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1.
BMC Infect Dis ; 20(1): 716, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993540

RESUMO

BACKGROUND: A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age. CASE PRESENTATION: The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5. CONCLUSION: MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Síndrome de Resposta Inflamatória Sistêmica/complicações , Adulto , Aspirina/administração & dosagem , Aspirina/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/virologia , Tosse/complicações , Diarreia/complicações , Dispneia/complicações , Feminino , Febre/complicações , Humanos , Imunoglobulinas Intravenosas/administração & dosagem , Imunoglobulinas Intravenosas/uso terapêutico , Pandemias , Faringite/complicações , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase , Síndrome de Resposta Inflamatória Sistêmica/tratamento farmacológico , Síndrome de Resposta Inflamatória Sistêmica/virologia , Resultado do Tratamento , Vômito/complicações
2.
J Pediatr Adolesc Gynecol ; 33(4): 429-431, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32224248

RESUMO

BACKGROUND: Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome is a cyclic autoinflammatory disease generally diagnosed in childhood. There have been studies suggesting a relationship between menstruation and other autoinflammatory syndromes such as familial Mediterranean fever (FMF), but not PFAPA specifically. CASE: This case describes a patient with a diagnosis of PFAPA who experienced complete resolution with tonsillectomy only to have recurrence of symptoms with onset of menstruation. She experienced symptom control with initiation of oral contraceptives. SUMMARY AND CONCLUSION: Prior to this case report, there had been no evidence in the literature suggesting a relationship between PFAPA and menstruation despite the observed association in other autoinflammatory syndromes. Onset of menses may be a trigger in PFAPA.


Assuntos
Febre/complicações , Linfadenite/complicações , Menstruação/fisiologia , Faringite/complicações , Estomatite Aftosa/complicações , Criança , Feminino , Febre/diagnóstico , Humanos , Linfadenite/diagnóstico , Masculino , Faringite/diagnóstico , Recidiva , Estomatite Aftosa/diagnóstico , Síndrome
3.
Acta otorrinolaringol. esp ; 71(2): 78-82, mar.-abr. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-192443

RESUMO

OBJETIVO: Relacionar la clínica de disfagia con la enfermedad de Forestier-Rotes-Querol o hiperostosis esquelética difusa idiopática (HEDI), desorden por osificación del ligamento cervical anterior común y calcificaciones en otras articulaciones. PACIENTES Y MÉTODOS: Revisión del historial clínico-radiológico de 455 pacientes que en 5 años consultaron en nuestro centro por disfagia, remitidos desde Atención Primaria o diferentes especialidades. El diagnóstico de HEDI se estableció en función de los criterios descritos por Resnick. RESULTADOS: Sobre un volumen total de 32.544 pacientes atendidos, el 1,4% consultó por disfagia alta. En 51 casos con esta sintomatología -el 11,2% de los sujeto- pudieron verificarse datos congruentes con los hallazgos radiológicos diagnósticos de HEDI. La incidencia observada fue de 7:100.000 habitantes-año. Dos casos con disfagia severa mejoraron con la retirada del hueso cervical neoformado. CONCLUSIONES: La HEDI supone una osificación interarticular anquilosante habitualmente sistémica pero asintomática. Al manifestarse, distorsiona principalmente las funciones de cuello y vías altas, generando sobre todo disfagia. Unos pocos casos requieren cirugía liberadora de estas calcificaciones


OBJECTIVE: To relate symptoms of dysphagia to Forestier-Rotes Querol disease or diffuse idiopathic skeletal hyperostosis (DISH), a disorder due to ossification in the anterior longitudinal ligament and calcifications in other entheses. PATIENTS AND METHODS: Review of clinical and radiological findings in 455 outpatients attended at our Centre with dysphagia, for 5 years, referred from dental, trauma, neurological or primary health care. A diagnosis of DISH was established using Resnick's criteria. RESULTS: We detected 51 cases with dysphagia consistent with DISH diagnostic criteria - 11.2% of subjects suffering this symptom- out of 32544 outpatients attended. An incidence of 7:100000 inhabitants per year was observed. Two cases showed significant improvement after removing the new bone in the spine. CONCLUSIONS: DISH is an ankylosing ossification between the joints, frequently systemic but showing no clinical symptoms. When symptoms manifest, neck movements and upper airways are involved, mainly dysphagia. A few cases need surgery to relieve the calcification processes


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Hiperostose Esquelética Difusa Idiopática/epidemiologia , Transtornos de Deglutição/complicações , Hiperostose Esquelética Difusa Idiopática/fisiopatologia , Transtornos de Deglutição/diagnóstico , Osteogênese , Estudos Retrospectivos , Faringite/complicações , Coluna Vertebral/diagnóstico por imagem
7.
Immunol Res ; 67(4-5): 304-309, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31745821

RESUMO

Macroscopic hematuria concomitant with acute pharyngitis is a characteristic feature of immunoglobulin A nephropathy (IgAN). Although the underlying mechanism of worsening hematuria has not been fully elucidated, activation of the innate immune system of nasopharynx-associated lymphoid tissue is thought to play an important role. The epipharynx is an immunologically activated site even under normal conditions, and enhanced activation of innate immunity is likely to occur in response to airborne infection. As latent but significant epipharyngitis presents in most IgAN patients, it is plausible that acute pharyngitis due to airway infection may contribute as a trigger of the epipharyngeal innate immune system, which is already upregulated in the chronically inflamed environment. The aim of this review was to discuss the mechanism of epipharynx-kidney axis involvement in glomerular vasculitis responsible for the worsening of hematuria in IgAN.


Assuntos
Imunidade Inata , Glomérulos Renais , Faringite , Faringe , Glomerulonefrite por IGA/etiologia , Glomerulonefrite por IGA/imunologia , Glomerulonefrite por IGA/patologia , Humanos , Glomérulos Renais/imunologia , Glomérulos Renais/patologia , Faringite/complicações , Faringite/imunologia , Faringite/patologia , Faringe/imunologia , Faringe/patologia
8.
Dermatol Online J ; 25(7)2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31450285

RESUMO

Numerous studies have suggested a correlation between oral health, the oral microbiome, and various dermatologic conditions, particularly psoriasis. In this study, we utilize a specially designed questionnaire administered to 265 patients at The Ohio State University's dermatology clinics to explore the relationship between psoriasis and a combination of factors that included dietary habits, oral health, and oral hygiene practices. Age, family history of psoriasis, previous diagnosis of strep throat or rheumatoid arthritis, and oral pain or discomfort experienced within the last 12 months were all found to be significant predictors of psoriasis. Additionally, higher body mass index scores, poor gum health, and speech difficulties related to dental problems were all correlated with more severe psoriasis symptoms. Conversely, patients who reported consuming fresh fruit at least once a day experienced milder symptoms. Our goal is to develop a better understanding of how and why psoriasis incidence is correlated with some of the oral health factors under review.


Assuntos
Dieta/efeitos adversos , Higiene , Saúde Bucal , Psoríase/etiologia , Adulto , Fatores Etários , Artrite Reumatoide/complicações , Estudos de Casos e Controles , Progressão da Doença , Humanos , Modelos Lineares , Modelos Logísticos , Pessoa de Meia-Idade , Gravidade do Paciente , Faringite/complicações , Faringite/microbiologia , Psoríase/genética , Estudos Retrospectivos , Fatores de Risco , Infecções Estreptocócicas/complicações , Inquéritos e Questionários
11.
Turk J Ophthalmol ; 49(3): 164-167, 2019 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-31245979

RESUMO

Tularemia is a zoonotic disease caused by Francisella tularensis, a highly virulent gram-negative coccobacillus. Oropharyngeal tularemia, one of the clinical subtypes, is the most common clinical form of the disease in Eastern Europe, including Turkey. This clinical form affects mostly the head and neck region and the most common complaints of patients are mass in the neck, sore throat, and fever. This form of tularemia may be confused with tonsillitis, pharyngitis, or cervical lymphadenitis caused by other microbial agents due to the nonspecific clinical and laboratory features. In this study, we present a patient with nasolacrimal duct obstruction and dacryocystitis caused by oropharyngeal tularemia.


Assuntos
Dacriocistite/etiologia , Infecções Oculares Bacterianas/etiologia , Francisella tularensis/isolamento & purificação , Obstrução dos Ductos Lacrimais/etiologia , Orofaringe/microbiologia , Faringite/complicações , Tularemia/complicações , Adulto , Dacriocistite/diagnóstico , Dacriocistite/microbiologia , Diagnóstico Diferencial , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/microbiologia , Humanos , Obstrução dos Ductos Lacrimais/diagnóstico , Obstrução dos Ductos Lacrimais/microbiologia , Imagem por Ressonância Magnética , Masculino , Ducto Nasolacrimal/microbiologia , Ducto Nasolacrimal/patologia , Orofaringe/diagnóstico por imagem , Faringite/diagnóstico , Faringite/microbiologia , Doenças Raras , Tularemia/diagnóstico
12.
BMC Res Notes ; 12(1): 339, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200755

RESUMO

OBJECTIVES: Streptococcus pyogenes is the most frequent cause of pharyngitis and skin infections in children. It is also the causative agent of dangerous immune-complications such as rheumatic fever and rheumatic heart disease which are common in Yemen. The aim of this study was to determine the throat carriage rate of Streptococcus pyogenes among asymptomatic school children in Sana'a city. RESULTS: A cross-sectional study was conducted from December to March of years 2012-2016. A total of 813 asymptomatic school children whose antistreptolysin O test was negative were included. The mean age of the students was 10.5 ± 2.8 years with a range from 5 to 15 years old. Throat swab and blood sample were taking from each student. One hundred and four (12.8%) healthy students were found to be Streptococcus pyogenes carriers. Pharyngeal Streptococcus pyogenes carriage rate was statistically insignificant among different age groups. However, it was found to be more common among females (66, 15%) than males (38, 10%) with statistically significant difference (χ2 = 4.52, P = 0.04). This study showed a high asymptomatic carriage rate of Streptococcus pyogenes in the throat of healthy school children in Sana'a city, Yemen.


Assuntos
Faringite/microbiologia , Faringe/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/fisiologia , Adolescente , Portador Sadio/epidemiologia , Portador Sadio/microbiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Faringite/complicações , Faringite/epidemiologia , Prevalência , Instituições Acadêmicas , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/epidemiologia , Iêmen/epidemiologia
13.
BMJ Case Rep ; 12(5)2019 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-31061197

RESUMO

Primary peritonitis, a bacterial infection within the peritoneal cavity that arises in the absence of an intraperitoneal source, is a rare entity in paediatrics. We describe the case of a previously healthy 11-year-old girl who presented with an acute abdomen and was found to have primary peritonitis due to Streptococcus pyogenes She had an episode of pharyngitis with pharyngeal cultures positive for S. pyogenes in the month prior to presentation. We performed a review of the literature to better elucidate the risk factors, pathophysiology and presentation of peritonitis due to S. pyogenes and to draw attention to the potential association between group A streptococcal pharyngitis and peritonitis.


Assuntos
Abdome Agudo/cirurgia , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Peritonite/patologia , Faringite/diagnóstico , Infecções Estreptocócicas/complicações , Streptococcus pyogenes/isolamento & purificação , Abdome Agudo/microbiologia , Apendicectomia , Criança , Feminino , Humanos , Cavidade Peritoneal , Peritonite/microbiologia , Peritonite/cirurgia , Faringite/complicações , Resultado do Tratamento
15.
Rheumatol Int ; 39(6): 1099-1105, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31020337

RESUMO

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a recurrent fever syndrome for which tonsillectomy is a therapeutic option curing the disease in most patients. Recurrence after remission with tonsillectomy is extremely rare. Increasing number of reports on diverse disease manifestations in PFAPA could give us clues about the disease etiopathogenesis. We aimed to describe a patient with recurrence of PFAPA syndrome after tonsillectomy and to review the previous studies including similar cases. We report a 17-year-old boy with PFAPA syndrome who experienced remission for 3 years after tonsillectomy and was later found to harbor an MEFV mutation when the disease relapsed. He responded well to colchicine treatment at relapse. The literature review revealed 14 articles describing 24 similar PFAPA patients. The therapeutic options include single-dose corticosteroids and nonsteroidal anti-inflammatory drugs during attacks, cimetidine, and resurgery. The presented case was the only one heterozygous for an MEFV mutation and treated with colchicine at disease relapse. Albeit rare, the reoccurrence of PFAPA after tonsillectomy could occur. The presence of such patients opposes with the hypothesis that the trigger or immune dysregulation in PFAPA pathogenesis resides in tonsils.


Assuntos
Colchicina/uso terapêutico , Febre/terapia , Linfadenopatia/terapia , Faringite/terapia , Estomatite Aftosa/terapia , Tonsilectomia , Moduladores de Tubulina/uso terapêutico , Adolescente , Febre/complicações , Heterozigoto , Humanos , Linfadenopatia/complicações , Masculino , Pescoço , Faringite/complicações , Pirina/genética , Recidiva , Estomatite Aftosa/complicações , Síndrome
16.
Biomarkers ; 24(5): 429-435, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30908094

RESUMO

Purpose: This study examined whether circulating C-reactive protein (CRP) is elevated in obstructive sleep apnoea (OSA) independent of the confounding effects of comorbidities, smoking, body mass index (BMI), age and gender. Methods: A systematic review of the literature was performed using PubMed, Embase and Cochrane databases from 1 January 1997 to 1 November 2017 using the key words obstructive sleep apnoea and C-Reactive protein to identify full text English language studies that compared CRP in adult non-smoking OSA participants without comorbidities and adult healthy non-smoking control participants matched for BMI, age and gender. Data from eligible studies were subjected to meta-analysis using RevMan version 5.3. Results: Five studies (219 OSA participants, 116 controls) met the selection criteria. The total standard mean difference for circulating high sensitivity CRP was 0.61 mg/dL higher in OSA participants than in control participants (confidence interval: 0.38 to 0.84, p < 0.00001), with low between-studies heterogeneity (df = 7, p = 0.16, I2 = 33%) and minimal evidence of publication bias. Conclusions: CRP levels in non-smoking OSA participants without comorbidities were increased relative to levels in healthy matched non-smoking control participants, suggesting that pharyngeal or systemic inflammatory effects attributable to OSA may elevate CRP.


Assuntos
Proteína C-Reativa/metabolismo , Síndromes da Apneia do Sono/sangue , Adulto , Proteína C-Reativa/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Faringite/complicações , Faringite/metabolismo , Fatores de Risco , Síndromes da Apneia do Sono/etiologia
17.
Acta Paediatr ; 108(8): 1385-1392, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30901126

RESUMO

AIM: Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is the most common cause of a periodic fever in childhood. The exact pathogenesis and the aetiology of PFAPA are still unknown. METHODS: We conducted a non-systematic review of published articles about PFAPA syndrome and summarised the evidence for diagnostic criteria and treatment options for PFAPA. RESULTS: The first proposed diagnostic criteria for PFAPA, in addition to periodic fever, included aphthous stomatitis, pharyngitis or cervical lymphadenitis in children younger than five years at the beginning of the symptoms. C-reactive protein (CRP) levels and leucocyte counts increase in most patients during episodes. Recent research reveals that tonsillectomy provides an immediate and long-lasting cure for PFAPA, even in the absence of classic criteria of aphthous stomatitis, pharyngitis or cervical adenitis and in children older than five years. CONCLUSION: We suggest that PFAPA can be diagnosed in children with at least five regularly occurring fever episodes without any other explanation, even in the absence of aphthous stomatitis, pharyngitis or cervical lymphadenitis and also in children older than five years.


Assuntos
Febre/complicações , Linfadenite/complicações , Faringite/complicações , Estomatite Aftosa/complicações , Pré-Escolar , Diagnóstico Diferencial , Febre/diagnóstico , Humanos , Linfadenite/diagnóstico , Faringite/diagnóstico , Estomatite Aftosa/diagnóstico , Síndrome
18.
Rheumatol Int ; 39(6): 957-970, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30798384

RESUMO

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a recurrent fever syndrome of early childhood with increasing number of adult-onset cases. Although it is a self-limited disease, it may negatively affect the quality of life. The aim of this review is to present a detailed analysis of PFAPA syndrome and an algorithm for diagnosis, therapeutic options, and evaluation of outcome. A comprehensive literature search was conducted through the Cochrane Library, Scopus, and MEDLINE/PubMed databases. The main topics covered are the epidemiology, clinical manifestations, diagnosis, differential diagnosis, etiopathogenesis, genetics, management, disease course and prognosis, disease in adults, unsolved issues, and unmet needs in PFAPA. The diagnosis of PFAPA is mainly based on clinical classification criteria. The most relevant hypothesis for pathogenesis is that dysregulated immune system in a genetically predisposed individual responds to a yet unidentified trigger in an exaggerated way. The pedigree analyses suggest a genetic background for the disease with an autosomal dominant pattern of inheritance. For management, single-dose corticosteroids during attacks and tonsillectomy remain the most effective therapies, while colchicine is a promising option to decrease attack frequency. There remain unsolved issues in PFAPA such as the exact etiopathogenesis and genetic background, the reason why the inflammation is restricted to the oropharyngeal lymphoid tissue, reasons for clock-work regularity of attacks, and self-limited disease course. There is need for a valid diagnostic criteria set with a high performance for both children and adults and consensus on management of PFAPA.


Assuntos
Febre/imunologia , Inflamação/imunologia , Linfadenite/imunologia , Faringite/imunologia , Estomatite Aftosa/imunologia , Corticosteroides/uso terapêutico , Febre/complicações , Febre/diagnóstico , Febre/terapia , Humanos , Inflamação/diagnóstico , Inflamação/terapia , Linfadenite/complicações , Linfadenite/diagnóstico , Linfadenite/terapia , Pescoço , Faringite/complicações , Faringite/diagnóstico , Faringite/terapia , Recidiva , Estomatite Aftosa/complicações , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/terapia , Síndrome , Tonsilectomia
19.
BMJ Case Rep ; 12(1)2019 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-30700448

RESUMO

Fusobacterium necrophorum is a rare infection most notable for causing Lemierre's syndrome. This consists of a primary oropharyngeal infection and septic thrombophlebitis, and one or more metastatic focus. Prior to the widespread use of antibiotics, Lemierre's syndrome commonly followed a rapidly progressing course, with a high mortality. We describe a case of a previously well 18-month-old boy who presented to the emergency department with a 3-week history of progressive, right-sided, painful neck swelling and systemic sepsis. He was initially treated conservatively with intravenous antibiotics, but ultimately required surgical drainage. Lemierre's syndrome is a rare condition with increasing incidence which can have significant adverse outcomes including death. Early recognition and treatment are essential, but identifying Lemierre's disease is challenging.


Assuntos
Fusobacterium necrophorum/isolamento & purificação , Síndrome de Lemierre/complicações , Síndrome de Lemierre/diagnóstico , Faringite/complicações , Faringite/tratamento farmacológico , Sepse/complicações , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Cavidades Cranianas/diagnóstico por imagem , Cavidades Cranianas/microbiologia , Diagnóstico Diferencial , Drenagem , Humanos , Lactente , Veias Jugulares/diagnóstico por imagem , Veias Jugulares/microbiologia , Síndrome de Lemierre/tratamento farmacológico , Masculino , Pescoço/diagnóstico por imagem , Pescoço/microbiologia , Radiografia Intervencionista , Sepse/diagnóstico , Sepse/tratamento farmacológico , Tomografia Computadorizada por Raios X , Tonsilite/complicações , Tonsilite/tratamento farmacológico , Resultado do Tratamento , Ultrassonografia
20.
Eur Arch Otorhinolaryngol ; 276(3): 775-783, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30739176

RESUMO

PURPOSE: Acute pharyngitis is an uncomfortable disorder mostly caused by viruses and for which antibiotics are unwarranted. This study compared lozenges containing ectoine, a natural extremolyte, with hyaluronic acid lozenges and hypertonic saline gargle for symptomatic treatment of acute viral pharyngitis. METHODS: This prospective, controlled clinical study, recruited 90 patients with moderate-to-severe pharyngitis symptoms who chose to use either ectoine (n = 35), hyaluronic acid (n = 35), or saline gargle (n = 20). Patients applied their 7-day treatment from the inclusion visit (V1) until the end-of-study visit (V2). Patients' pharyngitis symptoms, general health, general treatment effectiveness and tolerability, and patient compliance were assessed by investigators and patients. RESULTS: The sum score for three primary symptoms (pain on swallowing, urge to cough, and hoarseness) decreased by 79.5% (ectoine), 72.2% (hyaluronic acid), and 44.8% (saline gargle). Both lozenges were significantly superior to saline gargle (P < 0.05). Regarding general health improvement, ectoine was significantly superior to saline gargle (72.5% vs. 45.2%, P < 0.05), but hyaluronic acid (63.3%) was not. At V2, 65.7% of patients receiving ectoine reported "very good" general health vs. 48.6% of those receiving hyaluronic acid and 20.0% using saline gargle. Ectoine was significantly superior (P < 0.05) to both hyaluronic acid and saline gargle in terms of tolerability and patient compliance. No patients taking ectoine reported unpleasant sensations while applying their treatment, whereas almost half of patients using hyaluronic acid lozenges and saline gargle did. CONCLUSION: Treatment with ectoine lozenges significantly relieves moderate-to-severe symptoms of acute viral pharyngitis and is more effective and tolerable than treatments with hyaluronic acid lozenges and hypertonic saline gargle.


Assuntos
Diamino Aminoácidos/uso terapêutico , Ácido Hialurônico/uso terapêutico , Faringite/tratamento farmacológico , Solução Salina Hipertônica/uso terapêutico , Doença Aguda , Administração Oral , Adulto , Idoso , Tosse/tratamento farmacológico , Deglutição , Método Duplo-Cego , Feminino , Rouquidão/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Dor/tratamento farmacológico , Dor/etiologia , Medição da Dor , Cooperação do Paciente , Faringite/complicações , Faringite/virologia , Estudos Prospectivos , Resultado do Tratamento
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