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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Excessive intracuff pressure due to nitrous oxide diffusion into the cuff can damage the tracheal mucosa. Several endotracheal tubes have been developed (Trachelon gas barrier type tube, Brandt Anaesthesia tube) to limit nitrous oxide-related intracuff pressure increase. We investigated whether the incidence of postoperative sore throat could be reduced by using these tubes. Endotracheal intubation was performed in 37 adult female patients with either a standard tube (group S, n = 14), a gas barrier type tube (group G, n = 11), or a Brandt tube (group B, n = 12). All patients were interviewed 16-30 h postoperatively by anesthesiologist who did not know which tube had been used. The increase of intracuff pressure was significantly lower in group G (7.6 +/- 5.1 mmHg, mean +/- SD) and in group B (3.4 +/- 1.7 mmHg) than that in group S (24.0 +/- 9.5 mmHg). The incidence of postoperative sore throat was not significantly different among the groups, 36% (5/14) in group S, 45% (5/11) in group G, and 33% (4/12) in Group B. This incidence did not correlate with intracuff pressure increase. In conclusion, specially manufactured endotracheal tubes to limit excessive intracuff pressure did not effectively attenuate the incidence of postoperative sore throat in this patient population.
Masui 1996 Sep
PMID:[Postoperative sore throat--a comparison of standard cuff, gas-barrier cuff and Brandt anesthesia tube cuff]. 890 58

In 1995 the Norwegian general practitioners' associations embarked upon a three-year project to assess a new model for improving the quality of primary health care. Indicators are proposed for assessing quality and setting standards in local practice. Software has been developed to simplify collection of data and production of reports from computerized medical records. Peer groups of 5-10 practitioners discuss results, agree on local standards and plan improvements. General practitioners who participate in a cycle of quality improvement will be awarded credits for recertification as specialists in general practice. The initial topics are: care of diabetics, use of laboratory tests, management of sore throat, and management of migraine. This national project will be evaluated both in terms of improvement in the quality of care, and of the views of the participating practitioners.
Tidsskr Nor Laegeforen 1996 Sep 30
PMID:[Quality development in family practice--development and use of health indicators]. 892 66

During a period of one year, 126 patients were prospectively audited to analyse complications of endotracheal intubation in a general intensive care unit setting. A total of 62 complications were observed in 48 patients. The most frequent complications during intubation were hypotension and bradycardia. The blockage of endotracheal tubes significantly increased with the duration of intubation. Sore throat was the commonest (22%) complication following extubation. Other complications like stridor and ulceration of mouth and lips which followed extubation were not related to the duration of intubation.
J Pak Med Assoc 1996 Sep
PMID:Complications of endotracheal intubation in mechanically ventilated patients in a general intensive care unit. 893 84

The frequency and pattern of laryngeal mask airway (LMA) usage in a regional general hospital has been studied. Data were collected prospectively by means of a standardized record sheet which was completed at the time of anesthetic administration. During a 19-month period 10,150 patients underwent surgical procedures requiring general or regional anesthesia, of which 1,096 (men/ women: 791/305, ASA 3 or 4: 350, mean age: 64 years) were managed with the LMA. A clinically pattern airway was provided in 99.75% of occasions of whom 44.4% breathed spontaneously and 55.3% underwent positive pressure ventilation. The monthly frequencies of LMA usage increased significantly during the second year of the survey (25.1% vs 12.8%). Problems were recorded in 16.3% of cases: air leak 8.0%, laryngospasm 1.8%, desaturation (SpO2 < or = 90%) 1.8%, severe hypercarbia (PETCO2 > or = 50 mmHg) 1.0%, regurgitation 0.09%, sore throat 3.4%. No patient required intensive care management postoperatively. There were five cases of failed intubation managed with the LMA. This survey has shown that LMA has a well established role in anesthetic practice. Use of this device is equally safe and effective for both controlled and spontaneous ventilation in a wide range of starve patients undergoing most types of surgery.
Minerva Anestesiol 1996 Sep
PMID:The laryngeal mask airway: a survey of its usage in 1,096 patients. 903 36

This is the second in a series of practice guidelines commissioned by the Infectious Diseases Society of America through its Practice Guidelines Committee. The purpose of these guidelines is to provide assistance to clinicians when making decisions on treating the conditions specified in each guideline. The targeted providers are pediatricians, family practitioners, and internists. The targeted patients and setting for the acute pharyngitis guideline are pediatric, adolescent, and adult outpatients with a complaint of sore throat. Funding was provided by the IDSA. Panel members represented experts in adult and pediatric infectious diseases. The guidelines are evidence-based. A standard ranking system was used for the strength of the recommendations and the quality of the evidence cited in the literature reviewed. The document has been subjected to external review by peer reviewers as well as by the Practice Guidelines Committee and was approved by the IDSA Council. An executive summary, algorithms, and tables highlight the major recommendations. Indicators of quality will assist in guideline implementation. The guideline will be listed on the IDSA home page at http://www.idsociety.org.
Clin Infect Dis 1997 Sep
PMID:Diagnosis and management of group A streptococcal pharyngitis: a practice guideline. Infectious Diseases Society of America. 956 13

In developing country settings without access to bacterial culture and rapid diagnostic tests, the prevention of acute rheumatic fever depends on clinicians' presumptive treatment of streptococcal pharyngitis. This study evaluated the effectiveness of World Health Organization (WHO) acute respiratory infection guidelines in a large pediatric clinic (Abu Reesh Children's Hospital) in Cairo, Egypt. 451 children 2-13 years of age with sore throat and pharyngeal erythema were enrolled, 107 (24%) of whom had group A beta-hemolytic streptococci on throat culture. Purulent exudate, present in 99 (22%) of these children, was 31% sensitive and 81% specific for a positive culture. The WHO guidelines, which recommend treatment for pharyngeal exudate plus enlarged and tender cervical node, were 12% sensitive and 94% specific. Based on these guidelines, 13 of 107 children with a positive throat culture would correctly receive antibiotics and 323 of 344 with a negative culture would not receive antibiotics. A modified guideline in which exudate or large cervical nodes would indicate antibiotic treatment would be 84% sensitive and 40% specific. With this modification, 90 of 107 children with a positive throat culture would correctly receive antibiotics and 138 out of 344 with a negative culture would not receive treatment. However, additional prospective studies from other regions of Egypt are necessary before modified guidelines are implemented.
Lancet 1997 Sep 27
PMID:Effectiveness of clinical guidelines for the presumptive treatment of streptococcal pharyngitis in Egyptian children. 943 44

Laryngopharyngeal reflux is a new term given to gastroesophageal reflux leading to atypical symptoms in the upper aerodigestive tract. The manifestations of laryngopharyngeal reflux are varied and include chronic hoarseness, globus pharyngeus, sore throat, chronic cough, asthma, paroxysmal laryngospasm, and other less common symptoms. Making the diagnosis requires accurate history taking and can be confirmed by fiberoptic examination of the pharynx and larynx, as well as by ambulatory esophageal and pharyngeal pH monitoring. Stepwise treatment regimens are very effective in treating this condition, which exacerbates or imitates many seemingly unrelated disorders.
J Ky Med Assoc 1997 Sep
PMID:Laryngopharyngeal reflux: a modern day "great masquerader". 932 11

A previously healthy 28 year old Japanese man came to us with a genital ulcer which appeared 13 days before admission to our hospital. He had subsequently fever (40 degrees C), arthralgia, a sore throat and oral aphtha 6 days before admission. He had a history of sexual contact with a female commercial sex worker one week before his illness. On the day of admission, he had shallow ulcers on the lip, tongue and penis. Initial laboratory test included leukopenia and thrombocytopenia. His fever abated 3 days after admission. His condition and bicytopenia recovered completely after 12 days of admission. Although, his serum HIV-1 antibody was negative when he was admitted, 3 months later the antibody was seroconverted. And p24 antigen and HIV-1 RNA of stocked serum were positive. Diagnosis of primary HIV-1 infection was made. Recently, HIV-1 infection has been increasing in Japan. Consideration of this disease in differential diagnosis of acute febrile illness is necessary.
Kansenshogaku Zasshi 1997 Sep
PMID:[A case of primary HIV-1 infection]. 933 35

GABHS is the most common bacterial cause of tonsillopharyngitis, but this organism also produces acute otitis media; pneumonia; skin and soft-tissue infections; cardiovascular, musculoskeletal, and lymphatic infections; bacteremia; and meningitis. Most children and adolescents who develop a sore throat do not have GABHS as the cause; their infection is viral in etiology. Other bacterial pathogens produce sore throat infrequently (e.g., Chlamydia pneumoniae and Mycoplasma pneumoniae), and when they do, other concomitant clinical illness is present. Classic streptococcal tonsillopharyngitis has an acute onset; produces concurrent headache, stomach ache, and dysphagia; and upon examination is characterized by intense tonsillopharyngeal erythema, yellow exudate, and tender/enlarged anterior cervical glands. Unfortunately only about 20% to 30% of patients present with classic disease. Physicians overdiagnose streptococcal tonsillopharyngitis by a wide margin, which almost always leads to unnecessary treatment with antibiotics. Accordingly, use of throat cultures and/or rapid GABHS detection tests in the office is strongly advocated. Their use has been shown to be cost-effective and to reduce antibiotic overprescribing substantially. Penicillin currently is recommended by the American Academy of Pediatrics and American Heart Association as first-line therapy for GABHS infections; erythromycin is recommended for those allergic to penicillin. Virtually all patients improve clinically with penicillin and other antibiotics. However, penicillin treatment failures do occur, especially in tonsillopharyngitis in which 5% to 35% of patients do not experience bacteriologic eradication. Penicillin treatment failures are more common among patients who have been treated recently with the drug. Cephalosporins or azithromycin are preferred following penicillin treatment failures in selected patients as first-line therapy, based on a history of penicillin failures or lack of compliance and for impetigo. GABHS remain exquisitely sensitive to penicillin in vitro. There are several explanations for penicillin treatment failures, but the possibility of copathogen co-colonization in vivo has received the most attention. Treatment duration with penicillin should be 10 days to optimize cure in GABHS infections. A 5-day regimen is possible and approved by the United States Food and Drug Administration for cefpodoxime (a cephalosporin) and azithromycin (a macrolide). Prevention of rheumatic fever is the primary objective for antibiotic therapy of GABHS infections, but a reduction in contagion and faster clinical improvement also can be achieved. Development of streptococcal toxic shock syndrome and necrotizing fasciitis ("flesh-eating bacteria") are rising concerns. The portal of entry for these invasive GABHS strains is far more often skin and soft tissue than the tonsillopharynx.
Pediatr Rev 1998 Sep
PMID:Group A beta-hemolytic streptococcal infections. 974 11

We describe a patient with a streptococcal myositis/fasciitis and toxic shock syndrome following an intramuscular injection with diclofenac. A patient complaining of sore throat and headaches for two days and fever up to 38.5 degrees C for one day consulted her family physician. 75 mg of diclofenac were injected intramuscularly for symptomatic treatment. On the next day massive pain at the injection site and a generalized erythema occurs and fever up to 38.5 degrees C persists. She is admitted to the local hospital for suspected abscess formation. Despite rapid antibiotic treatment a septic shock develops. The patient is transferred to a tertiary care hospital. An extensive debridement is performed and the antibiotic regimen changed to high dose penicillin and clindamycin. The association of life threatening diseases due to Group A streptococci and non-steroidal anti-inflammatory drugs (NSAID) is well documented by several case reports. We believe there is no longer any need for intramuscular injections of NSAID. The rare but severe complications preclude further use of the intramuscular dosage in view of the availability of oral alternatives.
Ther Umsch 1998 Sep
PMID:[Erythema and fever after diclofenac i.m]. 978 79


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