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1.
J Res Health Sci ; 21(2): e00512, 2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-34465636

RESUMO

BACKGROUND: This study aimed to analyze the demographic and epidemiological features of identified COVID-19 cases in Kazakhstan. STUDY DESIGN: A cross-sectional study. METHODS: This cross-sectional study aimed to analyze COVID-19 cases (n=5116) collected from March 13 to June 6, 2020, in Kazakhstan. The data were obtained from a state official medical electronic database. The study investigated the geographic and demographic data of patients as well as the association of COVID-19 cases with gender and age. The prevalence of symptoms, the presence of comorbidities, complications, and COVID-19 mortality were determined for all patients. RESULTS: The mean±SD age of the patients in this study was 34.8±17.6 years, and the majority (55.7%) of COVID-19 cases were male and residents of cities (79.6%). In total, 80% of the cases had the asymptomatic/mild form of the disease. Cough (20.8 %) and sore throat (17.1%) were the most common symptoms among patients, and pneumonia was diagnosed in 1 out of 5 cases. Acute respiratory distress syndrome (ARDS) was recorded in 1.2% of the patients. The fatality rate was 1% in the study population and lethality was 2.6 times higher in males compared to females.  Each additional year in age increased the probability of COVID-19 infection by 1.06 times. The presence of cardiovascular, diabetes, respiratory, and kidney diseases affected the rate of mortality (P<0.05). CONCLUSION: The results demonstrated a high proportion (40%) of the asymptomatic type of coronavirus infection in the Kazakhstan population. The severity of COVID-19 symptoms and lethality were directly related to the age of patients and the presence of comorbidities.


Assuntos
COVID-19 , Portador Sadio/virologia , Tosse/etiologia , Pandemias , Faringite/etiologia , Adolescente , Adulto , Fatores Etários , Idoso , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/mortalidade , COVID-19/virologia , Portador Sadio/epidemiologia , Criança , Comorbidade , Tosse/epidemiologia , Estudos Transversais , Feminino , Humanos , Cazaquistão/epidemiologia , Masculino , Pessoa de Meia-Idade , Faringite/epidemiologia , Pneumonia/epidemiologia , Pneumonia/etiologia , Síndrome do Desconforto Respiratório/epidemiologia , Síndrome do Desconforto Respiratório/etiologia , Estudos Retrospectivos , SARS-CoV-2 , Fatores Sexuais , Adulto Jovem
2.
PLoS Med ; 18(9): e1003777, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34582457

RESUMO

BACKGROUND: Rapid detection, isolation, and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict COVID-19 and investigated whether predictive symptoms differ between the B.1.1.7 (Alpha) lineage (predominating as of April 2021 in the US, UK, and elsewhere) and wild type. METHODS AND FINDINGS: We obtained throat and nose swabs with valid SARS-CoV-2 PCR test results from 1,147,370 volunteers aged 5 years and above (6,450 positive cases) in the REal-time Assessment of Community Transmission-1 (REACT-1) study. This study involved repeated community-based random surveys of prevalence in England (study rounds 2 to 8, June 2020 to January 2021, response rates 22%-27%). Participants were asked about symptoms occurring in the week prior to testing. Viral genome sequencing was carried out for PCR-positive samples with N-gene cycle threshold value < 34 (N = 1,079) in round 8 (January 2021). In univariate analysis, all 26 surveyed symptoms were associated with PCR positivity compared with non-symptomatic people. Stability selection (1,000 penalized logistic regression models with 50% subsampling) among people reporting at least 1 symptom identified 7 symptoms as jointly and positively predictive of PCR positivity in rounds 2-7 (June to December 2020): loss or change of sense of smell, loss or change of sense of taste, fever, new persistent cough, chills, appetite loss, and muscle aches. The resulting model (rounds 2-7) predicted PCR positivity in round 8 with area under the curve (AUC) of 0.77. The same 7 symptoms were selected as jointly predictive of B.1.1.7 infection in round 8, although when comparing B.1.1.7 with wild type, new persistent cough and sore throat were more predictive of B.1.1.7 infection while loss or change of sense of smell was more predictive of the wild type. The main limitations of our study are (i) potential participation bias despite random sampling of named individuals from the National Health Service register and weighting designed to achieve a representative sample of the population of England and (ii) the necessary reliance on self-reported symptoms, which may be prone to recall bias and may therefore lead to biased estimates of symptom prevalence in England. CONCLUSIONS: Where testing capacity is limited, it is important to use tests in the most efficient way possible. We identified a set of 7 symptoms that, when considered together, maximize detection of COVID-19 in the community, including infection with the B.1.1.7 lineage.


Assuntos
COVID-19/complicações , COVID-19/diagnóstico , Modelos Biológicos , Ageusia/diagnóstico , Ageusia/etiologia , Ageusia/virologia , Anosmia/diagnóstico , Anosmia/etiologia , Anosmia/virologia , Apetite , Área Sob a Curva , COVID-19/virologia , Calafrios/diagnóstico , Calafrios/etiologia , Calafrios/virologia , Controle de Doenças Transmissíveis , Tosse/diagnóstico , Tosse/etiologia , Tosse/virologia , Inglaterra , Reações Falso-Positivas , Feminino , Febre/diagnóstico , Febre/etiologia , Febre/virologia , Humanos , Masculino , Programas de Rastreamento , Mialgia/diagnóstico , Mialgia/etiologia , Mialgia/virologia , Faringite/diagnóstico , Faringite/etiologia , Faringite/virologia , Reação em Cadeia da Polimerase , SARS-CoV-2/genética , Medicina Estatal
4.
Adv Emerg Nurs J ; 43(3): 198-205, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34397496

RESUMO

A 9-year old male presented to the emergency department for the evaluation of a sore throat. Initial history of present illness stated in the triage note was that "the child complained of a sore throat," suggesting possible pharyngitis. There was no evidence of stridor, sialorrhea, hypoxia, or aphonia. Further investigation of the history of present illness identified the concern for a possible esophageal foreign body. Imaging studies of the neck identified a fishbone in the esophagus. This case presentation discusses an atypical presentation of an esophageal foreign body and the subtle findings on assessment and imaging. This case highlights the importance of illiciting a history of present illness and the subtleties of esophageal foreign body identification.


Assuntos
Osso e Ossos , Corpos Estranhos/diagnóstico por imagem , Faringite/diagnóstico por imagem , Faringite/etiologia , Animais , Criança , Diagnóstico Diferencial , Serviço Hospitalar de Emergência , Esofagoscopia , Peixes , Corpos Estranhos/terapia , Humanos , Masculino , Faringite/terapia
5.
Medicine (Baltimore) ; 100(24): e26287, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128862

RESUMO

BACKGROUND: Supraglottic airway (SGA) devices do not definitively protect the airway from regurgitation of gastric contents. Increased gastric pressure and long operation time are associated with development of complications such as aspiration pneumonia. The aim of this study was to compare intragastric pressure between second-generation SGA and endotracheal tube (ETT) devices during long-duration laparoscopic hepatectomy. METHODS: A total of 66 patients was randomly assigned to 2 groups; 33 patients each in the ETT and SGA groups. Intragastric pressure was continuously measured via a gastric drainage tube with a three-way stopcock connected to the pressure monitoring device. Normal saline was added to the end of the gastric drainage tube at each operation time point. RESULTS: Intragastric pressure during pneumoperitoneum was no different between the 2 groups (P = .146) or over time (P = .094). The mean (standard deviation [SD]) pH of the SGA tip measured after operation was 6.7 (0.4), and a pH <4 was not observed. Relative risk of postoperative complications was significantly higher in the ETT group relative to the SGA group (sore throat, 5.5; cough,13.0). CONCLUSIONS: Use of SGA devices does not further increase intragastric pressure, even during prolonged upper abdominal laparoscopic surgery. Also, the frequency of postoperative sore throat and cough was significantly lower when the second-generation SGA device was used.


Assuntos
Intubação Intratraqueal/instrumentação , Pneumoperitônio Artificial/efeitos adversos , Complicações Pós-Operatórias/etiologia , Pressão/efeitos adversos , Tosse/etiologia , Monitoramento do pH Esofágico , Junção Esofagogástrica/fisiopatologia , Junção Esofagogástrica/cirurgia , Feminino , Hepatectomia/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Faringite/etiologia , Estudos Prospectivos , Estômago/fisiopatologia , Estômago/cirurgia , Resultado do Tratamento
7.
Eur J Anaesthesiol ; 38(8): 813-824, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34001761

RESUMO

BACKGROUND: Despite reported superior intubation outcomes associated with Parker Flex-Tip (PFT) tubes compared with those associated with standard polyvinylchloride tubes, the efficacy and safety of PFT tubes remain uncertain. OBJECTIVES: To compare the intubation outcomes between PFT and conventional standard polyvinylchloride tubes. DESIGN: Meta-analysis of randomised controlled trials. DATA SOURCES: Embase, Medline, Google Scholar, PubMed and the Cochrane controlled trials register from inception until 3 January 2021. ELIGIBILITY CRITERIA: All randomised trials comparing intubation outcomes between PFT (PFT group) and standard polyvinylchloride (standard polyvinylchloride group) tubes. RESULTS: Analysis of the 13 eligible trials showed no significant difference in successful first-attempt intubation rate [risk ratio (RR) 1.20, 95% confidence interval (CI) 0.99 to 1.44] (6 trials, 568 participants), trauma risk (RR 0.83, 95% CI 0.67 to 1.03) (5 trials, 501 participants) as well as the overall risks of epistaxis (RR 0.58, 95% CI 0.26 to 1.31) (3 trials, 262 participants), sore throat (RR 0.90, 95% CI 0.70 to 1.17) (4 trials, 451 participants) and hoarseness (RR 0.71, 95% CI 0.44 to 1.14) (4 trials, 451 participants) between the two groups. However, the intubation time was slightly shorter (weighted mean difference -4.2 s, 95% CI -7.4 to -1.0 s) (8 trials, 759 participants) and the risks of severe epistaxis (RR 0.15, 95% CI 0.03 to 0.84) (3 trials, 262 participants) and overall difficulty in airway manipulation (RR 0.48, 95% CI 0.29 to 0.80) (8 trials, 647 participants) were lower in the PFT group than those in the standard polyvinylchloride group. Trial sequential analysis conclusively confirmed a shorter intubation time with PFT tubes than with standard polyvinylchloride tubes, whereas other intubation outcomes were inconclusive. CONCLUSION: The use of PFT tubes for airway manipulation was associated with a shorter intubation time compared with the standard polyvinylchloride tubes. The results of trial sequential analysis suggest the need for further trials and meta-analysis to compare other intubation outcomes associated with the two devices. TRIAL REGISTRATION: PROSPERO CRD42020197670.


Assuntos
Intubação Intratraqueal , Faringite , Rouquidão , Humanos , Intubação Intratraqueal/efeitos adversos , Faringite/diagnóstico , Faringite/epidemiologia , Faringite/etiologia , Sistema Respiratório
8.
J Int Med Res ; 49(5): 3000605211017686, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34044638

RESUMO

OBJECTIVE: Postoperative sore throat (POST) is an undesirable intubation-related complication after surgery. Several studies have investigated the efficacy of perioperative intravenous dexmedetomidine administration for the prevention of POST, but the results have been inconsistent. We aimed to summarize all existing evidence and draw a more precise conclusion to guide future clinical work. METHODS: PubMed, Cochrane Library, EMBASE and China National Knowledge Infrastructure databases were comprehensively searched for all randomized controlled trials published before 1 February 2021 that investigated the efficacy of dexmedetomidine for the prevention of POST. RESULTS: Nine studies involving 400 patients were included in our meta-analysis. Compared with the control groups (i.e., saline and anesthetic drugs), perioperative intravenous use of dexmedetomidine significantly reduced the incidence of POST [risk ratio (RR): 0.56; 95% confidence interval (CI): 0.40-0.77; I2 = 0%) and coughing on the tube during extubation (RR: 0.58; 95% CI: 0.41-0.82; I2 = 0%). Additionally, patients in the dexmedetomidine group were more likely to develop bradycardia (RR: 2.46; 95% CI: 1.28-4.71; I2 = 0%) and hypotension (RR: 3.26; 95% CI: 1.14-9.33; I2 = 0%) during the administration of dexmedetomidine than those in the control group. CONCLUSION: Perioperative intravenous administration of dexmedetomidine has a positive effect on the prevention of POST.


Assuntos
Dexmedetomidina , Faringite , Administração Intravenosa , China , Dexmedetomidina/uso terapêutico , Humanos , Faringite/etiologia , Faringite/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle
9.
Anesth Analg ; 133(1): 58-67, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33886521

RESUMO

BACKGROUND: Topical pharmacological agents typically used to treat postoperative sore throat (POST) after tracheal intubation include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, lidocaine, Glycyrrhiza (licorice), and N-methyl-d-aspartate (NMDA) receptor antagonists (including ketamine and magnesium). However, the optimal prophylactic drug remains elusive. METHODS: The literature published before September 8, 2019 was searched on the PubMed, the Embase, the Web of Science, and the Cochrane Library. Randomized controlled trials (RCTs) covering topical prophylactic medications for patients with POST were included. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to assess the quality of evidence. The primary outcome is the risk of POST. Combining both direct and indirect evidence, a network meta-analysis was performed to assess odds ratios (ORs) between the topical pharmacological agents and surface under the cumulative ranking (SUCRA) curve for the treatment-based outcomes. This study is registered with PROSPERO, number CRD42020158985. RESULTS: Sixty-two RCTs (at least 73% of which were double blinded) that included a total of 6708 subjects and compared 6 categories of drugs and/or placebos were ultimately enrolled. All preventive interventions except lidocaine were more effective than placebo at the 4 time intervals. Lidocaine (OR: 0.35, 95% credible interval [CrI], 0.16-0.79) has a greater POST preventative intervention effect than the placebo at a time interval of only 2 to 3 hours after surgery. Relative to lidocaine, the risk of POST except 2 to 3 hours was lower for the following treatments: corticosteroids, ketamine, magnesium, NSAIDs, and Glycyrrhiza. The NMDA receptor antagonists studied here included ketamine and magnesium. Magnesium generally demonstrated greater benefit than ketamine at 24 hours postsurgery/extubation (OR: 0.41, 95% CrI, 0.18-0.92). Compared with ketamine, corticosteroids were associated with a reduced risk of POST during the 4 to 6 hours (OR: 0.40, 95% CrI, 0.19-0.83) and 24 hours (OR: 0.34, 95% CrI, 0.16-0.72) time intervals. During the 2 to 3 hours time interval, Glycyrrhiza (OR: 0.38, 95% CrI, 0.15-0.97) was more efficacious than magnesium. CONCLUSIONS: Our analysis shows that, among the 6 topical medications studied, lidocaine is not optimal for topical use to prevent POST. Glycyrrhizin, corticosteroids, NSAIDs, and NMDA receptor antagonists (ketamine and magnesium) are associated with a reduced postoperative pharyngeal pain across the 4 postsurgical time intervals studied, all of which can be chosen according to the clinical experience of the anesthesiologists and the patient preferences and are recommended for the reduction of postoperative throat pain.


Assuntos
Anestésicos Locais/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Intubação Intratraqueal/efeitos adversos , Dor Pós-Operatória/prevenção & controle , Faringite/prevenção & controle , Administração Tópica , Extubação/efeitos adversos , Extubação/tendências , Humanos , Intubação Intratraqueal/tendências , Metanálise em Rede , Dor Pós-Operatória/etiologia , Faringite/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Resultado do Tratamento
10.
Anaesth Intensive Care ; 49(2): 133-139, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33832336

RESUMO

Published reports of uvular necrosis are uncommon and it is possibly an under-reported complication of oropharyngeal manipulation. Uvular necrosis is thought to develop due to ischaemia secondary to mechanical compression of the uvula from oropharyngeal devices. Patients typically present with symptoms of a sore throat within 48 hours postoperatively. It is unclear whether there are any preventable factors, or any specific management strategies that might reduce this complication. Treatment is most commonly conservative management, including observation and simple analgesia. We present 13 cases of uvular injury that were reported to a web-based anaesthesia incident reporting system (webAIRS), a voluntary de-identified anaesthesia incident reporting system in Australia and New Zealand. While the postoperative findings varied, sore throat was the most frequent symptom. Most of the cases resolved spontaneously; the remainder with supportive treatment only. The findings suggest that patients who sustain a uvular injury can be reassured, but they should be advised to seek review early if sore throat persists or any difficulty with breathing develops.


Assuntos
Anestesia , Máscaras Laríngeas , Faringite , Austrália , Humanos , Doença Iatrogênica , Internet , Necrose/etiologia , Nova Zelândia , Faringite/etiologia , Complicações Pós-Operatórias , Gestão de Riscos , Úvula
11.
J Perianesth Nurs ; 36(3): 247-252, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33648860

RESUMO

PURPOSE: In general anesthesia, the laryngeal mask airway (LMA) is a frequently used effective option. The effect of nitrous oxide on intracuff pressure of the LMA and postoperative sore throat is well known; however, there are no studies related to the second-generation LMA Protector. The purpose of this study was to determine the differences in intracuff pressure and postoperative sore throat, depending on the use of nitrous oxide during general anesthesia using the LMA Protector. DESIGN: This randomized double-blind prospective study was conducted among 88 patients aged 20 to 70 years. METHODS: The cuff pressure started with a baseline of 40 cm H2O and was measured using a digital cuff pressure manometer for 30 minutes. Postoperative sore throat, dysphonia, dysphagia, and numeric rating scale scores were also recorded. FINDINGS: Over time, the intracuff pressure of the nitrous oxide group increased significantly compared with that of the air group. Furthermore, postoperative sore throat and pharyngolaryngeal complications were not significantly different between the two groups. CONCLUSIONS: Intracuff pressure of the LMA Protector increased during anesthesia using nitrous oxide. When the anesthesia time was less than 2 hours, however, there was no difference in postoperative sore throat.


Assuntos
Anestesia Geral , Máscaras Laríngeas , Faringite , Anestesia Geral/efeitos adversos , Humanos , Máscaras Laríngeas/efeitos adversos , Óxido Nitroso/efeitos adversos , Faringite/etiologia , Faringite/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos
12.
Acute Med ; 20(1): 78-82, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33749697

RESUMO

We present the case of a previously healthy, immunocompetent male with Lemierre's Syndrome. He presented with headache, sore throat and pyrexia. Initial blood tests revealed raised inflammatory markers and electrolyte abnormalities. Blood cultured Fusobacterium necrophorum. He developed respiratory distress and imaging confirmed lung abscess and empyema due to septic emboli. He required surgical drainage and a prolonged course of antibiotics. This case highlights the rare, but life-threatening condition of Lemierre's Syndrome. We discuss the importance of prompt recognition and early antibiotic therapy.


Assuntos
Síndrome de Lemierre , Faringite , Sepse , Antibacterianos/uso terapêutico , Fusobacterium necrophorum , Humanos , Síndrome de Lemierre/complicações , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/tratamento farmacológico , Masculino , Faringite/tratamento farmacológico , Faringite/etiologia , Sepse/tratamento farmacológico
13.
Zhen Ci Yan Jiu ; 46(2): 164-7, 2021 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-33788439

RESUMO

OBJECTIVE: To observe the effect of electroacupuncture (EA) intervention on postoperative sore throat (POST) and postoperative nausea and vomiting (PONV) after endotracheal intubation and general anesthesia. METHODS: According to the random number table, 60 patients of gastrointestinal surgery under general anesthesia with tracheal intubation were randomly divided into EA group (30 cases) and control group (30 cases). Patients in the EA group were given acupuncture at Shaoshang (LU11) 30 minutes before general anesthesia, and EA at Chize (LU5) and Hegu (LI4) continued until the operation was completed. The incidence and severity of POST and visual analogue scale (VAS) score at 12, 24, and 48 h after surgery, and the incidence and severity of PONV at 12, 24 h after surgery were analyzed, respectively. RESULTS: The incidence and severity of POST and PONV, and VAS score in the EA group were significantly lower than those in the control group 12 h and 24 h after surgery (P<0.05). Both groups had significant reductions in VAS score at 24 h and 48 h after surgery compared with that at 12 h (P<0.05). CONCLUSION: EA can significantly improve the prognosis of patients on sore throat and reduce the incidence of PONV.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Eletroacupuntura , Faringite , Humanos , Náusea , Faringite/etiologia , Faringite/terapia , Vômito
14.
Eur J Pediatr ; 180(6): 1867-1874, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33532889

RESUMO

Group A Streptococcus has been associated with a perianal infection. We conducted a systematic review of the literature on childhood streptococcal perianitis in three databases: Excerpta Medica, National Library of Medicine, and Web of Science. The main purposes were to document the clinical features, the tendency to recur, the association with an asymptomatic streptococcal throat carriage, the accuracy of rapid streptococcal tests, and the mechanism possibly underlying the acquisition of this infection. More than 80% of cases are boys ≤7.0 years of age with defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness. Perianitis is associated with a streptococcal tonsillopharyngitis in about every fifth case. The time to diagnosis is ≥3 weeks in 65% of cases. Recurrences occur within 3½ months in about 20% of cases. An asymptomatic group A streptococcal throat carriage occurs in 63% of cases. As compared with perianal Streptococcus A culture, the rapid streptococcal tests have a positive predictive value of 80% and a negative predictive value of 96%. It is hypothesized that digital inoculation from nasopharynx to anus underlies perianitis. Many cases are likely caused directly by children, who are throat and nasal carriers of Streptococcus A. Some cases might occur in children, who have their bottoms wiped by caregivers with streptococcal tonsillopharyngitis or carriage of Streptococcus.Conclusion: Perianitis is an infection with a distinctive presentation and a rather long time to diagnosis. There is a need for a wider awareness of this condition among healthcare professionals. What is Known: • Group A Streptococcus may cause perianitis in childhood. • Systemic antimicrobials (penicillin V, amoxycillin, or cefuroxime) are superior to topical treatment. What is New: • The clinical presentation is distinctive (defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness). • The time to diagnosis is usually ≥3 weeks. Recurrences occur in about 20% of cases.


Assuntos
Faringite , Infecções Estreptocócicas , Amoxicilina , Canal Anal , Criança , Feminino , Humanos , Masculino , Faringite/diagnóstico , Faringite/etiologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/epidemiologia , Streptococcus pyogenes
15.
J Int Med Res ; 49(2): 300060520961237, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33535830

RESUMO

OBJECTIVE: General anaesthesia with tracheal intubation results in sore throat. We evaluated the influence of the two-handed jaw thrust on postoperative sore throat in patients who require tracheal intubation. METHODS: In this prospective, double-blind, single-centre, parallel-arm, and randomised trial, 92 patients who were scheduled for general anaesthesia for total hip arthroplasty were allocated to one of two groups. In the jaw thrust group (n = 46), the two-handed jaw thrust manoeuvre was applied at intubation. In the control group (n = 46), conventional intubation with sham jaw thrust was performed. Incidences of airway morbidities including sore throat, hoarseness, and cough at 2, 4, and 24 hours postoperatively were compared. RESULTS: During the postoperative 24 hours, the incidence of sore throat (8 [17%] vs. 20 [44%]) and hoarseness were lower in the jaw thrust group (8 [17%] vs. 18 [39%]) compared with the control group. The incidence of cough during the postoperative 24 hours was similar between the groups. CONCLUSIONS: The jaw thrust manoeuvre significantly reduced sore throat and hoarseness in patients after general anaesthesia using tracheal intubation.Clinical trial registration: NCT03568279.


Assuntos
Faringite , Complicações Pós-Operatórias , Rouquidão/etiologia , Humanos , Intubação Intratraqueal/efeitos adversos , Faringite/etiologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos
16.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541982

RESUMO

A 54-year-old Chinese woman presented with a 3-month history of sore throat and dry cough, which was treated as chronic pharyngitis with minimal improvement. One month ago, she presented with painful right ear swelling without signs or symptoms of otitis media or otitis externa. She was treated with antibiotics and antiviral drugs without any improvement. Two weeks prior to her presentation to hospital, she developed bilateral costal margin pain with raised C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), mild chronic pharyngitis and painful right ear swelling. All other investigations including bloods and imaging were non-specific. Her painful right auricle swelling prompted the diagnosis of relapsing polychondritis (RP), which was supported by clinical improvement with high-dose corticosteroids. RP is a clinical diagnosis with non-specific inflammation of affected cartilage. It is a diagnosis of exclusion and early diagnosis can be made by the most common presenting feature of auricular chondritis.


Assuntos
Diagnóstico Diferencial , Pavilhão Auricular/fisiopatologia , Faringite/etiologia , Policondrite Recidivante/diagnóstico , Caixa Torácica , Corticosteroides/uso terapêutico , Dor no Peito/diagnóstico , Tosse/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
17.
Am J Otolaryngol ; 42(3): 102903, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33485050

RESUMO

OBJECTIVE: PFAPA syndrome is derived from the initials of the English words of the findings that make up the syndrome ("Periodic Fever", "Aphthous Stomatitis", "Pharyngitis", "Adenitis"). This study aims to evaluate the vestibular system in patients with PFAPA syndrome by the cVEMP test and to give a general review of PFAPA syndrome in light of current literature. METHODS: In this prospective study, 30 patients aged 4-6 who were diagnosed with PFAPA in a tertiary pediatrics clinic, between January 2016 and February 2020 and 30 children of the same age group who applied to a tertiary otorhinolaryngology clinic for other reasons and proven to have no hearing or vestibular problems were included and in addition to routine physical examination, electromyographic activity of the sternocleidomastoid muscle surface was measured. RESULTS: We found that the amplitude difference between cVEMP p1-n1 in patients with PFAPA syndrome in both ears decreased compared to the healthy control group. CONCLUSION: Our study proves there is a vestibular system involvement of PFAPA syndrome. This study is the first in the literature to search the relationship between PFAPA and the vestibular system.


Assuntos
Febre/etiologia , Linfadenite/etiologia , Periodicidade , Faringite/etiologia , Estomatite Aftosa/etiologia , Doenças Vestibulares/complicações , Doenças Vestibulares/diagnóstico , Testes de Função Vestibular/métodos , Vestíbulo do Labirinto/fisiopatologia , Fatores Etários , Criança , Pré-Escolar , Eletromiografia , Feminino , Febre/fisiopatologia , Humanos , Linfadenite/fisiopatologia , Masculino , Faringite/fisiopatologia , Estudos Prospectivos , Estomatite Aftosa/fisiopatologia , Síndrome , Doenças Vestibulares/fisiopatologia
18.
BMJ ; 372: m4903, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33414239

RESUMO

OBJECTIVE: To assess the use of proton pump inhibitors (PPIs) to treat persistent throat symptoms. DESIGN: Pragmatic, double blind, placebo controlled, randomised trial. SETTING: Eight ear, nose, and throat outpatient clinics, United Kingdom. PARTICIPANTS: 346 patients aged 18 years or older with persistent throat symptoms who were randomised according to recruiting centre and baseline severity of symptoms (mild or severe): 172 to lansoprazole and 174 to placebo. INTERVENTION: Random blinded allocation (1:1) to either 30 mg lansoprazole twice daily or matched placebo twice daily for 16 weeks. MAIN OUTCOME MEASURES: Primary outcome was symptomatic response at 16 weeks measured using the total reflux symptom index (RSI) score. Secondary outcomes included symptom response at 12 months, quality of life, and throat appearances. RESULTS: Of 1427 patients initially screened for eligibility, 346 were recruited. The mean age of the study sample was 52.2 (SD 13.7) years, 196 (57%) were women, and 162 (47%) had severe symptoms at presentation; these characteristics were balanced across treatment arms. The primary analysis was performed on 220 patients who completed the primary outcome measure within a window of 14-20 weeks. Mean RSI scores were similar between treatment arms at baseline: lansoprazole 22.0 (95% confidence interval 20.4 to 23.6) and placebo 21.7 (20.5 to 23.0). Improvements (reduction in RSI score) were observed in both groups-score at 16 weeks: lansoprazole 17.4 (15.5 to19.4) and placebo 15.6 (13.8 to 17.3). No statistically significant difference was found between the treatment arms: estimated difference 1.9 points (95% confidence interval -0.3 to 4.2 points; P=0.096) adjusted for site and baseline symptom severity. Lansoprazole showed no benefits over placebo for any secondary outcome measure, including RSI scores at 12 months: lansoprazole 16.0 (13.6 to 18.4) and placebo 13.6 (11.7 to 15.5): estimated difference 2.4 points (-0.6 to 5.4 points). CONCLUSIONS: No evidence was found of benefit from PPI treatment in patients with persistent throat symptoms. RSI scores were similar between the lansoprazole and placebo groups after 16 weeks of treatment and at the 12 month follow-up. TRIAL REGISTRATION: ISRCTN Registry ISRCTN38578686 and EudraCT 2013-004249-17.


Assuntos
Lansoprazol/administração & dosagem , Faringite/tratamento farmacológico , Inibidores da Bomba de Prótons/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Esofagite Péptica/complicações , Feminino , Refluxo Gastroesofágico/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Faringite/etiologia , Qualidade de Vida , Reino Unido
20.
West Afr J Med ; 38(1): 54-58, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33463708

RESUMO

BACKGROUND: The SARS-CoV-2 infection continues to ravage the global community since it was declared a pandemic. The socio-demographic and clinical characteristics defining the disease are mainly from Europe and Asia. The disease symptomatology is similar to the prevalent diseases in our environment, this could result in the delay in prompt identification and appropriate management of suspected cases toward combating community transmission. This study evaluates the prevalence, socio-demographic and clinical characteristics of positive cases of COVID -19. METHODS: This was a retrospective cohort study. Data on the socio-demographic, clinical characteristics and the results of the SARS-CoV-2 test of participants at the Nigerian Institute of Medical Research [NIMR] Modified Drive-through Centre for COVID-19 test sample collection over two months [24th February 2020- 27th April 2020] were retrieved from the electronic medical records (EMR). Data obtained were analyzed using SPSS version 22.0. RESULTS: A total number of 481 clients were evaluated in this review. The prevalence of SARS-CoV-2 infection in the population was 14.6%. The mean age of the positive cases was 42.2 [±15.9] years. The common symptoms reported by the positive cases were fever (40.0%), cough (32.9%), sore throat (17.1%) and running nose (15.7%). Fever depicted statistical significance with positive cases with the majority being of mild to moderate clinical severity. CONCLUSION: The prevalence of SARS-CoV-2 infection among this cohort was 14.6% with a male preponderance. Fever and sore throat were the variables that predicted SARS CoV-2 infection among our cohort.


Assuntos
COVID-19/epidemiologia , Pandemias , SARS-CoV-2 , Adolescente , Tosse/epidemiologia , Tosse/etiologia , Fadiga/epidemiologia , Fadiga/etiologia , Febre/epidemiologia , Febre/etiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Humanos , Masculino , Nigéria/epidemiologia , Faringite/epidemiologia , Faringite/etiologia , Prevalência , Estudos Retrospectivos
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