting during the infusion of cryopreserved peripheral blood stem cells. 1904 Oct 66

A 73-year-old man presented to our hospital with a sore throat (left-sided) and hiccups. The patient had mucosal swelling and erosions affecting the left posterior pillar, base of tongue, epiglottis, arytenoid, and aryepiglottic fold. As the laryngeal mucosal edema became worse, herpetic vesicles and erosions developed on the left cavum conchae, external auditory canal, and palate. The patient was treated with acyclovir and a steroid. His hiccups were treated with metoclopramide, but it had little effect, and hiccups only subsided gradually after the disappearance of erosions. His hiccups relapsed transiently with vomiting, and then resolved completely. Elevation of the CF titer after 2 weeks confirmed the diagnosis of herpes zoster. This condition should be considered in patients with unilateral sore throat and intractable hiccups, and treatment with acyclovir should be provided.
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PMID:Herpes zoster laryngitis with intractable hiccups. 1926 32


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