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Sample records for sore throat systematic

  1. Postoperative sore throat: a systematic review.

    PubMed

    El-Boghdadly, K; Bailey, C R; Wiles, M D

    2016-06-01

    Postoperative sore throat has a reported incidence of up to 62% following general anaesthesia. In adults undergoing tracheal intubation, female sex, younger age, pre-existing lung disease, prolonged duration of anaesthesia and the presence of a blood-stained tracheal tube on extubation are associated with the greatest risk. Tracheal intubation without neuromuscular blockade, use of double-lumen tubes, as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat. The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults, although it may in children. In adults, the i-gel(™) supraglottic airway device results in a lower incidence of postoperative sore throat. Cuffed supraglottic airway devices should be inflated sufficiently to obtain an adequate seal and intracuff pressure should be monitored. Children with respiratory tract disease are at increased risk. The use of supraglottic airway devices, oral, rather than nasal, tracheal intubation and cuffed, rather than uncuffed, tracheal tubes have benefit in reducing the incidence of postoperative sore throat in children. Limiting both tracheal tube and supraglottic airway device cuff pressure may also reduce the incidence. © 2016 The Association of Anaesthetists of Great Britain and Ireland.

  2. Sore Throat (For Parents)

    MedlinePlus

    ... 1- to 2-Year-Old First Aid: Sore Throat KidsHealth > For Parents > First Aid: Sore Throat A A A Sore throats are common at any age and can be ... They also can be caused by a strep throat infection, although this is rare in children younger ...

  3. Sore Throat (For Parents)

    MedlinePlus

    ... also can avoid sore throats by: not sharing food utensils and glasses with others avoiding contact with people who have sore ... Test: Throat Culture Flu Center What Is "PANS"? Tonsillitis Tonsils and ...

  4. Sore Throats

    MedlinePlus

    ... close quarters such as a child care center, classroom, office, prison, or military installation, you are at ... written permission. Throat Get Involved Professional Development Practice Management ENT Careers Marketplace Privacy Policy Terms of Use © ...

  5. Pharyngitis - sore throat

    MedlinePlus

    ... antibiotics if: A strep test or culture is positive. Your provider cannot diagnose strep throat by symptoms ... alone. A culture for chlamydia or gonorrhea is positive. Sore throat caused by the flu (influenza) may ...

  6. Sore Throat: Treatment

    MedlinePlus

    ... include: Slippery elm Licorice root Marshmallow root Honeysuckle flower and other Chinese medicine herbs Preparing for your appointment If you or your child has a sore throat, make an appointment with your family doctor or your ...

  7. Sore Throat: Symptoms and Causes

    MedlinePlus

    ... more than two weeks Viruses that cause the common cold and flu (influenza) also cause most sore throats. ... Viral illnesses that cause a sore throat include: Common cold Flu (influenza) Mononucleosis (mono) Measles Chickenpox Croup — a ...

  8. Sore Throat: Self-Management

    MedlinePlus

    Sore throat Self-management By Mayo Clinic Staff Regardless of the cause of your sore throat, these at-home care strategies can help you ... rest your voice. Drink fluids. Fluids keep the throat moist and prevent dehydration. Avoid caffeine and alcohol, ...

  9. Lidocaine for preventing postoperative sore throat.

    PubMed

    Tanaka, Yuu; Nakayama, Takeo; Nishimori, Mina; Sato, Yuki; Furuya, Hitoshi

    2009-07-08

    Sore throat is a common side effect of general anaesthesia and is reported by between 30% and 70% of patients after tracheal intubation. The likelihood of a sore throat varies with the type, diameter, and cuff pressure of the endotracheal tube used. If intubation is essential, it may be helpful to give drugs prophylactically to alleviate postoperative sore throat. Local anaesthetics and steroids have been used for this purpose. The objective of this review was to evaluate the effectiveness and any harms of topical and systematic lidocaine for the prevention of postoperative sore throat in adults undergoing endotracheal intubation as part of general anaesthesia. We searched CENTRAL (The Cochrane Library 2007, Issue 3), MEDLINE (January 1966 to June 2007), and EMBASE (1980 to June 2007). We also contacted manufacturers and researchers in the field. We included randomized controlled trials of topical and systemic prophylactic lidocaine therapy versus control (using air or saline) that reported on the risk and severity of postoperative sore throat as an outcome. Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information, such as the risk of adverse effects. We included 1232 patients from 15 studies; 672 patients received topical or systemic lidocaine therapy and 560 patients were allocated to the control group. Both the topical and systemic lidocaine therapy significantly reduced the risk of postoperative sore throat (risk ratio (RR) 0.58; 95% confidence interval (CI) 0.41 to 0.82). To evaluate the severity of sore throat on a visual analogue scale (VAS), 219 patients received topical or systemic lidocaine therapy and 152 patients were allocated to the control groups. The severity of sore throat was reduced (mean difference (MD) -11.9; 95% CI -16.44 to -7.32), an effect that neared statistical significance. The adverse effects of lidocaine were not reported in these studies. Our systematic review

  10. Effectiveness of ketamine gargle in reducing postoperative sore throat in patients undergoing airway instrumentation: a systematic review.

    PubMed

    Mayhood, Jillian; Cress, Kayla

    2015-09-01

    Postoperative sore throat is a common, minor adverse event, second to postoperative nausea and vomiting, occurring in individuals undergoing general anesthesia. Postoperative sore throat has the potential to not only diminish patient satisfaction, but also increase the need for adjunct pain therapy in the post anesthesia care unit. Many techniques are utilized to reduce postoperative sore throat; however no one intervention has proven to be completely effective. The use of ketamine gargle is a novel intervention but the effectiveness of administering it prior to induction of general anesthesia is still uncertain. Therefore, further evaluation of current evidence is needed to determine the effectiveness of ketamine gargle in reducing the incidence of postoperative sore throat. The objective of this review was to determine the effectiveness of ketamine gargle in comparison to placebo or another intervention in reducing the incidence of postoperative sore throat in patients undergoing airway instrumentation. The participants in this review were adult patients who received ketamine gargle or placebo prior to induction of general anesthesia for a variety of surgical procedures requiring endotracheal intubation.This review examined studies that evaluated the effectiveness of ketamine gargle compared to placebo or another intervention in reducing the incidence of postoperative sore throat.This review considered studies that measured the incidence of postoperative sore throat using a direct question survey with a four-point scale (0 = no sore throat; 1,2,3 = presence of sore throat).This review included randomized controlled trials only; no other types of articles were discovered upon searching. The comprehensive search strategy aimed to find both English language studies prior to August 2014.Databases used were: EMBASE, CINAHL, MEDLINE, ProQuest, Web of Science and Cochrane Central Register of Controlled Trials. Google Scholar, MEDNAR, New York Academy of Medicine Grey

  11. Lidocaine for preventing postoperative sore throat.

    PubMed

    Tanaka, Yuu; Nakayama, Takeo; Nishimori, Mina; Tsujimura, Yuka; Kawaguchi, Masahiko; Sato, Yuki

    2015-07-14

    included (eight studies, 814 participants) the effect was no longer significant (RR 0.71, 95% CI 0.47 to 1.09). Lidocaine given systemically in two studies (320 participants) did not reveal evidence of an effect (RR 0.44, 95% CI 0.19 to 1.05 ). The severity of sore throat as measured on a visual-analogue scale (VAS) was reduced by lidocaine therapy (six trials, 611 participants, (mean difference (MD) -10.80, 95% CI -14.63 to -6.98). The adverse effects of lidocaine were not reported in these studies, though toxicity is generally rare. In our revised systematic review, although the results of included studies show generally positive results, they should be interpreted carefully. The effect size of lidocaine appeared to be affected by study quality; drug concentration; route of administration; management of cuff pressure during anaesthesia; the included population; and the type of outcome measured.

  12. Managing Sore Throat: Theory Versus Practice

    PubMed Central

    Wong, Thomas; Tiessen, Esther

    1989-01-01

    The authors address the reliability of clinical impression in the management of sore throat. Five primary care family physicians in rural Ontario examined 222 patients with sore throats. The clinical impression of either Group A β-hemolytic streptococcal (GABHS) or non-GABHS pharyngitis was recorded and throat cultures were ordered in each case. The physicians predicted that 50% of the cultures would be positive for GABHS, whereas only 13.5% actually had positive results. The initial clinical diagnosis of “strep throat” was correct only one in five times. Without cultures, at least 112 patients would have been treated with antibiotics, 87 unnecessarily. The authors conclude that the clinical prediction of GABHS is inaccurate and can lead to unnecessary use of antibiotics. PMID:21249054

  13. Sore throat and hoarseness after total intravenous anaesthesia.

    PubMed

    Maruyama, K; Sakai, H; Miyazawa, H; Toda, N; Iinuma, Y; Mochizuki, N; Hara, K; Otagiri, T

    2004-04-01

    Sore throat and hoarseness are common complications, but these have not been studied after total i.v. anaesthesia. We prospectively studied 418 surgical patients, aged 15-92 yr, after total i.v. anaesthesia with propofol, fentanyl and ketamine to assess possible factors associated with sore throat and hoarseness. We found sore throat in 50% and hoarseness in 55% of patients immediately after surgery. This decreased to 25% for sore throat and 24% for hoarseness on the day after surgery. Both sore throat and hoarseness were more common in females and when lidocaine spray had been used. Cricoid pressure during laryngoscopy was inversely associated with the risk of sore throat. Knowledge of these factors may reduce postoperative throat complications, and improve patient satisfaction.

  14. Sore throat in primary care project: a clinical score to diagnose viral sore throat.

    PubMed

    Mistik, Selcuk; Gokahmetoglu, Selma; Balci, Elcin; Onuk, Fahri A

    2015-06-01

    Viral agents cause the majority of sore throats. However, there is not currently a score to diagnose viral sore throat. The aims of this study were (i) to find the rate of bacterial and viral causes, (ii) to show the seasonal variations and (iii) to form a new scoring system to diagnose viral sore throat. A throat culture for group A beta haemolytic streptococci (GABHS) and a nasopharyngeal swab to detect 16 respiratory viruses were obtained from each patient. Over a period of 52 weeks, a total of 624 throat cultures and polymerase chain reaction analyses were performed. Logistic regression analysis was performed to find the clinical score. Viral infection was found in 277 patients (44.3%), and GABHS infection was found in 116 patients (18.5%). An infectious cause was found in 356 patients (57.1%). Rhinovirus was the most commonly detected infectious agent overall (highest in November, 34.5%), and the highest GABHS rate was in November (32.7%). Analysis of data provided a scoring system, called the Mistik Score, to diagnose viral sore throat. The predictive model for positive viral analysis included the following variables: absence of headache, stuffy nose, sneezing, temperature of ≥37.5°C on physical examination, and the absence of tonsillar exudate and/or swelling. The probability of a positive viral analysis for a score of 5 was 82.1%. The Mistik Score may be useful to diagnose viral sore throat. We suggest its use either alone or in combination with the Modified Centor Score. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Sore Throat - Multiple Languages: MedlinePlus

    MedlinePlus

    ... gov/languages/sorethroat.html Other topics A-Z A B C D E F G H I J K L M N O P Q R S T U V W XYZ List of All Topics All Sore Throat - Multiple Languages To use the sharing features on this page, please enable JavaScript. Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) ...

  16. Pregame Sore Throat, Postgame Intensive Care Unit.

    PubMed

    Stork, Natalie C; Smoot, M Kyle

    2016-05-01

    A collegiate football athlete presented, on game day, with an acute onset of sore throat. He was afebrile, speaking in full sentences, without signs of respiratory distress. His examination was negative for lymphadenopathy or tonsillar enlargement or exudate. Twelve hours after initial presentation, he developed acute epiglottitis. He underwent urgent fiberoptic intubation and was empirically treated with broad-spectrum antibiotics and corticosteroids. Currently, there are no published reports of acute epiglottitis in athletes. Consequently, there is no evidence to guide return to play decisions. Return to play, following acute epiglottitis, should include resolution of symptoms and a graded return to play, taking into consideration the level of deconditioning the athlete experienced from hospitalization.

  17. Effect of Intracuff Lidocaine on Postoperative Sore Throat and the Emergence Phenomenon: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    Lam, Fai; Lin, Yu-Cih; Tsai, Hsiao-Chien; Chen, Ta-Liang

    2015-01-01

    Background Postoperative sore throat and other airway morbidities are common and troublesome after endotracheal tube intubation general anesthesia (ETGA). We propose lidocaine as endotracheal tube (ETT) cuff inflation media to reduce the postintubation-related emergence phenomenon. Methods We searched PubMed, EMBASE, and Cochrane databases systematically for randomized controlled trials (RCTs) that have investigated the outcome of intracuff lidocaine versus air or saline in patients receiving ETGA. Using a random-effects model, we conducted a meta-analysis to assess the relative risks (RRs) and mean difference (MD) of the incidence and intensity of relevant adverse outcomes. Results We reviewed nineteen trials, which comprised 1566 patients. The incidence of early- and late-phase postoperative sore throat (POST), coughing, agitation, hoarseness, and dysphonia decreased significantly in lidocaine groups, with RRs of 0.46 (95% confidence interval [CI]: 0.31 to 0.68), 0.41 (95% CI: 0.25 to 0.66), 0.43 (95% CI: 0.31 to 0.62), 0.37 (95% CI: 0.25 to 0.55), 0.43 (95% CI: 0.29 to 0.63), and 0.19 (95% CI: 0.08 to 0.5), respectively, when compared with the control groups. The severity of POST also reduced significantly (mean difference [MD] -16.43 mm, 95% CI: -21.48 to -11.38) at 1 h and (MD -10.22 mm, 95% CI: -13.5 to -6.94) at 24 h. Both alkalinized and non-alkalinized lidocaine in the subgroup analyses showed significant benefits in emergence phenomena prevention compared with the control. Conclusion Our results indicate that both alkalinized and non-alkalinized intracuff lidocaine may prevent and alleviate POST and postintubation-related emergence phenomena. PMID:26288276

  18. Antibiotic prescribing in patients with self-reported sore throat

    PubMed Central

    Schilder, Anne; Fragaszy, Ellen; E. R. Evans, Hannah; Dukes, Oliver; Manikam, Logan; Little, Paul; Smith, Sarah C.; Hayward, Andrew

    2017-01-01

    Objectives: To investigate the predictors of general practitioner (GP) consultation and antibiotic use in those developing sore throat. Methods: We conducted a prospective population-based cohort study on 4461 participants in two rounds (2010–11) from 1897 households. Results: Participants reported 2193 sore throat illnesses, giving a community sore throat incidence of 1.57/ person-year. 13% of sore throat illnesses led to a GP consultation and 56% of these consultations led to antibiotic use. Participants most likely to have sore throats included women and children (e.g. school compared with retirement age); adjusted incidence rate ratio (aIRR) of 1.33 and 1.52, respectively. Participants with sore throat were more likely to consult their GP if they were preschool compared with retirement age [adjusted OR (aOR) 3.22], had more days of sore throat (aOR 1.11), reported more severe pain (aOR 4.24) or reported fever (aOR 3.82). Antibiotics were more often used by chronically ill individuals (aOR 1.78), those reporting severe pain (aOR 4.14), those reporting fever (aOR 2.58) or children with earache (aOR 1.85). Among those who consulted, males and adults who reported feeling anxious were more likely to use antibiotics; aOR 1.87 and 5.36, respectively. Conclusions: Only 1 in 10 people who have a sore throat see a doctor and more than half of those attending get antibiotics. Further efforts to curb antibiotic use should focus on reducing initial GP consultations through public information promoting safe self-management, targeted at groups identified above as most likely to attend with sore throats. PMID:27999063

  19. Guideline for the management of acute sore throat.

    PubMed

    Pelucchi, C; Grigoryan, L; Galeone, C; Esposito, S; Huovinen, P; Little, P; Verheij, T

    2012-04-01

    The European Society for Clinical Microbiology and Infectious Diseases established the Sore Throat Guideline Group to write an updated guideline to diagnose and treat patients with acute sore throat. In diagnosis, Centor clinical scoring system or rapid antigen test can be helpful in targeting antibiotic use. The Centor scoring system can help to identify those patients who have higher likelihood of group A streptococcal infection. In patients with high likelihood of streptococcal infections (e.g. 3-4 Centor criteria) physicians can consider the use of rapid antigen test (RAT). If RAT is performed, throat culture is not necessary after a negative RAT for the diagnosis of group A streptococci. To treat sore throat, either ibuprofen or paracetamol are recommended for relief of acute sore throat symptoms. Zinc gluconate is not recommended to be used in sore throat. There is inconsistent evidence of herbal treatments and acupuncture as treatments for sore throat. Antibiotics should not be used in patients with less severe presentation of sore throat, e.g. 0-2 Centor criteria to relieve symptoms. Modest benefits of antibiotics, which have been observed in patients with 3-4 Centor criteria, have to be weighed against side effects, the effect of antibiotics on microbiota, increased antibacterial resistance, medicalisation and costs. The prevention of suppurative complications is not a specific indication for antibiotic therapy in sore throat. If antibiotics are indicated, penicillin V, twice or three times daily for 10 days is recommended. At the present, there is no evidence enough that indicates shorter treatment length. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

  20. Tracheal intubation and sore throat: a mechanical explanation.

    PubMed

    Chandler, M

    2002-02-01

    Although tracheal intubation remains a valuable tool, it may result in pressure trauma and sore throat. The evidence for an association between these sequelae is not conclusive and sore throat may be caused at the time of intubation. This hypothesis was tested in a mechanical model and the results from tracheal intubation compared with those from insertion of a laryngeal mask airway, which is associated with a lower incidence of sore throat. Use of the model suggests that the tracheal tube and laryngeal mask airway impinge on the pharyngeal wall in different manners and involve different mechanisms for their conformation to the upper airway, but that in a static situation, the forces exerted on the pharyngeal wall are low with both devices. It also suggests that the incidence of sore throat should be lower for softer and smaller tracheal tubes and that the standard 'Magill' curve (radius of curvature 140 +/- 20 mm) is about optimum for the average airway.

  1. When a Sore Throat Is a More Serious Infection

    MedlinePlus

    ... Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ... sore throat, because strep infections are treated with antibiotics. Diagnosis and Treatment If your child has a ...

  2. Ketamine gargle for attenuating postoperative sore throat.

    PubMed

    Canbay, O; Celebi, N; Sahin, A; Celiker, V; Ozgen, S; Aypar, U

    2008-04-01

    Tracheal intubation is a foremost cause of trauma to the airway mucosa, resulting in postoperative sore throat (POST) with reported incidences of 21-65%. We compared the effectiveness of ketamine gargles with placebo in preventing POST after endotracheal intubation. Forty-six, ASA I-II, patients undergoing elective surgery for septorhinoplasty under general anaesthesia were enrolled in this prospective, randomized, placebo-controlled, single-blind study. Patients were randomly allocated into two groups of 23 subjects each: Group C, saline 30 ml; Group K, ketamine 40 mg in saline 30 ml. Patients were asked to gargle this mixture for 30 s, 5 min before induction of anaesthesia. POST was graded at 0, 2, 4, and 24 h after operation on a four-point scale (0-3). POST occurred more frequently in Group C, when compared with Group K, at 0, 2, and 24 h and significantly more patients suffered severe POST in Group C at 4 and 24 h compared with Group K (P<0.05). Ketamine gargle significantly reduced the incidence and severity of POST.

  3. Magnesium and Ketamine Gargle and Postoperative Sore Throat

    PubMed Central

    Teymourian, Houman; Mohajerani, Seyed Amir; Farahbod, Alireza

    2015-01-01

    Background: Postoperative sore throat is one of the most common complications after endotracheal intubation. Both Ketamine and magnesium can block N-methyl-D-aspartic acid (NMDA) receptors and provide central and local analgesia. Objectives: To compare the effect of magnesium sulfate and ketamine gargle on the incidence and severity of postoperative sore throat. Patients and Methods: A total of 100 patients candidate for emergency acute appendicitis surgery were enrolled in the study. Patients in ketamine group received ketamine gargle (0.5 mg/kg) and magnesium group received magnesium sulfate gargle (20 mg/kg up to 30 mL dextrose water 20%) 15 minutes before the operation. Patient complaint of postoperative sore throat, and its severity measured by visual analogue scale (VAS) were recorded at baseline in recovery room, and then 2, 4, and 24 hours after operation. Results: There were no significant differences between age, sex, and body mass index (BMI) between two groups of patients. Hemodynamics of patients, including blood pressure, respiratory rate, oxygen saturation %, and conscious state were not significantly different (P > 0.05). Number of patients with sore throat were significantly lower in magnesium group compared to ketamine group at 2 (P = 0.032), 4 (P = 0.02), and 24 hours (P = 0.01) after the operation. Sore throat pain score (VAS) was significantly lower in magnesium group compared to ketamine group at 2 (P = 0.019), 4 (P = 0.028), and 24 hours (P = 0.014) after the operation. Conclusions: Magnesium at low dose decreases sore throat and pain severity more effectively compared to ketamine gargle. PMID:26161316

  4. Magnesium and Ketamine Gargle and Postoperative Sore Throat.

    PubMed

    Teymourian, Houman; Mohajerani, Seyed Amir; Farahbod, Alireza

    2015-06-01

    Postoperative sore throat is one of the most common complications after endotracheal intubation. Both Ketamine and magnesium can block N-methyl-D-aspartic acid (NMDA) receptors and provide central and local analgesia. To compare the effect of magnesium sulfate and ketamine gargle on the incidence and severity of postoperative sore throat. A total of 100 patients candidate for emergency acute appendicitis surgery were enrolled in the study. Patients in ketamine group received ketamine gargle (0.5 mg/kg) and magnesium group received magnesium sulfate gargle (20 mg/kg up to 30 mL dextrose water 20%) 15 minutes before the operation. Patient complaint of postoperative sore throat, and its severity measured by visual analogue scale (VAS) were recorded at baseline in recovery room, and then 2, 4, and 24 hours after operation. There were no significant differences between age, sex, and body mass index (BMI) between two groups of patients. Hemodynamics of patients, including blood pressure, respiratory rate, oxygen saturation %, and conscious state were not significantly different (P > 0.05). Number of patients with sore throat were significantly lower in magnesium group compared to ketamine group at 2 (P = 0.032), 4 (P = 0.02), and 24 hours (P = 0.01) after the operation. Sore throat pain score (VAS) was significantly lower in magnesium group compared to ketamine group at 2 (P = 0.019), 4 (P = 0.028), and 24 hours (P = 0.014) after the operation. Magnesium at low dose decreases sore throat and pain severity more effectively compared to ketamine gargle.

  5. Post-Intubation Sore Throat and Menstruation Cycles

    PubMed Central

    Orandi, Amirali; Orandi, Amirhossein; Najafi, Atabak; Hajimohammadi, Fatemeh; Soleimani, Sara; Zahabi, Somayeh

    2013-01-01

    Background Postoperative sore throat is one of the most common complications of general anesthesia and intubation with prevalence of 18%-65% in different studies. Several risk factors including female gender, postoperative nausea and vomiting and so on have been mentioned. Objectives The aim of this study was to evaluate the incidence of postoperative sore throat in females and its association with menstrual cycles. Patients and Methods One hundred females between 18-45 years old with ASA class I or II without predicted difficult airway that were candidate for operation in supine position were enrolled in study. Patients who had pulmonary disease, smoking, common cold within two weeks prior to the operation, previous traumatic intubation history, removable dentures, any congenital or acquired deformity in face, neck, mouth and airway, any known pathology in mouth like aphthous and mouth ulcer,pregnant women, and patients with irregular cycles, and those taking oral contraceptive pills were excluded. By the same protocol general anesthesia was provided and the patients were asked to fill out a three-point scale questionnaire (Low, High, None) 1,6 and 24 hours following intubation to study and record the incidence and severity of sore throat, dysphagia and hoarseness. The date of last menstrual period had been recorded as well. Results Of 100 patients, in the first six hours, 51 patients had sore throat and 49 had no pain. During the first 6 hours, 33 patients (33%) had dysphagia and 13 patients had hoarseness at 6th postoperative hour. Age, weight, LMP, intubation time, operation and extubation time and coughing were compared to sore throat, dysphagia and hoarseness. The association between the incidence of coughing and bucking and sore throat was significant (P = 0.03). None of the parameters had a statistically meaningful association with dysphagia. Conclusions According to our results, by omitting probable risk factors of incidence of sore throat and evaluation

  6. Group A streptococcal sore throat in a periurban population of northern India: a one-year prospective study.

    PubMed Central

    Nandi, S.; Kumar, R.; Ray, P.; Vohra, H.; Ganguly, N. K.

    2001-01-01

    OBJECTIVE: To estimate the incidence and risk factors of group A streptococcus (GAS) sore throat among school-aged children living in a periurban slum area of Chandigarh, North India. METHODS: A total of 536 children aged 5-15 years from 261 families identified by a systematic random selection method were enrolled in the study. Episodes of sore throat were recorded through fortnightly home visits over a one-year period. The local vernacular (Hindi) terms gala kharab (bad throat) and khansi jukam (cough and cold) were used to identify symptoms of sore throat, and throat swab specimens were collected from children who had these symptoms on the day of the home visit. Bacterial culture was carried out and the isolation of GAS was confirmed using group-A-specific antiserum. FINDINGS: The incidences of sore throat and GAS sore throat were, respectively, 7.05 and 0.95 episodes per child-year. The incidence was higher in the following situations: among 11-year-olds, during the winter (November to January) and rainy (August) months (a bimodal peak), among children living in houses where there was no separate room for the kitchen, and in homes that included a tobacco smoker. CONCLUSION: The results show that the incidence of GAS sore throat was related to age, season, and indoor air pollution. PMID:11436474

  7. School Nurses on the Front Lines of Medicine: A Student With Fever and Sore Throat.

    PubMed

    Olympia, Robert P

    2016-05-01

    Fever and sore throat are common chief complaints encountered by school nurses. This article explains the etiology of both fever and sore throat in children, describes the office assessment, and delineates life-threatening complications associated with fever and sore throat that may prompt the school nurse to transfer the child to a local emergency department. © 2016 The Author(s).

  8. Prospective surveillance of streptococcal sore throat in a tropical country.

    PubMed

    Steer, Andrew C; Jenney, Adam W J; Kado, Joseph; Good, Michael F; Batzloff, Michael; Magor, Graham; Ritika, Roselyn; Mulholland, Kim E; Carapetis, Jonathan R

    2009-06-01

    Acute rheumatic fever and rheumatic heart disease cause a high burden of disease in Fiji and surrounding Pacific Island countries, but little is known about the epidemiology of group A streptococcal (GAS) pharyngitis in the region. We designed a study to estimate the prevalence of carriage of beta-hemolytic streptococci (BHS) and the incidence of BHS culture-positive sore throat in school aged children in Fiji. We conducted twice-weekly prospective surveillance of school children aged 5 to 14 years in 4 schools in Fiji during a 9-month period in 2006, after an initial phase of pharyngeal swabbing to determine the prevalence of BHS carriage. We enrolled 685 children. The prevalence of GAS carriage was 6.0%, while the prevalence of group C streptococcal (GCS) and group G streptococcal (GGS) carriage was 6.9% and 12%, respectively. There were 61 episodes of GAS culture-positive sore throat during the study period equating to an incidence of 14.7 cases per 100 child-years (95% CI, 11.2-18.8). The incidence of GCS/GGS culture-positive sore throat was 28.8 cases per 100 child-years (95% CI, 23.9-34.5). The clinical nature of GAS culture-positive sore throat was more severe than culture-negative sore throat, but overall was mild compared with that found in previous studies. Of the 101 GAS isolates that emm sequence typed there were 45 emm types with no dominant types. There were very few emm types commonly encountered in industrialized nations and only 9 of the 45 emm types found in this study are emm types included in the 26-valent GAS vaccine undergoing clinical trials. GAS culture-positive sore throat was more common than expected. Group C and group G streptococci were frequently isolated in throat cultures, although their contribution to pharyngeal infection is not clear. The molecular epidemiology of pharyngeal GAS in our study differed greatly from that in industrialized nations and this has implications for GAS vaccine clinical research in Fiji and other tropical

  9. Ear Acupuncture for Acute Sore Throat: A Randomized Controlled Trial

    DTIC Science & Technology

    2014-09-26

    SEP 2014 2. REPORT TYPE Final 3. DATES COVERED 4. TITLE AND SUBTITLE Ear acupuncture for acute sore throat. A randomized controlled trial...Auncular Acupuncture is a low risk option for acute pain control •Battlefield acupuncture (BFA) IS a specific auncular acupuncture technique •BFA IS...Strengths: Prospect1ve RCT •Weaknesses Small sample stze. no sham acupuncture performed, patients not blinded to treatment •Th1s study represents an

  10. Predictors of postoperative sore throat in intubated children.

    PubMed

    Calder, Alyson; Hegarty, Mary; Erb, Thomas O; von Ungern-Sternberg, Britta S

    2012-03-01

    The incidence of postoperative sore throat (POST) following intubation is not well defined in the pediatric population. The etiology is multifactorial and includes impairment of subglottic mucosal perfusion and edema as a result of the pressures exerted by cuffed or uncuffed tubes. To determine the incidence of, and risk factors for, POST in intubated children undergoing elective day-case surgery. Five hundred patients aged 3-16 years were studied prospectively. Endotracheal tube (ETT) choice (cuffed or uncuffed) was left to the anesthetist. The cuff was inflated either until loss of audible leak or to a determined pressure using a cuff manometer. The research team then measured the cuff pressure (CP). POST incidence and intensity was determined by interviewing patients prior to discharge from the same day procedure unit. Chi-square testing and stepwise logistic regression were used to determine the predictors of POST. Of the 111 (22%) children developed a sore throat, 19 (3.8%) a sore neck, and 5 (1%) a sore jaw. 19% of patients with cuffed ETTs complained of sore throat compared with 37% of those intubated with an uncuffed ETT. The incidence of POST increased with CP; 0-10% at 0 cmH(2)O, 4% at 11-20 cmH(2)O, 20% at 21-30 cmH(2)O, 68% at CP 31-40 cmH(2)O, and 96% at CP >40 cmH(2)O. The ETT CP and use of uncuffed ETTs were univariate predictors of POST. Children intubated with uncuffed ETTs are more likely to have POST. ETT CP is positively correlated with the incidence of POST. When using cuffed ETTs, CP should be routinely measured intraoperatively. © 2011 Blackwell Publishing Ltd.

  11. Throat swabs have no influence on the management of patients with sore throats.

    PubMed

    Cheung, L; Pattni, V; Peacock, P; Sood, S; Gupta, D

    2017-09-06

    Throat swabs are neither specific nor sensitive for micro-bacteria causing sore throat symptoms; however, current guidelines suggest they are still useful in some cases. Retrospective and prospective analyses were conducted of throat swabs requested within the months of January 2016 and August 2016, respectively. The study comprised 247 patients. Fifty-nine (24 per cent) had a positive culture. Forty-six grew group A beta-haemolytic streptococci, with the remainder growing candida (n = 10), coliform (n = 1) and klebsiella (n = 2). There was no significant difference in culture rates between primary or secondary care sources (χ2 = 0.56, p = 0.45). None of the swabs influenced a variation in patient management from local antimicrobial policies. Current practice has an estimated annual financial impact of £3 434 340 on the National Health Service. Throat swabs do not influence the antimicrobial treatment for patients with sore throats, even under current guidelines, and incur unnecessary cost. Current clinical guidelines could be reviewed to reduce the number of throat swabs being conducted unnecessarily.

  12. Tonsillitis and sore throat in children

    PubMed Central

    Stelter, Klaus

    2014-01-01

    Surgery of the tonsils is still one of the most frequent procedures during childhood. Due to a series of fatal outcomes after hemorrhage in children in Austria in 2006, the standards and indications for tonsillectomy have slowly changed in Germany. However, no national guidelines exist and the frequency of tonsil surgery varies across the country. In some districts eight times more children were tonsillectomized than in others. A tonsillectomy in children under six years should only be done if the child suffers from recurrent acute bacterially tonsillitis. In all other cases (i.e. hyperplasia of the tonsils) the low risk partial tonsillectomy should be the first line therapy. Postoperative pain and the risk of hemorrhage are much lower in partial tonsillectomy (=tonsillotomy). No matter whether the tonsillotomy is done by laser, radiofrequency, shaver, coblation, bipolar scissor or Colorado needle, as long as the crypts are kept open and some tonsil tissue is left behind. Total extracapsular tonsillectomy is still indicated in severely affected children with recurrent infections of the tonsils, allergy to antibiotics, PFAPA syndrome (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) and peritonsillar abscess. With regard to the frequency and seriousness of the recurrent tonsillitis the indication for tonsillectomy in children is justified if 7 or more well-documented, clinically important, adequately treated episodes of throat infection occur in the preceding year, or 5 or more of such episodes occur in each of the 2 preceding years (according to the paradise criteria). Diagnosis of acute tonsillitis is clinical, but sometimes it is hard to distinguish viral from bacterial infections. Rapid antigen testing has a very low sensitivity in the diagnosis of bacterial tonsillitis and swabs are highly sensitive but take a long time. In all microbiological tests the treating physician has to keep in mind, that most of the bacterials, viruses and

  13. Tonsillitis and sore throat in children.

    PubMed

    Stelter, Klaus

    2014-01-01

    Surgery of the tonsils is still one of the most frequent procedures during childhood. Due to a series of fatal outcomes after hemorrhage in children in Austria in 2006, the standards and indications for tonsillectomy have slowly changed in Germany. However, no national guidelines exist and the frequency of tonsil surgery varies across the country. In some districts eight times more children were tonsillectomized than in others. A tonsillectomy in children under six years should only be done if the child suffers from recurrent acute bacterially tonsillitis. In all other cases (i.e. hyperplasia of the tonsils) the low risk partial tonsillectomy should be the first line therapy. Postoperative pain and the risk of hemorrhage are much lower in partial tonsillectomy (=tonsillotomy). No matter whether the tonsillotomy is done by laser, radiofrequency, shaver, coblation, bipolar scissor or Colorado needle, as long as the crypts are kept open and some tonsil tissue is left behind. Total extracapsular tonsillectomy is still indicated in severely affected children with recurrent infections of the tonsils, allergy to antibiotics, PFAPA syndrome (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) and peritonsillar abscess. With regard to the frequency and seriousness of the recurrent tonsillitis the indication for tonsillectomy in children is justified if 7 or more well-documented, clinically important, adequately treated episodes of throat infection occur in the preceding year, or 5 or more of such episodes occur in each of the 2 preceding years (according to the paradise criteria). Diagnosis of acute tonsillitis is clinical, but sometimes it is hard to distinguish viral from bacterial infections. Rapid antigen testing has a very low sensitivity in the diagnosis of bacterial tonsillitis and swabs are highly sensitive but take a long time. In all microbiological tests the treating physician has to keep in mind, that most of the bacterials, viruses and

  14. [Tonsillitis and sore throat in childhood].

    PubMed

    Stelter, K

    2014-03-01

    Surgery of the tonsils is still one of the most frequent procedures during childhood. Due to a series of fatal outcome after hemorrhage in children in Austria in 2006, the standards and indications for tonsillectomy slowly change in Germany since that. However, there exist no national guidelines and the frequency of tonsil surgery varies in the country. In some districts eight times more children were tonsillectomized than in others. A tonsillectomy in children under 6 years should only be done if the child suffers from recurrent acute bacterially tonsillitis. In all other cases (i. e. hyperplasia of the tonsils) the low risk partial tonsillectomy should be the first line therapy. Postoperative pain and the risk of hemorrhage are much lower in partial tonsillectomy (= tonsillotomy). No matter whether the tonsillotomy is done by laser, radiofrequency, shaver, coblation, bipolar scissor or Colorado needle, as long as the crypts are kept open and some tonsil tissue is left behind. Total extracapsular tonsillectomy is still indicated in severely affected children with recurrent infections of the tonsils, allergy to antibiotics, PFAPA syndrome (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) and peritonsillar abscess. With regard to the frequency and seriousness of the recurrent tonsillitis the indication for tonsillectomy in children is justified if 7 or more well-documented, clinically important, adequately treated episodes of throat infection occur in the preceding year, or 5 or more such episodes occur in each of the 2 preceding years (according to the paradise criteria). Diagnosis of acute tonsillitis is clinical, but sometimes it is hard to distinguish viral from bacterial infections. Rapid antigen testing has a very low sensitivity in the diagnosis of bacterial tonsillitis and swabs are highly sensitive but take a long time. In all microbiological tests the treating physician has to keep in mind, that most of the bacterials, viruses and

  15. Acute sinusitis and sore throat in primary care.

    PubMed

    Del Mar, Chris

    2016-08-01

    Sore throat and acute sinusitis are not straightforward diagnoses. Trying to guess the responsible pathogen may not be the best approach. Being guided by empirical evidence may be more useful. It suggests some, but very few, benefits for antibiotics. This has to be balanced with some, but few, harms from antibiotics, including diarrhoea, rash and thrush. Prescribers should also be aware of the risk of antibiotic resistance for the individual, as well as for the population as a whole. GPs should explain the evidence for the benefits and the harms of antibiotics to patients within a shared decision-making framework.

  16. 21 CFR 201.315 - Over-the-counter drugs for minor sore throats; suggested warning.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Over-the-counter drugs for minor sore throats... AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING Specific Labeling Requirements for Specific Drug Products § 201.315 Over-the-counter drugs for minor sore throats; suggested warning. The Food and...

  17. An unusual case of a sore throat and otalgia in a 4-year-old boy.

    PubMed

    Siupšinskienė, Nora; Padervinskis, Evaldas; Poškienė, Lina; Endeley, Nganjo; Vaitkus, Saulius

    2012-01-01

    A sore throat, otalgia, and snoring are the common symptoms seen in children presenting to an otorhinolaryngological clinic. Sometimes, however, these symptoms may be suggestive of an aggressive malignancy. We present a rare case of Burkitt's lymphoma of the tonsil in a young child, which initially manifested as a sore throat and otalgia.

  18. Causes of sore throat after intubation: a prospective observational study of multiple anesthesia variables.

    PubMed

    Levin, Phillip D; Chrysostomos, Chrysostomou; Ibarra, Carlos A; Ledot, Stephan; Naito, Daigo; Weissman, Charles; Avidan, Alexander

    2017-06-01

    Sore throat is common after intubation for surgery. This observational study investigated cuff pressure and a large range of clinical covariates to explore the etiology of sore throat. Approximately 24 hours after surgery six questions relating to pain, upper airway symptoms and sore throat were delivered to patients who had undergone intubation. Sore throat was correlated with demographics, anesthesia variables and cuff pressure (measured for a subset of patients). Sore throat was reported by 270/518 (52%) patients with VAS Score 45.9±25.1 (range 0-100). Sore throat patients were significantly younger, had a lower ASA status, were more frequently female, had shorter surgeries and lower nitrous oxide exposure, had a higher proportion of smaller tracheal tubes (7.5 mm internal diameter vs. 8 mm), had a higher incidence of nasogastric drainage, higher propofol doses and a higher usage of ketorolac. Decreasing age (odds ratio 0.976, 95% confidence intervals 0.961-0.992, P=0.003) and the presence of a nasogastric tube when the questionnaire was delivered (OR 1.83, 95% CI: 1.06-3.14, P=0.03) remained significant predictors of sore throat on multivariate analysis. Mean cuff pressure (measured for 160 patients) was 56.8±41.9 mmHg. Cuff pressure was similar amongst patients with and without sore throat (57±46 vs. 53±38 mmHg, P=0.58). There was no correlation between cuff pressure and severity of sore throat (r=0.004, P=0.37). Only age and the presence of a nasogastric tube after surgery were significant predictors for sore throat. This result contradicts most other studies of cuff pressure where fewer covariates were measured.

  19. Flurbiprofen microgranules for relief of sore throat: a randomised, double-blind trial

    PubMed Central

    Russo, Marc; Bloch, Mark; de Looze, Fred; Morris, Christopher; Shephard, Adrian

    2013-01-01

    Background Many people with sore throat seek, and are often inappropriately prescribed, antibiotics. Aim The objective of this study was to determine the analgesic efficacy of flurbiprofen 8.75 mg microgranules versus placebo. These microgranules are a possible alternative treatment for patients with sore throat due to upper respiratory tract infection (URTI). Design and setting Randomised, double-blind, placebo-controlled, multiple-dose study conducted at eight primary care sites in Australia. Method Participants with sore throat of onset within the past 4 days received either flurbiprofen 8.75 mg microgranules or non-medicated placebo microgranules. Throat soreness, difficulty in swallowing, sore throat pain intensity, sore throat relief, oral temperature, and treatment benefits were all assessed at regular intervals. Result Of 373 patients from eight centres, 186 received flurbiprofen 8.75 mg microgranules and 187 received placebo microgranules (intent-to-treat population). Throat soreness was significantly reduced over the first 2 hours after the first dose. Reductions in difficulty in swallowing were observed at all time points from 5 to 360 minutes after the first dose, after taking flurbiprofen microgranules versus placebo. Sore throat relief was also evident at 1 minute and lasted for at least 6 hours. The multiple-dose efficacy results showed reduction of difficulty in swallowing at the end of days 1–3 and sore throat relief at the end of day 1. Conclusion Microgranules containing flurbiprofen 8.75 mg provided fast and effective relief from sore throat due to URTI and represent an alternative treatment option to antibiotic therapy. PMID:23561694

  20. Oral corticosteroid use for clinical and cost-effective symptom relief of sore throat: study protocol for a randomized controlled trial.

    PubMed

    Cook, Johanna; Hayward, Gail; Thompson, Matthew; Hay, Alastair D; Moore, Michael; Little, Paul; Harman, Kim; Wolstenholme, Jane; Perera, Rafael; Voysey, Merryn; Allen, Julie; Breen, Maria; Heneghan, Carl

    2014-09-18

    Management of acute sore throat poses a significant burden on UK general practices, with almost 10% of registered patients attending their GP with sore throat every year. Nearly half of all patients presenting with acute sore throat are treated with antibiotics, despite their limited effect. In a recent systematic review we demonstrated that a single dose of steroids reduced the severity and time to resolution of sore throat. However, all of the trials included looked at the use of steroids alongside antibiotics and only one was in a primary care setting. This trial aims to assess the efficacy and cost-effectiveness of a single oral dose of corticosteroids on symptoms of sore throat in patients receiving either a delayed antibiotic prescription or no antibiotics at all in UK primary care. A double-blind, two arm, randomized, placebo controlled trial in adults (≥ 18 years of age) presenting to primary care with acute sore throat (throat swab for bacterial culture. Participants are being randomized to treatment arms at a ratio of 1:1. Treatment arms will be stratified according to whether patients are being given a delayed antibiotic prescription or no antibiotic prescription and by recruiting centre (Oxford, Bristol or Southampton). Outcome data is being collected at 24 and 48 hours via text message or telephone call, from days 0 to 7 using a patient symptom diary and at one month via a GP notes review. This will be the first randomized controlled trial of oral corticosteroids in adults presenting to primary care with sore throat in the UK, and the first to examine the clinical and cost-effectiveness of oral corticosteroids for the treatment of sore throat in the absence of antibiotics. This trial is registered with Current Controlled Trials on 26 March 2013, registration number: ISRCTN17435450.

  1. Impact of laryngeal mask airway cuff pressures on the incidence of sore throat in children.

    PubMed

    Wong, Justin Gin Leong; Heaney, Mairead; Chambers, Neil A; Erb, Thomas O; von Ungern-Sternberg, Britta S

    2009-05-01

    Hyperinflation of laryngeal mask airway cuffs can cause harm to the upper airway mainly by exerting high pressures on pharyngeal and laryngeal structures thus impairing mucosal perfusion. Although cuff manometers can be used to guide the monitoring of cuff pressures, their use is not routine in many institutions. In a prospective audit, we assessed the incidence of sore throat following day-case-surgery in relation to the intracuff pressure within the laryngeal mask airway. Four hundred children (3-21 years) were consecutively included in this study. The laryngeal mask airway was inflated as deemed necessary by the attending anesthetist. Cuff pressures were measured using a calibrated cuff manometer (Portex Limited, Hythe, Kent, UK, 0-120 cm H2O, pressures exceeding the measurement range were set at 140 cm H2O for statistical purposes) at induction of anesthesia. Forty-five children (11.25%) developed sore throat, 32 (8%) sore neck and 17 (4.25%) sore jaw. Of those that developed sore throat, 56.5% had cuff pressures exceeding >100 cm H2O. In contrast, when cuff pressures were <40 cm H2O, there were no episodes of sore throat, whilst there was only a 4.6% occurrence of sore throat if cuff pressures were between 40-60 cm H2O. We have demonstrated that intra cuff pressure in laryngeal mask airways is closely related to the development of sore throat with higher pressures increasing its likelihood. Hence, cuff pressures should be measured routinely using a manometer to minimize the incidence of sore throat.

  2. Effect of Endotracheal Tube Cuff Shape on Postoperative Sore Throat After Endotracheal Intubation.

    PubMed

    Chang, Jee-Eun; Kim, Hyerim; Han, Sung-Hee; Lee, Jung-Man; Ji, Sanghwan; Hwang, Jin-Young

    2017-03-31

    Although minor, a sore throat after endotracheal intubation can adversely affect patient satisfaction and postoperative function. We compared the effects of 2 endotracheal tube cuff shapes on postoperative sore throat. One hundred ninety-one adult patients were included in the study. After induction of anesthesia, patients were randomized to endotracheal intubation with a conventional cylindrical-shaped cuff (Group C, n = 95) or a tapered-shaped cuff (Group T, n = 96). The number of intubation attempts, time to achieve endotracheal intubation, and duration of intubation were recorded. Postoperative sore throat and hoarseness were assessed at 1, 6, and 24 hours after surgery. A 0- to 100-mm visual analog scale was used to evaluate sore throat severity. The primary outcome of this study was the overall cumulative incidence of postoperative sore throat in the 24-hour evaluation period in the 2 groups. The overall incidence of postoperative sore throat was lower in Group T than in Group C (32% vs 54%; relative risk = 0.60, 95% confidence interval: 0.43-0.85; P = .003). At 6 hours after surgery, the incidence and severity of postoperative sore throat were lower in Group T compared with Group C (Bonferroni-corrected P < .05). Postoperative hoarseness also occurred less frequently in Group T compared with Group C (19% vs 37%; P = .006). Group T had lower incidence of hoarseness at 1 and 6 hours after surgery than Group C (Bonferroni-corrected P <.05), but the incidence of hoarseness at 24 hours after surgery did not differ between groups. Intubation using an endotracheal tube with a tapered cuff reduced the incidence and severity of postoperative sore throat and the incidence of hoarseness after surgery when compared with an endotracheal tube with a cylindrical cuff.

  3. Effects of topical dexamethasone in postoperative sore throat

    PubMed Central

    Kim, Soo Bin; Lee, Wonjin; Ki, Seunghee; Kim, Myoung-Hun; Cho, Kwangrae; Lim, Se Hun; Lee, Kun Moo; Choi, Deul-Nyuck; Oh, Minkyung

    2017-01-01

    Background Postoperative sore throat (POST) is a complication that undermines patient satisfaction and increases discomfort in the postoperative period. The present study examined the effects of dexamethasone gargle and endotracheal tube cuff soaking on the incidence and severity of POST. Methods Ninety patients undergoing laparoscopic cholecystectomy were randomly allocated into three groups: 0.9% normal saline gargling and tube soaking (group C), 0.05% dexamethasone solution gargling and 0.9% normal saline tube soaking (group G), 0.9% normal saline gargling and 0.05% dexamethasone tube soaking (group S). The incidence and severity of POST were then assessed and recorded at 24 hours after surgery. Results The total incidence of POST was significantly different among the groups (P < 0.05), and group S exhibited a significantly lower incidence of POST than group C (P < 0.0167). In addition, the POST intensity of group G and group S was less severe than those of group C (Both P < 0.0167). Conclusions Among patients undergoing laparoscopic cholecystectomy, those who gargled with 0.05% dexamethasone solution exhibited lower severity of POST than the control group, and those whose endotracheal tube cuff was soaked in the dexamethasone solution before intubation exhibited significantly lower incidence and severity of POST than the control group. PMID:28184268

  4. Gargling with ketamine attenuates the postoperative sore throat.

    PubMed

    Rudra, A; Ray, Suchanda; Chatterjee, S; Ahmed, A; Ghosh, S

    2009-02-01

    Postoperative sore throat (POST) is a common complication of anaesthesia with endotracheal tube that affects patient satisfaction after surgery. Therefore, this complication remains to be resolved in patients undergoing endotracheal intubation. The aim of the study was to compare the effectiveness of ketamine gargles with placebo in preventing POST after endotracheal intubation. Forty patients scheduled for elective surgery under general anaesthesia were randomized into: Group C, water 30 ml; Group K, ketamine 50 mg in water 29 ml. Patients were asked to gargle this mixture for 40 seconds, 5 minutes before induction of anaesthesia. POST was graded at 4, 8 and 24 hours after operation on a four-point scale (0-3). In the Control group POST occurred more frequently, when compared with patients belonging to Ketamine group, at 4, 8, and 24 hours and significantly more patients suffered severe POST in Control group at 8 and 24 hours compared with Ketamine group (P<0.05). We demonstrated that gargling with ketamine significantly attenuated POST, with no drug-related side effects were observed.

  5. Gargling with Ketamine Attenuates the Postoperative Sore Throat

    PubMed Central

    Rudra, A; Ray, Suchanda; Chatterjee, S; Ahmed, A; Ghosh, S

    2009-01-01

    Summary Postoperative sore throat (POST) is a common complication of anaesthesia with endotracheal tube that affects patient satisfaction after surgery. Therefore, this complication remains to be resolved in patients undergoing endotracheal intubation. The aim of the study was to compare the effectiveness of ketamine gargles with placebo in preventing POST after endotracheal intubation. Forty patients scheduled for elective surgery under general anaesthesia were randomized into: Group C, water 30 ml; Group K, ketamine 50 mg in water 29 ml. Patients were asked to gargle this mixture for 40 seconds, 5 minutes before induction of anaesthesia. POST was graded at 4, 8 and 24 hours after operation on a four-point scale (0-3). In the Control group POST occurred more frequently, when compared with patients belonging to Ketamine group, at 4, 8, and 24 hours and significantly more patients suffered severe POST in Control group at 8 and 24 hours compared with Ketamine group (P<0.05). We demonstrated that gargling with ketamine significantly attenuated POST, with no drug-related side effects were observed. PMID:20640076

  6. Prophylactic effect of dexamethasone in reducing postoperative sore throat

    PubMed Central

    Park, Sun-young; Lee, Ae-ri; Cho, Sung-Hwan; Chae, Won Seok; Jin, Hee Cheol; Lee, Jeong Seok; Kim, Yong Ik

    2010-01-01

    Background This study was performed to compare the effectiveness of prophylactic dexamethasone and postintubation dexamethasone in reducing the incidence and severity of postoperative sore throat (POST). Methods This was a prospective, randomized, double-blind clinical trial. The study population consisted of 70 patients between 20 and 60 years old who were classified as American Society of Anesthesiologists I-II and were scheduled for elective laparoscopic cholecystectomy. The patients were divided randomly into two groups. Patients in the prophylactic and postintubation groups received intravenous injection of 10 mg of dexamethasone 30 min before or after tracheal intubation, respectively. The patients were interviewed 1, 6, and 24 h after the operation. The incidence and severity of POST were recorded. Results The severity scores of POST at 1 and 6 h after the operation were significantly lower in the prophylactic group than in the postintubation group. There were no significant differences in the incidence of POST during the 24 h after the operation between the two groups (22/32 in the prophylactic group vs. 27/34 in the postintubation group, P = 0.403). Conclusions Intravenous injection of 10 mg of dexamethasone was more effective in reducing the severity of POST when administered before tracheal intubation compared with after tracheal intubation. PMID:20498806

  7. Dexpanthenol pastille and benzydamine hydrochloride spray for the prevention of post-operative sore throat.

    PubMed

    Gulhas, N; Canpolat, H; Cicek, M; Yologlu, S; Togal, T; Durmus, M; Ozcan Ersoy, M

    2007-02-01

    In this study, we aimed to compare the effectiveness of dexpanthenol pastille and benzydamine hydrochloride spray on the prevention of a sore throat. One hundred and eighty patients undergoing general anaesthesia, who were ASA I-II and with their ages ranging between 15 and 70 years, were randomly allocated to three groups, each consisting of 60 patients. For group B, four puffs of benzydamine hydrochloride were sprayed into the mouth initially 30 min before the operation and repeatedly 5 min before anaesthesia induction. For group D, two pastilles of dexpanthenol were administered orally to be sucked 30 min before the operation. For group P, four puffs of distilled water were sprayed into the mouth initially 30 min before the operation. Post-operatively, patients were evaluated for a sore throat for the duration of 24 h. The incidence of a sore throat was significantly lower for group D when compared with group B and group P. The incidence of a sore throat was similar for group B and group P. According to the sore throat grading system, the number of patients experiencing no complaints was significantly higher for group D when compared with group B and group P. The number of patients achieving moderate scores was significantly higher for group B when compared with group D. The administration of 200 mg of dexpanthenol prophylactically before endotracheal intubation is effective in the prevention of post-operative sore throat.

  8. Comparison of the Incidence of Sore Throat After Rapid Sequence Intubation With Succinylcholine and Cisatracurium

    PubMed Central

    Solatpour, Farhad; Teymourian, Houman; Mohajerani, Seyed Amir; Hoseinzadegan Shirazi, Fatemeh; Lotfollah Zadeh, Saran; Baikpour, Maryam; Amraei, Razie

    2014-01-01

    Background: Postoperative sore throat is a common complication of endotracheal intubation and can lead to dissatisfaction after surgery. Airway management has the strongest influence on the incidence of sore throat and improving endotracheal intubating conditions can reduce this complaint. Type of induction agent used during anesthesia can contribute to variances in the degree of post-operative sore throat. Objectives: We aimed to compare the incidence of postoperative sore throat after rapid sequence induction with Succinylcholine and high dose Cisatracurium. Patients and Methods: The study was carried out on patients admitted to Shohada-e-Tajrish hospital for emergent abdominal surgery. Of the 80 patients who were enrolled in the study, 40 were randomly assigned to receive Succinylcholine while the remaining patients received Cistracurium during induction. Sore throat, muscle ache, hoarseness, dry throat and pain were assessed in each patient at baseline in recovery and at 2, 4, 12 and 24 hours post-operation. Results: Number of patients who developed sore throat was significantly higher in the Succinylcholine group (75%) compared to Cisatracurium group (27.5%) at the time of entrance to the recovery room (P = 0.001). These numbers decreased at 2 hours post–operation (42% versus 17.5%) but the difference was still statistically significant (P < 0.05). At 12 (P = 0.062) and 24 (P = 0.14) hours post operation, the difference was no longer significant. Conclusions: Use of high dose Cisatracurium for induction during rapid sequence intubation carries a lower chance of developing sore throat compared to Succinylcholine. Studies comparing other adverse effects of these two agents are required to guide physician's choice of induction agent. PMID:25289376

  9. Acute thoracic aortic dissection presenting as sore throat: report of a case.

    PubMed Central

    Liu, Wen-Pin; Ng, Kim-Choy

    2004-01-01

    Acute dissection of the aorta can be one of the most dramatic of cardiovascular emergencies. Its symptoms can occur abruptly and progress rapidly. Prompt recognition and appropriate intervention is crucial. However, not all aortic dissections present with classic symptoms of abrupt chest, back, or abdominal pain, and the diagnosis may be missed. Aortic dissection presenting as a sore throat is quite unusual. A 53-year-old man presented with sore throat as the early symptom of an acute thoracic aortic dissection. Unfortunately, the diagnosis was delayed, and the patient died. Given the high morbidity and mortality after delayed recognition or misdiagnosis, aortic dissection should be considered in the differential diagnosis of a patient presenting with sore throat and normal findings of neck and throat, even when there is no classic symptoms. PMID:15829145

  10. Laryngotracheal application of lidocaine spray increases the incidence of postoperative sore throat after total intravenous anesthesia.

    PubMed

    Maruyama, Koichi; Sakai, Hironori; Miyazawa, Hideki; Iijima, Kyou; Toda, Naoyuki; Kawahara, Shuji; Hara, Katsumi

    2004-01-01

    To determine the effect of laryngotracheal application of different doses of lidocaine spray on postoperative sore throat and hoarseness, we evaluated the incidence and severity of these complications in 168 ASA I-III patients aged 15-92 years in a placebo-controlled study. After induction of anesthesia with propofol, ketamine, fentanyl, and vecuronium, the laryngotracheal area was sprayed immediately before intubation with lidocaine spray either 5 times (L5 group, n = 47) or 10 times (L10 group, n = 48) or with normal saline 1 ml (placebo group, n = 51). Postoperative sore throat and hoarseness were evaluated immediately after surgery and on the day after surgery. The incidence of sore throat was significantly higher in the L10 group than in the placebo group on both the day of and the day after surgery. The severity of sore throat was significantly higher in the L5 and L10 groups than in the placebo group on the day of surgery. On the day after surgery, the severity of sore throat remained significantly higher in the L10 group than in the placebo group. Although the incidence and severity of sore throat increased in a dose-dependent manner, these were not significantly different between the L5 and L10 groups. In addition, the incidence and severity of hoarseness did not differ at all among the three groups. We recommend that applications of lidocaine spray to the laryngotracheal area should be avoided to help eliminate unnecessary postoperative sore throat, thereby leading to improvement in patient satisfaction.

  11. Ketorolac Tromethamine Spray Prevents Postendotracheal-Intubation-Induced Sore Throat after General Anesthesia

    PubMed Central

    Yang, H. L.; Tsai, S. C.; Tsay, P. K.; Lin, H. T.

    2016-01-01

    Background. Postoperative sore throat is one of the major complaints of general anesthesia in the postanesthesia care unit. This prospective study investigated the preventive effect of ketorolac tromethamine spray in postendotracheal-intubation-induced sore throat after general anesthesia. Methods. Surgical patients undergoing general anesthesia with endotracheal intubation were recruited from a medical center. Patients were randomly assigned to group K (treated with 5% ketorolac tromethamine spray) or group D (treated with distilled water spray). Before intubation, each endotracheal tube was sprayed with the appropriate solution by physicians over the 20 cm length of the cuff. Each group comprised 95 patients fitting the inclusion and exclusion criteria for whom complete data sets were collected. The intensity of the sore throat was measured at 1, 3, 6, and 24 h after surgery, and data were compared. Results. The two groups had similar characteristics. Postoperative sore throat was significantly less frequent in group K than in group D (p < 0.001) and the pain intensity was significantly lower in group K than in group D at each time point (all p < 0.001). Conclusions. This study demonstrated that preanesthesia 5% ketorolac tromethamine spray could effectively decrease postendotracheal-intubation-induced sore throat in patients undergoing general anesthesia. PMID:28025646

  12. Does benzydamine hydrochloride applied preemptively reduce sore throat due to laryngeal mask airway?

    PubMed

    Kati, Ismail; Tekin, Murat; Silay, Emin; Huseyinoglu, Urfettin A; Yildiz, Huseyin

    2004-09-01

    Sore throat is a common postoperative complaint. We investigated whether preemptive benzydamine hydrochloride (BH) treatment could prevent sore throat due to a laryngeal mask airway (LMA) cuff inflated with air. One-hundred ASA status I-II patients who underwent general anesthesia were randomly divided into two groups. In the first group, four puffs of BH were applied to the pharynx 30 min before the operation and 5 min before the induction of anesthesia. Distilled water with a similar bottle was applied with the same protocol in the second group. Anesthetic induction was provided with propofol and fentanyl. The pressure of the LMA cuff inflated with room air was measured after the first adjustment and after 30, 60, and 90 min of inflation in both groups. At the end of operation, the LMA was removed after the recovery of spontaneous breathing. After the operation, patients were asked about sore throat symptoms at the first, second, and fourth hours. There were no significant differences between groups for cuff pressures, cuff volumes, analgesic doses, or operation times. However, sore throat symptoms were significantly less severe for the BH group during both resting and swallowing. In conclusion, preemptive topical BH may decrease the incidence of sore throat due to LMA use.

  13. Efficacy of intravenous dexamethasone to reduce incidence of postoperative sore throat: A prospective randomized controlled trial

    PubMed Central

    Bagchi, Dipanjan; Mandal, Mohan Chandra; Das, Sabyasachi; Sahoo, Tirtha; Basu, Sekhar Ranjan; Sarkar, Sanhita

    2012-01-01

    Background: Sore throat and hoarseness are common complications of endotracheal intubation. It may be very distressing for the patient and may lead to sleep disturbances and unpleasant memories. Materials and Methods: This prospective double-blinded randomized control trial was aimed to determine the efficacy of prophylactic intravenous dexamethasone to reduce the incidence of postoperative sore throat at 1 hour after tracheal extubation. Ninety six patients of either sex aged between 18 to 60 years scheduled for elective surgeries needing general anesthesia with endotracheal intubation, were randomly allocated into two groups A and B. The patients received either intravenous 0.2 mg/kg dexamethasone (group A, n = 48) or normal saline (group B, n = 47) just before induction. Trachea was intubated with appropriate size disposable endotracheal tubes for securing the airway. Follow up for the incidence of sore throat, cough and hoarseness was done at 1, 6 and 24 hours post-extubation. Results: At 1 hour post-extubation, the incidence of sore throat in the control group was 48.9% compared with 18.8% in the dexamethasone group (P<0.002). Conclusions: Prophylactic intravenous dexamethasone in a dose of 0.2 mg/kg can reduce the incidence of postoperative sore throat at 1 hour post-extubation by around 30%, with the efficacy being around 60%. PMID:23225928

  14. Benzydamine hydrochloride on postoperative sore throat: a meta-analysis of randomized controlled trials.

    PubMed

    Chen, Chien-Yu; Kuo, Chien-Ju; Lee, Yuan-Wen; Lam, Fai; Tam, Ka-Wai

    2014-03-01

    Sore throat is a common postoperative complaint. The etiology of postoperative sore throat (POST) is considered the result of damage to airway mucosa after insertion of a laryngeal mask airway device or endotracheal tube. This paper proposes benzydamine hydrochloride (BH), a topical nonsteroidal anti-inflammatory drug (NSAID) with additional analgesic and local anesthetic properties, for POST prevention. We systematically searched PubMed, EMBASE™, Cochrane, and other relevant databases for randomized controlled trials (RCTs) that investigated the outcome of topical application of BH vs non-application in patients undergoing general anesthesia. Using a random effects model, meta-analyses were conducted to assess the relative risks of the incidence of POST within 24 hr following the surgical procedure. The secondary outcomes included postoperative nausea and vomiting, dry mouth, coughing, and local irritation. We reviewed five trials that included 824 patients in total. Our results indicated that the incidence of POST was significantly reduced in the BH group, with risk ratios (RRs) of 0.37 (95% confidence interval [CI]: 0.20 to 0.68) at zero to one hour, 0.39 (95% CI: 0.27 to 0.57) at one to two hours, 0.42 (95% CI: 0.22 to 0.81) at four to six hours, 0.29 (95% CI: 0.10 to 0.88) at six to 12 hr, and 0.32 (95% CI: 0.18 to 0.56) at 12 to 24 hr, compared with the control groups. Patients reported local irritation, but no major BH-related complications were observed. Our results indicate that the incidence of POST can be significantly reduced by prophylactic BH topical application to the oral cavity or airway devices. Further RCTs are required to overcome the limitations of heterogeneity and to determine the optimal dosage and application of BH for managing POST.

  15. Scintigraphy can be used to compare delivery of sore throat formulations.

    PubMed

    Limb, M; Connor, A; Pickford, M; Church, A; Mamman, R; Reader, S; Shephard, A; Aspley, S; Goulder, M A

    2009-04-01

    Sore throat (pharyngitis) is commonly treated with over-the-counter lozenges, tablets, sprays and gargles. While the efficacy of the active ingredients has been examined, less is known about the comparative efficacy of the different delivery formats. A pilot study was initially performed, followed by an open-label, four-way crossover study in healthy volunteers to quantitatively assess the delivery efficacy of a lozenge, tablet, spray and gargle, using technetium-99m and scintigraphy as a marker of deposition and clearance of the active ingredients. Initial deposition in the mouth and throat combined was significantly greater for the solid dose forms (lozenge and tablet) than for the spray or gargle. Rates of clearance were initially similar for the tablet and lozenge with low levels of radioactivity present at up to 2 h. At 10 and 20 min, significantly more of the dose remained for the lozenge than for the tablet. The mouth appeared to act as a reservoir for continued clearance to the throat. Scintigraphy is an effective means of quantifying the delivery efficiency, and hence availability, of sore throat medications. The results presented here suggest that both lozenges and tablets offer considerable advantages over sprays or gargles, both in terms of proportion of the dose delivered to the mouth and throat, combined, and clearance from these regions. These delivery formats provide fast, effective and prolonged delivery of active ingredients, highlighting their potential benefits for sore throat medication.

  16. Streptococcal sore throat followup program in a hospital clinic, New York City.

    PubMed Central

    Kaufman, A; Murray, D; Starita, L; Brickner, P W

    1975-01-01

    To improve followup and treatment of patients with streptococcal sore throat at St. Vincent's Hospital and Medical Center, New York City, a simple and inexpensive method was devised for recalling and treating untreated patients with positive throat cultures and culturing household contacts. The program was conducted by a clinic nurse and a secretary, with only occasional assistance from a physician. All services were free for those without Medicaid coverage. The secretary sent notification letters to all patients with positive cultures urging them to return for treatment and emphasizing the need for their contacts to come for screening. The secretary, trained in the throat culturing technique, also performed the laboratory work on the cultures from contacts. The clinic nurse swabbed the throats of all contacts and administered treatment, according to a standing-order protocol, to all with culture-proved streptococcal sore throat. A comparison of initially untreated patients with positive cultures seen 3 months before and 6 months after the program was started revealed that 46 percent returned for treatment after the notification letter was sent; before the program only 21 percent returned for treatment. No attempt had been made to reach household contacts before the program began. The rate of streptococcal sore throat in contacts was 14 percent, and in the clinic patients it was 11 percent during the first 6 months of the program. Images p369-a p371-a PMID:808824

  17. Difference between a Sore Throat, Strep, and Tonsillitis

    MedlinePlus

    ... will not help and need not be prescribed. Antibiotics If the test shows that your child does have strep throat, your pediatrician will prescribe an antibiotic to be taken by mouth or by injection. ...

  18. Risk factors for development of postoperative sore throat and hoarseness after endotracheal intubation in women: a secondary analysis.

    PubMed

    Jaensson, Maria; Gupta, Anil; Nilsson, Ulrica G

    2012-08-01

    Postoperative sore throat and hoarseness are common and disturbing complications following endotracheal intubation, and women are more frequently affected by these symptoms. This study explores risk factors associated with postoperative sore throat and hoarseness in women following intubation. In this prospective cross-sectional study, 97 patients undergoing elective ear, nose, and throat surgery or plastic surgery were included. Eight different variables were analyzed to detect possible associations for the development of postoperative sore throat or hoarseness. For data analysis, the chi2 test and the odds ratio were used. Three variables were found to be significant risk factors for postoperative sore throat: age greater than 60 years (P = .01), the use of a throat pack (P = .04), and endotracheal tube No. 7.0 (size 7 mm; P = .02). The only risk factor found to be significantly associated with developing hoarseness was an endotracheal cuff pressure below 20 centimeters of water (P = .04). Larger studies are needed to confirm these risk factors.

  19. Effect of clonidine premedication on postoperative sore throat and hoarseness after total intravenous anesthesia.

    PubMed

    Maruyama, Koichi; Yamada, Takeshi; Hara, Katsumi

    2006-01-01

    To determine the effect of oral clonidine premedication on postoperative sore throat and hoarseness, we evaluated the incidence and severity of each of these complications in patients who underwent elective surgery in the supine position. The subjects were 82 patients, American Society of Anesthiologists (ASA) status I-III, aged 15-82 years. They were premedicated with either 150 microg oral clonidine and 20 mg raftidine (clonidine group; n = 41) or with 20 mg raftidine only (control group; n = 41) 2 h before anesthesia induction. General anesthesia was maintained with propofol, ketamine, fentanyl, and vecuronium, with or without epidural anesthesia. Postoperative sore throat and hoarseness were evaluated immediately after surgery and on the day after surgery. The incidences of sore throat and hoarseness tended to be higher in the clonidine group than in the control group; however, the difference did not reach statistical significance. There were no significant differences in the severity of these symptoms between the two groups. In conclusion, oral premedication with 150 microg clonidine did not prevent postoperative sore throat or hoarseness, and may have exacerbated these symptoms.

  20. 21 CFR 201.315 - Over-the-counter drugs for minor sore throats; suggested warning.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Over-the-counter drugs for minor sore throats; suggested warning. 201.315 Section 201.315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING Specific Labeling Requirements for Specific...

  1. 21 CFR 201.315 - Over-the-counter drugs for minor sore throats; suggested warning.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Over-the-counter drugs for minor sore throats; suggested warning. 201.315 Section 201.315 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL LABELING Specific Labeling Requirements for Specific...

  2. An evaluation of the management of patients with sore throats by practice nurses and GPs.

    PubMed

    Cox, C; Jones, M

    2000-11-01

    Practice nurses are increasingly involved in the management of minor illnesses in primary care. However, there has been little work published that evaluates the quality of the service they offer to patients. In our practice (semi-rural, 14,000 patients) a nursing triage system for minor illnesses has been established since 1992. To compare the quality of management of sore throats by practice nurses and general practitioners (GPs) in a routine nursing triage system. An observational study assessing all patients over the age of two years presenting over a six-month period (February-August 1997) to either the practice nurse or GP with a sore throat as the chief presenting complaint. Patients were followed up at five to seven days by a researcher and recovery rates, analgesic requirements, reconsultation rates, and satisfaction rates were recorded. Patients who were still symptomatic at five to seven days were followed up again at 28 days and outcomes recorded. A total of 44% of patients consulted the practice nurse and 56% consulted the GP. Severity of presenting illness was similar in the two groups. The number of patients whose sore throats had settled, reconsultation rates, antibiotic prescription, and dissatisfaction rates were the same for both groups. However, the patients consulting the nurse had a more favourable outcome on indices such as patients' perception of being back to normal health (64% versus 53%) and median number of days for the sore throat to settle (four versus five). Nurses tended to see younger patients (mean age = 22.5 years versus 28.3 years) and more patients seeing the practice nurse recalled receiving advice about home remedies (76% versus 54%). Practice nurses can establish a safe and effective service for treatment of sore throats in a time-restricted triage system.

  3. The effect of intracuff alkalinized 2% lidocaine on emergence coughing, sore throat, and hoarseness in smokers.

    PubMed

    Navarro, Laís Helena Camacho; Lima, Rodrigo Moreira e; Aguiar, Andressa Simões; Braz, José Reinaldo Cerqueira; Carness, Jeffrey M; Módolo, Norma Sueli Pinheiro

    2012-01-01

    We evaluated whether endotracheal tube (ETT) intracuff alkalinized lidocaine was superior to saline in blunting emergence coughing, postoperative sore throat, and hoarseness in smokers. In our prospective, double-blind trial, we enrolled 50 smoking patients undergoing surgery under general anesthesia including nitrous oxide (N2O). Patients were randomly allocated to receive either ETT intracuff 2% lidocaine plus 8.4% sodium bicarbonate (L group), or ETT intracuff 0.9% saline (S group). The ETT cuff was inflated to achieve a cuff pressure that prevented air leak during positive pressure ventilation. Incidence of emergence coughing, sore throat, and hoarseness were analyzed. The volume of inflation solution, the intracuff pressure, the duration of anesthesia, the time elapsed to extubation after discontinuation of anesthesia, and the volume of the inflation solution and the air withdrawn from the ETT cuff were also recorded. Intracuff alkalinized 2% lidocaine was superior to saline in blunting emergence coughing (p < 0.001). The incidence of sore throat was significantly lower in the L group at the post-anesthesia care unit (PACU) (p = 0.02). However, at 24 hours after extubation, sore throat incidence was similar in both groups (p = 0.07). Incidence of hoarseness was similar in both groups. Intracuff pressure in the saline group increased with time while the intracuff pressure in the lidocaine group remained constant. The present study demonstrated that the intracuff alkalinized 2% lidocaine was superior to saline in decreasing the incidence of emergence coughing and sore throat during the postoperative period in smokers.

  4. Management of patients with sore throats in relation to guidelines: An interview study in Sweden

    PubMed Central

    Strandberg, Eva Lena; Gröndal, Hedvig; Brorsson, Annika; Thulesius, Hans; André, Malin

    2014-01-01

    Abstract Objective. To explore how a group of Swedish general practitioners (GPs) manage patients with a sore throat in relation to current guidelines as expressed in interviews. Design. Qualitative content analysis was used to analyse semi-structured interviews. Setting. Swedish primary care. Subjects. A strategic sample of 25 GPs. Main outcome measures. Perceived management of sore throat patients. Results. It was found that nine of the interviewed GPs were adherent to current guidelines for sore throat and 16 were non-adherent. The two groups differed in terms of guideline knowledge, which was shared within the team for adherent GPs while idiosyncratic knowledge dominated for the non-adherent GPs. Adherent GPs had no or low concerns for bacterial infections and differential diagnosis whilst non-adherent GPs believed that in patients with a sore throat any bacterial infection should be identified and treated with antibiotics. Patient history and examination was mainly targeted by adherent GPs whilst for non-adherent GPs it was often redundant. Non-adherent GPs reported problems getting patients to abstain from antibiotics, whilst no such problems were reported in adherent GPs. Conclusion. This interview study of sore throat management in a strategically sampled group of Swedish GPs showed that while two-thirds were non-adherent and had a liberal attitude to antibiotics one-third were guideline adherent with a restricted view on antibiotics. Non-adherent GPs revealed significant knowledge gaps. Adherent GPs had discussed guidelines within the primary care team while non-adherent GPs had not. Guideline implementation thus seemed to be promoted by knowledge shared in team discussions. PMID:25363143

  5. Management of patients with sore throats in relation to guidelines: an interview study in Sweden.

    PubMed

    Hedin, Katarina; Strandberg, Eva Lena; Gröndal, Hedvig; Brorsson, Annika; Thulesius, Hans; André, Malin

    2014-12-01

    To explore how a group of Swedish general practitioners (GPs) manage patients with a sore throat in relation to current guidelines as expressed in interviews. Qualitative content analysis was used to analyse semi-structured interviews. Swedish primary care. A strategic sample of 25 GPs. Perceived management of sore throat patients. It was found that nine of the interviewed GPs were adherent to current guidelines for sore throat and 16 were non-adherent. The two groups differed in terms of guideline knowledge, which was shared within the team for adherent GPs while idiosyncratic knowledge dominated for the non-adherent GPs. Adherent GPs had no or low concerns for bacterial infections and differential diagnosis whilst non-adherent GPs believed that in patients with a sore throat any bacterial infection should be identified and treated with antibiotics. Patient history and examination was mainly targeted by adherent GPs whilst for non-adherent GPs it was often redundant. Non-adherent GPs reported problems getting patients to abstain from antibiotics, whilst no such problems were reported in adherent GPs. This interview study of sore throat management in a strategically sampled group of Swedish GPs showed that while two-thirds were non-adherent and had a liberal attitude to antibiotics one-third were guideline adherent with a restricted view on antibiotics. Non-adherent GPs revealed significant knowledge gaps. Adherent GPs had discussed guidelines within the primary care team while non-adherent GPs had not. Guideline implementation thus seemed to be promoted by knowledge shared in team discussions.

  6. Double-blind study of benzydamine hydrochloride, a new treatment for sore throat.

    PubMed

    Wethington, J F

    1985-01-01

    Forty-four patients with sore throat participated in a placebo-controlled, double-blind clinical trial of benzydamine hydrochloride administered as a gargle. After medical evaluation and throat culture, 21 patients were treated with a solution containing benzydamine and 23 patients with a placebo solution. Statistical analysis of scores from patients' diaries showed that benzydamine solution afforded significantly greater (P less than 0.001) relief of pain and dysphagia at 24 hours than did the placebo solution. Physician evaluations at 24 hours showed that the benzydamine solution had significantly greater effect than did placebo on hyperemia (P less than 0.004) and edema (P less than 0.005). Side effects were minimal and of no clinical significance. The findings indicate that benzydamine hydrochloride is safe and effective therapy for the signs and symptoms of sore throat.

  7. [Efficacy of bFGF atomization inhalation on postoperative sore throat following oral and maxillofacial surgery under general anesthesia].

    PubMed

    Liu, Bin; Jiang, Yin-Hua; Xiao, Jian; Li, Xiao-Kun

    2016-08-01

    To observe the effect of recombinant human basic fibroblast growth factor (bFGF) atomization inhalation on postoperative sore throat following oral and maxillofacial operation under general anethesia. Forty patients in whom oral and maxillofacial operation trachea was removed under general anesthesia were randomly divided into treatment and control groups; the treatment group received bFGF 35000IU + normal saline 20 mL, compression inhalation, day 1, every 20min, continued for 3 d; the control group was given normal saline 5 mL + dexamethasone 5 mg + gentamicin 80000 U + chymotrypsin 4000 U, compression inhalation, twice a day, every 20 min, continued for 3 d. Occurrence of postoperative sore throat 12 h after operation was recorded and visual analog scale (VAS) of sore throat (swallowing) 12,24,48,72 h after operation was measured. SPSS l4.0 software package was used for statistical analysis. The incidence of sore throat in the treatment group was significantly lower than that in the control group (P<0.01) 12 h after operation; sore throat (swallowing) VAS 12,24,48 and 72 h after operation in the treatment group were significantly lower than that in the control group (P<0.05). bFGF atomization inhalation can reduce the incidence of sore throat and sore throat level in oral and maxillofacial surgery after endotracheal intubation.

  8. Strep throat

    MedlinePlus

    Pharyngitis - streptococcal; Streptococcal pharyngitis; Tonsillitis - strep; Sore throat strep ... Strep throat is most common in children between ages 5 and 15, although anyone can get it. Strep throat ...

  9. Severe sore throat in a patient with AIDS.

    PubMed

    Zuger, A

    1996-01-01

    A case of a 45-year-old HIV-infected male who developed a severe throat infection with serious complications is reported. Despite a low CD4 count, the patient suffered only one significant illness in ten years since his diagnosed HIV infection. Overly aggressive antibiotic therapy caused fungal and thrush infections, leading to dehydration and extreme weight loss. The patient was treated with rehydration therapy, antifungal agents, and TMP-SMX, after which other complications, including multiple infections and B-cell lymphoma, were diagnosed. He refused chemotherapy after one course of treatment and was sent home with hospice care.

  10. Dysphagia, dysphonia and sore throat following cerebral infarction: an unexpected cause.

    PubMed

    Slade, Peter Michael Edward; Larsen, Matthew Peter

    2015-07-06

    A 75-year-old woman presented with left-sided weakness. There was no speech disturbance or reported swallowing difficulties. CT of the head revealed infarction in the territory of the right middle cerebral artery. The patient was transferred to the acute stroke unit and a nasogastric tube was placed following a failed swallow screening test. The following day, on assessment, there was considerable pain on swallowing. The tone and quality of the patient's voice had deteriorated and there was significant dysphagia. Seven days later a plastic item, later identified as the patient's denture, was expectorated. Following this, the dysphagia, dysphonia and sore throat rapidly resolved. The case highlights the importance of considering foreign body in the differential, and oral cavity examination in the assessment of a patient with dysphagia and sore throat is essential. 2015 BMJ Publishing Group Ltd.

  11. [Adult-onset Still's disease following severe sore throat and fever. Case report].

    PubMed

    Saito, Yuki; Toriumi, Sayaka; Otake, Rika; Suzuki, Mitsuya

    2008-01-01

    Adult-onset Still's disease (AOSD) is characterized by fever, rash, and joint pain and may lead to chronic arthritis. The cause of AOSD is unknown, and it is rare. In children, Still's Disease is called systemic juvenile rheumatoid arthritis. We encountered a patient with adult-onset Still's disease following a severe sore throat and fever. The patient was a 17-year-old woman who consulted our hospital because of a sore throat and fever. She was admitted and treated with antibiotics, but the fever persisted. Laboratory parameters of inflammatory activity increased at an accelerated rate, and after ruling out sepsis, EBV-associated disease, and malignant lymphoma, a diagnosis of AOSD was made. Steroid therapy was very effective. When acute pharyngitis is observed in association with significant changes in laboratory parameters despite mild local symptoms, or when pharyngitis is observed in association with joint pain, continuous fever, and a rash, it is important to consider AOSI).

  12. The prophylactic effect of dexamethasone on postoperative sore throat in prone position surgery

    PubMed Central

    Lee, Sang Ho; Lee, Yoon Chan; Choi, So Ron; Lee, Seung-Cheol; Lee, Jong Hwan; Chung, Chan Jong

    2016-01-01

    Background Sore throat and hoarseness are common complications after general anesthesia with tracheal intubation. The position for patients can affect the incidence of postoperative sore throat (POST) by causing displacement of the endotracheal tube. This study investigated the prophylactic effect of dexamethasone in prone position surgeries. Methods One hundred-fifty patients undergoing lumbar spine surgery (18-75 yr) were randomly allocated into the normal saline group (group P, n = 50), dexamethasone 0.1 mg/kg group (group D1, n = 50) or dexamethasone 0.2 mg/kg group (group D2, n = 50). The incidence and severity of POST, hoarseness, and cough were measured using direct interview at 1, 6, and 24 h after tracheal extubation. The severity of POST, hoarseness, and cough were graded using a 4-point scale. Results At 1, 6, and 24 h after extubation, the incidence of sore throat was significantly lower in group D1 (1 h; P = 0.015, 6 h; P < 0.001, 24 h; P = 0.038) and group D2 (1 h; P < 0.001, 6 h; P < 0.001, 24 h; P = 0.017) compared to group P. There were less number of patients in the groups D1 and D2 than group P suffering from moderate grade of POST at 1, 24 h after extubation. The incidence of hoarseness at 1, 6, and 24 h after extubation was significantly lower in groups D2 than group P (P < 0.001). There were no significant differences in the incidence of cough among the three groups. Conclusions The prophylactic use of dexamethasone 0.1 mg/kg and 0.2 mg/kg in prone surgery reduces the incidence of postoperative sore throat and dexamethasone 0.2 mg/kg decreases the incidence of hoarseness. PMID:27274371

  13. Postoperative Sore Throat After Laryngoscopy With Macintosh or Glide Scope Video Laryngoscope Blade in Normal Airway Patients

    PubMed Central

    Najafi, Atabak; Imani, Farsad; Makarem, Jalil; Khajavi, Mohammad Reza; Etezadi, Farhad; Habibi, Shirin; Shariat Moharari, Reza

    2014-01-01

    Background: The Glide Scope videolaryngoscope provides a suitable view for intubation, with less force required. Objectives: The present study was conducted, to compare postoperative sore throat and hoarseness after laryngoscopy and intubation, by Macintosh blade or Glide Scope video laryngoscope in normal airway patients. Patients and Methods: Three hundred patients were randomly allocated into two groups of 150: Macintosh blade laryngoscope or Glide Scope video laryngoscope. The patients were evaluated for 48 hours for sore throat and hoarseness by an interview. Results: The incidence and severity of sore throat in the Glide Scope group, at 6, 24 and 48 hours after the operation, were significantly lower than in the Macintosh laryngoscope group. In addition, the incidence of hoarseness in the Glide Scope group, at 6 and 24 hours after the operation, were significantly lower than in the Macintosh laryngoscope group. The incidence and severity of sore throat in men, at 6 and 24 hours after the operation, were significantly lower than in the women. Conclusions: The incidence and severity of sore throat and hoarseness after tracheal intubation by Glide Scope were lower than in the Macintosh laryngoscope. The incidence and severity of sore throat were increased by intubation and longer operation times. PMID:24660157

  14. Prophylactic Effects of Lidocaine or Beclomethasone Spray on Post-Operative Sore Throat and Cough after Orotracheal Intubation

    PubMed Central

    Banihashem, Nadia; Alijanpour, Ebrahim; Hasannasab, Bahman; Zarei, Ali

    2015-01-01

    Introduction: Post-operative sore throat and cough are common complications of endotracheal intubation. These conditions may be very distressing for the patient and may lead to unpleasant memories. This study was performed in order to determine whether beclomethasone and lidocaine spray could reduce the frequency of post-operative sore throat and hoarseness after tracheal extubation. Materials and Methods: Ninety women (18–60 years of age) with an American Society of Anesthesiologists (ASA) physical status I or II and undergoing elective mastoidectomy were randomized into three groups of 30 patients. The endotracheal tubes in each group were sprayed with 50% beclomethasone, 10% lidocaine hydrochloride, or normal saline (control group) before endotracheal intubation. Patients were examined for sore throat (none, mild, moderate, or severe), cough, and hoarseness at 1 and 24 h after extubation. Results: There was a significantly lower incidence and severity of post-operative sore throat in the beclomethasone group than the lidocaine and control groups (P<0.05) at each observation time point. At 24 h after extubation, the incidence and severity of sore throat and cough was significantly lower in the lidocaine compared with the control group. The incidence of hoarseness was not significantly different among the three groups. Conclusion: Spraying beclomethasone and lidocaine on the endotracheal tube is a simple and effective method to reduce the incidence and severity of post-operative sore throat. PMID:26082898

  15. Incidence of sore throat in children following use of flexible laryngeal mask airways - impact of an introducer device.

    PubMed

    William, Anthea; Chambers, Neil A; Erb, Thomas O; von Ungern-Sternberg, Britta S

    2010-09-01

    Insertion of a flexible laryngeal mask airway (FLMA) is more difficult and therefore might result in a higher risk for trauma to the upper airway. To facilitate the insertion of FLMA, the use of an introducer device (Portex Limited, Hythe, Kent, UK) was promoted. However, the impact of the use of this device on the occurrence of postoperative sore throat is unknown. Four hundred children (3-21 years) undergoing elective ambulatory surgery were consecutively included in this study. In 196 cases, the FLMA was inserted using an introducer device. The FLMA cuff was then inflated and the pressure adjusted to below 60 cmH(2)O (according to manufacturers guidelines) using a calibrated cuff manometer (Portex Limited). Three types of FLMA were available: FLMA classic, FLMA unique (both FLMA PacMed, Richmond, Victoria, Australia) and FLMA ProBreathe (Well Lead Medical Co Ltd., Hualong, Guangzhou, China). Prior to discharge, patients' pain was assessed using an age appropriate scale. Thirteen children (3.3%) developed sore throat, two (0.5%) sore neck and three (0.75%) sore jaw. Of those that developed sore throat, seven had a FLMA inserted with an introducer, six without an introducer. Using a laryngeal mask airways (LMA) with a polyvinyl chloride (PVC), surface was associated with a higher risk for sore throat compared with an LMA with a silicone surface (P = 0.0002). In this study with controlled low cuff pressures, the incidence of sore throat was low. The use of an introducer device did not affect the rate of sore throat.

  16. Reducing sore throat following laryngeal mask airway insertion: comparing lidocaine gel, saline, and washing mouth with the control group.

    PubMed

    Taghavi Gilani, Mehryar; Miri Soleimani, Iman; Razavi, Majid; Salehi, Maryam

    2015-01-01

    Laryngeal mask airway is still accompanied by complications such as sore throat. In this study, effects of three methods of reducing postoperative sore throat were compared with the control group. 240 patients with ASA I, II candidates for cataract surgery were randomly divided into four same groups. No supplementary method was used in the control group. In the second, third and fourth groups, lidocaine gel, washing cuff before insertion, and washing mouth before removing laryngeal mask airway were applied, respectively. Anesthesia induction was done with fentanyl, atracurium, and propofol and maintained with propofol infusion. The incidence of sore throat was evaluated during the recovery, 3-4h later and after 24h using verbal analog scale. The data were analyzed by t-test, analysis of variance and chi-square using SPSS V11.5. Age, gender, duration of surgery and cuff pressure were the same in all the four groups. Incidence of sore throat at recovery room was highest in the control group (43.3%) and lowest in the washing mouth group (25%). However, no significant statistical difference was observed between these four groups (recovery, p=0.30; discharge, p=0.31; examination, p=0.52). In this study, increased duration of operation had a significant relationship with the incidence of sore throat (p=0.041). Sore throat is a common postoperative problem, but no special method has been found completely efficient yet. In this study, cuff washing, lidocaine gel, and mouth washing before removing laryngeal mask airway were not helpful for sore throat. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  17. [Reducing sore throat following laryngeal mask airway insertion: comparing lidocaine gel, saline, and washing mouth with the control group].

    PubMed

    Taghavi Gilani, Mehryar; Miri Soleimani, Iman; Razavi, Majid; Salehi, Maryam

    2015-01-01

    Laryngeal mask airway is still accompanied by complications such as sore throat. In this study, effects of three methods of reducing postoperative sore throat were compared with the control group. 240 patients with ASA I, II candidates for cataract surgery were randomly divided into four same groups. No supplementary method was used in the control group. In the second, third and fourth groups, lidocaine gel, washing cuff before insertion, and washing mouth before removing laryngeal mask airway were applied, respectively. Anesthesia induction was done with fentanyl, atracurium, and propofol and maintained with propofol infusion. The incidence of sore throat was evaluated during the recovery, 3-4h later and after 24h using verbal analog scale. The data were analyzed by t-test, analysis of variance and chi-square using SPSS V11.5. Age, gender, duration of surgery and cuff pressure were the same in all the four groups. Incidence of sore throat at recovery room was highest in the control group (43.3%) and lowest in the washing mouth group (25%). However, no significant statistical difference was observed between these four groups (recovery, p=0.30; discharge, p=0.31; examination, p=0.52). In this study, increased duration of operation had a significant relationship with the incidence of sore throat (p=0.041). Sore throat is a common postoperative problem, but no special method has been found completely efficient yet. In this study, cuff washing, lidocaine gel, and mouth washing before removing laryngeal mask airway were not helpful for sore throat. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. Sore throat following three adult supraglottic airway devices: A randomised controlled trial.

    PubMed

    L'Hermite, Joël; Dubout, Elisabeth; Bouvet, Sophie; Bracoud, Laure-Hélène; Cuvillon, Philippe; Coussaye, Jean-Emmanuel de La; Ripart, Jacques

    2017-07-01

    Sore throat is a common complaint after surgery. It affects patient satisfaction and can affect activity after discharge. The supraglottic airway device (SAD) offers an alternative to traditional tracheal intubation with potential benefit in preventing sore throat. The aim of this study was to compare the incidence of sore throat following three different SADs, the laryngeal mask airway Unique (LMA-U) and the more recent LMA Supreme (LMA-S) and the I-gel. A randomised single-blind controlled three parallel-group trial. University Hospital of Nîmes, Division of Anaesthesia Intensive Care Pain and Emergency, Nîmes, France, from April 2009 to September 2012. A total of 546 patients scheduled to undergo elective surgery of less than 2 h under general anaesthesia were randomly allocated to receive the LMA-U, the LMA-S or the I-gel. Anaesthesia was induced with propofol and sufentanil and maintained with propofol or with sevoflurane in air-oxygen. After airway device insertion, intra-cuff pressure was adjusted to less than 60 mmHg (LMA-U, LMA-S) and pressure-controlled ventilation initiated. The primary study endpoint was to compare incidence of sore throat 24 h postoperatively (H+24) following placement of the LMA-U, LMA-S and the I-gel. Secondary endpoints were clinical performance (airway leak pressure, dynamic airway compliance, complications during maintenance), ease of use (device insertion time, success on first attempt, ease of insertion and removal) and other adverse events (neck or jaw pain, dysphonia, dysphagia, nausea and vomiting). The authors analysed 177, 174 and 173 patients who received LMA-U, the LMA-S and the I-gel, respectively. The primary endpoint was assessed in 436 patients. In total, 104 patients (23.9%) patients reported a H+24 sore throat, with no difference between groups (P = 0.34). H+24 dysphagia with liquids was higher (P = 0.0065) with the LMA-S (12.1%) compared with LMA-U (5.3%) and I-gel (2.9%). Airway leak pressure (cmH2

  19. Predictors of suppurative complications for acute sore throat in primary care: prospective clinical cohort study

    PubMed Central

    Stuart, Beth; Hobbs, F D Richard; Butler, Chris C; Hay, Alastair D; Campbell, John; Delaney, Brendan; Broomfield, Sue; Barratt, Paula; Hood, Kerenza; Everitt, Hazel; Mullee, Mark; Williamson, Ian; Mant, David; Moore, Michael

    2013-01-01

    Objective To document whether elements of a structured history and examination predict adverse outcome of acute sore throat. Design Prospective clinical cohort. Setting Primary care. Participants 14 610 adults with acute sore throat (≤2 weeks’ duration). Main outcome measures Common suppurative complications (quinsy or peritonsillar abscess, otitis media, sinusitis, impetigo or cellulitis) and reconsultation with new or unresolving symptoms within one month. Results Complications were assessed reliably (inter-rater κ=0.95). 1.3% (177/13 445) of participants developed complications overall and 14.2% (1889/13 288) reconsulted with new or unresolving symptoms. Independent predictors of complications were severe tonsillar inflammation (documented among 13.0% (1652/12 717); odds ratio 1.92, 95% confidence interval 1.28 to 2.89) and severe earache (5% (667/13 323); 3.02, 1.91 to 4.76), but the model including both variables had modest prognostic utility (bootstrapped area under the receiver operator curve 0.61, 0.57 to 0.65), and 70% of complications (124/177) occurred when neither was present. Clinical prediction rules for bacterial infection (Centor criteria and FeverPAIN) also predicted complications, but predictive values were also poor and most complications occurred with low scores (67% (118/175) scoring ≤2 for Centor; 126/173 (73%) scoring ≤2 for FeverPAIN). Previous medical problems, sex, temperature, and muscle aches were independently but weakly associated with reconsultation with new or unresolving symptoms. Conclusion Important suppurative complications after an episode of acute sore throat in primary care are uncommon. History and examination and scores to predict bacterial infection cannot usefully identify those who will develop complications. Clinicians will need to rely on strategies such as safety netting or delayed prescription in managing the uncertainty and low risk of complications. PMID:24277339

  20. Effect of Intravenous Hydrocortisone on Preventing Postoperative Sore Throat Followed by Laryngeal Mask Airway Use in patients Undergoing Urogenital Surgeries

    PubMed Central

    Eydi, Mahmood; Kolahdouzan, Khosro; EJ Golzari, Samad

    2013-01-01

    Introduction: Postoperative sore throat is a common complication which can lead to discomfort after operation and delay in patients’ returning to normal daily activities. The present study was carried out to evaluate the influence of intravenous hydrocortisone on preventing postoperative sore throat followed by laryngeal mask airway use. Methods: Sixty patients who were scheduled to undergo urogenital surgery were divided into two groups. Five minutes before anesthesia induction, 100 mg of intravenous hydrocortisone or placebo with the same volume were given to the patients randomly. At the end of the operation and after LMAs were removed, patients were asked about having sore throat at hours 2, 4 and 24 after operation. Results: There were three and six cases of sore throat after operation in hydrocortisone and in placebo groups respectively which showed no significant statistical difference (P=0.472). No cases of moderate or severe pain were reported in any of the patients in both groups and no statistically significant difference was observed regarding pain severity in recovery, hours 2, 4 or 24 after operation. Conclusion: Based on the statistical data obtained from this research, administrating intravenous hydrocortisone five minutes before anesthesia induction has no effect on postoperative sore throat severity and degree in urogenital surgeries. PMID:24251006

  1. The effect of endotracheal tube cuff pressure change during gynecological laparoscopic surgery on postoperative sore throat: a control study.

    PubMed

    Geng, Guiqi; Hu, Jingyi; Huang, Shaoqiang

    2015-02-01

    Postoperative respiratory complications related to endotracheal intubation usually present as cough, sore throat, hoarseness. The aim of the study was to examine the effects of endotracheal tube cuff pressure changes during gynecological laparoscopic surgery on postoperative sore throat rates. Thirty patients who underwent gynecological laparoscopic surgery and 30 patients who underwent laparotomy under general anesthesia with endotracheal intubation were included. After induction of general anesthesia and endotracheal intubation, the cuff was inflated to 25 mmHg. At 5, 15, 30, 45 and 60 min after endotracheal intubation, cuff pressure and peak airway pressure were recorded. At 2 and 24 h after surgery, the patients were assessed for complaints of a sore throat. In patients who underwent laparotomy, cuff pressure and peak airway pressure did not change significantly at different time points after intubation. In patients who received laparoscopic surgery, cuff pressure and peak airway pressure were significantly increased compared to initial pressure at all examined time points. In both groups, the endotracheal tube cuff pressure and peak airway pressure were significantly correlated (R=0.9431, P<0.01; R=0.8468, P<0.01). Compared to patients who had undergone laparotomy, patients who had undergone laparoscopic surgery showed significantly higher sore throat scores at both 2 and 24 h after surgery (P<0.01). Pneumoperitoneum and Trendelenburg position may increase airway pressure and cuff pressure, resulting in increased incidence of postoperative sore throat.

  2. Tonsillectomy: a cost-effective option for childhood sore throat? Further analysis of a randomized controlled trial.

    PubMed

    Wilson, Janet A; Steen, I Nick; Lock, Catherine A; Eccles, Martin P; Carrie, Sean; Clarke, Ray; Kubba, Haytham; Raine, Chris H; Zarod, Andrew; Bond, John

    2012-01-01

    To compare the estimated cost-effectiveness of childhood (adeno)tonsillectomy vs medical therapy for recurrent sore throats from the intention-to-treat (ITT) analysis of a randomized controlled trial (RCT) with that modeled on the recorded timing of surgical interventions as observed in all participants irrespective of their original group allocation. A pragmatic RCT (trial) with a parallel nonrandomized patient preference group (cohort) of (adeno)tonsillectomy vs medical therapy. Five secondary care UK otolaryngology departments. Eligible children, aged 4 to 15 years, were enrolled to the trial (268) or cohort (461) groups. Outcomes included sore throat diaries, quality of life, and general practice consultations. The RCT protocol ITT analysis was compared with an as-treated analysis incorporating the cohort group, modeled to reflect the timing of tonsillectomy and the differential switch rates among the original groups. In the RCT ITT analysis, tonsillectomy saved 3.5 sore throats, whereas the as-treated model suggested an average reduction of more than 8 sore throats in 2 years for surgery within 10 weeks of consultation, falling to only 3.5 twelve months later due to the spontaneous improvement in the medical therapy group. In eligible UK school-age children, tonsillectomy can save up to 8 sore throats at a reasonable cost, if performed promptly. Further prospective data collection, accounting for baseline and per-trial preferences and choice, is urgently needed.

  3. Nonrheumatic myopericarditis post acute streptococcal pharyngitis: An uncommon cause of sore throat with ST segment elevation.

    PubMed

    Pourmand, Ali; Gelman, Daniel; Davis, Steven; Shokoohi, Hamid

    2017-05-01

    Nonrheumatic myopericarditis is an uncommon complication of acute pharyngitis caused by Group A Streptococcal infection (GAS). While the natural history of carditis complicating acute rheumatic fever is well established, the incidence, pathophysiology and clinical course of nonrheumatic myopericarditis are ill defined. Advances in rapid bedside testing for both myocardial injury and GAS pharyngitis have allowed for increasing recognition of this uncommon complication in patients presenting with a sore throat with associated chest discomfort. We describe a case of a 34years old man with GAS pharyngitis complicated by acute myopericarditis who presented with chest pain, ST segment elevation on electrocardiogram, and elevated cardiac biomarkers. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. A clinical score to reduce unnecessary antibiotic use in patients with sore throat

    PubMed Central

    McIsaac, W J; White, D; Tannenbaum, D; Low, D E

    1998-01-01

    OBJECTIVE: To validate a score based on clinical symptoms and signs for the identification of group A Streptococcus (GAS) infection in general practice patients with score throat. DESIGN: A single throat swab was used as the gold standard for diagnosing GAS infection. Clinical information was recorded by experienced family physicians on standardized encounter forms. Score criteria were identified by means of logistic regression modelling of data from patients enrolled in the first half of the study. The score was then validated among the remaining patients. SETTING: University-affiliated family medicine centre in Toronto. PATIENTS: A total of 521 patients aged 3 to 76 years presenting with a new upper respiratory tract infection from December 1995 to February 1997. OUTCOME MEASURES: Sensitivity, specificity and likelihood ratios for identification of GAS infection with the score approach compared with throat culture. Proportion of patients prescribed antibiotics, throat culture use, and sensitivity and specificity with usual physician care and with score-based recommendations were compared. RESULTS: A score was developed ranging in value from 0 to 4. The sensitivity of the score for identifying GAS infection was 83.1%, compared with 69.4% for usual physician care (p = 0.06); the specificity values of the 2 approaches were similar. Among patients aged 3 to 14 years, the sensitivity of the score approach was higher than that of usual physician care (96.9% v. 70.6%) (p < 0.05). The proportion of patients receiving initial antibiotic prescriptions would have been reduced 48% by following score-based recommendations compared with observed physician prescribing (p < 0.001), without any increase in throat culture use. CONCLUSIONS: An age-appropriate sore throat score identified GAS infection in children and adults with sore throat better than usual care by family physicians, with significant reductions in unnecessary prescribing of antibiotics. A randomized trial

  5. A comparative study of the diagnostic methods for Group A streptococcal sore throat in two reference hospitals in Yaounde, Cameroon.

    PubMed

    Gonsu, Hortense Kamga; Bomki, Cynthia Mbimenyuy; Djomou, François; Toukam, Michel; Ndze, Valantine Ngum; Lyonga, Emilia Enjema; Mbakop, Calixte Didier; Koulla-Shiro, Sinata

    2015-01-01

    Sore throat is a common complaint in general practice which is more frequent in children. The most frequent pathogenic bacteria associated with this infection is Streptococcus pyogenes. Rapid Antigen Diagnostic Test (RADT) facilitates the rapid identification and consequently prompt treatment of patients, prevents complications, and also reduces the risk of spread of Group A Streptococcus (GAS). The main objective of this study was to assess the diagnostic value of a rapid streptococcal antigen detection test in patients with sore throat. A cross-sectional descriptive study was carried out from January to April 2011 on patients aged 3 to 72 years consulting for pharyngitis or sore throat at the paediatric and Ear, Nose and Throat units of the University Teaching Hospital Yaounde and the Central Hospital Yaounde. Two throat swabs were collected per patient. One was used for the rapid test and the other for standard bacteriological analysis. The prevalence of GAS in the study population was 22.5%. Out of the 71 samples collected, the RADT detected group A streptococcal antigens in 12 of 16 positive cultures giving a sensitivity of 75%. The specificity of the rapid test was 96%, with positive predictive value of 85.7%, and negative predictive value of 93% respectively. Rapid test may have an additional value in the management of patients with high risk of having GAS infection. However, tests with a higher sensitivity are needed for accurate and reliable results for early diagnosis of patients with sore throat caused by GAS.

  6. A comparative study of the diagnostic methods for Group A streptococcal sore throat in two reference hospitals in Yaounde, Cameroon

    PubMed Central

    Gonsu, Hortense Kamga; Bomki, Cynthia Mbimenyuy; Djomou, François; Toukam, Michel; Ndze, Valantine Ngum; Lyonga, Emilia Enjema; Mbakop, Calixte Didier; Koulla-Shiro, Sinata

    2015-01-01

    Introduction Sore throat is a common complaint in general practice which is more frequent in children. The most frequent pathogenic bacteria associated with this infection is Streptococcus pyogenes. Rapid Antigen Diagnostic Test (RADT) facilitates the rapid identification and consequently prompt treatment of patients, prevents complications, and also reduces the risk of spread of Group A Streptococcus (GAS). The main objective of this study was to assess the diagnostic value of a rapid streptococcal antigen detection test in patients with sore throat. Methods A cross-sectional descriptive study was carried out from January to April 2011 on patients aged 3 to 72 years consulting for pharyngitis or sore throat at the paediatric and Ear, Nose and Throat units of the University Teaching Hospital Yaounde and the Central Hospital Yaounde. Two throat swabs were collected per patient. One was used for the rapid test and the other for standard bacteriological analysis. Results The prevalence of GAS in the study population was 22.5%. Out of the 71 samples collected, the RADT detected group A streptococcal antigens in 12 of 16 positive cultures giving a sensitivity of 75%. The specificity of the rapid test was 96%, with positive predictive value of 85.7%, and negative predictive value of 93% respectively. Conclusion Rapid test may have an additional value in the management of patients with high risk of having GAS infection. However, tests with a higher sensitivity are needed for accurate and reliable results for early diagnosis of patients with sore throat caused by GAS. PMID:27386017

  7. Sore Throat

    MedlinePlus

    ... 1998familydoctor.org editorial staffProcedures & DevicesAttention-Deficit Hyperactivity Disorder (ADHD)March 2017April 1997familydoctor.org editorial staffInfants and ToddlersCytomegalovirusMarch ...

  8. Salient beliefs and intentions to prescribe antibiotics for patients with a sore throat.

    PubMed

    Walker, A. E.; Grimshaw, J. M.; Armstrong, E. M.

    2001-11-01

    OBJECTIVES: General practitioners (GPs) in the UK continue to prescribe antibiotics for patients with sore throats despite evidence that they are ineffective and can contribute to the growth of antibiotic resistance in the population. This study uses the theory of planned behaviour (TPB) to investigate the strength of intention to prescribe antibiotics, and to identify the salient beliefs associated with this intention. DESIGN: Cross-sectional study testing hypotheses derived from the TPB. METHOD: A 66-item postal questionnaire was distributed to a random sample of GPs in one NHS region (N = 185). The questionnaire included measures of intention to prescribe antibiotics, attitude, behavioural beliefs and evaluations, normative beliefs and evaluations, perceived behavioural control, control beliefs, and past prescribing. RESULTS: Two-thirds of the GPs returned complete questionnaires (N = 126, 68%). The majority intended to prescribe antibiotics for less than half of their patients with sore throats (N = 69, 55%). The variables specified in TPB predicted 48% of the variance in intention, with past behaviour adding a further 15%. Seven salient beliefs distinguished between doctors who intend to prescribe antibiotics and those who do not. CONCLUSIONS: Attitudes towards antibiotics and control beliefs are important predictors of intention to prescribe, as predicted by TPB. Interventions could target salient beliefs associated with motivation to prescribe.

  9. The effect of cuff pressure on postoperative sore throat after Cobra perilaryngeal airway.

    PubMed

    Joe, Han Bum; Kim, Dae Hee; Chae, Yun Jeong; Kim, Jong Yeop; Kang, Min; Park, Kwan Sik

    2012-04-01

    The cuff volume of the Cobra perilaryngeal airway (CobraPLA) is larger than that of other alternative airway devices and makes it difficult to predict the effect of cuff pressure on the perilaryngeal mucosa. We tested the hypothesis that adjustment of the cuff pressure of the CobraPLA could reduce the incidence of postoperative sore throat (POST). After induction of general anesthesia and insertion of the CobraPLA by standardized method, the cuff pressure was set to 60 cmH(2)O (group C, n = 87) or adjusted to minimal seal-up pressure +5 cmH(2)O (group A, n = 87). The frequency and severity (0, none; 1, mild; 2, moderate; 3, severe) of throat soreness, pain, discomfort, and adverse effects were evaluated 1 and 24 h after removal of the CobraPLA. Incidence of moderate POST in group C was higher than that in group A (11% vs. 2%, P = 0.021) whereas the overall POST incidence was not different between the two groups (31% vs. 20%, P = 0.092). The inflated air volume of group A was different from that of group C (41 vs. 50 ml, P = 0.009). Adjustment of cuff pressure reduces the incidence of moderate POST after use of the CobraPLA.

  10. The Effect of Green Tea Gargle Solution on Sore Throat After Coronary Artery Bypass Grafting: A Randomized Clinical Trial

    PubMed Central

    Jafari, Hedayat; Ariaeifar, Mohammad Reza; Yazdani Charati, Jamshid; Soleimani, Aria; Nasiri Formi, Ebrahim

    2016-01-01

    Background Tracheal intubation is an essential method of keeping the airway open in patients under general anesthesia. Sore throat is a prevalent complication after endotracheal intubation. Objectives The aim of this study was to investigate the effect of green tea gargling on sore throat after coronary artery bypass grafting (CABG). Patients and Methods This was a single-blind, randomized clinical trial, in which 121 patients who had undergone CABG were divided into two groups: those who gargled distilled water and those who gargled a green tea solution. An hour after extubation, the patients of the intervention group were asked to gargle 30 cc of green tea, and the patients of the control group were asked to gargle 30 cc of distilled water, every 6 hours for up to 24 hours (four times per patient). A sore throat questionnaire was filled out 6, 12, and 24 hours after endotracheal extubation. Results The results showed that there were no significant differences between the two groups with regard to patient age, sex, body mass index, smoking background, and duration of anesthesia. There was no significant difference between the two groups in terms of sore throat before the intervention (P = 0.461) and 6 hours after the intervention (P = 0.901). However, a significant difference was observed between the two groups in terms of sore throat 12 hours (P = 0.047) and 24 hours (P < 0.001) after removing the endotracheal tube. Conclusions Gargling a green tea solution, an anti-inflammatory, natural, and harmless substance, can reduce the pain of sore throat in patients after endotracheal extubation. PMID:27642569

  11. Efficacy of benzydamine hydrochloride dripping at endotracheal tube cuff for prevention of postoperative sore throat.

    PubMed

    Nimmaanrat, Sasikaan; Chokkijchai, Kedsirin; Chanchayanon, Thavat

    2013-10-01

    Postoperative sore throat (POST) is a frequent consequence following ETT intubation, which may negatively affect the postoperative course and patient satisfaction. Benzydamine hydrochloride is a topically-applied non-steroidal anti-inflammatory drug (NSAID). The authors evaluated the analgesic effect of benzydamine hydrochloride dripping on the ETT cuff on POST. Eighty-six patients participated in this randomized controlled trial. They were assigned into either the benzydamine hydrochloride or the control group. The whole ETT cuff was dripped either with 3 ml (4.5 mg) of benzydamine hydrochloride or nothing five minutes prior to anesthesia induction. The incidence and severity of POST at 0, 2, 4, 6, 12 and 24 hours postoperatively were assessed. The potential adverse effects of benzydamine hydrochloride (throat numbness throat burning sensation, dry mouth, and thirst) were also evaluated. Twenty-five patients (58.14%) in each group had POST (p-value = 1). The severity of POST (calculated from affected patients) in both groups at different time points was not significantly different. Patients in the benzydamine hydrochloride group did not have a higher incidence of adverse effects. We found that dripping benzydamine hydrochloride on the ETT cuff neither reduced the incidence of POST nor increased the incidence of adverse effects in comparison with no intervention.

  12. Sore throat: effective communication delivers improved diagnosis, enhanced self-care and more rational use of antibiotics.

    PubMed

    van der Velden, A W; Bell, J; Sessa, A; Duerden, M; Altiner, A

    2013-11-01

    The majority of throat infections are of viral origin and resolve without antibiotic treatment. Despite this, antibiotic use for sore throat infections remains high, partly because it is difficult to determine when antibiotics may be useful, on the basis of physical findings alone. Antibiotics may be beneficial in bacterial throat infections under certain clinical and epidemiological circumstances; however, even many of those infections in which bacteria play a role do resolve just as quickly without antibiotics. Furthermore, non-medical factors such as patient expectations and patient pressure are also important drivers of antibiotic use. To address these issues, a behavioural change is required that can be facilitated by improved communication between primary healthcare providers and patients. In this article, we provide doctors, nurses and pharmacy staff, working in primary care or in the community, with a structured approach to sore throat management, with the aim of educating and empowering patients to self-manage their condition. The first component of this approach involves identifying and addressing patients' expectations and concerns with regard to their sore throat and eliciting their opinion on antibiotics. The second part is dedicated to a pragmatic assessment of the severity of the condition, with attention to red-flag symptoms and risk factors for serious complications. Rather than just focusing on the cause (bacterial or viral) of the upper respiratory tract infections as a rationale for antibiotic use, healthcare providers should instead consider the severity of the patient's condition and whether they are at high risk of complications. The third part involves counselling patients on effective self-management options and providing information on the expected clinical course. Such a structured approach to sore throat management, using empathetic, non-paternalistic language, combined with written patient information, will help to drive patient

  13. [Postoperative sore throat and intracuff pressure: comparison among endotracheal intubation, laryngeal mask airway and cuffed oropharyngeal airway].

    PubMed

    Saeki, H; Morimoto, Y; Yamashita, A; Nagusa, Y; Shimizu, K; Oka, H; Miyauchi, Y

    1999-12-01

    We studied which device is most useful to reduce postoperative sore-throat. We investigated the relationship between intracuff pressure and postoperative sore-throat in using endotracheal intubation (ET), the laryngeal mask airway (LMA) and the cuffed oropharyngeal airway (COPA) in adult patients. We classified sore-throat into categories; pain at rest, hoarseness and dysphasia. We evaluated pain at rest by the score (0: no pain, 1: mild discomfort, 2: mild pain, 3: severe pain). Pain at rest (scores 1, 2, 3) was complained by 10 patients in ET group, 3 in LMA group, 5 in COPA group on the day of operation, showing significantly lower incidence of pain at rest in LMA group than in ET group. Hoarseness was complained by 15 patients in ET group, 2 in LMA group and 4 in COPA group, showing significantly lower incidence of hoarseness in LMA and COPA groups than in ET group. Dysphasia was complained by 3 in ET group, 1 in LMA group and 2 in COPA group, showing no significant difference. These results suggest that LMA is most appropriate to reduce postoperative sore-throat.

  14. The Effect of Flurbiprofen on Postoperative Sore Throat and Hoarseness After LMA-ProSeal Insertion: A Randomised, Clinical Trial

    PubMed Central

    Uztüre, Neslihan; Menda, Ferdi; Bilgen, Sevgi; Keskin, Özgül; Temur, Sibel; Köner, Özge

    2014-01-01

    Objective We hypothesized that flurbiprofen lozenges reduce the ProSeal laryngeal mask airway (LMA) related symptoms of Post Operative Sore Throat (POST), hoarseness and dysphagia compared to placebo lozenges. Methods Eighty American Society of Anesthesiologists (ASA) I–II patients undergoing general anaesthesia with LMA were included in this prospective, randomized, placebo-controlled clinical and single centre (university hospital) study. Group F received an 8.75 mg flurbiprofen lozenge (Strefen®) and Group P received a placebo lozenge 45 minutes before the induction of anaesthesia. Postoperative sore throat, hoarseness and dysphagia were evaluated 30 minutes after removal of the LMA in the recovery room and then at 4, 12 and 24 h after surgery using a 4-point scale. Data were analysed using Student’s t test, and Fisher’s exact and Mann-Whitney U tests. A p value of <0.05 was considered statistically significant. Results The 8.75 mg flurbiprofen lozenges reduced the severity of early (30 mins) POST and dysphagia. The severity of dysphagia at 4 h and hoarseness at 12 h were also significantly reduced in Group F. There were no significant differences betweeen the groups regarding incidence of sore throat, dysphagia and hoarseness throughout the study period. Conclusion Preoperative flurbiprofen lozenges reduce the severity of early postoperative sore throat and dysphagia. PMID:27366405

  15. Etiologic predictive value of a rapid immunoassay for the detection of group A Streptococcus antigen from throat swabs in patients presenting with a sore throat.

    PubMed

    Orda, Ulrich; Gunnarsson, Ronny; Orda, Sabine; Fitzgerald, Mark; Rofe, Geoff; Dargan, Anna

    2016-04-01

    Clinical reasoning utilizing certain symptoms and scores has not proven to be a reliable decision-making tool to determine whether or not to suspect a group A Streptococcus (GAS) infection in the patient presenting with a sore throat. Culture as the so-called 'gold standard' is impracticable because it takes 1 to 2 days (and even longer in remote locations) for a result, and thus treatment decisions will be made without the result available. Rapid diagnostic antigen tests have demonstrated sufficient sensitivities and specificities in detecting GAS antigens to identify GAS throat infections. Throat swab samples were collected from patients attending the Mount Isa Hospital emergency department for a sore throat; these samples were compared to swab samples collected from healthy controls who did not have a sore throat. Both groups were aged 3-15 years. All swab samples were analyzed with a point-of-care test (Alere Test Pack +Plus with OBC Strep A). The etiologic predictive value (EPV) of the throat swab was calculated. The 95% confidence interval for positive EPV was 88-100% and for negative EPV was 97-99%, depending on assumptions made. This study demonstrates that the point-of-care test Alere Test Pack +Plus Strep A has a high positive predictive value and is able to rule in GAS infection as long as the proportion of carriers is low. Also the negative predictive value for ruling out GAS as the etiologic agent is very high irrespective of the carrier rate. Hence, this test is always useful to rule out GAS infection. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Efficacy and Safety of an Oral Ambroxol Spray in the Treatment of Acute Uncomplicated Sore Throat.

    PubMed

    de Mey, C; Patel, J; Lakha, D R; Richter, E; Koelsch, S

    2015-12-01

    Compare the efficacy and tolerability of oral spray formulations delivering 2.5, 5, and 10 mg ambroxol (AXS) per application (4 actuations/application) in relieving acute sore throat vs. spraying a matched placebo solution. Multi-centre, placebo-controlled, randomised, double-blind trial with up to 6 daily applications of the assigned medication for up to 3 days. 511 outpatients with acute sore throat were enrolled, 494 were treated. Up to 6 spray applications per day as needed for up to 3 days. All treatments led to a reduction in pain intensity (PI); the mean cumulative PI-reductions over the first 2 h after the 1(st) dose (SPIDnorm(0-2)) were 24.7, 26.6, 26.0, and 32.2% (SEM: 0.023) of the predose PI for treatment with placebo, and the 2.5, 5, and 10 mg AXS, respectively. These mean reductions were 2 (CI: -3.6; 7.5), 1.3 (CI: -4.3; 6.8), and 7.5 (CI: 2.0;13.1) percent points larger than for placebo. The 2.5 and 5 mg AXS were not distinguishable from placebo, but the 10 mg AXS was evidently superior. The numbers needed to treat (NNT) when comparing 10 mg AXS with placebo, were 9.5 and 8.8 for an average pain relief of 33 and 50% of the maximum achievable effect over the first 2 h. 10 mg AXS showed a statistically significantly superior pain reduction relative to the placebo spray. Treatment with 10 mg AXS reaches an extent of pain relief that can be accepted to be clinically meaningful and was well tolerated. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Nebulized ketamine decreases incidence and severity of post-operative sore throat

    PubMed Central

    Ahuja, Vanita; Mitra, Sukanya; Sarna, Rashi

    2015-01-01

    Background and Aims: Post-operative sore throat (POST) occurs in 21-65% of patients. Ketamine used earlier as gargle for reducing POST has limitations. The aim of this study was to see if nebulised ketamine reduces POST. Methods: We conducted a prospective, randomised, placebo-control, and double-blind controlled trial. After written informed consent, 100 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-60 years, of either sex undergoing surgery under general anaesthesia (GA) were enrolled. Patients were randomised into two groups; group saline (S) received saline nebulisation 5.0 ml and group ketamine (K) received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulisation for 15 min. GA was induced 10 min after completion of nebulisation in the patients. The POST and haemodynamic monitoring were done pre-nebulization, pre-induction, on reaching post-anaesthesia care unit, and at 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0-3). Results: The overall incidence of POST was 33%; 23 patients (46%) in saline and 10 patients (20%) in ketamine group experienced POST (Fisher's exact P = 0.01). The use of ketamine nebulization attenuated POST at 2 h and 4 h post-operatively (P < 0.05). The primary outcome was incidence of POST at 4 h; 13 patients in group S versus 4 patients in group K (P = 0.03) experienced POST at 4 h. The moderate sore throat occurred in 6 patients in group S and none in group K at 2 h, post-operatively (P = 0.02). Conclusion: Ketamine nebulization significantly attenuated the incidence and severity of POST, especially in the early post-operative period, with no adverse effects. PMID:25684812

  18. Nebulized ketamine decreases incidence and severity of post-operative sore throat.

    PubMed

    Ahuja, Vanita; Mitra, Sukanya; Sarna, Rashi

    2015-01-01

    Post-operative sore throat (POST) occurs in 21-65% of patients. Ketamine used earlier as gargle for reducing POST has limitations. The aim of this study was to see if nebulised ketamine reduces POST. We conducted a prospective, randomised, placebo-control, and double-blind controlled trial. After written informed consent, 100 patients belonging to American Society of Anaesthesiologists physical status I-II in the age group 20-60 years, of either sex undergoing surgery under general anaesthesia (GA) were enrolled. Patients were randomised into two groups; group saline (S) received saline nebulisation 5.0 ml and group ketamine (K) received ketamine 50 mg (1.0 ml) with 4.0 ml of saline nebulisation for 15 min. GA was induced 10 min after completion of nebulisation in the patients. The POST and haemodynamic monitoring were done pre-nebulization, pre-induction, on reaching post-anaesthesia care unit, and at 2, 4, 6, 8, 12 and 24 h post-operatively. POST was graded on a four-point scale (0-3). The overall incidence of POST was 33%; 23 patients (46%) in saline and 10 patients (20%) in ketamine group experienced POST (Fisher's exact P = 0.01). The use of ketamine nebulization attenuated POST at 2 h and 4 h post-operatively (P < 0.05). The primary outcome was incidence of POST at 4 h; 13 patients in group S versus 4 patients in group K (P = 0.03) experienced POST at 4 h. The moderate sore throat occurred in 6 patients in group S and none in group K at 2 h, post-operatively (P = 0.02). Ketamine nebulization significantly attenuated the incidence and severity of POST, especially in the early post-operative period, with no adverse effects.

  19. The Effect of Betamethasone Gel and Lidocaine Jelly Applied Over Tracheal Tube Cuff on Postoperative Sore Throat, Cough, and Hoarseness.

    PubMed

    Narimani, Mahnaz; Seyed Mehdi, Seyed Ahmad; Gholami, Farshid; Ansari, Ladan; Aryafar, Mohammad; Shahbazi, Fatemeh

    2016-08-01

    The purpose of the study was to investigate the effect of betamethasone gel and lidocaine jelly (over tracheal tube cuff) compared with distilled water on the postextubation syndrome incidence (sore throat, cough, and hoarseness). Double-blind randomized clinical trial study was used. Ninety-nine patients of either sex undergoing elective surgery, under general anesthesia with endotracheal intubation, were recruited. Patients were randomized into three group, betamethasone gel, lidocaine jelly, or distilled water applied on the external surface of the tracheal tube. Patients were assessed for postoperative sore throat, cough, and hoarseness at 1, 6, and 24 hours after surgery. In the first hour after surgery, the patients who received lidocaine or betamethasone had a significantly greater incidence of sore throat than the patients who received distilled water (RR = 2.9). In the sixth hour after surgery, there was a better effect of distilled water on reducing the incidence of sore throat, but no significant differences between the three groups were seen 24 hours after surgery. The incidence of cough was significantly lower in the distilled water group (P < .02) except at the first and 24 hours postoperative when the incidence of cough was similar. The incidence of hoarseness was similar between the three groups at 1, 6, and 24 hours after surgery. In this study, the use of lidocaine gel and betamethasone does not reduce the incidence of sore throat or cough after intubation as much as distilled water. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  20. Comparing the Effect of Dexamethasone before and after Tracheal Intubation on Sore Throat after Tympanoplasty Surgery: A Randomized Controlled trial

    PubMed Central

    Eidi, Mahmoud; Seyed Toutounchi, Seyed Javad; Kolahduzan, Khosro; Sadeghian, Parisa; Seyed Toutounchi, Negisa

    2014-01-01

    Introduction: Presence of a sore throat after surgery is a common side effect of general anesthesia with intratracheal intubation and can cause discomfort for the patient and prolong the recovery process. In this study we compared the effect of dexamethasone before and after intubation on the incidence of sore throat after tympanoplasty surgery. Materials and Methods: In a double-blind, randomized clinical trial, 70 patients aged 30–60 years with American Society of Anesthesiologists (ASA) physical status I or II who were candidates for tympanoplasty under anesthetic conditions were studied in two separate groups. The first group received intravenous (IV) dexamethasone (8 mg) 30 mins prior to intubation while the second group received the same dose of dexamethasone 30 mins after intubation. The incidence and severity of the sore throat in both groups were then evaluated. Results: There was no significant difference between two groups in intensity of sore throat (62.9% vs. 57.1%), cough (65.7% vs. 62.9%), or hoarseness (62.9% vs. 65.7%) within 24 h after surgery. Detection of blood in oral secretions or on the tracheal tube was the same in both groups (5.7%). The incidence of coughs during the extubation was 0% in first group and 11.4% in second group. Conclusion: According to the results of this research there was no significant difference in incidence and intensity of sore throat in patients receiving dexamethasone before or after intubation. Further, no significant difference in intensity of coughs or hoarseness was observed. PMID:24744997

  1. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial

    PubMed Central

    2009-01-01

    Background The aim of this trial was to assess the relative efficacy of a sage/echinacea spray and a chlorhexidine/lidocaine spray in the treatment of acute sore throats. Methods This was a multicenter, randomized, double-blind, double-dummy controlled trial carried out in eleven general practices in Switzerland. A total of 154 patients (133 analyzed in per protocol collective) at least 12 years old with acute sore throat present for not more than 72 hours prior to inclusion and with a throat score ≥6 participated in the study. They used either an echinacea/sage spray or a chlorhexidine/lidocaine spray with two puffs every 2 hours, in a double-dummy blinded manner, up to 10 times daily until they were symptom-free, for a maximum of 5 days. The main outcome measures was the comparison of response rates during the first three days. A response was defined as a decrease of at least 50% of the total symptoms compared to baseline. Results The echinacea/sage treatment exhibited similar efficacy to the chlorhexidine/lidocaine treatment in reducing sore throat symptoms during the first 3 days (P(x < Y) = .5083). Response rates after 3 days were 63.8% in the echinacea/sage group and 57.8% in the chlorhexidine/lidocaine group. For all secondary parameters, such as time to becoming symptom free, throat pain, and global assessments of efficacy by the physician and patient, no difference between the two treatments was seen. They were both very well tolerated. Conclusion An echinacea/sage preparation is as efficacious and well tolerated as a chlorhexidine/lidocaine spray in the treatment of acute sore throats. PMID:19748859

  2. Comparing the effectiveness of Betamethasone Gel with Lidocaine Gel local application on endotracheal tube in preventing post-operative sore throat (POST).

    PubMed

    Fayyaz, Aatir; Furqan, Aamir; Ammar, Ali; Akhtar, Rahat

    2017-06-01

    To see whether betamethasone gel or lidocaine gel is superior in reducing the incidence of post-operative sore throat after tracheal extubation. This clinical study was conducted at the Nishtar Hospital and Medical College, Multan, Pakistan, from July to December 2015, and comprised patients who were set to undergo elective surgery under general anaesthesia. The patients were divided into two equal groups. In group 1, endotracheal tube was lubricated with betamethasone gel (0.05%). In group 2, endotracheal tube was lubricated with 4.0% lidocaine gel. SPSS 20 was used for data analysis. Generalised estimating equation was used to see the association between the treatment methods and severity of sore throat over time. Of the 120 patients, there were 60(50%) each in the two groups. The mean intubation time was 5.58±1.31 hours in group 1and 5.43±1.21 hours in group 2. Besides, 7(11.7%) patients developed mild sore throat and 3(5.0%) moderate sore throat in group 1,whereas 13(21.7%) patients developed mild sore throat, 7(11.6%) moderate and 2(3.3%) severe sore throat after one hour of extubation (p=0.04). After 6 hours, there were 2(3.3%) patients with moderate and 1(1.7%) with severe sore throat in group 1 compared to 8(13.3%) with moderate and 4(6.7%) with severe sore throat in group 2. After 24 hours,5(8.3%) patients developed mild and 2(3.3%) moderate sore throat in group 1 compared to 14(23.7%) patients with mild sore throat, 5(8.5%) with moderate and 1(1.7%) with severe throat in group 2. Generalised estimating equation analysis showed a significant positive association between application of lidocaine gel on endotracheal tube and severity of sore throat (p<0.001). Local application of betamethasone gel was associated with reduced risk of post-operative sore throat as compared to local application of lidocaine gel on the endotracheal tube.

  3. Comparison of Effectiveness of Betamethasone gel Applied to the Tracheal Tube and IV Dexamethasone on Postoperative Sore Throat: A Randomized Controlled Trial

    PubMed Central

    Tabari, Masoomeh; Soltani, Ghasem; Zirak, Nahid; Alipour, Mohammad; Khazaeni, Kamran

    2013-01-01

    Introduction: Postoperative sore throat is a common complaint in patients with endotracheal intubation and has potentially dangerous complications. This randomized controlled trial study investigated the incidence of postoperative sore throat after general anesthesia when betamethasone gel is applied to a tracheal tube compared with when IV dexamethasone is prescribed. Materials and Methods: Two hundred and twenty five American Society of Anesthesiologist (ASA)-class I and II patients undergoing elective abdominal surgery with tracheal intubation were randomly divided into three groups: betamethasone gel, intravenous (IV) dexamethasone, and control groups. In the post-anesthesia care unit, a blinded anesthesiologist interviewed all patients regarding postoperative sore throat at 1,6, and 24 hours after surgery. Results: The incidence of sore throat was significantly lower in the betamethasone gel group compared with the IV dexamethasone and control groups, 1, 6, and 24 hours after surgery. In the first day after surgery 10.7% of the betamethasone group had sore throat whereas 26.7% of the IV dexamethasone group and 30.7% of the control group had sore throat. Bucking before extubation was observed in 14(18.4%), 8(10.4%), and 9(12.2%) patients, in the IV dexamethasone, betamethasone gel, and control group, respectively. Conclusion: We concluded that wide spread application of betamethasone gel over tracheal tubes effectively mitigates postoperative sore throat, compared with IV dexamethasone application. PMID:24303443

  4. Amylmetacresol/2,4-dichlorobenzyl alcohol, hexylresorcinol, or carrageenan lozenges as active treatments for sore throat.

    PubMed

    Morokutti-Kurz, Martina; Graf, Christine; Prieschl-Grassauer, Eva

    2017-01-01

    Up to 80% of sore throats are caused by viruses. Several over the counter products are available which provide symptomatic, not causal relief. For such lozenges, containing the antiseptics and local anesthetics amylmetacresol (AMC) and 2,4-dichlorobenzyl alcohol (DCBA) or hexylresorcinol (HR), recently an additional virucidal effect was published. Therefore, we tested a set of Strepsils(®) lozenges, containing either HR (Max [#2]) or AMC/DCBA (Original [#3], Extra Strong [#4], Warm [#5], Orange and Vitamin C [#6], Sugar free Lemon [#7], Children/Strawberry [#8] and Soothing Honey and Lemon [#9]) for their antiviral efficiency against representatives of respiratory viruses known to cause sore throat: human rhinovirus (HRV) 1a, HRV8, influenza virus A H1N1n, Coxsackievirus A10, and human coronavirus (hCoV) OC43. The lozenges were tested head to head with Coldamaris(®) lozenges (#1), which contain the patented antiviral iota-carrageenan. None of the tested AMC/DCBA or HR containing lozenges shows any antiviral effectiveness against HRV8 at the tested concentrations, whereas all are moderately active against HRV1a. Only lozenge #5 shows any activity against hCoV OC43 and Coxsackievirus A10 at the tested concentrations. Similarly, only lozenge #3 is moderately active against influenza A H1N1n virus. The data indicates that neither the isolated effect of the active ingredients nor the pH but rather one or more of the excipients of the specific formulations are responsible for the antiviral effect of some of the AMC/DCBA or HR containing lozenges. In contrast, carrageenan-containing lozenges are highly active against all viruses tested. In another experiment, we showed that binding and inactivation of virus particles by iota-carrageenan are fast and highly effective. During the residence time of the lozenge in the mouth, the viral titer is reduced by 85% and 91% for influenza A virus and hCoV OC43, respectively. Carrageenan-containing lozenges are, therefore, suitable

  5. Amylmetacresol/2,4-dichlorobenzyl alcohol, hexylresorcinol, or carrageenan lozenges as active treatments for sore throat

    PubMed Central

    Morokutti-Kurz, Martina; Graf, Christine; Prieschl-Grassauer, Eva

    2017-01-01

    Up to 80% of sore throats are caused by viruses. Several over the counter products are available which provide symptomatic, not causal relief. For such lozenges, containing the antiseptics and local anesthetics amylmetacresol (AMC) and 2,4-dichlorobenzyl alcohol (DCBA) or hexylresorcinol (HR), recently an additional virucidal effect was published. Therefore, we tested a set of Strepsils® lozenges, containing either HR (Max [#2]) or AMC/DCBA (Original [#3], Extra Strong [#4], Warm [#5], Orange and Vitamin C [#6], Sugar free Lemon [#7], Children/Strawberry [#8] and Soothing Honey and Lemon [#9]) for their antiviral efficiency against representatives of respiratory viruses known to cause sore throat: human rhinovirus (HRV) 1a, HRV8, influenza virus A H1N1n, Coxsackievirus A10, and human coronavirus (hCoV) OC43. The lozenges were tested head to head with Coldamaris® lozenges (#1), which contain the patented antiviral iota-carrageenan. None of the tested AMC/DCBA or HR containing lozenges shows any antiviral effectiveness against HRV8 at the tested concentrations, whereas all are moderately active against HRV1a. Only lozenge #5 shows any activity against hCoV OC43 and Coxsackievirus A10 at the tested concentrations. Similarly, only lozenge #3 is moderately active against influenza A H1N1n virus. The data indicates that neither the isolated effect of the active ingredients nor the pH but rather one or more of the excipients of the specific formulations are responsible for the antiviral effect of some of the AMC/DCBA or HR containing lozenges. In contrast, carrageenan-containing lozenges are highly active against all viruses tested. In another experiment, we showed that binding and inactivation of virus particles by iota-carrageenan are fast and highly effective. During the residence time of the lozenge in the mouth, the viral titer is reduced by 85% and 91% for influenza A virus and hCoV OC43, respectively. Carrageenan-containing lozenges are, therefore, suitable as

  6. Comparative study between benzydamine hydrochloride gel, lidocaine 5% gel and lidocaine 10% spray on endotracheal tube cuff as regards postoperative sore throat.

    PubMed

    Mekhemar, Nashwa Abdallah; El-Agwany, Ahmed Samy; Radi, Wafaa Kamel; El-Hady, Sherif Mohammed

    2016-01-01

    Postoperative sore throat is a common complication after endotracheal intubation. After tracheal intubation, the incidence of sore throat varies from 14.4% to 50%. The aim of the study was to compare between benzydamine hydrochloride gel, lidocaine 5% gel and lidocaine 10% spray on the endotracheal tube cuff as regards postoperative sore throat. The present study was carried out on 124 patients admitted to Alexandria university hospitals for lumbar fixation surgery requiring general anesthesia. Patients were randomly allocated into 4 groups. Benzydamine hydrochloride gel, 5% lidocaine hydrochloride gel, 10% lidocaine hydrochloride spray, or normal saline were applied on endotracheal tube cuffs before endotracheal intubation. The patients were examined for sore throat (none, mild, moderate, or severe) at 0, 1, 6, 12, and 24h after extubation. The results were collected, analyzed and presented in table and figure. The highest incidence of postoperative sore throat occurred at 6h after extubation in all groups. There was a significantly lower incidence of postoperative sore throat in the benzydamine group than 5% lidocaine gel, 10% lidocaine spray, and normal saline groups. The benzydamine group had significantly decreased severity of postoperative sore throat compared with the 10% lidocaine, 5% lidocaine, and normal saline groups at observation time point. Compared with the 5% lidocaine the 10% lidocaine group had significantly increased incidence and severity of postoperative sore throat after extubation. Compared with normal saline the 10% lidocaine group had increased incidence of postoperative sore throat. There were no significant differences among groups in local or systemic side effects. So in conclusion, benzydamine hydrochloride gel on the endotracheal tube cuff is a simple and effective method to reduce the incidence and severity of postoperative sore throat. Application of 10% lidocaine spray should be avoided because of worsening of postoperative sore

  7. [Comparative study between benzydamine hydrochloride gel, lidocaine 5% gel and lidocaine 10% spray on endotracheal tube cuff as regards postoperative sore throat].

    PubMed

    Mekhemar, Nashwa Abdallah; El-Agwany, Ahmed Samy; Radi, Wafaa Kamel; El-Hady, Sherif Mohammed

    2016-01-01

    Postoperative sore throat is a common complication after endotracheal intubation. After tracheal intubation, the incidence of sore throat varies from 14.4% to 50%. The aim of the study was to compare between benzydamine hydrochloride gel, lidocaine 5% gel and lidocaine 10% spray on the endotracheal tube cuff as regards postoperative sore throat. The present study was carried out on 124 patients admitted to Alexandria university hospitals for lumbar fixation surgery requiring general anesthesia. Patients were randomly allocated into 4 groups. Benzydamine hydrochloride gel, 5% lidocaine hydrochloride gel, 10% lidocaine hydrochloride spray, or normal saline were applied on endotracheal tube cuffs before endotracheal intubation. The patients were examined for sore throat (none, mild, moderate, or severe) at 0, 1, 6, 12, and 24h after extubation. The results were collected, analyzed and presented in table and figure. The highest incidence of postoperative sore throat occurred at 6h after extubation in all groups. There was a significantly lower incidence of postoperative sore throat in the benzydamine group than 5% lidocaine gel, 10% lidocaine spray, and normal saline groups. The benzydamine group had significantly decreased severity of postoperative sore throat compared with the 10% lidocaine, 5% lidocaine, and normal saline groups at observation time point. Compared with the 5% lidocaine the 10% lidocaine group had significantly increased incidence and severity of postoperative sore throat after extubation. Compared with normal saline the 10% lidocaine group had increased incidence of postoperative sore throat. There were no significant differences among groups in local or systemic side effects. So in conclusion, benzydamine hydrochloride gel on the endotracheal tube cuff is a simple and effective method to reduce the incidence and severity of postoperative sore throat. Application of 10% lidocaine spray should be avoided because of worsening of postoperative sore

  8. [An instant pain-relief effect of balance acupuncture for relieving sore throat in acute pharyngitis patients].

    PubMed

    Yang, Shi-Hong; Xie, Ping-Chang; Qin, Xiao-Lan

    2012-08-01

    To observe the instant effect of "Balance Acupuncture" in relieving sore throat in patients with acute pharyngitis. A total of 74 acute pharyngitis patients with sore throat were randomly assigned to treatment group (Balance Acupuncture, n = 36) and placebo acupuncture group (sham acupoint, n = 38). Patients of the Balance Acupuncture group were treated by acupuncture stimulation of bilateral "Yantong" (sore throat) point (the mid-point of the second metacarpal bone on the radial side) and those of the sham acupoint group were treated by acupuncture stimulation of the sham point (the site 1 cm lateral to the mid-point between the ulnar endpoint of the cubic transverse striation and that of the wrist-palm transverse striation). After insertion, the acupuncture needle was manipulated repeatedly till "Deqi" for patients of the treatment group but not manipulated for patients of the placebo acupuncture group, then removed immediately. The VAS (Visual Analogue Scores) were assessed 1 min after the treatment in addition to safety index records. Before the treatment, the VAS values of the treatment group and sham acupoint group were (5.25 +/- 1.51) points and (4.83 +/- 1.59) points, respectively, which had no significant differences between the two groups (P > 0.05). One minute after the treatment, VAS values of the treatment and sham acupoint groups were (2.11 +/- 1.88) points and (3.39 +/- 1.94) points, respectively, both decreasing significantly (P < 0.01). The effect of the former group was significantly superior to that of the sham acupoint group (P < 0.05). Both Balance Acupuncture and sham-acupoint acupuncture treatments can relieve sore throat in acute pharyngitis patients, and the therapeutic effect of Balance Acupuncture treatment is obviously better.

  9. Efficacy and safety of ambroxol lozenges in the treatment of acute uncomplicated sore throat. EBM-based clinical documentation.

    PubMed

    de Mey, Christian; Peil, Hubertus; Kölsch, Stephan; Bubeck, Jürgen; Vix, Jean-Michel

    2008-01-01

    Sore throat is the hallmark of acute pharyngitis. Although usually caused by viral infections, it is frequently treated with antibiotics. Such inappropriate use of antibiotics might best be challenged by offering efficacious and safe symptomatic pain relief instead. However, there is need for robust evidence to support such alternatives. Presently, the evidence from randomised, placebo-controlled, double-blind clinical trials (RCT) with the local anaesthetic ambroxol (CAS 23828-92-4) in the treatment of sore throat is being reviewed. This relates to five RCT in 1,772 patients; 1,713 were evaluable with regard to efficacy. Treatment with ambroxol lozenges was statistically significantly superior to placebo in reducing sore throat pain intensity with a high level of consistency of the estimated effect across the different studies. The effect had an early onset and lasted up to at least 3 h after a single first lozenge. The pain relief was associated with a statistically superior regression of pharyngeal redness and inflammation; with ambroxol, the overall efficacy was more frequently rated as at least "good". Treatment with the ambroxol lozenges was well tolerated. There was heterogeneity in reporting adverse events: in one later study with less severe baseline pain intensity there was more frequent reporting of hypoaesthesia of the oral cavity and tongue as an untoward phenomenon. In patients with more severe baseline pain this reflection of the medication's pharmacological action was only rarely reported as untoward. It is concluded that lozenges containing 20 mg ambroxol are a safe and efficacious treatment for acute uncomplicated sore throat of recent onset in adult patients.

  10. Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway: a prospective study

    PubMed Central

    2014-01-01

    Background Postoperative sore throat and hoarseness are common minor complications following airway manipulation. This study was primarily done to determine gender differences in the incidence of these symptoms and the location of POST after laryngeal mask airway (LMA) and endotracheal tube (ETT). Methods A total of 112 men and 185 women were included during a four month period. All patients were evaluated postoperatively and after 24 hours about the occurrence of sore throat, its location and hoarseness. If the patients had any symptom, they were followed-up at 48, 72 and 96 hours until the symptoms resolved. Results There was no significant gender difference in postoperative sore throat (POST) and postoperative hoarseness (PH) when analyzing both airway devices together. The incidence of sore throat and hoarseness were higher postoperatively after an ETT than an LMA (32% vs. 19%, p = 0.012) and 57% vs. 33% (p < 0.001) respectively. Significantly more women than men had POST after an LMA (26% vs. 6%, p = 0.004). No significant gender difference was found in either POST or PH after an ETT or in the incidence of PH after an LMA. More patients located their pain below the larynx after an ETT vs. an LMA (24% vs. 4%). Pain above the larynx was more common after an LMA than an ETT (52% vs. 37%). Conclusions In a clinical setting where women are intubated with a smaller size ETT than men, there were no significant differences in POST or PH between genders. Additionally, more women than men have POST when an LMA is used. Awareness of POST and PH may help streamline patients in whom the best airway device could be used during anesthesia and surgery. PMID:25061426

  11. Evaluation of preoperative Strepsils lozenges on incidence of postextubation cough and sore throat in smokers undergoing anesthesia with endotracheal intubation.

    PubMed

    Gupta, Divya; Agrawal, Sanjay; Sharma, Jagdish P

    2014-04-01

    Post-operative sore throat (POST) is an undesirable side effect of endotracheal intubation. Pharmacological and non-pharmacological measures have been utilized for minimizing the morbidity caused by POST. We have tested use of Strepsils lozenges in providing efficacy for decreasing POST in smokers presenting for surgery under general anesthesia with endotracheal intubation. 100 patients, 20-65 years, American Society of Anesthesiologists (ASA) physical status I and II, either sex, history of smoking, posted for elective surgical procedure of more than 1 hour, requiring general anesthesia with endotracheal intubation were included and randomly divided into groups (n = 50) to receive Strepsils (Group A) and sugar candy (Group B). The patients were assessed for cough, sore throat, and hoarseness of voice after extubation, 30 min, 12 hrs, and 24 hrs after extubation. At extubation no cough was seen in 39 (78%) patients (group A) compared to 23 (46%) patients (Group B), and mild cough in 22% (Group A) and 52% (Group B). Incidence of sore throat at extubation was lower in group A compared to Group B (P = 0.04). At other times of observations (30 min,12 hrs and 24 hrs) there was a significant decrease in incidence of sore throat in Group A compared to Group B (P = 0.000). Hoarseness of voice was not observed in any patient in either group. Use of preoperative Strepsils lozenges decreases incidence of POST and maybe utilized as a simple and cost-effective measure for decreasing the symptoms of POST and increasing the satisfaction of patients.

  12. Evaluation of preoperative Strepsils lozenges on incidence of postextubation cough and sore throat in smokers undergoing anesthesia with endotracheal intubation

    PubMed Central

    Gupta, Divya; Agrawal, Sanjay; Sharma, Jagdish P.

    2014-01-01

    Post-operative sore throat (POST) is an undesirable side effect of endotracheal intubation. Pharmacological and non-pharmacological measures have been utilized for minimizing the morbidity caused by POST. We have tested use of Strepsils lozenges in providing efficacy for decreasing POST in smokers presenting for surgery under general anesthesia with endotracheal intubation. Materials and Methods: 100 patients, 20-65 years, American Society of Anesthesiologists (ASA) physical status I and II, either sex, history of smoking, posted for elective surgical procedure of more than 1 hour, requiring general anesthesia with endotracheal intubation were included and randomly divided into groups (n = 50) to receive Strepsils (Group A) and sugar candy (Group B). The patients were assessed for cough, sore throat, and hoarseness of voice after extubation, 30 min, 12 hrs, and 24 hrs after extubation. Results: At extubation no cough was seen in 39 (78%) patients (group A) compared to 23 (46%) patients (Group B), and mild cough in 22% (Group A) and 52% (Group B). Incidence of sore throat at extubation was lower in group A compared to Group B (P = 0.04). At other times of observations (30 min,12 hrs and 24 hrs) there was a significant decrease in incidence of sore throat in Group A compared to Group B (P = 0.000). Hoarseness of voice was not observed in any patient in either group. Conclusions: Use of preoperative Strepsils lozenges decreases incidence of POST and maybe utilized as a simple and cost-effective measure for decreasing the symptoms of POST and increasing the satisfaction of patients. PMID:24843341

  13. Gargling with sodium azulene sulfonate reduces the postoperative sore throat after intubation of the trachea.

    PubMed

    Ogata, Junchi; Minami, Kouichiro; Horishita, Takafumi; Shiraishi, Munehiro; Okamoto, Takashi; Terada, Tadanori; Sata, Takeyoshi

    2005-07-01

    Postoperative sore throat (POST) is a complication that remains to be resolved in patients undergoing endotracheal intubation. In this study, we investigated whether preoperative gargling with sodium 1,4-dimethyl-7-isopropylazulene-3-sulfonate monohydrate (sodium azulene sulfonate, Azunol) reduces POST after endotracheal intubation. Forty patients scheduled for elective surgery under general anesthesia were randomized into Azunol and control groups. In the Azunol group, patients gargled with 4 mg Azunol diluted with 100 mL tap water (40 microg/mL). In the control group, patients gargled with 100 mL of tap water. After emergence from general anesthesia, the patients with POST were counted and POST was evaluated using a verbal analog pain scale. There were no significant differences between the two groups by age, height, body weight, gender distribution, or duration of anesthesia and surgery. In the control group, 13 patients (65%) complained of POST, which remained 24 h later in nine patients (45%). In the Azunol group, five patients (25%) also complained of POST, which completely disappeared by 24 h later. The incidence of POST and verbal analog pain scale scores in the Azunol group decreased significantly compared with the control group. We demonstrated that gargling with Azunol effectively attenuated POST with no adverse reactions.

  14. Incidence and risk factors of postoperative sore throat after endotracheal intubation in Korean patients.

    PubMed

    Lee, Jin Young; Sim, Woo Seog; Kim, Eun Sung; Lee, Sangmin M; Kim, Duk Kyung; Na, Yu Ri; Park, Dahye; Park, Hue Jung

    2017-04-01

    Objective To investigate the incidence of postoperative sore throat (POST) in Korean patients undergoing general anaesthesia with endotracheal intubation and to assess potential risk factors. Methods This prospective study enrolled patients who underwent all types of elective surgical procedures with endotracheal intubation and general anaesthesia. The patients were categorized into group S (those with a POST) or group N (those without a POST). The demographic, clinical and anaesthetic characteristics of each group were compared. Results This study enrolled 207 patients and the overall incidence of POST was 57.5% ( n = 119). Univariate analysis revealed that significantly more patients in group S had a cough at emergence and hoarseness in the postanaesthetic care unit compared with group N. Receiver operating characteristic curve analysis showed that an intracuff pressure ≥17 cmH2O was associated with POST. Multivariate analysis identified an intracuff pressure ≥17 cmH2O and cough at emergence as risk factors for POST. At emergence, as the intracuff pressure over ≥17 cmH2O increased, the incidence of hoarseness increased. Conclusions An intracuff pressure ≥17 cmH2O and a cough at emergence were risk factors for POST in Korean patients. Intracuff monitoring during anaesthesia and a smooth emergence are needed to prevent POST.

  15. Incidence and severity of postoperative sore throat: a randomized comparison of Glidescope with Macintosh laryngoscope.

    PubMed

    Aqil, Mansoor; Khan, Mueen Ullah; Mansoor, Saara; Mansoor, Saad; Khokhar, Rashid Saeed; Narejo, Abdul Sattar

    2017-09-12

    Postoperative sore throat (POST) is a common problem following endotracheal (ET) intubation during general anesthesia. The objective was to compare the incidence and severity of POST during routine intubation with Glidescope (GL) and Macintosh laryngoscope (MCL). One hundred forty adult patients ASA I and II with normal airway, scheduled to undergo elective surgery under GA requiring ET intubation were enrolled in this prospective randomized study and were randomly divided in two groups, GL and MCL. Incidence and severity of POST was evaluated at 0, 6, 12 and 24 h after surgery. At 0 h, the incidence of POST was more in MCL than GL (n = 41 v.s n = 22, P = 0.001), and also at 6 h after surgery (n = 37 v.s n = 23, P = 0.017). Severity of POST was more at 0, 6 and 12 h after surgery in MCL (P < 0.001, P = 0.001, P = 0.004 respectively). Routine use of GL for ET tube placement results in reduction in the incidence and severity of POST compared to MCL. ClinicalTrials.gov NCT02848365 . Retrospectively Registered (Date of registration: July, 2016).

  16. Bilateral Peritonsillar Abscess in an Infant: An Unusual Presentation of Sore Throat

    PubMed Central

    Chueiri, Letícia; Jacques, Janaina; de Mello, Maria Fernanda Piccoli Cardoso; da Silva, Martin Batista Coutinho; Zatt, Daniel Buffon; Cunha, Rosana Cristine Otero; Maranhão, Andre Souza de Albuquerque

    2017-01-01

    Introduction Peritonsillar abscess is considered a suppurative complication of acute tonsillitis. It is usually unilateral and clinically evident bilateral presentation is uncommon. The condition affects mainly children older than 10 years and young adults. Herein we present a rare case of bilateral peritonsillar abscess in an infant. Presentation of Case A 1-year-old boy presented with a two-day history of worsening sore throat, loss of appetite, vomiting, and fever. Examination of the oral cavity and oropharynx revealed enlarged and inflamed tonsils and a bilaterally congested and bulging soft palate. CT scan confirmed the hypothesis of bilateral peritonsillar abscess. Antibiotic therapy was instituted and after 5 days only slight regression of swelling of the soft palate was observed. He underwent a surgical procedure for draining the abscesses. After the procedure, he presented good clinical and laboratory evolution and was discharged home. Discussion Although peritonsillar abscesses are considered common complications of acute tonsillitis bilateral cases are extremely rare, especially in early childhood. The diagnosis is based on history and physical examination and the treatment remains controversial among otolaryngologists. Conclusion Bilateral peritonsillar abscess should be diagnosed and treated promptly and adequately to prevent respiratory obstruction and to avoid dissemination into the deep neck spaces. PMID:28912993

  17. Novel preoperative pharmacologic methods of preventing postoperative sore throat due to tracheal intubation.

    PubMed

    Kalil, David M; Silvestro, Loraine S; Austin, Paul N

    2014-06-01

    Postoperative sore throat (POST) is usually self-limiting but was rated by patients as one of the top 10 most undesirable anesthetic outcomes. Pharmacologic interventions that have been suggested to decrease the incidence of POST include application of local anesthetics and corticosteroids to the cuff of the endotracheal tube. These interventions often require extra steps during induction of general anesthesia. We sought evidence for using nonsteroidal, nonlocal anesthetic, topical pharmacologic interventions conveniently implemented preoperatively to decrease the incidence of POST. One hundred seventeen potential evidence sources were located, with 11 randomized controlled trials meeting inclusion criteria. The evidence examined ketamine, aspirin, and azulene gargle; benzydamine gargle or oral spray; dexpanthenol pastilles; and lozenges containing amyl-m-cresol or magnesium. Although there were methodologic concerns with the studies, the evidence suggested that all the treatment medications decreased the incidence of POST at early and late intervals. The severity of POST was also typically reduced. Preoperative ketamine and aspirin gargle are probably the most promising for providers practicing in the United States. However, before these agents are recommended for general use, large multicenter trials should be done exploring not only efficacy but also dose-response relationships and side effects.

  18. The effect of intravenous low dose ketamine for reducing postoperative sore throat.

    PubMed

    Park, Sun Young; Kim, Sang Hyun; Noh, Jung Il; Lee, Su Myoung; Kim, Mun Gyu; Kim, Sang Ho; Ok, Si Young; Kim, Soon Im

    2010-07-01

    This study was performed to evaluate the effectiveness of intravenous low dose ketamine for reducing the incidence and severity of postoperative sore throat (POST). This was a prospective, randomized, double-blind clinical trial. The study population consisted of 70 patients between 20 and 70 years old who were classified as American Society of Anesthesiologists I-II and were scheduled for elective laparoscopic cholecystectomy. The patients were divided randomly into two groups. Patients in the ketamine group received an intravenous injection of 0.5 mg/kg of ketamine just before induction, followed by 10 microg/kg/min throughout the operation. Patients in the control group received intravenous saline instead of ketamine. The patients were interviewed 1, 6, and 24 h after the operation. The incidence and severity of POST were recorded. No significant differences in the incidence and severity of POST during the 24 h after the operation were found between the two groups (21/31 in the ketamine group vs. 26/34 in the control group, P = 0.398). Intravenous injection of low dose ketamine was not effective for reducing POST.

  19. The effect of intravenous low dose ketamine for reducing postoperative sore throat

    PubMed Central

    Kim, Sang Hyun; Noh, Jung Il; Lee, Su Myoung; Kim, Mun Gyu; Kim, Sang Ho; Ok, Si Young; Kim, Soon Im

    2010-01-01

    Background This study was performed to evaluate the effectiveness of intravenous low dose ketamine for reducing the incidence and severity of postoperative sore throat (POST). Methods This was a prospective, randomized, double-blind clinical trial. The study population consisted of 70 patients between 20 and 70 years old who were classified as American Society of Anesthesiologists I-II and were scheduled for elective laparoscopic cholecystectomy. The patients were divided randomly into two groups. Patients in the ketamine group received an intravenous injection of 0.5 mg/kg of ketamine just before induction, followed by 10 µg/kg/min throughout the operation. Patients in the control group received intravenous saline instead of ketamine. The patients were interviewed 1, 6, and 24 h after the operation. The incidence and severity of POST were recorded. Results No significant differences in the incidence and severity of POST during the 24 h after the operation were found between the two groups (21/31 in the ketamine group vs. 26/34 in the control group, P = 0.398). Conclusions Intravenous injection of low dose ketamine was not effective for reducing POST. PMID:20651994

  20. Group A streptococcal endophthalmitis complicating a sore throat in a 2-year-old child.

    PubMed

    Fitzgerald, Felicity; Harris, Kathryn; Henderson, Robert; Edelsten, Clive

    2015-04-09

    A previously well 2-year-old presented to her general practitioner after 5 days of fever, lethargy, sore throat and a slightly red eye. A viral infection was diagnosed. Two days later, she re-presented with a swollen right eyelid and a moderately red eye. Oral amoxicillin and chloramphenicol eye drops were prescribed. The next day, marked periorbital swelling developed. She was admitted to hospital and parenteral ceftriaxone was started. Examination under anaesthetic showed injected globe diffuse corneal clouding and peripheral corneal opacities; ultrasound and CT suggested endophthalmitis. On transfer to a tertiary centre, intraocular vancomycin and subconjunctival cefuroxime were given. Aqueous fluid samples were positive for group A Streptococcus (GAS) by PCR, so parenteral clindamycin was added. GAS endophthalmitis was confirmed 1 day later from the positive intraocular fluid culture results. Visual evoked potentials revealed complete loss of vision. The eye was removed to limit potential spread. She made a good recovery postoperatively and was discharged on oral antibiotics. 2015 BMJ Publishing Group Ltd.

  1. Comparing the effect of ketamine and benzydamine gargling with placebo on post-operative sore throat: A randomized controlled trial.

    PubMed

    Faiz, Seyed Hamid Reza; Rahimzadeh, Poupak; Poornajafian, Alireza; Nikzad, Naghme

    2014-01-01

    Air way intubation for general anesthesia usually leads to sore throat after surgery. Ketamine plays an important role to block a number of receptors related to pain. Benzydamine hydrochloride is a non-steroidal anti-inflammatory drug that has been used to improve oropharyngeal disorders. In this study, it was intended to compare the effect of gargling different solutions before the surgery on post-operative sore throat (POST) in patients who underwent general anesthesia for hysterectomy. A total of 60 patients who underwent the elective hysterectomy were entered to the randomized controlled trial regarding to the eligibility criteria. Patients were simply randomly allocated to three groups and received one code. Every code was representative for a specific drug: 20 cc normal saline (control group) or 1.5 mg benzydamine in 20 cc solution or 20 mg ketamine in 20 cc solutions. All the research teams were blinded to the received solutions. POST was evaluated with numerical rating scale. The data were entered to SPSS software and analysis of variance (ANOVA) and Kruskal-Wallis one-way analysis of variance test, were performed. The mean ages of ketamine, benzydamine, and normal saline recipients were not significantly different. The trend of the severity of sore throat during the first 24 h after the operation in ketamine recipients was significantly lower than the other two groups (P < 0.001). The pain scale after surgery was reduced by using both ketamine and benzydamine, but the ketamine effect was more noticeable.

  2. Comparison of illumigene Group A Streptococcus Assay with Culture of Throat Swabs from Children with Sore Throats in the New Zealand School-Based Rheumatic Fever Prevention Program.

    PubMed

    Upton, Arlo; Bissessor, Liselle; Farrell, Elizabeth; Shulman, Stanford T; Zheng, Xiaotian; Lennon, Diana

    2016-01-01

    Group A streptococcal (GAS) pharyngitis is a particularly important condition in areas of New Zealand where the incidence of acute rheumatic fever remains unacceptably high. Prompt diagnosis and treatment of GAS pharyngitis are cornerstones of the Rheumatic Fever Prevention Programme, but these are hindered by the turnaround time of culture. Tests with excellent performance and rapid turnaround times are needed. For this study, throat swabs (Copan ESwabs) were collected from schoolchildren self-identifying with a sore throat. Samples were tested by routine culture and the illumigene GAS assay using loop-mediated isothermal amplification. Discrepant results were resolved by retesting of the same specimen by an alternative molecular assay. Seven hundred fifty-seven throat swab specimens were tested by both methods. The performance characteristics of the illumigene assay using culture on blood agar as the "gold standard" and following discrepancy analysis were as follows: sensitivity, 82% and 87%, respectively; specificity, 93% and 98%, respectively; positive predictive value, 61% and 88%, respectively; and negative predictive value, 97% and 97%, respectively. In our unique setting of a school-based throat swabbing program, the illumigene assay did not perform quite as well as described in previous reports. Despite this, its improved sensitivity and rapid turnaround time compared with those of culture are appealing. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  3. Identifying barriers and tailoring interventions to improve the management of urinary tract infections and sore throat: a pragmatic study using qualitative methods

    PubMed Central

    Flottorp, Signe; Oxman, Andrew D

    2003-01-01

    Background Theories of behaviour change indicate that an analysis of factors that facilitate or impede change is helpful when trying to influence professional practice. The aim of this study was to identify barriers to implementing evidence-based guidelines for urinary tract infection and sore throat in general practice in Norway, and to tailor interventions to address these barriers. Methods We used a checklist to identify barriers and possible interventions to address these in an iterative process that included a review of the literature, brainstorming, focus groups, a pilot study, small group discussions and interviews. Results We identified at least one barrier for each category. Both guidelines recommended increased use of telephone consultations and reduced use of laboratory tests, and the barriers and the interventions were similar for the two guidelines. The complexity of changing routines involving patients, general practitioners and general practitioner assistants, loss of income with telephone consultations, fear of overlooking serious disease, perceived patient expectations and lack of knowledge about the evidence for the guidelines were the most prominent barriers. The interventions that were tailored to address these barriers included support for change processes in the practices, increasing the fee for telephone consultations, patient information leaflets and computer-based decision support and reminders. Conclusion A systematic approach using qualitative methods helped identify barriers and generate ideas for tailoring interventions to support the implementation of guidelines for the management of urinary tract infections and sore throat. Lack of resources limited our ability to address all of the barriers adequately. PMID:12622873

  4. Phytochemical, Antimicrobial, and Toxicological Evaluation of Traditional Herbs Used to Treat Sore Throat

    PubMed Central

    Mehreen, Arifa; Waheed, Muzzamil; Liaqat, Iram; Arshad, Najma

    2016-01-01

    The in vitro antibacterial activities of 29 traditional medicinal plants used in respiratory ailments were assessed on multidrug resistant Gram-positive and Gram-negative bacteria isolated from the sore throat patients and two reference strains. The methanolic, n-hexane, and aqueous extracts were screened by the agar well diffusion assay. Bioactive fractions of effective extracts were identified on TLC coupled with bioautography, while their toxicity was determined using haemolytic assay against human erythrocytes. Qualitative and quantitative phytochemical analysis of effective extracts was also performed. Methanolic extract of 18 plants showed antimicrobial activity against test strains. Adhatoda vasica (ZI = 17–21 mm, MIC: 7.12–62.5 μg/mL), Althaea officinalis (ZI = 16–20 mm, MIC: 15.62–31.25 μg/mL), Cordia latifolia (ZI = 16–20 mm, MIC: 12.62–62.5 μg/mL), Origanum vulgare (ZI = 20–22 mm, MIC: 3–15.62 μg/mL), Thymus vulgaris (ZI = 21–25 mm, MIC: 7.81–31.25 μg/mL), and Ziziphus jujuba (ZI = 14–20 mm, MIC: 7.81–31.25 μg/mL) showed significant antibacterial activity. Alkaloid fractions of Adhatoda vasica, Cordia latifolia, and Origanum vulgare and flavonoid fraction of the Althaea officinalis, Origanum vulgare, Thymus Vulgaris, and Ziziphus jujuba exhibited antimicrobial activity. Effective plant extracts show 0.93–0.7% erythrocyte haemolysis. The results obtained from this study provide a scientific rationale for the traditional use of these herbs and laid the basis for future studies to explore novel antimicrobial compounds. PMID:27429983

  5. Phytochemical, Antimicrobial, and Toxicological Evaluation of Traditional Herbs Used to Treat Sore Throat.

    PubMed

    Mehreen, Arifa; Waheed, Muzzamil; Liaqat, Iram; Arshad, Najma

    2016-01-01

    The in vitro antibacterial activities of 29 traditional medicinal plants used in respiratory ailments were assessed on multidrug resistant Gram-positive and Gram-negative bacteria isolated from the sore throat patients and two reference strains. The methanolic, n-hexane, and aqueous extracts were screened by the agar well diffusion assay. Bioactive fractions of effective extracts were identified on TLC coupled with bioautography, while their toxicity was determined using haemolytic assay against human erythrocytes. Qualitative and quantitative phytochemical analysis of effective extracts was also performed. Methanolic extract of 18 plants showed antimicrobial activity against test strains. Adhatoda vasica (ZI = 17-21 mm, MIC: 7.12-62.5 μg/mL), Althaea officinalis (ZI = 16-20 mm, MIC: 15.62-31.25 μg/mL), Cordia latifolia (ZI = 16-20 mm, MIC: 12.62-62.5 μg/mL), Origanum vulgare (ZI = 20-22 mm, MIC: 3-15.62 μg/mL), Thymus vulgaris (ZI = 21-25 mm, MIC: 7.81-31.25 μg/mL), and Ziziphus jujuba (ZI = 14-20 mm, MIC: 7.81-31.25 μg/mL) showed significant antibacterial activity. Alkaloid fractions of Adhatoda vasica, Cordia latifolia, and Origanum vulgare and flavonoid fraction of the Althaea officinalis, Origanum vulgare, Thymus Vulgaris, and Ziziphus jujuba exhibited antimicrobial activity. Effective plant extracts show 0.93-0.7% erythrocyte haemolysis. The results obtained from this study provide a scientific rationale for the traditional use of these herbs and laid the basis for future studies to explore novel antimicrobial compounds.

  6. Effect of magnesium sulfate nebulization on the incidence of postoperative sore throat

    PubMed Central

    Yadav, Monu; Chalumuru, Nitish; Gopinath, Ramachandran

    2016-01-01

    Background and Aims: Postoperative sore throat (POST) is a well-recognized complication after general anesthesia (GA). Numerous nonpharmacological and pharmacological measures have been used for attenuating POST with variable success. The present study was conducted to compare the efficiency of preoperative nebulization of normal saline and magnesium sulfate in reducing the incidence of POST following GA. Materials and Methods: Following institutional ethical committee approval and written informed consent, a prospective randomized double-blinded study was conducted in 100 cases divided into two equal groups. Patients included in the study were of either gender belonging to American Society of Anesthesiologist (ASA) status 1 or 2 undergoing elective surgery of approximately 2 h or more duration requiring tracheal intubation. Patients in Group A are nebulized with 3 ml of normal saline and the patients in Group B are nebulized with 3 ml of 225 mg isotonic nebulized magnesium sulfate for 15 min, 5 min before induction of anesthesia. The incidence of POST at rest and on swallowing and any undue complaints at 0, 2, 4, and 24 h in the postoperative period are evaluated. Results: There is no significant difference in POST at rest during 0th, 2nd and 4th h between normal saline and MgSO4. Significant difference is seen at 24th h, where MgSO4 lessens POST. There is no significant difference in POST on swallowing during 0th and 2nd h between normal saline and MgSO4. Significant difference is seen at 4th h, where MgSO4 has been shown to lessen POST. Conclusions: MgSO4 significantly reduces the incidence of POST compared to normal saline. PMID:27275043

  7. 'I've just taken you to see the man with the CD on his head': the experience and management of recurrent sore throat in children.

    PubMed

    Lock, Catherine; Baker, Rachel; Brittain, Katie

    2010-03-01

    Tonsillectomies for children with recurrent sore throat are common. There is a perception amongst medical professionals that parents are eager for surgical intervention but the parent/child perspective is overlooked in the literature. This study aimed to identify parent/child experience of recurrent sore throat. The study was qualitative, using grounded theory approach to data collection/analysis. Semi-structured, in-depth, interviews were conducted with 12 dyads of children (aged 4-16) and their parents, attending two Ear, Nose and Throat outpatient clinics held at a hospital in North East England, referred by their General Practitioner for recurrent sore throats. Analysis revealed recurrent sore throats significantly affected the families' quality of life. Families felt the need for antibiotics and tonsillectomies although parent and child were not always in agreement over their choice of treatment. Families felt empowered when the health care system showed some flexibility, such as allowing self re-referral, giving families greater choice in the way they managed the condition. Policy makers need to be aware of the consequences of recurrent sore throats in children and the needs of families in managing this chronic condition. More flexible approaches to health care, such as self re-referral and use of waiting list to review symptoms, may be needed if the number of tonsillectomies is to be reduced.

  8. Comparing the effect of ketamine and benzydamine gargling with placebo on post-operative sore throat: A randomized controlled trial

    PubMed Central

    Faiz, Seyed Hamid Reza; Rahimzadeh, Poupak; Poornajafian, Alireza; Nikzad, Naghme

    2014-01-01

    Background: Air way intubation for general anesthesia usually leads to sore throat after surgery. Ketamine plays an important role to block a number of receptors related to pain. Benzydamine hydrochloride is a non-steroidal anti-inflammatory drug that has been used to improve oropharyngeal disorders. In this study, it was intended to compare the effect of gargling different solutions before the surgery on post-operative sore throat (POST) in patients who underwent general anesthesia for hysterectomy. Materials and Methods: A total of 60 patients who underwent the elective hysterectomy were entered to the randomized controlled trial regarding to the eligibility criteria. Patients were simply randomly allocated to three groups and received one code. Every code was representative for a specific drug: 20 cc normal saline (control group) or 1.5 mg benzydamine in 20 cc solution or 20 mg ketamine in 20 cc solutions. All the research teams were blinded to the received solutions. POST was evaluated with numerical rating scale. The data were entered to SPSS software and analysis of variance (ANOVA) and Kruskal-Wallis one-way analysis of variance test, were performed. Results: The mean ages of ketamine, benzydamine, and normal saline recipients were not significantly different. The trend of the severity of sore throat during the first 24 h after the operation in ketamine recipients was significantly lower than the other two groups (P < 0.001). Conclusion: The pain scale after surgery was reduced by using both ketamine and benzydamine, but the ketamine effect was more noticeable. PMID:25371873

  9. Burden of acute sore throat and group A streptococcal pharyngitis in school-aged children and their families in Australia.

    PubMed

    Danchin, Margaret H; Rogers, Susan; Kelpie, Loraine; Selvaraj, Gowri; Curtis, Nigel; Carlin, John B; Nolan, Terence M; Carapetis, Jonathan R

    2007-11-01

    The objective of this study was to determine the incidence, transmission, carriage, and risk factors for group A streptococcal pharyngitis in school-aged children and their families. A 16-month, prospective, family-based cohort study was undertaken from August 2001 through December 2002 in Melbourne, Australia. A total of 202 families (853 people) with at least 1 child aged 3 to 12 years were randomly selected from 3 primary care practices across suburban Melbourne to collect surveillance data for acute group A streptococcal pharyngitis, including serology for index and secondary cases and intermittent carriage data. Cohort retention was 97% for 16 months. The incidence of acute sore throat, group A streptococcal swab-positive pharyngitis, and serologically confirmed group A streptococcal pharyngitis was 33, 13, and 8 per 100 child-years, respectively, for school-aged children (5-12 years) and 60, 20, and 15 per 100 family-years, respectively. Sore throat was less common in adults than children, but adults with sore throat were as likely as children to have group A streptococcal culture-positive or serologically proven pharyngitis. In families who had a primary case, 43% had at least 1 secondary case, and in family members who were at risk, 13% contracted a secondary case. The spring, summer, and winter carriage rates for children were 13%, 8%, and 16%, respectively, and for adults the rate was 2% across all seasons. Group A streptococcal pharyngitis is still common, and the peak incidence occurs in school-aged children. However, the incidence in adults is higher than expected, and the number of secondary cases in families may be an important factor when considering the potential benefits of treatment.

  10. [Changes in intracuff pressure of endotracheal tubes permeable or resistant to nitrous oxide and incidence of postoperative sore throat].

    PubMed

    Sato, Koji; Tanaka, Makoto; Nishikawa, Toshiaki

    2004-07-01

    We assessed the nitrous oxide (N2O) gas-barrier properties of a new endotracheal tube cuff, the Profile Soft-Seal Cuff (Resistant: R) (Sims Portex, Kent, UK). The tracheas of randomly selected patients were intubated with the Profile Cuff (Permeable: P) (Sims Portex) tuble or with Portex Soft-Seal Cuff (R) (n=20 each) endotracheal tube. Cuffs were inflated with air, and intracuff pressure was measured during anesthesia using 67% N2O. Postoperative sore throat was assessed. In addition, the volume-pressure relationship of the cuff was determined in vitro. Cuff pressure increased gradually during anesthesia in both groups. The mean cuff pressure of the group R was significantly lower than that of the group P from 10 minutes to 230 minutes. The inflated gas and the deflated gas were not significantly different in both groups. The incidence of postoperative sore throat was not significantly different between the two groups. In vitro, the mean cuff pressure of the group R was significantly lower than that of the group P. The difference of cuff pressure is considered due to the difference in cuff compliance.

  11. Comparison of Usefulness of Ketamine and Magnesium Sulfate Nebulizations for Attenuating Postoperative Sore Throat, Hoarseness of Voice, and Cough.

    PubMed

    Rajan, Sunil; Malayil, George Jacob; Varghese, Rekha; Kumar, Lakshmi

    2017-01-01

    Postoperative sore throat (POST) is a complication that is unresolved in patients undergoing endotracheal intubation. To compare the effects of ketamine and magnesium sulfate nebulizations in two strengths, on the incidence and severity of POST, hoarseness, and cough. Sixty surgical patients undergoing elective abdominal and lower limb surgeries under combined epidural and general anesthesia were included in this prospective, randomized, double-blinded study. Patients in each group were nebulized with the respective study drug 15 min prior to the surgery, i.e., ketamine in Group K, magnesium sulfate 250 mg, and 500 mg in Group M1 and Group M2, respectively, and normal saline as control in Group C. A standardized anesthesia protocol was followed for all patients. After extubation, the patients were asked to grade POST, hoarseness, and cough at 0, 2, 4, 12, and 24 h. One-way analysis of variance, Chi-square test, Fisher's exact test, paired t-tests, and Wilcoxon's signed-rank test as applicable. Ketamine and magnesium sulfate 500 mg demonstrated a statistically significant decrease in POST at 0, 2, and 4 h, and postoperative hoarseness at 0 h. There was decrease in the incidence and severity of sore throat, hoarseness, and cough at all periods in the study groups as compared with control. Nebulization with ketamine 50 mg and magnesium sulfate 500 mg, 15 min before induction of general anesthesia and intubation, reduce the incidence and severity of POST and hoarseness of voice.

  12. In vitro evaluation of five rapid antigen detection tests for group A beta-haemolytic streptococcal sore throat infections.

    PubMed

    Lasseter, Gemma M; McNulty, Cliodna A M; Richard Hobbs, F D; Mant, David; Little, Paul

    2009-12-01

    Using accurate and easy to use rapid antigen detection tests (RADTs) to identify group A beta-haemolytic Streptococci (GABHS) sore throat infections could reduce unnecessary antibiotic prescribing and antimicrobial resistance. Although there is no international consensus on the use of RADTs, these kits have been widely adopted in Finland, France and the USA. Yet in the UK, the Clinical Knowledge Summaries, that provide the main online guidance for GPs, discourage RADTs use, citing their poor sensitivity and inability to impact on prescribing decisions in acute sore throat infections. The purpose of this study was to evaluate the ease of use and in vitro accuracy (sensitivity and specificity) of the five most commonly used RADTs in Europe (OSOM Ultra, Quickvue Dipstick, Streptatest, Clearview Exact Strep A and IMI Test Pack). To ensure the RADTs were evaluated objectively, a standardized in vitro method using known concentrations of GABHS was used to remove the inherent biases associated with clinical studies. The IMI Test Pack was the easiest RADT to use overall. The ability to detect all positive GABHS (sensitivity) varied considerably between kits from 95% [95% confidence interval (CI): 88-98%], for the IMI Test Pack and OSOM, to 62% (95% CI: 51-72%) for Clearview, at the highest GABHS concentration. None of the RADTs gave any false-positive results with commensal flora-they were 100% specific. The IMI Test Pack is most suitable for use in primary care, as it had high sensitivity, high specificity and was easy to use.

  13. Stakeholders' views of recurrent sore throat, tonsillitis and their management: a qualitative interview study for the NAtional Trial of Tonsillectomy IN Adults (NATTINA Part 1).

    PubMed

    McSweeney, L A; Rousseau, N S; Wilson, J A; Wilkes, S; Haighton, C A

    2017-04-01

    To determine the impact of recurrent sore throats and tonsillitis in adults and stakeholder views of treatment pathways. Qualitative semistructured interview design reporting novel data from a feasibility study for a UK national trial of tonsillectomy in adults. Nine study sites linked to ear, nose and throat departments in National Health Service hospitals located across the United Kingdom. Fifteen patients, 11 general practitioners and 22 ear, nose and throat staff consented to in-depth interviews, which were analysed using a framework analysis approach. Views of stakeholder groups. Recurrent sore throats were reported to severely impact patients' family, work and social life. Ear, nose and throat staff stated that patients faced increasing barriers to secondary care service access. General practitioners were under pressure to reduce 'limited clinical value' surgical procedures. The findings from this study suggest that there is a disconnect between the attitudes of the stakeholders and the reality of recurrent sore throat, tonsillectomy procedures and service provision. More evidence for the role of tonsillectomy is needed from randomised controlled trials to determine whether it should continue to be ranked as a procedure of limited clinical effectiveness. © 2016 John Wiley & Sons Ltd.

  14. 21 CFR 201.315 - Over-the-counter drugs for minor sore throats; suggested warning.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... anesthetic, chewing gum containing aspirin, various mouth washes and gargles and other articles sold over the counter for the relief of minor irritations of the mouth or throat. It will not object to the labeling of...

  15. Tolerability of ibuprofen, aspirin and paracetamol for the treatment of cold and flu symptoms and sore throat pain.

    PubMed

    Moore, N; Le Parc, J M; van Ganse, E; Wall, R; Schneid, H; Cairns, R

    2002-12-01

    This double-blind randomised study compared the tolerability of ibuprofen (up to 1.2 g daily), aspirin and paracetamol (both up to 3 g daily) for up to seven days, in patients with mild to moderate pain resulting from cold/flu symptoms or sore throat (CF/ST) (n = 2,815). The main outcome was the rate of significant adverse events (SGAE). Rates of SGAE for ibuprofen, aspirin and paracetamol were respectively 12.0%, 15.7% and 12.3%. Ibuprofen was significantly better tolerated than aspirin (p = 0.02) and had comparable tolerability with paracetamol. The latter was also true for total digestive system events and for abdominal pain and dyspepsia. In conclusion, in patients with CF/ST, ibuprofen used at over-the-counter doses is as well tolerated as paracetamol and much better tolerated than aspirin.

  16. Effect of Oral Dexamethasone Without Immediate Antibiotics vs Placebo on Acute Sore Throat in Adults: A Randomized Clinical Trial.

    PubMed

    Hayward, Gail Nicola; Hay, Alastair D; Moore, Michael V; Jawad, Sena; Williams, Nicola; Voysey, Merryn; Cook, Johanna; Allen, Julie; Thompson, Matthew; Little, Paul; Perera, Rafael; Wolstenholme, Jane; Harman, Kim; Heneghan, Carl

    2017-04-18

    Acute sore throat poses a significant burden on primary care and is a source of inappropriate antibiotic prescribing. Corticosteroids could be an alternative symptomatic treatment. To assess the clinical effectiveness of oral corticosteroids for acute sore throat in the absence of antibiotics. Double-blind, placebo-controlled randomized trial (April 2013-February 2015; 28-day follow-up completed April 2015) conducted in 42 family practices in South and West England, enrolled 576 adults recruited on the day of presentation to primary care with acute sore throat not requiring immediate antibiotic therapy. Single oral dose of 10 mg of dexamethasone (n = 293) or identical placebo (n = 283). Primary: proportion of participants experiencing complete resolution of symptoms at 24 hours. Secondary: complete resolution at 48 hours, duration of moderately bad symptoms (based on a Likert scale, 0, normal; 6, as bad as it could be), visual analog symptom scales (0-100 mm; 0, no symptom to 100, worst imaginable), health care attendance, days missed from work or education, consumption of delayed antibiotics or other medications, adverse events. Among 565 eligible participants who were randomized (median age, 34 years [interquartile range, 26.0-45.5 year]; 75.2% women; 100% completed the intervention), 288 received dexamethasone; 277, placebo. At 24 hours, 65 participants (22.6%) in the dexamethasone group and 49 (17.7%) in the placebo group achieved complete resolution of symptoms, for a risk difference of 4.7% (95% CI, -1.8% to 11.2%) and a relative risk of 1.28 (95% CI; 0.92 to 1.78; P = .14). At 24 hours, participants receiving dexamethasone were not more likely than those receiving placebo to have complete symptom resolution. At 48 hours, 102 participants (35.4%) in the dexamethasone group vs 75 (27.1%) in the placebo group achieved complete resolution of symptoms, for a risk difference of 8.7% (95% CI, 1.2% to 16.2%) and a relative risk of 1.31 (95% CI, 1.02 to 1

  17. Efficacy and Safety of Ambroxol Lozenges in the Treatment of Acute Uncomplicated Sore Throat - a Pooled Analysis.

    PubMed

    de Mey, C; Koelsch, S; Richter, E; Pohlmann, T; Sousa, R

    2016-07-01

    A pooled analysis is presented of 7 placebo-controlled RCT that investigated lozenges containing ambroxol for pain relief in acute sore throat.2 242 patients were treated with different ambroxol doses or control treatments, 2 183 were evaluable for efficacy. The present analysis is focused on the recommended dose of 20 mg (AXL20): 856 patients were treated with AXL20, 847 with matched placebo lozenges (PL).The average reduction in pain intensity over the first 3 h after the first AXL20 ranged from 38% to 52% of the maximum achievable effect (MAE). The overall treatment difference between AXL20 and PL was 11% (95% CI: 8-13%) of the MAE (post-hoc meta-analysis). The corresponding NNT was 6.0 (CI: 4.7-8.4) for an average pain reduction from baseline of 33% of the MAE over the first 3 h.71.9, 79.0, and 85.3% of the AXL20-patients scored the efficacy as "very good or good" at the end of the 1(st), 2(nd) and 3(rd) day, respectively, vs. 57.5, 64.4, and 70.4% of the PL-patients resulting in odds ratios of 1.9 (CI: 1.5-2.3) for the 1(st), 2.1 (CI: 1.7-2.6) for the 2(nd) and 2.43 (CI: 1.8-3.3) for the 3(rd) day.At the end of treatment 'no redness' or 'slightly red' was scored on pharyngeal inspection in 84.4% and 77.3% of AXL20- and PL-patients (OR: 1.6, CI: 1.3-1.9).AXL20-treatment was well tolerated and is safe and efficacious for acute uncomplicated sore throat of recent onset in adolescent and adult patients. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Effect on postoperative sore throat of spraying the endotracheal tube cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine.

    PubMed

    Hung, Nan-Kai; Wu, Ching-Tang; Chan, Shun-Ming; Lu, Chueng-He; Huang, Yuan-Shiou; Yeh, Chun-Chang; Lee, Meei-Shyuan; Cherng, Chen-Hwan

    2010-10-01

    Postoperative sore throat (POST) is a common complication after endotracheal intubation. We compared the effectiveness on POST of spraying the endotracheal tube (ETT) cuff with benzydamine hydrochloride, 10% lidocaine, and 2% lidocaine. Three hundred seventy-two patients were randomly allocated into 4 groups. The ETT cuffs in each group were sprayed with benzydamine hydrochloride, 10% lidocaine hydrochloride, 2% lidocaine hydrochloride, or normal saline before endotracheal intubation. After insertion, the cuffs were inflated to an airway leak pressure of 20 cm H(2)O. Anesthesia was maintained with propofol. The patients were examined for sore throat (none, mild, moderate, or severe) at 1, 6, 12, and 24 hours after extubation. The highest incidence of POST occurred at 6 hours after extubation in all groups. There was a significantly lower incidence of POST in the benzydamine group than 10% lidocaine, 2% lidocaine, and normal saline groups (P < 0.05) at each observation time point. At 6 hours after extubation, the incidence of POST was significantly lower in the benzydamine group (17.0%) compared with 10% lidocaine (53.7%), 2% lidocaine (37.0%), and normal saline (40.8%) groups (P < 0.05). The benzydamine group had significantly decreased severity of POST compared with the 10% lidocaine, 2% lidocaine, and normal saline groups (P < 0.05) at each observation time point. Compared with the 2% lidocaine and normal saline groups, the 10% lidocaine group had significantly increased severity of POST at 1, 6, and 12 hours after extubation. There were no significant differences among groups in local or systemic side effects. Spraying benzydamine hydrochloride on the ETT cuff is a simple and effective method to reduce the incidence and severity of POST.

  19. The effectiveness of benzydamine hydrochloride spraying on the endotracheal tube cuff or oral mucosa for postoperative sore throat.

    PubMed

    Huang, Yuan-Shiou; Hung, Nan-Kai; Lee, Meei-Shyuan; Kuo, Chang-Po; Yu, Jyh-Cherng; Huang, Go-Shine; Cherng, Chen-Hwan; Wong, Chih-Shung; Chu, Chi-Hong; Wu, Ching-Tang

    2010-10-01

    The etiology of postoperative sore throat (POST) is considered to be the result of laryngoscopy, intubation damage, or inflated cuff compression of the tracheal mucosa. In this study, we compared the effectiveness in alleviating POST using different approaches to benzydamine hydrochloride (BH) administration by spraying the endotracheal tube (ET) cuff or the oropharyngeal cavity, or both. Three hundred eighty patients were included in this prospective and double-blind study, which was randomized into 4 groups: group A, oropharyngeal cavity spray of BH, and distilled water on the ET cuff; group B, both the oropharyngeal cavity and the ET cuff received BH spray; group C, the ET cuff received BH spray, and the oropharyngeal cavity received distilled water; and group D, distilled water sprayed on both the ET tube and into the oropharyngeal cavity. The patients were examined for sore throat (none, mild, moderate, severe) at 0, 2, 4, and 24 hours postextubation. The incidence of POST was 23.2%, 13.8%, 14.7%, and 40.4% in groups A, B, C, and D, respectively. POST occurred significantly less frequently in groups B and C compared with group D (odds ratio: 0.36; 95% confidence interval: 0.21-0.60; P < 0.05). However, there was no significant difference between groups A and D (odds ratio: 0.62; 95% confidence interval: 0.38-1.01). Moreover, there was no significant interaction between spraying BH over the oropharyngeal cavity and the ET cuff on the incidence of POST (P = 0.088). The severity of POST was significantly more intense in group D compared with groups B and C (P < 0.001). Group B had a significantly higher incidence of local numbness, burning, and/or stinging sensation compared with patients in group D (P < 0.05). This study indicates that spraying BH on the ET cuff decreases the incidence and severity of POST without increased BH-related adverse effects.

  20. Comparison of Usefulness of Ketamine and Magnesium Sulfate Nebulizations for Attenuating Postoperative Sore Throat, Hoarseness of Voice, and Cough

    PubMed Central

    Rajan, Sunil; Malayil, George Jacob; Varghese, Rekha; Kumar, Lakshmi

    2017-01-01

    Context: Postoperative sore throat (POST) is a complication that is unresolved in patients undergoing endotracheal intubation. Aim: To compare the effects of ketamine and magnesium sulfate nebulizations in two strengths, on the incidence and severity of POST, hoarseness, and cough. Settings and Design: Sixty surgical patients undergoing elective abdominal and lower limb surgeries under combined epidural and general anesthesia were included in this prospective, randomized, double-blinded study. Subjects and Methods: Patients in each group were nebulized with the respective study drug 15 min prior to the surgery, i.e., ketamine in Group K, magnesium sulfate 250 mg, and 500 mg in Group M1 and Group M2, respectively, and normal saline as control in Group C. A standardized anesthesia protocol was followed for all patients. After extubation, the patients were asked to grade POST, hoarseness, and cough at 0, 2, 4, 12, and 24 h. Statistical Analysis Used: One-way analysis of variance, Chi-square test, Fisher's exact test, paired t-tests, and Wilcoxon's signed-rank test as applicable. Results: Ketamine and magnesium sulfate 500 mg demonstrated a statistically significant decrease in POST at 0, 2, and 4 h, and postoperative hoarseness at 0 h. There was decrease in the incidence and severity of sore throat, hoarseness, and cough at all periods in the study groups as compared with control. Conclusion: Nebulization with ketamine 50 mg and magnesium sulfate 500 mg, 15 min before induction of general anesthesia and intubation, reduce the incidence and severity of POST and hoarseness of voice. PMID:28663608

  1. Prescribing style and variation in antibiotic prescriptions for sore throat: cross-sectional study across six countries.

    PubMed

    Cordoba, Gloria; Siersma, Volkert; Lopez-Valcarcel, Beatriz; Bjerrum, Lars; Llor, Carl; Aabenhus, Rune; Makela, Marjukka

    2015-01-29

    Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescribing style within and across groups of GPs from six countries. Cross-sectional study with the inclusion of 457 GPs and 6394 sore throat patients. We describe variation in prescribing antibiotics for sore throat patients across six countries and assess whether variation in "prescribing style"--understood as a subjective tendency to prescribe--has an important effect on variation in prescription of antibiotics by using the concept of prescribing style as a latent variable in a multivariable model. We report variation as a Median Odds Ratio (MOR) which is the transformation of the random effect variance onto an odds ratio; Thus, MOR = 1 means similar odds or strict homogeneity between GPs' prescribing style, while a MOR higher than 1 denotes heterogeneity in prescribing style. In all countries some GPs always prescribed antibiotics to all their patients, while other GPs never did. After adjusting for patient and GP characteristics, prescribing style in the group of GPs from Russia was about three times more heterogeneous than the prescribing style in the group of GPs from Denmark--Median Odds Ratio (6.8, 95% CI 3.1;8.8) and (2.6, 95% CI 2.2;4.4) respectively. Prescribing style is an important source of variation in prescription of antibiotics within and across countries, even after adjusting for patient and GP characteristics. Interventions aimed at influencing the prescribing style of GPs must encompass context-specific actions at the policy-making level alongside GP-targeted interventions to enable GPs to react more objectively to the external demands that are in place when making the decision of prescribing antibiotics or not.

  2. Who really gets strep sore throat? Confounding and effect modification of a time-varying exposure on recurrent events.

    PubMed

    Follmann, Dean; Huang, Chiung-Yu; Gabriel, Erin

    2016-10-30

    Unmeasured confounding is the fundamental obstacle to drawing causal conclusions about the impact of an intervention from observational data. Typically, covariates are measured to eliminate or ameliorate confounding, but they may be insufficient or unavailable. In the special setting where a transient intervention or exposure varies over time within each individual and confounding is time constant, a different tack is possible. The key idea is to condition on either the overall outcome or the proportion of time in the intervention. These measures can eliminate the unmeasured confounding either by conditioning or by use of a proxy covariate. We evaluate existing methods and develop new models from which causal conclusions can be drawn from such observational data even if no baseline covariates are measured. Our motivation for this work was to determine the causal effect of Streptococcus bacteria in the throat on pharyngitis (sore throat) in Indian schoolchildren. Using our models, we show that existing methods can be badly biased and that sick children who are rarely colonized have a high probability that the Streptococcus bacteria are causing their disease. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  3. Effect of prophylactic benzydamine hydrochloride on postoperative sore throat and hoarseness after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled trial.

    PubMed

    Chang, Jee-Eun; Min, Seong-Won; Kim, Chong-Soo; Han, Sung-Hee; Kwon, Yong-Suk; Hwang, Jin-Young

    2015-10-01

    We evaluated the prophylactic effect of benzydamine hydrochloride (BH) spray on postoperative sore throat and hoarseness secondary to intubation with a double-lumen endobronchial tube (DLT). Ninety-two adult patients undergoing thoracic surgery using DLT intubation were studied. The DLT cuff and oropharyngeal cavity were sprayed with normal saline (Group S; n = 46) or BH (Group BH; n = 46) prior to intubation. Postoperative sore throat and hoarseness were evaluated at one, six, and 24 hr after surgery. Sore throat was evaluated using a 0-100 mm visual analogue scale (VAS). Hoarseness was defined as a change in voice quality. Compared with Group S, postoperative sore throat occurred less frequently in Group BH at one hour (mean difference, 28.3%; 95% confidence interval [CI], 8.7 to 45.1; P = 0.01), at six hours (mean difference, 32.6%; 95% CI, 12.6 to 49.2; P < 0.01), and at 24 hr (mean difference, 28.3%; 95% CI, 9.3 to 44.7; P = 0.01) after surgery. Group BH had lower VAS scores for postoperative sore throat at one hour (mean difference, 12.8; 95% CI, 4.9 to 20.7), at six hours (mean difference, 11.9; 95% CI, 4.8 to 19.1; P < 0.01), and at 24 hr (mean difference, 5.3; 95% CI, 0.9 to 9.7; P = 0.01) after surgery. Hoarseness also occurred less frequently in Group BH at one hour (mean difference, 23.9%; 95% CI, 6.8 to 39.6; P = 0.01), at six hours (mean difference, 23.9%; 95% CI, 7.4 to 39.3; P = 0.01), and at 24 hr (mean difference, 21.7%; 95% CI, 5.5 to 37.0; P = 0.02) after surgery (P < 0.01). Prophylactic application of BH to the DLT cuff and oropharyngeal cavity reduces the incidence and severity of postoperative sore throat and the incidence of hoarseness associated with DLT intubation. The trial was registered at the Clinical Research Information Service (KCT0001068).

  4. Efficacy of disintegrating aspirin in two different models for acute mild-to-moderate pain: sore throat pain and dental pain.

    PubMed

    Voelker, M; Schachtel, B P; Cooper, S A; Gatoulis, S C

    2016-02-01

    A recently developed fast-release aspirin tablet formulation has been evaluated in two different pain models. The dental impaction pain model and the sore throat pain model are widely used for assessing analgesia, including acute mild-to-moderate pain. Both studies were double-blind, randomized, parallel group and compared a single dose of 1000 mg aspirin with 1000 mg paracetamol and with placebo and investigated the onset and overall time course of pain relief. Speed of onset was measured by the double-stopwatch method for time to meaningful pain relief and time to first perceptible pain relief. Pain intensity and pain relief were rated subjectively over a 6-h (dental pain) and 2-h (sore throat pain) time period. In both models fast-release aspirin and commercial paracetamol were statistically significantly different from placebo for onset of action, summed pain intensity differences and total pain relief. Meaningful pain relief was achieved within a median of 42.3 and 42.9 min for aspirin and paracetamol, respectively, in the dental pain model. The corresponding numbers in sore throat pain were 48.0 and 40.4 min. All treatments in both studies were safe and well tolerated. No serious adverse events were reported and no subject was discontinued due to an adverse event. Overall the two studies clearly demonstrated efficacy over placebo in the two pain models and a comparable efficacy and safety profile between aspirin and an equivalent dose of paracetamol under the conditions of acute dental pain and acute sore throat pain. Trial registration These trials were registered with ClinicalTrials.gov, registration number: NCT01420094, registration date: July 27, 2011 and registration number: NCT01453400, registration date: October 13, 2011.

  5. Effect of preoperative licorice lozenges on incidence of postextubation cough and sore throat in smokers undergoing general anesthesia and endotracheal intubation.

    PubMed

    Gupta, Diyva; Agrawal, Sanjay; Sharma, Jagdish P

    2013-06-01

    Post-Operative Sore Throat (POST) is an undesirable side effect ofendotracheal intubation. Pharmacological and non-pharmacological measures have been utilized for minimizing the morbidity caused by POST. We have tested whether medicated lozenges of Licorice provides efficacy in decreasing POST in smokers presenting for surgery under general anesthesia with endotracheal intubation. 100 patients, 20 - 65 years, American Society ofAnaesthesiologists (ASA) physical status Grade I & II, of either sex, with history of smoking, and posted for elective surgical procedure lasting more than one hour and requiring general anesthesia with endotracheal intubation were included and randomly divided into two groups (n = 50) to receive Licorice lozenges (Group A) and Sugar Candy (Group B). The patients were assessed for cough, sore throat and hoarseness of voice immediately after extubation and then at 30 min, 12 hrs and 24 hrs after extubation utilizing scoring system of Harding and McVey. Overall incidence of postextubation cough was less in Group A (12 patients, 24%) compared to Group B (26 patients, 52%) (p = 0.002). Magnitude of sore throat (Grades 0/1/2/3) was seen in 48/2/0/0 patients (Group A) and 46/4/0/0 (Group B) at extubation (p = 0.40) and 34/16/0/0 (Group A) and 28/20/2/0 (Group B) at 30 min (p = 0.17). At 12 and 24 hours, the magnitudes of sore throats were 24/25/1/0 (Group A) & 12/38/0/0 (Group B) (p = 0.02) and 26/23/1/0 (Group A) & 15/35/0/0 (Group B) (p = 0.03) respectively. Use of licorice lozenges is efficacious for reducing the distressing complaint of POST in postoperative period among smokers.

  6. Pain relief of sore throat with a new anti-inflammatory throat lozenge, ibuprofen 25 mg: A randomised, double-blind, placebo-controlled, international phase III study.

    PubMed

    Bouroubi, Athmane; Donazzolo, Yves; Donath, Franck; Eccles, Ron; Russo, Marc; Harambillet, Nadine; Gautier, Stéphanie; Montagne, Agnès

    2017-09-04

    The aim of this study was to compare the efficacy and safety of a new oromucosal ibuprofen form, ibuprofen 25 mg lozenge, in single and repeat dosing for up to 4 days, to the matched placebo, in the treatment of acute sore throat pain in adults. In this randomised, double-blind, placebo-controlled trial, adult patients with non-streptococcal sore throat and signs of moderate-to-severe associated pain (≥5 on the objective Tonsillo-Pharyngitis Assessment 21-point scale and ≥60 mm on the subjective 0-100 mm visual analogue Sore Throat Pain Intensity Scale [STPIS]) were assigned ibuprofen 25 mg (n=194) or matching placebo (n=191) lozenge treatment. Efficacy was assessed (at the investigating centre up to 2 hours after first dosing, then on an ambulatory basis) by parameters derived from patient's scores on scales of pain relief, pain intensity, and global efficacy assessment. The primary efficacy end-point was the time-weighted TOTal PAin Relief (TOTPAR) over 2 hours after first dosing using the Sore Throat Relief Scale (STRS). Safety and local tolerability were assessed. Ibuprofen 25 mg was superior to placebo on numerous pain relief parameters; TOTPAR was significantly higher with ibuprofen 25 mg over 2 hours after first dosing (P<.05), the effect being apparent from the first evaluation at 15 minutes (P<.05). The STPIS reduction in favour of ibuprofen 25 mg was not significant vs placebo. Mean STRS scores and patient's global efficacy assessment both reflected a higher efficacy of ibuprofen 25 mg over the 4-day treatment period with tests of statistical significance up to day 1 evening (P<.05), and, in patients with still clinically significant pain (n=128), after an average 4 days (P<.01). Ibuprofen 25 mg lozenge was well tolerated with a safety profile similar to placebo. Low-dose ibuprofen 25 mg lozenge in repeat dosing provides in adults more efficacious and rapid relief of sore throat pain and is as well tolerated as placebo. Clinical

  7. Canker Sores

    MedlinePlus

    Canker sores are small, round sores in your mouth. They can be on the inside of your cheek, under your tongue, or in the back of your throat. They usually have a red edge and a gray center. They can be quite painful. They are ...

  8. Comparison between betamethasone gel applied over endotracheal tube and ketamine gargle for attenuating postoperative sore throat, cough and hoarseness of voice.

    PubMed

    Shaaban, Ahmad R; Kamal, Sahar M

    2012-02-01

    Tracheal intubation for general anesthesia often leads to trauma of the airway mucosa resulting in postoperative sore throat, hoarseness of voice and cough. The aim of this study was to evaluate two different methods as regard their efficacy for controlling the postoperative pharyngo-laryngo-tracheal sequelae (sore throat, cough, hoarseness of voice) after general anesthesia with laryngoscopy and tracheal intubation. We compared between the effects of betamethasone gel applied over the endotracheal tube and gargling with ketamine solution in reducing these complications during the first 24 postoperative hours after elective surgical procedures in a prospective randomized controlled single blind clinical trial. Seventy five patients ASA physical status I and II, undergoing elective surgery under general anesthesia using endotracheal intubation were enrolled in this prospective, randomized, single-blind study. Patients were randomly divided into 3 groups of 25 patients each: Group (K): (n: 25) Patients in this group were asked to gargle with ketamine 40 mg in 30 ml saline for 60 seconds as repeated smaller attempts, 5 minutes before induction of anesthesia. Group (B) (n: 25): Endotracheal tubes were lubricated with 0.05% betamethasone gel. Group (C) (n: 25): patients did not receive ketamine gargle nor betamethasone gel. The incidence and the severity of Postoperative sore throat, cough, and hoarseness of voice were graded at 0, 2, 4, and 24 h after operation by a blinded investigator. The incidence and severity of sore throat were significantly lower in group (K) and group (B) than group (C) (p < 0.05) at all time intervals. While there was no significant difference between group (K) and group (B) (p > 0.05). The incidence and severity of cough and hoarseness of voice were significantly lower in group (B) than group (C) and group (k) (p < 0.05) at all time intervals. Gargling with ketamine before induction of anesthesia is comparable with application of 0

  9. PRImary care Streptococcal Management (PRISM) study: identifying clinical variables associated with Lancefield group A β-haemolytic streptococci and Lancefield non-Group A streptococcal throat infections from two cohorts of patients presenting with an acute sore throat.

    PubMed

    Little, Paul; Moore, Michael; Hobbs, F D R; Mant, David; McNulty, Cliodna; Williamson, Ian; Cheng, Edith; Stuart, Beth; Kelly, Joanne; Barnett, Jane; Mullee, Mark

    2013-10-25

    To assess the association between features of acute sore throat and the growth of streptococci from culturing a throat swab. Diagnostic cohort. UK general practices. Patients aged 5 or over presenting with an acute sore throat. Patients were recruited for a second cohort (cohort 2, n=517) consecutively after the first (cohort 1, n=606) from similar practices. Predictors of the presence of Lancefield A/C/G streptococci. The clinical score developed from cohort 1 had poor discrimination in cohort 2 (bootstrapped estimate of area under the receiver operator characteristic (ROC) curve (0.65), due to the poor validity of the individual items in the second data set. Variables significant in multivariate analysis in both cohorts were rapid attendance (prior duration 3 days or less; multivariate adjusted OR 1.92 cohort, 1.67 cohort 2); fever in the last 24 h (1.69, 2.40); and doctor assessment of severity (severely inflamed pharynx/tonsils (2.28, 2.29)). The absence of coryza or cough and purulent tonsils were significant in univariate analysis in both cohorts and in multivariate analysis in one cohort. A five-item score based on Fever, Purulence, Attend rapidly (3 days or less), severely Inflamed tonsils and No cough or coryza (FeverPAIN) had moderate predictive value (bootstrapped area under the ROC curve 0.73 cohort 1, 0.71 cohort 2) and identified a substantial number of participants at low risk of streptococcal infection (38% in cohort 1, 36% in cohort 2 scored ≤1, associated with a streptococcal percentage of 13% and 18%, respectively). A Centor score of ≤1 identified 23% and 26% of participants with streptococcal percentages of 10% and 28%, respectively. Items widely used to help identify streptococcal sore throat may not be the most consistent. A modified clinical scoring system (FeverPAIN) which requires further validation may be clinically helpful in identifying individuals who are unlikely to have major pathogenic streptococci.

  10. A multicentre, randomised, double-blind, single-dose study assessing the efficacy of AMC/DCBA Warm lozenge or AMC/DCBA Cool lozenge in the relief of acute sore throat.

    PubMed

    Wade, Alan G; Morris, Christopher; Shephard, Adrian; Crawford, Gordon M; Goulder, Michael A

    2011-02-18

    Clinically proven over-the-counter (OTC) treatment options are becoming increasingly important in the self-management of acute sore throat. The aim of this study was to determine the analgesic and sensorial benefits of two different amylmetacresol/2,4-dichlorobenzyl alcohol (AMC/DCBA) throat lozenge formulation variants, AMC/DCBA Warm lozenge and AMC/DCBA Cool lozenge, compared with an unflavoured, non-medicated placebo lozenge in the relief of acute sore throat due to upper respiratory tract infections. In this multicentre, randomised, double-blind, single-dose study, 225 adult patients with acute sore throat were randomly assigned to receive either one AMC/DCBA Warm lozenge (n = 77), one AMC/DCBA Cool lozenge (n = 74) or one unflavoured, non-medicated lozenge (matched for size, shape and demulcency; n = 74). After baseline assessments, patients received their assigned lozenge and completed four rating assessments at 11 timepoints from 1 to 120 minutes post dose. Analgesic properties were assessed by comparing severity of throat soreness and sore throat relief ratings. Difficulty in swallowing, throat numbness, functional, sensorial and emotional benefits were also assessed. Both the AMC/DCBA Warm and AMC/DCBA Cool lozenge induced significant analgesic, functional, sensorial and emotional effects compared with the unflavoured, non-medicated lozenge. Sore throat relief, improvements in throat soreness and difficulty in swallowing, and throat numbness were observed as early as 1-5 minutes, and lasted up to 2 hours post dose. Sensorial benefits of warming and cooling associated with the AMC/DCBA Warm and AMC/DCBA Cool lozenge, respectively, were experienced soon after first dose, and in the case of the latter, it lasted long after the lozenge had dissolved. Emotional benefits of feeling better, happier, less distracted and less frustrated were reported in those taking either of the AMC/DCBA throat lozenge variants, with no differences in adverse events compared with

  11. Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review.

    PubMed

    Morad, Anna; Sathe, Nila A; Francis, David O; McPheeters, Melissa L; Chinnadurai, Sivakumar

    2017-02-01

    The effectiveness of tonsillectomy or adenotonsillectomy ("tonsillectomy") for recurrent throat infection compared with watchful waiting is uncertain. To compare sleep, cognitive, behavioral, and health outcomes of tonsillectomy versus watchful waiting in children with recurrent throat infections. MEDLINE, Embase, and the Cochrane Library. Two investigators independently screened studies against predetermined criteria. One investigator extracted data with review by a second. Investigators independently assessed risk of bias and strength of evidence (SOE) and confidence in the estimate of effects. Seven studies including children with ≥3 infections in the previous 1 to 3 years addressed this question. In studies reporting baseline data, number of infections/sore throats decreased from baseline in both groups, with greater decreases in sore throat days, clinician contacts, diagnosed group A streptococcal infections, and school absences in tonsillectomized children in the short term (<12 months). Quality of life was not markedly different between groups at any time point. Few studies fully categorized infection/sore throat severity; attrition was high. Throat infections, utilization, and school absences improved in the first postsurgical year in tonsillectomized children versus children not receiving surgery. Benefits did not persist over time; longer-term outcomes are limited. SOE is moderate for reduction in short-term throat infections and insufficient for longer-term reduction. SOE is low for no difference in longer-term streptococcal infection reduction. SOE is low for utilization and missed school reduction in the short term, low for no difference in longer-term missed school, and low for no differences in quality of life. Copyright © 2017 by the American Academy of Pediatrics.

  12. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management).

    PubMed

    Little, Paul; Hobbs, F D Richard; Moore, Michael; Mant, David; Williamson, Ian; McNulty, Cliodna; Cheng, Ying Edith; Leydon, Geraldine; McManus, Richard; Kelly, Joanne; Barnett, Jane; Glasziou, Paul; Mullee, Mark

    2013-10-10

    To determine the effect of clinical scores that predict streptococcal infection or rapid streptococcal antigen detection tests compared with delayed antibiotic prescribing. Open adaptive pragmatic parallel group randomised controlled trial. Primary care in United Kingdom. Patients aged ≥ 3 with acute sore throat. An internet programme randomised patients to targeted antibiotic use according to: delayed antibiotics (the comparator group for analyses), clinical score, or antigen test used according to clinical score. During the trial a preliminary streptococcal score (score 1, n=1129) was replaced by a more consistent score (score 2, n=631; features: fever during previous 24 hours; purulence; attends rapidly (within three days after onset of symptoms); inflamed tonsils; no cough/coryza (acronym FeverPAIN). Symptom severity reported by patients on a 7 point Likert scale (mean severity of sore throat/difficulty swallowing for days two to four after the consultation (primary outcome)), duration of symptoms, use of antibiotics. For score 1 there were no significant differences between groups. For score 2, symptom severity was documented in 80% (168/207 (81%) in delayed antibiotics group; 168/211 (80%) in clinical score group; 166/213 (78%) in antigen test group). Reported severity of symptoms was lower in the clinical score group (-0.33, 95% confidence interval -0.64 to -0.02; P=0.04), equivalent to one in three rating sore throat a slight versus moderate problem, with a similar reduction for the antigen test group (-0.30, -0.61 to -0.00; P=0.05). Symptoms rated moderately bad or worse resolved significantly faster in the clinical score group (hazard ratio 1.30, 95% confidence interval 1.03 to 1.63) but not the antigen test group (1.11, 0.88 to 1.40). In the delayed antibiotics group, 75/164 (46%) used antibiotics. Use of antibiotics in the clinical score group (60/161) was 29% lower (adjusted risk ratio 0.71, 95% confidence interval 0.50 to 0.95; P=0.02) and in the

  13. Protocol for north of England and Scotland study of tonsillectomy and adeno-tonsillectomy in children (NESSTAC). A pragmatic randomised controlled trial comparing surgical intervention with conventional medical treatment in children with recurrent sore throats

    PubMed Central

    Bond, John; Wilson, Janet; Eccles, Martin; Vanoli, Alessandra; Steen, Nick; Clarke, Ray; Zarod, Andrew; Lock, Catherine; Brittain, Katie; Speed, Chris; Rousseau, Nikki

    2006-01-01

    Background Uncertainties surrounding the effectiveness and cost-effectiveness of childhood tonsillectomy for recurrent sore throat led the NHS Health Technology Assessment Programme to commission this research to evaluate the effectiveness and cost-effectiveness of tonsillectomy and adeno-tonsillectomy in comparison with standard non-surgical management in children aged under 16 with recurrent throat infections. The aim is to evaluate if tonsillectomy and adeno-tonsillectomy reduces the number of episodes of sore throats among children to a clinically significant extent. Methods/design A simple prospective pragmatic randomised controlled trial with economic analysis and prospective cohort study of non-trial participants comparing surgical intervention with conventional medical treatment. The treatment arm will receive tonsillectomy and adeno-tonsillectomy while in the control arm non-surgical conventional medical treatment only will be used. The primary outcome measure will be reported number of episodes of sore throat over two years with secondary outcomes measures of reported number of episodes of sore throat, otitis media and upper respiratory tract infection which invoke a GP consultation; reported number of symptom-free days; reported severity of sore throats and surgical and anaesthetic morbidity. The study will take place in five hospitals in the UK. The trial population will be 406 children aged 4–15 on their last birthday with recurrent sore throat referred by primary care to the 5 otolaryngology departments. The duration of the study is seven years (July 2001- July 2008). Discussion As with all pragmatic randomised controlled trials it is impossible to control the external environment in which the research is taking place. Since this trial began a number of factors have arisen which could affect the outcome including; a reduction in the incidence of respiratory tract infections, marked socio-economic differences in consultation rates, the results from

  14. PRImary care Streptococcal Management (PRISM) study: identifying clinical variables associated with Lancefield group A β-haemolytic streptococci and Lancefield non-Group A streptococcal throat infections from two cohorts of patients presenting with an acute sore throat

    PubMed Central

    Little, Paul; Moore, Michael; Hobbs, F D R; Mant, David; McNulty, Cliodna; Williamson, Ian; Cheng, Edith; Stuart, Beth; Kelly, Joanne; Barnett, Jane; Mullee, Mark

    2013-01-01

    Objective To assess the association between features of acute sore throat and the growth of streptococci from culturing a throat swab. Design Diagnostic cohort. Setting UK general practices. Participants Patients aged 5 or over presenting with an acute sore throat. Patients were recruited for a second cohort (cohort 2, n=517) consecutively after the first (cohort 1, n=606) from similar practices. Main outcome Predictors of the presence of Lancefield A/C/G streptococci. Results The clinical score developed from cohort 1 had poor discrimination in cohort 2 (bootstrapped estimate of area under the receiver operator characteristic (ROC) curve (0.65), due to the poor validity of the individual items in the second data set. Variables significant in multivariate analysis in both cohorts were rapid attendance (prior duration 3 days or less; multivariate adjusted OR 1.92 cohort, 1.67 cohort 2); fever in the last 24 h (1.69, 2.40); and doctor assessment of severity (severely inflamed pharynx/tonsils (2.28, 2.29)). The absence of coryza or cough and purulent tonsils were significant in univariate analysis in both cohorts and in multivariate analysis in one cohort. A five-item score based on Fever, Purulence, Attend rapidly (3 days or less), severely Inflamed tonsils and No cough or coryza (FeverPAIN) had moderate predictive value (bootstrapped area under the ROC curve 0.73 cohort 1, 0.71 cohort 2) and identified a substantial number of participants at low risk of streptococcal infection (38% in cohort 1, 36% in cohort 2 scored ≤1, associated with a streptococcal percentage of 13% and 18%, respectively). A Centor score of ≤1 identified 23% and 26% of participants with streptococcal percentages of 10% and 28%, respectively. Conclusions Items widely used to help identify streptococcal sore throat may not be the most consistent. A modified clinical scoring system (FeverPAIN) which requires further validation may be clinically helpful in identifying individuals who are

  15. Utility and sensitivity of the sore throat pain model: results of a randomized controlled trial on the COX-2 selective inhibitor valdecoxib.

    PubMed

    Schachtel, Bernard P; Pan, Sharon; Kohles, Joseph D; Sanner, Kathleen M; Schachtel, Emily P; Bey, Mary

    2007-07-01

    The sore throat pain model was employed in this randomized, placebo-controlled trial to examine the sensitivity of the model in testing the efficacy of valdecoxib as an acute analgesic drug. Changes were made to the study design by employing a different diagnostic index for tonsillo-pharyngitis, a different rating scale (derived from Lasagna's pain thermometer), and alternative analyses, individual responder rates. Under double-blind conditions, 197 patients with painful pharyngitis were randomly allocated to valdecoxib 20 mg bid (n = 65), valdecoxib 40 mg qd (n = 66), or placebo (n = 66) for 24 hours. The expanded Tonsillo-Pharyngitis Assessment and the Lasagna Pain Scale were validated as sensitive study instruments. Both dosage regimens provided significantly greater pain relief compared with placebo on standard efficacy measures over the 24-hour study (all P < .05). Tests for individual response (eg, percentage of patients with at least moderate relief) confirmed these results, and other response rates identified the high sensitivity of the model itself (eg, only 5% of placebo-treated patients achieved >or=50% of maximum total pain relief over 6 hours). These findings indicate that sore throat is a sensitive model to assess analgesic efficacy.

  16. Postoperative Sore Throat Prevention in Ambulatory Surgery: A Comparison between Preoperative Aspirin and Magnesium Sulfate Gargle – A Prospective, Randomized, Double-blind Study

    PubMed Central

    Chattopadhyay, Surajit; Das, Anjan; Nandy, Sabyasachi; RoyBasunia, Sandip; Mitra, Tapobrata; Halder, Partha Sarathi; Chhaule, Subinay; Mandal, Subrata Kumar

    2017-01-01

    Background: Postoperative sore throat (POST) frequently hampers the positive feedback of ambulatory surgery in spite of so many measures. This study was carried out to compare the efficacy of preoperative magnesium sulfate and aspirin gargle in preventing POST after ambulatory surgery. Materials and Methods: It was a prospective, randomized, and double-blinded study. Fifty-six adult patients of either sex, aged 25–50, of American Society of Anesthesiologists physical status I–II, scheduled for day care surgery, were randomly allocated to Group A ([n = 28] receiving aspirin gargle [325 mg tablet]) and Group M ([n = 28] receiving magnesium sulfate [20 mg/kg] gargle). In both groups, the medications were made into 20 mL of (5% dextrose) solution. Patients were asked to gargle with this mixture for 30 s, 15 min before induction of anesthesia. Episodes of POST were measured at 0, 2, 4, 6, 9, 12, and 16 h postoperatively with a four-point scale. Results: Both groups had a similar demographic profile with comparable oxygen saturation, hemodynamics, and consciousness status at immediate postoperative period. Number of patients with sore throat was significantly lower in magnesium group compared to aspirin group at 0 h (P = 0.0376), 2 h (P = 0.0429), 4 h (P = 0.0394) after the operation. POST pain score (visual analog scale) was significantly (P < 0.05) lower in magnesium group compared to aspirin group after the operation at 0, 2, 4 h after operation. Conclusion: It is evident that preoperative magnesium sulfate gargle significantly attenuated the incidence and severity of POST, especially in the early postoperative period, with no adverse effects in patients undergoing day care surgery under general anesthesia. PMID:28298764

  17. Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review

    PubMed Central

    Herbert, Rob D; Gabriel, Michael

    2002-01-01

    Objective To determine the effects of stretching before and after exercising on muscle soreness after exercise, risk of injury, and athletic performance. Method Systematic review. Data sources Randomised or quasi-randomised studies identified by searching Medline, Embase, CINAHL, SPORTDiscus, and PEDro, and by recursive checking of bibliographies. Main outcome measures Muscle soreness, incidence of injury, athletic performance. Results Five studies, all of moderate quality, reported sufficient data on the effects of stretching on muscle soreness to be included in the analysis. Outcomes seemed homogeneous. Stretching produced small and statistically non-significant reductions in muscle soreness. The pooled estimate of reduction in muscle soreness 24 hours after exercising was only 0.9 mm on a 100 mm scale (95% confidence interval −2.6 mm to 4.4 mm). Data from two studies on army recruits in military training show that muscle stretching before exercising does not produce useful reductions in injury risk (pooled hazard ratio 0.95, 0.78 to 1.16). Conclusions Stretching before or after exercising does not confer protection from muscle soreness. Stretching before exercising does not seem to confer a practically useful reduction in the risk of injury, but the generality of this finding needs testing. Insufficient research has been done with which to determine the effects of stretching on sporting performance. What is already known on this topicReviews of the effects of stretching before exercising have drawn conflicting conclusionsThe literature on effects of stretching before and after exercising on muscle soreness and risk of injury has not been systematically reviewedWhat this study addsStretching before and after exercising does not confer protection from muscle soreness and stretching before exercise does not seem to confer a practically useful reduction in the risk of injury PMID:12202327

  18. The effect of lidocaine jelly on a taper-shaped cuff of an endotracheal tube on the postoperative sore throat: a prospective randomized study: A CONSORT compliant article.

    PubMed

    Lee, Jiwon; Lee, Yong-Cheol; Son, Je-Do; Lee, Jae-Yoon; Kim, Hyun-Chang

    2017-09-01

    Postoperative sore throat (POST) following general anesthesia with endotracheal intubation is a common complication. We hypothesized that lidocaine jelly applied to the tapered cuff of the endotracheal tube (ETT) might decrease the incidence of POST most commonly arising from endotracheal intubation. A total of 208 patients under general anesthesia were randomly assigned into 1 of 2 groups. In the lidocaine group (n = 104), the distal part of ETTs with tapered-shaped cuff was lubricated with lidocaine jelly. In the control group (n = 104), the distal part of ETTs with tapered-shaped cuff was lubricated with normal saline. The incidence of POST, hoarseness, and cough in the postanesthesia patients was compared. The overall incidence of POST was higher in the lidocaine group than in the normal saline group [60 (58%) vs 40 (39%), P = .006]. The incidence of POST at 1 hour postoperatively was higher in the lidocaine group than in the normal saline group [53 (51%) vs 32 (31%), P = .003]. The overall incidence of hoarseness for 24 hours postoperatively was comparable (P = .487). The overall incidence of cough for 24 hours postoperatively is higher in the lidocaine group (P = .045). The lidocaine jelly applied at the distal part of ETT with tapered-shaped cuff increased the overall incidence of POST in patients undergoing general anesthesia.

  19. The effect of lidocaine jelly on a taper-shaped cuff of an endotracheal tube on the postoperative sore throat: a prospective randomized study

    PubMed Central

    Lee, Jiwon; Lee, Yong-Cheol; Son, Je-Do; Lee, Jae-Yoon; Kim, Hyun-Chang

    2017-01-01

    Abstract Background: Postoperative sore throat (POST) following general anesthesia with endotracheal intubation is a common complication. We hypothesized that lidocaine jelly applied to the tapered cuff of the endotracheal tube (ETT) might decrease the incidence of POST most commonly arising from endotracheal intubation. Methods: A total of 208 patients under general anesthesia were randomly assigned into 1 of 2 groups. In the lidocaine group (n = 104), the distal part of ETTs with tapered-shaped cuff was lubricated with lidocaine jelly. In the control group (n = 104), the distal part of ETTs with tapered-shaped cuff was lubricated with normal saline. The incidence of POST, hoarseness, and cough in the postanesthesia patients was compared. Results: The overall incidence of POST was higher in the lidocaine group than in the normal saline group [60 (58%) vs 40 (39%), P = .006]. The incidence of POST at 1 hour postoperatively was higher in the lidocaine group than in the normal saline group [53 (51%) vs 32 (31%), P = .003]. The overall incidence of hoarseness for 24 hours postoperatively was comparable (P = .487). The overall incidence of cough for 24 hours postoperatively is higher in the lidocaine group (P = .045). Conclusion: The lidocaine jelly applied at the distal part of ETT with tapered-shaped cuff increased the overall incidence of POST in patients undergoing general anesthesia. PMID:28906414

  20. An evaluation of the efficacy of aspirin and benzydamine hydrochloride gargle for attenuating postoperative sore throat: a prospective, randomized, single-blind study.

    PubMed

    Agarwal, Anil; Nath, S S; Goswami, Debolina; Gupta, Devendra; Dhiraaj, Sanjay; Singh, Prabhat K

    2006-10-01

    Postoperative sore throat (POST), although a minor complication, remains a source of postoperative morbidity. We compared the efficacy of dispersible aspirin gargle to benzydamine hydrochloride (a topical nonsteroidal anti inflammatory drug) gargles for prevention of POST. We enrolled 60 consecutive female patients, 16-60 yr of age, ASA physical status I or II, undergoing elective modified radical mastectomy under general anesthesia in this prospective, randomized, placebo-controlled, single-blind study. Patients were randomly divided into 3 groups of 20 subjects each: Group 1 (C) mineral water; Group 2 (AS) tab aspirin 350 mg; and Group 3 (BH) 15 mL of benzydamine hydrochloride (0.15%). All the medications were made into 30 mL of solution. Patients were asked to gargle this mixture for 30 s, 5 min before induction of anesthesia. Grading of POST was done at 0, 2, 4, and 24 h postoperatively on a 4-point scale (0-3). Aspirin gargles reduced the incidence of POST for 4 h whereas benzydamine hydrochloride gargles reduced POST for 24 h. POST was more severe in the control group at 0 and 2 h (P < 0.05). Aspirin and benzydamine hydrochloride gargles significantly reduced the incidence and severity of POST (P < 0.05).

  1. The effect of ketorolac and dexamethasone on the incidence of sore throat in women after thyroidectomy: a prospective double-blinded randomized trial

    PubMed Central

    2017-01-01

    Background We evaluated the effect of two drugs with anti-inflammatory action, dexamethasone and ketorolac, on reduction of postoperative sore throat (POST) after general anesthesia with endotracheal intubation in patients undergoing thyroidectomy. Methods One hundred and ninety-two female patients scheduled to undergo general anesthesia with endotracheal intubation for thyroidectomy were enrolled in this prospective study. Participants were randomly allocated to receive intravenous medication; placebo (Group C, n = 45), ketorolac 30 mg immediately before intubation (Group Kpre, n = 47), ketorolac 30 mg at the end of surgery (Group Kpost, n = 45) and dexamethasone 10 mg (Group D, n = 43). The incidence and severity of POST and hoarseness were evaluated at 1, 6 and 24 hours after surgery. Results Incidences and severities of POST at rest and during swallowing in first 6 hours after extubation were comparable among 4 groups. At 24 hours postextubation, the incidence (P = 0.002, 95% CI of proportion differences; 0.05–0.39) and severity (P = 0.008) of POST during swallowing were significantly lower in group D than in group C. Kpre and Kpost groups did not show a greater reduction in POST than group C, despite lower rescue analgesic requirement at 1 hour after extubation in group Kpre (P = 0.006; 95% CI of proportion differences; 0.07–0.38). No intergroup differences were observed in incidences of hoarseness or adverse events. Conclusions Intravenous administration of dexamethasone 10 mg, but not ketorolac, before induction of anesthesia reduces the incidence and severity of POST during swallowing at 24 hours after thyroidectomy. PMID:28184269

  2. A Randomized, Double-blind, Non-inferiority Trial of Magnesium Sulphate versus Dexamethasone for Prevention of Postoperative Sore Throat after Lumbar Spinal Surgery in the Prone Position

    PubMed Central

    Park, Jin Ha; Shim, Jae-Kwang; Song, Jong-Wook; Jang, Jaewon; Kim, Ji Hoon; Kwak, Young-Lan

    2015-01-01

    Background: Postoperative sore throat (POST) is a frequent complication of tracheal intubation, particularly after surgery in the prone position. We designed this study to validate the non-inferiority of magnesium sulphate against dexamethasone for prevention of POST after lumbar spinal surgery. Methods: One hundred and forty-six patients were randomly allocated to receive either magnesium or dexamethasone. Before anesthetic induction, the magnesium group (n = 73) received magnesium sulphate 30 mg/kg followed by 10 mg/kg/h by continuous infusion until the end of surgery. The dexamethasone group (n = 73) received dexamethasone 8 mg. The primary endpoint was the overall incidence of POST, which was assessed serially over 48 hr postoperatively. The predefined margin of non-inferiority for magnesium against dexamethasone was 15%. Results: Overall incidences of POST at rest (50.7% versus 49.3% in the magnesium and dexamethasone group, respectively, p = 0.869) and swallowing (65.8% versus 61.6% in the magnesium and dexamethasone group, respectively, p = 0.606) were not different between the groups. The upper limit of the 90% confidence interval, which must be lower than the predefined margin of non-inferiority to prove the non-inferiority of magnesium sulphate against dexamethasone, for at rest and swallowing were 14.97% (p = 0.0496) and 17.19% (p = 0.0854), respectively. The incidences and severities of POST and hoarseness were also not different between the groups throughout the study period. Conclusions: Prophylactic magnesium sulphate appears to be non-inferior to dexamethasone for the prevention of POST at rest in patients undergoing lumbar spinal surgery in the prone position. PMID:26516308

  3. The rational clinical examination. Does this patient have strep throat?

    PubMed

    Ebell, M H; Smith, M A; Barry, H C; Ives, K; Carey, M

    2000-12-13

    Sore throat is a common complaint, and identifying patients with group A beta-hemolytic streptococcal pharyngitis (strep throat) is an important task for clinicians. Previous reviews have not systematically reviewed and synthesized the evidence. To review the precision and accuracy of the clinical examination in diagnosing strep throat. MEDLINE search for articles about diagnosis of strep throat using history-taking and physical examination. Large blinded, prospective studies (having > or =300 patients with sore throat) reporting history and physical examination data and using throat culture as the reference standard were included. Of 917 articles identified by the search, 9 met all inclusion criteria. Pairs of authors independently reviewed each article and used consensus to resolve discrepancies. The most useful findings for evaluating the likelihood of strep throat are presence of tonsillar exudate, pharyngeal exudate, or exposure to strep throat infection in the previous 2 weeks (positive likelihood ratios, 3.4, 2.1, and 1.9, respectively) and the absence of tender anterior cervical nodes, tonsillar enlargement, or exudate (negative likelihood ratios, 0.60, 0.63, and 0.74, respectively). No individual element of history-taking or physical examination is accurate enough by itself to rule in or rule out strep throat. Three validated clinical prediction rules are described for adult and pediatric populations. While no single element of history-taking or physical examination is sufficiently accurate to exclude or diagnose strep throat, a well-validated clinical prediction rule can be useful and can help physicians make more informed use of rapid antigen tests and throat cultures.

  4. Intravenous dexamethasone versus ketamine gargle versus intravenous dexamethasone combined with ketamine gargle for evaluation of post-operative sore throat and hoarseness: A randomized, placebo-controlled, double blind clinical trial

    PubMed Central

    Safavi, Mohammadreza; Honarmand, Azim; Fariborzifar, Arghavan; Attari, Mohammadali

    2014-01-01

    Background: Sore throat and hoarseness are the most frequent subjective complaints after tracheal intubation for general anesthesia. We conducted a prospective, randomized, double-blind, placebo controlled study to evaluate the efficacy of intravenous (IV) dexamethasone plus ketamine gargle for reducing the incidence and severity of post-operative sore throat (POST) and hoarseness. Materials and Methods: 140 patients (aged 16-65 year) scheduled for elective surgery were enrolled. Patients were randomly allocated into four groups of 35 subjects each: Group K, gargled 40 mg ketamine in 30 ml saline; Group D, were infused 0.2 mg/kg IV dexamethasone; Group KD, gargled 40 mg ketamine in 30 ml saline plus 0.2 mg/kg IV dexamethasone; Group P (placebo) that received saline (gargle and IV). POST was graded at 0, 2, 4, 8, 16 and 24 h after operation on a four-point scale (0-3). Results: The incidence and severity of POST were significantly lower in Group KD, compared with the other groups at all times after tracheal extubation for up to 24 h (P < 0.05). Also the incidence and severity of hoarseness were significantly lower in each Groups of KD and K and D compared with group placebo (P < 0.05). Conclusion: The prophylactic use of 0.2 mg/kg of IV dexamethasone plus ketamine gargle significantly reduced the incidence and severity of POST compared with using each of these drugs alone or using placebo. PMID:25371869

  5. Intravenous dexamethasone versus ketamine gargle versus intravenous dexamethasone combined with ketamine gargle for evaluation of post-operative sore throat and hoarseness: A randomized, placebo-controlled, double blind clinical trial.

    PubMed

    Safavi, Mohammadreza; Honarmand, Azim; Fariborzifar, Arghavan; Attari, Mohammadali

    2014-01-01

    Sore throat and hoarseness are the most frequent subjective complaints after tracheal intubation for general anesthesia. We conducted a prospective, randomized, double-blind, placebo controlled study to evaluate the efficacy of intravenous (IV) dexamethasone plus ketamine gargle for reducing the incidence and severity of post-operative sore throat (POST) and hoarseness. 140 patients (aged 16-65 year) scheduled for elective surgery were enrolled. Patients were randomly allocated into four groups of 35 subjects each: Group K, gargled 40 mg ketamine in 30 ml saline; Group D, were infused 0.2 mg/kg IV dexamethasone; Group KD, gargled 40 mg ketamine in 30 ml saline plus 0.2 mg/kg IV dexamethasone; Group P (placebo) that received saline (gargle and IV). POST was graded at 0, 2, 4, 8, 16 and 24 h after operation on a four-point scale (0-3). The incidence and severity of POST were significantly lower in Group KD, compared with the other groups at all times after tracheal extubation for up to 24 h (P < 0.05). Also the incidence and severity of hoarseness were significantly lower in each Groups of KD and K and D compared with group placebo (P < 0.05). The prophylactic use of 0.2 mg/kg of IV dexamethasone plus ketamine gargle significantly reduced the incidence and severity of POST compared with using each of these drugs alone or using placebo.

  6. Side Effects: Mouth and Throat Problems

    Cancer.gov

    Cancer treatments may cause dental, mouth, and throat side effects such as changes in taste (dysgeusia), dry mouth (xerostomia), infections, mouth sores, pain or swelling in your mouth (oral mucositis), sensitivity to foods, and swallowing problems.

  7. Throat Cancer

    MedlinePlus

    ... to cancerous tumors that develop in your throat (pharynx), voice box (larynx) or tonsils. Your throat is a muscular tube that begins behind your nose and ends in your neck. Throat cancer most often begins in the flat cells that ...

  8. The association of sore throat and psoriasis might be explained by histologically distinctive tonsils and increased expression of skin-homing molecules by tonsil T cells

    PubMed Central

    Sigurdardottir, S L; Thorleifsdottir, R H; Valdimarsson, H; Johnston, A

    2013-01-01

    Recent studies have highlighted the involvement of the palatine tonsils in the pathogenesis of psoriasis, particularly among patients with recurrent throat infections. However, the underlying immunological mechanism is not well understood. In this study we confirm that psoriasis tonsils are infected more frequently by β-haemolytic Streptococci, in particular Group C Streptococcus, compared with recurrently infected tonsils from patients without skin disease. Moreover, we show that tonsils from psoriasis patients contained smaller lymphoid follicles that occupied a smaller tissue area, had a lower germinal centre to marginal zone area ratio and contained fewer tingible body macrophages per unit area compared with recurrently infected tonsils from individuals without skin disease. Psoriasis patients' tonsils had a higher frequency of skin-homing [cutaneous lymphocyte-associated antigen (CLA+)] CD4+ and CD8+ T cells, and this correlated significantly with their frequency of blood CLA+ T cells. The psoriasis patients also had a higher frequency of tonsil T cells expressing the interleukin (IL)-23 receptor that was expressed preferentially by the CLA+ T cell population. In contrast, recurrently infected tonsils of individuals without skin disease had a higher frequency of tonsil T cells expressing the activation marker CD69 and a number of chemokine receptors with unknown relevance to psoriasis. These findings suggest that immune responses in the palatine tonsils of psoriasis patients are dysregulated. The elevated expression of CLA and IL-23 receptor by tonsil T cells may promote the egression of effector T cells from tonsils to the epidermis, suggesting that there may be functional changes within the tonsils, which promote triggering or exacerbation of psoriasis. PMID:23750651

  9. Pressure Sores

    MedlinePlus

    ... night. Pressure sores also are called bedsores or pressure ulcers. The sores change appearance over 4 stages. In ... SeniorsTags: antibiotics, Dermatologic, elderly, higher, older adults, Overview, Pressure Ulcers Family Health, Seniors September 2000 Copyright © American Academy ...

  10. Pressure Sores

    MedlinePlus

    Pressure sores are areas of damaged skin caused by staying in one position for too long. They ... wheelchair, or are unable to change your position. Pressure sores can cause serious infections, some of which ...

  11. Cold Sore

    MedlinePlus

    ... genitals. Most people who are infected with the virus that causes cold sores never develop signs and symptoms. Cold sores ... an infection — test positive for evidence of the virus that causes cold sores. People who have weakened immune systems are ...

  12. Mouth sores

    MedlinePlus

    ... like acetaminophen. For canker sores: Apply a thin paste of baking soda and water to the sore. Mix 1 part hydrogen peroxide with 1 part water and apply this mixture to the sores using a ... (Aphthasol), or chlorhexidine gluconate (Peridex) mouthwash. Over-the- ...

  13. Effects of protein supplements on muscle damage, soreness and recovery of muscle function and physical performance: a systematic review.

    PubMed

    Pasiakos, Stefan M; Lieberman, Harris R; McLellan, Tom M

    2014-05-01

    Protein supplements are frequently consumed by athletes and recreationally-active individuals, although the decision to purchase and consume protein supplements is often based on marketing claims rather than evidence-based research. To provide a systematic and comprehensive analysis of literature examining the hypothesis that protein supplements enhance recovery of muscle function and physical performance by attenuating muscle damage and soreness following a previous bout of exercise. English language articles were searched with PubMed and Google Scholar using protein and supplements together with performance, exercise, competition and muscle, alone or in combination as keywords. Inclusion criteria required studies to recruit healthy adults less than 50 years of age and to evaluate the effects of protein supplements alone or in combination with carbohydrate on performance metrics including time-to-exhaustion, time-trial or isometric or isokinetic muscle strength and markers of muscle damage and soreness. Twenty-seven articles were identified of which 18 dealt exclusively with ingestion of protein supplements to reduce muscle damage and soreness and improve recovery of muscle function following exercise, whereas the remaining 9 articles assessed muscle damage as well as performance metrics during single or repeat bouts of exercise. Papers were evaluated based on experimental design and examined for confounders that explain discrepancies between studies such as dietary control, training state of participants, sample size, direct or surrogate measures of muscle damage, and sensitivity of the performance metric. High quality and consistent data demonstrated there is no apparent relationship between recovery of muscle function and ratings of muscle soreness and surrogate markers of muscle damage when protein supplements are consumed prior to, during or after a bout of endurance or resistance exercise. There also appears to be insufficient experimental data

  14. Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review

    PubMed Central

    Ernst, E.

    1998-01-01

    BACKGROUND: Delayed onset muscle soreness (DOMS) is a frequent problem after unaccustomed exercise. No universally accepted treatment exists. Massage therapy is often recommended for this condition but uncertainty exists about its effectiveness. AIM: To determine whether post-exercise massage alleviates the symptoms of DOMS after a bout of strenuous exercise. METHOD: Various computerised literature searches were carried out and located seven controlled trials. RESULTS: Most of the trials were burdened with serious methodological flaws, and their results are far from uniform. However, most suggest that post-exercise massage may alleviate symptoms of DOMS. CONCLUSIONS: Massage therapy may be a promising treatment for DOMS. Definitive studies are warranted. 


 PMID:9773168

  15. Worried Your Sore Throat May Be Strep?

    MedlinePlus

    ... maintained by: Office of the Associate Director for Communication, Digital Media Branch, Division of Public Affairs Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs Funding ...

  16. Ketamine gargling and postoperative sore throat.

    PubMed

    Shrestha, S K; Bhattarai, B; Singh, J

    2010-01-01

    Tracheal intubation is a foremost cause of trauma to the airway mucosa, resulting in postoperative sorethroat (POST). The aim of the study was to compare the effectiveness of ketamine gargle with placebo in preventing POST after endotracheal intubation. Forty patients scheduled for elective surgery under general anaesthesia were enrolled in this randomized, control trial. Patients were randomly allocated into two groups of 20 patients each: Group C, gargling with drinking water 30 ml; Group K, gargling with ketamine 50 mg in drinking water 30 ml for 30 s, 5 min before induction of anaesthesia. POST was graded at 4, 8, and 24 hours respectively after operation on a four- point scale (0-3). POST occurred more frequently in Group C, when compared with Group K at 4, 8, and 24 hours. Ketamine gargle reduces the incidence of POST after endotracheal intubation.

  17. Mouth or Throat Pain or Sores

    MedlinePlus

    ... with milk Crackers, hard-crust breads, salted rolls Fruits and vegetables Soft, non-acidic fruit and vegetables, ... toast, hard rolls, dry crackers, English muffins, bagels Fruits and vegetables Cooked or blenderized fruits and vegetables ...

  18. Canker Sores

    MedlinePlus

    ... them is to keep an ulcer diary. By writing down when you have outbreaks of canker sores, ... of Canker Sores” Prepared by the AAOM Web Writing Group Updated 31 December 2007 Japanese Translation - 日本語訳 ...

  19. [Are antioxidant supplements effective in reducing delayed onset muscle soreness? A systematic review].

    PubMed

    Candia-Luján, Ramón; De Paz Fernández, José Antonio; Costa Moreira, Osvaldo

    2014-10-05

    Introducción: En los últimos años los suplementos antioxidantes han cobrado popularidad para contrarrestar los efectos de los radicales libres y los síntomas del daño muscular, entre los que se encuentra el dolor muscular tardío (DMT). Objetivo: realizar una revisión sistemática en diferentes bases de datos para conocer los efectos de los suplementos antioxidantes sobre el DMT. Método: Se llevó a cabo una búsqueda en las bases de datos; Cochrane Library, Pubmed, Scopus y SportDiscus y la Web Of Science (WOS). Las palabras y acrónimos usados fueron; Delayed onset muscle soreness, exercise induced muscle damage, DOMS, EIMD, antioxidant y oxidative stress. Resultados: Se identificaron 54 artículos de los cuales se recuperaron 48, todos ellos en inglés, 17 relacionados con la vitamina C y E, catorce corresponden a suplementos polifenòlicos, once a otros suplementos antioxidantes y seis a suplementos comerciales todos ellos usados para combatir, entre otras variables, el DMT. Conclusiones: Tanto las vitaminas como los suplementos comerciales presentan baja efectividad en la disminución del DMT, mientras que los polifenoles y otros suplementos antioxidantes muestran entre moderada y buena efectividad en el combate al DMT. Sin embargo, gran parte de los estudios presentan efectividad en la disminución de otros síntomas del daño muscular además de ayudar en la recuperación postejercicio.

  20. Throat Culture

    MedlinePlus

    ... products and services. Advertising & Sponsorship: Policy | Opportunities Throat Culture Share this page: Was this page helpful? Collecting | ... treatment | Getting results | see BLOOD SAMPLE Collecting A culture is a test that is often used to ...

  1. Inter- and intrarater reliability of the Waterlow pressure sore risk scale: a systematic review.

    PubMed

    Kottner, Jan; Dassen, Theo; Tannen, Antje

    2009-03-01

    The Waterlow scale is one of the pressure ulcer risk assessment scales which are frequently criticised for their low reliability. It is widely used in the United Kingdom, Europe and all over the world. The study objectives were to systematically review and evaluate inter- and intrarater reliability and/or agreement of the whole Waterlow scale and its single items. The overall aim was to find out if the Waterlow scale is applicable to daily clinical practice. Systematic review. MEDLINE (1985-June 2008), EMBASE (1985-June 2008), CINAHL (1985-June 2008) and World Wide Web. Selections of relevant studies, data extractions, recalculations of reliability and agreement coefficients, and study quality assessments were independently conducted by two researchers. Designs, methods and results of relevant studies were systematically described, compared and interpreted. Eight research reports were identified containing the results of nine inter- and intrarater reliability and agreement studies. Only three studies were considered as high quality studies. The Waterlow scale in clinical practice was examined in four studies. Interrater agreement for the total score varied between 0% and 57%. Taking into account any differences of up to two points the total score agreement increased to up to 86%. Median ranges of differences among raters scoring single items were high for 'poor nutrition', 'skin type', and 'mobility'. Recalculated intrarater reliability for one researcher was ICC(2,1)=0.97 (95% C.I. 0.94-0.98). Empirical evidence is rare regarding reliability and agreement among nurses when using the Waterlow scale in clinical practice. Interrater agreement for the total score is comparable to other pressure ulcer risk assessment scales. The interrater reliability has never been examined. Therefore, evaluation of reliability and agreement and evaluation of the applicability of the Waterlow scale to clinical practice are limited. It is very likely that the items 'poor nutrition

  2. Cold Sores

    MedlinePlus

    ... causes oral herpes, or cold sores. Type 1 herpes virus infects more than half of the U.S. population by the time they reach their 20s. Type 2 usually affects the genital area Some people have no symptoms from the ...

  3. Canker Sore

    MedlinePlus

    ... or baking soda rinse (dissolve 1 teaspoon of baking soda in 1/2 cup warm water). Dab a small amount of milk of magnesia on your canker sore a few times a day. Avoid abrasive, acidic or spicy foods that can cause further ...

  4. Strep Throat (For Teens)

    MedlinePlus

    ... I Help Someone Who's Being Bullied? Volunteering Strep Throat KidsHealth > For Teens > Strep Throat Print A A ... How Can I Feel Better? What Is Strep Throat? Strep throat is a contagious disease, which means ...

  5. Throat Infections are Associated with Exacerbation in a Substantial Proportion of Patients with Chronic Plaque Psoriasis.

    PubMed

    Thorleifsdottir, Ragna H; Eysteinsdóttir, Jenna H; Olafsson, Jón H; Sigurdsson, Martin I; Johnston, Andrew; Valdimarsson, Helgi; Sigurgeirsson, Bardur

    2016-08-23

    Streptococcal throat infections are known to trigger or exacerbate psoriasis, and several studies support the benefit of tonsillectomy. To evaluate the potential of tonsillectomy as a treatment, we used a retrospective study-specific questionnaire to assess the proportion of psoriasis patients with sore throat-associated psoriasis exacerbations. Our survey sampled 275 psoriasis patients. Of patients with plaque psoriasis, 42% reported sore throat-associated psoriasis exacerbations, and of patients with confirmed streptococcal infections, 72% reported aggravation. Notably, women and patients with early onset psoriasis were more likely to report psoriasis exacerbation after a sore throat (p < 0.001, p = 0.046, respectively). Other psoriasis aggravation factors were more common in patients with sore throat-associated exacerbations (p < 0.01). Of tonsillectomized patients, 49% reported subsequent improvement and had more frequent sore throat-associated aggravation of psoriasis than patients who did not improve after tonsillectomy (p = 0.015). These findings suggest a closer association between sore throats, streptococcal throat infections and plaque psoriasis than reported previously.

  6. Throat infections are associated with exacerbation in a substantial proportion of patients with chronic plaque psoriasis

    PubMed Central

    Thorleifsdottir, Ragna H.; Eysteinsdottir, Jenna H.; Olafsson, Jon H.; Sigurdsson, Martin I.; Johnston, Andrew; Valdimarsson, Helgi; Sigurgeirsson, Bardur

    2016-01-01

    Streptococcal throat infections are known to trigger or exacerbate psoriasis, and several studies support the benefit of tonsillectomy. To evaluate the potential of tonsillectomy as a treatment, we used a retrospective study-specific questionnaire to assess the proportion of psoriasis patients with sore throat-associated psoriasis exacerbations. Our survey sampled 275 psoriasis patients. 42% of patients with plaque psoriasis reported sore throat-associated psoriasis exacerbations, and 72% of patients with confirmed streptococcal infections reported aggravation. Notably, women and early onset psoriasis patients were more likely to report psoriasis exacerbation after a sore throat (p<0.001, p=0.046 respectively). Other psoriasis aggravation factors were more common in patients with sore throat-associated exacerbations (p<0.01). 49% of tonsillectomized patients reported subsequent improvement and had more frequent sore throat-associated aggravation of psoriasis than patients who did not improve after tonsillectomy (p=0.015). These findings suggest a closer association between sore throats, streptococcal throat infections and plaque psoriasis than previously reported. PMID:26984718

  7. Throat swab culture

    MedlinePlus

    ... easy to tolerate. In very few people, the sensation of gagging may lead to an urge to vomit or cough. Alternative Names Throat culture and sensitivity; Culture - throat Images Throat anatomy Throat swabs References Nussenbaum B, Bradford CR. Pharyngitis in adults. In: ...

  8. Genital sores - male

    MedlinePlus

    ... within a day of its appearance) Syphilis (small, painless open sore or ulcer [called a chancre] on ... genitals or around the anus) Lymphogranuloma venereum (small painless sore on the male genitals) Other types of ...

  9. Coping with Cold Sores

    MedlinePlus

    ... found inside the mouth.) What Causes Cold Sores? Cold sores are caused by a virus called herpes (say: HUR-peez). Herpes is one ... the world. The medical name for the specific virus that causes cold sores is herpes simplex. There are two types ...

  10. Throat or larynx cancer

    MedlinePlus

    Vocal cord cancer; Throat cancer; Laryngeal cancer; Cancer of the glottis; Cancer of oropharynx or hypopharynx ... use tobacco are at risk of developing throat cancer. Drinking too much alcohol over a long time ...

  11. Strep Throat (For Parents)

    MedlinePlus

    ... The bacteria that cause strep throat (group A streptococcus ) tend to hang out in the nose and ... Rapid Scarlet Fever Strep Test: Throat Culture Tonsillitis Pneumonia Sinusitis Fever and Taking Your Child's Temperature Word! ...

  12. Skin (Pressure) Sores

    MedlinePlus

    ... Dry Skin Itching Skin Color Changes Pressure Sores Scars and Wounds Treatments and Side Effects Managing Cancer-related Side Effects ... Dry Skin Itching Skin Color Changes Pressure Sores Scars and Wounds More In Treatment & Support Understanding Your Diagnosis Finding and Paying for ...

  13. Cold Sores (HSV-1)

    MedlinePlus

    ... A Week of Healthy Breakfasts Shyness Cold Sores (HSV-1) KidsHealth > For Teens > Cold Sores (HSV-1) A A A What's in this article? ... or around a person's lips, are caused by herpes simplex virus-1 (HSV-1) . But they don't ...

  14. Get Smart: Know When Antibiotics Work - Sore Throat

    MedlinePlus

    ... Glossary For Patients Common Illnesses Bronchitis (Chest Cold) Common Cold & Runny Nose Ear Infection Influenza (Flu) Sinus Infection ( ... scratchy, and may be a symptom of the common cold or other upper respiratory tract infection. The following ...

  15. Sore Throat? Know When To Call the Doctor

    MedlinePlus

    ... Medicare Payment: MACRA Veterans Issues State Government Affairs Veterans Choice Program Education Osteopathic Medical Schools Students Interns and Residents Opportunities Database (Search for a ...

  16. Streptococcal throat infections and exacerbation of chronic plaque psoriasis: a prospective study.

    PubMed

    Gudjonsson, J E; Thorarinsson, A M; Sigurgeirsson, B; Kristinsson, K G; Valdimarsson, H

    2003-09-01

    Guttate psoriasis has a well-known association with streptococcal throat infections but the effects of these infections in patients with chronic psoriasis remains to be evaluated in a prospective study. To determine whether streptococcal throat infections are more common in and can cause exacerbation in patients with chronic psoriasis. Two hundred and eight patients with chronic plaque psoriasis and 116 unrelated age-matched household controls were followed for 1 year. At recruitment all patients were examined, their disease severity scored and throat swabs taken. Patients and corresponding controls were then re-examined and tested for streptococcal colonization whenever they reported sore throat or exacerbation of their psoriasis during the study period. The psoriasis patients reported sore throat significantly more often than controls (61 of 208 vs. three of 116, P < 0.0001), and beta-haemolytic streptococci of Lancefield groups A, C and G (M protein-positive streptococci) were more often cultured from the patients than the controls (19 of 208 vs. one of 116, P = 0.003). A significant exacerbation of psoriasis (P = 0.004) was observed only if streptococci were isolated and the patients were assessed 4 days or later after the onset of sore throat. No difference was observed between groups A, C or G streptococci in this respect. This study confirms anecdotal and retrospective reports that streptococcal throat infections can cause exacerbation of chronic plaque psoriasis. It is concluded that psoriasis patients should be encouraged to report sore throat to their physician and that early treatment of streptococcal throat infections might be beneficial in psoriasis. A controlled trial for assessing potential benefits of tonsillectomy in patients with severe psoriasis should also be considered.

  17. Genital sores - female

    MedlinePlus

    ... painless sores. Less common infections such as chancroid , granuloma inguinale , molluscum contagiosum , and syphilis may also cause ... Elsevier; 2016:chap 16. Read More Chancroid Donovanosis (granuloma inguinale) Genital herpes Genital warts Melanoma Molluscum contagiosum ...

  18. Strep Throat (For Parents)

    MedlinePlus

    ... so important to teach kids the importance of hand washing — good hygiene can lessen their chances of getting ... to Fever Tonsils and Tonsillectomies Strep Test (Video) Hand Washing Strep Throat Tonsillitis Contact Us Print Resources Send ...

  19. Strep Throat (For Teens)

    MedlinePlus

    ... hang out in the nose and throat, so sneezing, coughing, or shaking hands can easily spread the ... people. Cover your mouth and nose when you sneeze or cough to prevent passing fluid droplets to ...

  20. Effectiveness of nurse-led clinics on service delivery and clinical outcomes in adults with chronic ear, nose and throat complaints: a systematic review.

    PubMed

    Whiteford, Caroline; White, Sarahlouise; Stephenson, Matthew

    2016-04-01

    Ear, nose and throat complaints are very common and can cause significant disruption to patients' lives. Many conditions are of a chronic nature and are not currently managed in a timely manner by general practitioners in the community. This may be due to a lack of specialized knowledge, necessary diagnostic equipment or time for lengthy patient education on management of their condition. A nurse-led model of care may be an effective alternative. To examine the effectiveness of nurse-led clinics on adults with chronic ear, nose and throat complaints. Adult patients, aged 18 years and older, attending ear, nose and throat clinics, regardless of the complaint. Nurse-led care in general practice and acute care in which the nurse was identified as taking a lead role in the care of the patients with chronic ear, nose and throat complaints. General practitioner-led care, or ear, nose and throat consultant-led care, sometimes described as "standard care". Service delivery outcomes, clinical and health outcomes and financial outcomes. Any relevant quantitative studies published in English between 1980 and 2013 were considered. A standardized three-step search strategy aimed to find both published and unpublished studies. Databases searched include PubMed, CINAHL, Cochrane Library (CENTRAL), Scopus, Embase, MedNar and ProQuest Theses and Dissertations. Methodological validity was assessed independently by two reviewers using standardized critical appraisal instruments from the Joanna Briggs Institute. Due to methodological heterogeneity of the included studies, no statistical pooling was possible and all results are presented narratively. The search identified 13,536 titles, of which 20 potentially relevant articles were retrieved. Of these 20, 17 were excluded following full-text review leaving three studies that were assessed for methodological quality and included in the review. Service delivery outcome findings were that patient satisfaction was equal or higher and

  1. Draft Genome Sequences of Streptococcus pyogenes Strains Associated with Throat and Skin Infections in Lebanon.

    PubMed

    Tokajian, Sima; Eisen, Jonathan A; Jospin, Guillaume; Coil, David A

    2014-05-15

    We present the draft genome sequences of nine clinical Streptococcus pyogenes isolates recovered from patients suffering from sore throat and skin infections. An average of 2,454,334 paired-end reads per sample were generated, which assembled into 21 to 198 contigs, with a G+C content of 38.4 to 38.5%. Copyright © 2014 Tokajian et al.

  2. Canker Sores (For Parents)

    MedlinePlus

    ... open sores that have a white or yellowish coating and a red "halo" around them. They tend ... take you to a site outside of KidsHealth's control. About KidsHealth Nemours.org Reading BrightStart! Contact Us ...

  3. Strep Throat Test

    MedlinePlus

    ... serious complications, such as rheumatic fever . A throat culture is more sensitive than the rapid strep test, but it may take 24-48 hours for results. According to 2012 guidelines from the Infectious Diseases Society of America (IDSA), confirmatory testing on adults is not usually ...

  4. [Pressure sore revision surgery].

    PubMed

    Dorsche, Karin Marion

    2010-02-22

    Pressure sores are a major problem for patients as well as society in general. Immobilised patients are especially at risk. This group of patients with pressure sores should be hospitalised to perform surgical revision of the wound and reconstruction using a flap. Such surgery demands extensive postoperative relief of the flap. The University Centre for Wound Healing at Odense University Hospital has tested the effects of a reduction of the formerly recommended relief period from three to two weeks. In this article we report results covering all patients who have undergone surgery and reconstruction of pressure sores during the period from 1st October 2001 to 1st November 2008. The results are divided into two periods: the period before and the period after the introduction of the reduced relief period. A total of 80 patients were included; 34 in the first period and 46 in the second period. We achieved a considerable reduction in median length of stay from 38 to 27 days with no increase in surgical or complication frequency. Furthermore, the share of fully healed remained unchanged. We believe that there is no risk in shortening the immobile postoperative relief phase following reconstruction of pressure wounds in immobilised patients.

  5. Scoop on Strep Throat (For Kids)

    MedlinePlus

    ... in the Operating Room? The Scoop on Strep Throat KidsHealth > For Kids > The Scoop on Strep Throat ... bacteria to others. How Can I Prevent Strep Throat? If someone in your house has strep throat, ...

  6. Incidence, causes, severity and treatment of throat discomfort: a four-region online questionnaire survey.

    PubMed

    Addey, Dilys; Shephard, Adrian

    2012-08-10

    Acute sore throat is commonly associated with viral infections. Consumers typically rely on over-the-counter treatments and other remedies to treat symptoms; however, limited information is available regarding consumer perceptions of sore throat or treatment needs. The aim of this study was to investigate perceptions of throat discomfort and how these influence attitudes and consumer behaviour with regard to treatment. Online consumer surveys were completed by participants invited by email between 2003 and 2004 in four markets: the UK, France, Poland, and Malaysia. The questionnaire consisted of 24 questions that covered key issues surrounding throat discomfort including incidence in the past 12 months, causes, severity, effects on functionality and quality of life, actions taken to relieve throat discomfort, the efficacy of these approaches and the reasons behind using specific products. In total, 6465 men and women aged ≥18 years were surveyed, identifying 3514 participants who had suffered throat discomfort/irritation in the past 12 months (response rate of 54%). These participants completed the full survey. The breakdown of throat discomfort sufferers was: UK, 912; France, 899; Poland, 871; Malaysia, 832. A high proportion of respondents experienced one or more instances of throat discomfort in the previous 12 months, with an overall incidence of 54%. Infections including the common cold/influenza and other bacteria/viruses were commonly perceived causes of throat discomfort (72% and 46%, respectively). Physical and environmental factors were also perceived to be causative, including airborne pollution (28%), smoking (23%), and air conditioning (31%). Symptoms perceived to be caused by an infection were associated with a higher degree of suffering (mean degree of suffering for bacteria/virus and common cold/influenza; 3.4 and 3.0, respectively). Medicinal products were used for all perceived causes, but more commonly for sore throats thought to be caused by

  7. Incidence, causes, severity and treatment of throat discomfort: a four-region online questionnaire survey

    PubMed Central

    2012-01-01

    Background Acute sore throat is commonly associated with viral infections. Consumers typically rely on over-the-counter treatments and other remedies to treat symptoms; however, limited information is available regarding consumer perceptions of sore throat or treatment needs. The aim of this study was to investigate perceptions of throat discomfort and how these influence attitudes and consumer behaviour with regard to treatment. Methods Online consumer surveys were completed by participants invited by email between 2003 and 2004 in four markets: the UK, France, Poland, and Malaysia. The questionnaire consisted of 24 questions that covered key issues surrounding throat discomfort including incidence in the past 12 months, causes, severity, effects on functionality and quality of life, actions taken to relieve throat discomfort, the efficacy of these approaches and the reasons behind using specific products. Results In total, 6465 men and women aged ≥18 years were surveyed, identifying 3514 participants who had suffered throat discomfort/irritation in the past 12 months (response rate of 54%). These participants completed the full survey. The breakdown of throat discomfort sufferers was: UK, 912; France, 899; Poland, 871; Malaysia, 832. A high proportion of respondents experienced one or more instances of throat discomfort in the previous 12 months, with an overall incidence of 54%. Infections including the common cold/influenza and other bacteria/viruses were commonly perceived causes of throat discomfort (72% and 46%, respectively). Physical and environmental factors were also perceived to be causative, including airborne pollution (28%), smoking (23%), and air conditioning (31%). Symptoms perceived to be caused by an infection were associated with a higher degree of suffering (mean degree of suffering for bacteria/virus and common cold/influenza; 3.4 and 3.0, respectively). Medicinal products were used for all perceived causes, but more commonly for sore

  8. Temperature in the throat

    NASA Astrophysics Data System (ADS)

    Kaviani, Dariush; Mosaffa, Amir Esmaeil

    2016-09-01

    We study the temperature of extended objects in string theory. Rotating probe D-branes admit horizons and temperatures a la Unruh effect. We find that the induced metrics on slow rotating probe D1-branes in holographic string solutions including warped Calabi-Yau throats have distinct thermal horizons with characteristic Hawking temperatures even if there is no black hole in the bulk Calabi-Yau. Taking the UV/IR limits of the solution, we show that the world volume black hole nucleation depends on the deformation and the warping of the throat. We find that world volume horizons and temperatures of expected features form not in the regular confining IR region but in the singular nonconfining UV solution. In the conformal limit of the UV, we find horizons and temperatures similar to those on rotating probes in the AdS throat found in the literature. In this case, we also find that activating a background gauge field form the U (1) R-symmetry modifies the induced metric with its temperature describing two different classes of black hole solutions.

  9. Randomised, double-blind, placebo-controlled studies on flurbiprofen 8.75 mg lozenges in patients with/without group A or C streptococcal throat infection, with an assessment of clinicians' prediction of 'strep throat'.

    PubMed

    Shephard, A; Smith, G; Aspley, S; Schachtel, B P

    2015-01-01

    Diagnosing group A streptococcus (Strep A) throat infection by clinical examination is difficult, and misdiagnosis may lead to inappropriate antibiotic use. Most patients with sore throat seek symptom relief rather than antibiotics, therefore, therapies that relieve symptoms should be recommended to patients. We report two clinical trials on the efficacy and safety of flurbiprofen 8.75 mg lozenge in patients with and without streptococcal sore throat. The studies enrolled adults with moderate-to-severe throat symptoms (sore throat pain, difficulty swallowing and swollen throat) and a diagnosis of pharyngitis. The practitioner assessed the likelihood of Strep A infection based on historical and clinical findings. Patients were randomised to flurbiprofen 8.75 mg or placebo lozenges under double-blind conditions and reported the three throat symptoms at baseline and at regular intervals over 24 h. A total of 402 patients received study medication (n = 203 flurbiprofen, n = 199 placebo). Throat culture identified Strep A in 10.0% of patients and group C streptococcus (Strep C) in a further 14.0%. The practitioners' assessments correctly diagnosed Strep A in 11/40 cases (sensitivity 27.5%, and specificity 79.7%). A single flurbiprofen lozenge provided significantly greater relief than placebo for all three throat symptoms, lasting 3-4 h for patients with and without Strep A/C. Multiple doses of flurbiprofen lozenges over 24 h also led to symptom relief, although not statistically significant in the Strep A/C group. There were no serious adverse events. The results highlight the challenge of identifying Strep A based on clinical features. With the growing problem of antibiotic resistance, non-antibiotic treatments should be considered. As demonstrated here, flurbiprofen 8.75 mg lozenges are an effective therapeutic option, providing immediate and long-lasting symptom relief in patients with and without Strep A/C infection. © 2014 John Wiley & Sons Ltd.

  10. Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study

    PubMed Central

    Little, Paul; Hobbs, FD Richard; Mant, David; McNulty, Cliodna AM; Mullee, Mark

    2012-01-01

    Background Management of pharyngitis is commonly based on features which are thought to be associated with Lancefield group A beta-haemolytic streptococci (GABHS) but it is debatable which features best predict GABHS. Non-group A strains share major virulence factors with group A, but it is unclear how commonly they present and whether their presentation differs. Aim To assess the incidence and clinical variables associated with streptococcal infections. Design and setting Prospective diagnostic cohort study in UK primary care. Method The presence of pathogenic streptococci from throat swabs was assessed among patients aged ≥5 years presenting with acute sore throat. Results Pathogenic streptococci were found in 204/597 patients (34%, 95% CI = 31 to 38%): 33% (68/204) were non-group A streptococci, mostly C (n = 29), G (n = 18) and B (n = 17); rarely D (n = 3) and Streptococcus pneumoniae (n = 1). Patients presented with similar features whether the streptococci were group A or non-group A. The features best predicting A, C or G beta-haemolytic streptococci were patient’s assessment of severity (odds ratio [OR] for a bad sore throat 3.31, 95% CI = 1.24 to 8.83); doctors’ assessment of severity (severely inflamed tonsils OR 2.28, 95% CI = 1.39 to 3.74); absence of a bad cough (OR 2.73, 95% CI = 1.56 to 4.76), absence of a coryza (OR 1.54, 95% CI = 0.99 to 2.41); and moderately bad or worse muscle aches (OR 2.20, 95% CI = 1.41 to 3.42). Conclusion Non-group A strains commonly cause streptococcal sore throats, and present with similar symptomatic clinical features to group A streptococci. The best features to predict streptococcal sore throat presenting in primary care deserve revisiting. PMID:23211183

  11. Incidence and clinical variables associated with streptococcal throat infections: a prospective diagnostic cohort study.

    PubMed

    Little, Paul; Hobbs, F D Richard; Mant, David; McNulty, Cliodna A M; Mullee, Mark

    2012-11-01

    Management of pharyngitis is commonly based on features which are thought to be associated with Lancefield group A beta-haemolytic streptococci (GABHS) but it is debatable which features best predict GABHS. Non-group A strains share major virulence factors with group A, but it is unclear how commonly they present and whether their presentation differs. To assess the incidence and clinical variables associated with streptococcal infections. Prospective diagnostic cohort study in UK primary care. The presence of pathogenic streptococci from throat swabs was assessed among patients aged ≥5 years presenting with acute sore throat. Pathogenic streptococci were found in 204/597 patients (34%, 95% CI = 31 to 38%): 33% (68/204) were non-group A streptococci, mostly C (n = 29), G (n = 18) and B (n = 17); rarely D (n = 3) and Streptococcus pneumoniae (n = 1). Patients presented with similar features whether the streptococci were group A or non-group A. The features best predicting A, C or G beta-haemolytic streptococci were patient's assessment of severity (odds ratio [OR] for a bad sore throat 3.31, 95% CI = 1.24 to 8.83); doctors' assessment of severity (severely inflamed tonsils OR 2.28, 95% CI = 1.39 to 3.74); absence of a bad cough (OR 2.73, 95% CI = 1.56 to 4.76), absence of a coryza (OR 1.54, 95% CI = 0.99 to 2.41); and moderately bad or worse muscle aches (OR 2.20, 95% CI = 1.41 to 3.42). Non-group A strains commonly cause streptococcal sore throats, and present with similar symptomatic clinical features to group A streptococci. The best features to predict streptococcal sore throat presenting in primary care deserve revisiting.

  12. Taking Care of Pressure Sores

    MedlinePlus

    ... between dressing changes. 6. Check for signs of wound healing with each dressing change. 7. If there are ... Surgery is frequently required for this type of wound. How to know if the sore is healing The sore will get smaller. Pinkish tissue usually ...

  13. Factors in delayed muscle soreness.

    PubMed

    Abraham, W M

    1977-01-01

    The possible causes of delayed muscle soreness which occur 24 to 48 hr after exercise were examined from three different approaches, each designed to test an existing hypothesis. Surface electromyograms were used to evaluate the muscle spasm theory; the possibility of actual muscle cell damage was monitored by the presence of myoglobinuria, while the ratio of hydroxyproline/creatinine (OHP/Cr) in 24 hr urine collection was used as a marker for connective tissue involvement. In the first study, although all volunteers developed muscle soreness 24 and 48 hr after exercise, no change in the EMG activity of the sore muscles was observed. Myoglobin excretion was found in 88% of the subjects who developed soreness. However, in a second study, 92% of the subject who performed both moderate and heavy exercise but did not develop muscle soreness had myoglobinuria. In contrast, during a third experiment subjects on gelatin-free diets showed an increase (P less than .1) in the OHP/Cr between control (.020+/-.001) and 48 hr post-exercise (.002+/-.001, X+/-SE). Soreness resulted in all cases. When the OHP/Cr value is taken for the day of maximal soreness, the post-exercise mean increases to .024+/-.001 and the level of significance rises (P less than .005). These observations support the concept that exercise induced soreness may be related to disruption of the connective tissue elements in the muscle and/or their attachments.

  14. [One case of throat B-cell lymphoma with ipsilateral thyroid papillary carcinoma].

    PubMed

    Cui, Zhenying; Zhou, Bo; Deng, Zehai

    2013-11-01

    A female patient of 56 years old had hoarseness that seems worse after talking excessively,which occasionally associated with slightly sore throat and pharyngeal foreign body sensation. The symptoms are not associated with sore throat, fever, night sweats, not drinking cough, breathing and swallowing difficulties, but no cough, bloody sputum. Neck ultrasound can be showed: goiter and real echo uneven thickening, increased blood supply pan; the right thyroid lobe multiple cysts pan. Enhanced CT shows occupying lesions were found out in the right side of the supraglottic larynx gap and the right lobe of the thyroid, nature to be determined. Full thyroid function showed: thyroid microsomal antibodies 278.2 u/ml, the rest of the indicators in the normal range. Other routine preoperative examinations were normal. Immunohistochemistry: CD45(++) CD68(+) CD99(++) EMA(-) CK(-) Sclc(-) TTF-1(--) CgA(-) SY(-) NSE(--) S-100(-) ESA(-). Supported by immunohistochemistry, hyperplasia organizations was diffuse lymphoid tissue. Through expert consultation by superior hospital the pathology showed: Hashimoto's thyroiditis with thyroid papillary carcinoma (lesions of the right thyroid); Lesion on the right side of the throat gene rearrangement results show: B lymphocyte clonal consider mucosa-associated extranodal marginal zone B-cell lymphoma the gene rearrangement that the right side of the throat disease is: B lymphocyte clonal, be considerd mucosa-associated extranodal marginal zone B-cell lymphoma. throat B-cell lymphoma; thyroid papillary carcinoma (right side); Hashimoto's thyroiditis (right side).

  15. Throat and nasal swabs for molecular detection of respiratory viruses in acute pharyngitis.

    PubMed

    Ali, Mohsin; Han, Sangsu; Gunst, Chris J; Lim, Steve; Luinstra, Kathy; Smieja, Marek

    2015-10-29

    Detection of specific respiratory viruses is important for surveillance programs, where nasopharyngeal or nasal swabs have traditionally been used. Our objective was to determine whether sampling with a throat swab provides incremental benefit-when used in conjunction with a nasal swab-to detect respiratory viruses among patients with acute pharyngitis in the outpatient setting. Among 83 university students with acute pharyngitis, we detected respiratory viruses with molecular assays on two samples collected per student: with a flocked nasal mid-turbinate swab and a rayon throat swab. Forty-eight (58 %) patients had virus-positive samples, with 49 virus positives detected by either swab (one patient had a dual viral co-infection). The most common viruses were rhinovirus, coronavirus, and influenza A virus. Specifically, 29 virus positives were detected by both swabs, 14 exclusively by the nasal swab, and six exclusively by the throat swab. The additional six virus positives detected by the throat swab corresponded to an absolute increase in viral detection of 7.1 % (95 % CI: 1.2-12.9 %); the specific viruses detected were four rhinoviruses and two coronaviruses. The flocked nasal swab samples respiratory viruses well, even among patients whose primary complaint is a sore throat. The rayon throat swab has modest incremental value over and above using the flocked nasal mid-turbinate swab alone, which suggests that while throat swabs alone would not be adequate for respiratory viral surveillance, they may have value as a supplementary test.

  16. Risk factors for postoperative throat pain after general anaesthesia with endotracheal intubation at the University of Gondar Teaching Hospital, Northwest Ethiopia, 2014

    PubMed Central

    Gemechu, Biruk Melkamu; Gebremedhn, Endale Gebreegziabher; Melkie, Tadesse Belayneh

    2017-01-01

    Introduction Postoperative sore throat is listed from the top as patients’ most undesirable outcome in the postoperative period. It is believed to originate from mucosal dehydration or edema, tracheal ischemia secondary to the pressure of endotracheal tube cuffs, aggressive oropharyngeal suctioning, and mucosal erosion from friction between delicate tissues and the endotracheal tube. Even if the problem was indicated in many literatures, it has never been studied in our country. The study aimed to assess prevalence and factors associated with postoperative sore throat among patients who were operated under general anesthesia with endotracheal intubation. Methods Hospital based cross sectional study was conducted from February 25 - April 10, 2014 in Gondar University hospital. Patient interview and chart review were employed for data collection. Bivariate and multivariate logistic regressions were used to determine the association. Results A total of 240 out of 299 patients were included in this study with a response rate of 80.3%. The prevalence of postoperative sore throat within 48 hours after operation was 59.6%. Factors which had association with postoperative sore throat from the multivariate logistic regression were female sex (AOR = 3.3, 95% CI: 1.07, 10.375), repeated number of attempts to intubate (AOR = 3.291, 95% CI: 1.658, 6.531), and the use of nasogastric tube (AOR = 0.41, 95% CI: 0.174, 0.965) respectively. Conclusion The prevalence of postoperative sore throat was high in Gondar University Hospital. Awareness creation about the problem should be made for health professionals and postoperative sore throat management protocol need to be introduced. PMID:28904657

  17. Herpes Simplex Virus (Cold Sores)

    MedlinePlus

    ... not always necessary. In these tests, a tissue scraping of the sores may be examined under the ... Academy of Pediatrics) The information contained on this Web site should not be used as a substitute ...

  18. Scoop on Strep Throat (For Kids)

    MedlinePlus

    ... Tall or Too Short All About Puberty Strep Throat KidsHealth > For Kids > Strep Throat Print A A ... Información sobre la amigdalitis estreptocócica What Is Strep Throat? Strep throat is a disease caused by a ...

  19. Bed surfaces and pressure sore prevention: an abridged report.

    PubMed

    Brown, S J

    2001-01-01

    This article summarizes the results of a systematic review of randomized controlled trials testing the effectiveness of special beds, mattresses, and cushions in preventing and treating pressure sores. The review's citation is Cullum, N., Deeks, J., Sheldon, T.A., Song, F., & Fletcher, A.W. (2000). Beds, mattresses and cushions for pressure sore prevention and treatment (Cochrane Review). The Cochrane Library, 4. An integrative research review. 37 studies were included in the analysis. A broad search of databases and unpublished studies was conducted. Data were extracted from those that met the inclusion criteria. Studies were grouped in various ways but mainly by type of product evaluated. Many special products designed to prevent or treat pressure sores are more effective than standard hospital foam mattresses in preventing and treating pressure sores. Special pressure-relieving surfaces should be used for patients at risk for skin breakdown. Individual practitioners and agencies should have a systematic protocol for assessing patients' risk of skin breakdown and for taking action when patients are determined to be at risk. The findings of this review provide some guidance for choosing particular products, albeit not definitive evidence for matching risk levels to products.

  20. Staphylococcus aureus and sore nipples.

    PubMed Central

    Livingstone, V. H.; Willis, C. E.; Berkowitz, J.

    1996-01-01

    OBJECTIVE: To correlate clinical symptoms and signs of sore nipples with the presence of Staphylococcus aureus and to determine the probability of mothers having S aureus-infected nipples when these local symptoms and signs are found. DESIGN: Two cohorts of consecutive patients were enrolled regardless of presenting complaint. A questionnaire was administered to determine the presence and severity of sore nipples. Objective findings on breast examination were documented. A nipple swab was taken for culture and sensitivity. SETTING: Breastfeeding clinic serving patients referred by family physicians, pediatricians, and community health nurses. PATIENTS: A sample of 227 breastfeeding mothers was collected in two cohorts. MAIN OUTCOME MEASURES: Answers to questions about sore nipples, objective findings from physical examination, and results from nipple swabs. RESULTS: Most subjects (51%) had sore nipples, and 45% of subjects had objective findings on examination; 23% of subjects had a positive nipple swab culture; 15% grew S aureus on culture. The risk of having S aureus colonization was 4.8 times greater if nipple pain was moderate or severe rather than mild. A break in nipple integument associated with cracks, fissures, ulcers, or pus gave a 35% chance of having S aureus colonization, five times greater than when the integument was intact. CONCLUSIONS: The study showed that mothers with infants younger than 1 month who complained of moderate to severe nipple pain and who had cracks, fissures, ulcers, or exudates had a 64% chance of having positive skin cultures and a 54% chance of having S aureus colonization. PMID:8653033

  1. Sore shoulder in physical practice.

    PubMed

    Pecar, Dzemal; Mujić, Muzafer; Pecar, Muris

    2005-05-01

    Sore shoulder or shoulder region is frequently encountered in general population. According to reference data prevalence ranges between 15 and 20% in 40-45 age group. A weak bone support enables extensive excursions of this joint and simultaneously reduces its stability. We analyzed successfulness of sore shoulder treatment in a sample of 1115 patients treated in the Center for physical medicine and rehabilitation between 1996 and 2004. All the patients reported to the Center either in acute phase or in the phase of chronic state exacerbation, with limited function that was graded on the scale 0 to 5. Type and kind of sore shoulder cause was determined by clinical examination and, where needed, by X-ray. Of the total number of cases, 33 patients did not report for follow up examination, 166 patients were forwarded to other physical therapy centers for treatment so the final analysis included 916 patients (82%) whose treatment success was evaluated on the scale 0 to 5. In 659 (58%) patients the inflammation of musculus biceps long tendon was identified as a cause of sore shoulder. The least frequent cause was the blow syndrome (impingement)--20 (2%). In 666 patients (73%) the problem was resolved by local instillation of depo corticosteroids (Betamethason 7 mg) so the physical treatment was not required.

  2. Duration of symptoms of respiratory tract infections in children: systematic review

    PubMed Central

    Vodicka, Talley A; Blair, Peter S; Buckley, David I; Heneghan, Carl; Hay, Alastair D

    2013-01-01

    Objective To determine the expected duration of symptoms of common respiratory tract infections in children in primary and emergency care. Design Systematic review of existing literature to determine durations of symptoms of earache, sore throat, cough (including acute cough, bronchiolitis, and croup), and common cold in children. Data sources PubMed, DARE, and CINAHL (all to July 2012). Eligibility criteria for selecting studies Randomised controlled trials or observational studies of children with acute respiratory tract infections in primary care or emergency settings in high income countries who received either a control treatment or a placebo or over-the-counter treatment. Study quality was assessed with the Cochrane risk of bias framework for randomised controlled trials, and the critical appraisal skills programme framework for observational studies. Main outcome measures Individual study data and, when possible, pooled daily mean proportions and 95% confidence intervals for symptom duration. Symptom duration (in days) at which each symptom had resolved in 50% and 90% of children. Results Of 22 182 identified references, 23 trials and 25 observational studies met inclusion criteria. Study populations varied in age and duration of symptoms before study onset. In 90% of children, earache was resolved by seven to eight days, sore throat between two and seven days, croup by two days, bronchiolitis by 21 days, acute cough by 25 days, common cold by 15 days, and non-specific respiratory tract infections symptoms by 16 days. Conclusions The durations of earache and common colds are considerably longer than current guidance given to parents in the United Kingdom and the United States; for other symptoms such as sore throat, acute cough, bronchiolitis, and croup the current guidance is consistent with our findings. Updating current guidelines with new evidence will help support parents and clinicians in evidence based decision making for children with respiratory

  3. Postoperative Respiratory Complications of Laryngeal Mask Airway and Tracheal Tube in Ear, Nose and Throat Operations

    PubMed Central

    Safaeian, Reza; Hassani, Valiollah; Movasaghi, Gholamreza; Alimian, Mahzad; Faiz, Hamid Reza

    2015-01-01

    Background: Supraglottic devices could be used to reduce postoperative respiratory complications, but there are few studies focused on their use in more prolonged surgeries. Objectives: In this study, we compared postoperative respiratory complications in patients with prolonged ear, nose and throat (ENT) surgeries, whose airways were controlled with tracheal tube or laryngeal mask airway (LMA). Materials and Methods: In a randomized control trial (RCT), 171 candidates of prolonged ENT surgeries were randomly assigned into two groups. In group one (n = 85) LMA and in group two (n = 86) endotracheal tube were used for airway control. The incidences of four postoperative respiratory complications including sore throat, hoarseness, cough and shortness of breath in immediate postoperative period were measured and compared among patients of each group. Results: Sore throat was recorded in 32.9% of patients with LMA and 44.2% of intubated patients, but it was not statistically significant (Fisher’s Exact test = 0.158). Hoarseness was recorded in 3.5% of patients with LMA and 24.4% of intubated patients (Fisher’s Exact test = 0.000). In 1.2% of patients with LMA cough was recorded; it was also seen in 7% of the intubated patients (Fisher’s Exact test = 0.005). Shortness of breath was mentioned by two intubated patients (2.3%) and in patient with LMA we did not record this complication. Conclusions: LMA in prolonged ENT surgeries was associated with reduced respiratory complications. PMID:26473104

  4. Practical Management of Pressure Sores

    PubMed Central

    Jordan, John M.

    1992-01-01

    Pressure sores are common in the debilitated elderly. Causal factors are unrelieved pressure, shearing forces, friction, and moisture. Preventive measures should be used for all high-risk patients, defined by general condition, mental status, degree of incontinence, amount of activity, and mobility. Principles of treating ulcers include pressure relief, reducing bacterial counts, debriding necrotic tissue, and providing a moist, clean environment. Imagesp2385-ap2389-ap2392-a PMID:21221298

  5. Strep Test: Throat Culture (For Parents)

    MedlinePlus

    ... Your 1- to 2-Year-Old Strep Test: Throat Culture KidsHealth > For Parents > Strep Test: Throat Culture A A A What's in this article? ... cultivo de exudado faríngeo What It Is A throat culture or strep test is performed by using ...

  6. Strep Test: Throat Culture (For Parents)

    MedlinePlus

    ... Be Smart About Social Media Strep Test: Throat Culture KidsHealth > For Parents > Strep Test: Throat Culture Print A A A What's in this article? ... de exudado faríngeo What It Is A throat culture or strep test is performed by using a ...

  7. Warped Throats at the LHC

    SciTech Connect

    Underwood, Bret

    2007-11-20

    We discuss how the detailed geometry of warped compactification can significantly impact collider data. We show how the details of the cross section for dilepton production (such as the spacing, the width, and the peaks of the KK graviton resonances) for a generic class of warped throats which are closely related to the Randall-Sundrum model depend sensitively on the precise shape of the warp factor.

  8. The limits of pressure sore prevention.

    PubMed Central

    Hagisawa, S; Barbenel, J

    1999-01-01

    Pressure sore prevalence and incidence were assessed in 275 patients who were admitted to a well-staffed internal medicine ward during a 12-month study period or who were present on day 1. Pressure sore risk was assessed by use of the Braden scale and patients scoring 16 or less were provided with intensive preventive care. During the study period 5.1% (95% confidence interval 2.7-7.8) of 275 patients had pressure sores (prevalence) and 4.4% (1.9-6.9) developed sores (incidence). None of the 239 patients who were assessed as not being at risk developed a sore. 36 patients were assessed as being at risk at some time during the study and 12 of these developed sores despite receiving high-quality preventive care. The results suggest that not all pressure sores can be prevented in severely ill patients. We believe that the 4.4% incidence of sores in this study approaches the current limit of prevention. PMID:10703495

  9. Evidence-based medicine: pressure sores.

    PubMed

    Cushing, Carolyn A; Phillips, Linda G

    2013-12-01

    After studying this article, the participant should be able to: 1. Cite risk factors for pressure sore development. 2. Detail the pathophysiology of pressure sores. 3. List the types and classification of pressure sores. 4. Consider the various nonsurgical conservative wound management strategies. 5. Describe the appropriate surgical interventions for each pressure sore type. 6. Understand the causes of recurrent pressure sores and methods of avoiding recurrence. Pressure sores are the result of unrelieved pressure, usually over a bony prominence. With an estimated 2.5 million pressure ulcers treated annually in the United States at a cost of $11 billion, pressure sores represent a costly and labor-intensive challenge to the health care system. A comprehensive team approach can address both prevention and treatment of these recalcitrant wounds. Consideration must be given to the patient's medical and socioeconomic condition, as these factors are significantly related to outcomes. Mechanical prophylaxis, nutritional optimization, treatment of underlying infection, and spasm control are essential in management. A variety of pressure sore patterns exist, with surgical approaches directed to maximize future coverage options. A comprehensive approach is detailed in this article to provide the reader with the range of treatment options available.

  10. The limits of pressure sore prevention.

    PubMed

    Hagisawa, S; Barbenel, J

    1999-11-01

    Pressure sore prevalence and incidence were assessed in 275 patients who were admitted to a well-staffed internal medicine ward during a 12-month study period or who were present on day 1. Pressure sore risk was assessed by use of the Braden scale and patients scoring 16 or less were provided with intensive preventive care. During the study period 5.1% (95% confidence interval 2.7-7.8) of 275 patients had pressure sores (prevalence) and 4.4% (1.9-6.9) developed sores (incidence). None of the 239 patients who were assessed as not being at risk developed a sore. 36 patients were assessed as being at risk at some time during the study and 12 of these developed sores despite receiving high-quality preventive care. The results suggest that not all pressure sores can be prevented in severely ill patients. We believe that the 4.4% incidence of sores in this study approaches the current limit of prevention.

  11. Pressure sore prevention in acutely ill patients.

    PubMed

    James, H

    1997-03-01

    A wide range of factors affect the skin's ability to withstand pressure, friction and shear. Clinically validated pressure-relieving equipment is essential to prevent pressure sores in acutely ill patients. A successful pressure sore prevention strategy depends on sufficient resource allocation, appropriate levels and types of preventive equipment and evaluation.

  12. Pressure sore prevention in nursing homes.

    PubMed

    Clay, M

    Staff working in nursing homes are caring for increasingly dependent residents who are consequently at great risk of developing pressure sores. Mary Clay offers a guide to the essential principles of pressure sore prevention as a teaching aid for all caring staff.

  13. Factors Associated with Shin Soreness in Athletes.

    ERIC Educational Resources Information Center

    Myburgh, Kathryn H.; And Others

    1988-01-01

    To identify factors which cause shin soreness in athletes, 25 injured exercisers and a control group of 25 uninjured exercisers were studied. Methodology and results are presented and analyzed. Differences in calcium intake between the two groups is cited as a key factor in causing shin soreness. (JL)

  14. [A boy with blood blisters on his lips after having a sore throat].

    PubMed

    van Els, Anne L; Drewes, A J Noud

    2014-01-01

    An 8-year-old boy came to the Emergency Department with blood blisters on both lips, limiting him in his oral intake. He had no history of herpes simplex or use of any medication. The symptoms turned out to be caused by erythema exsudativum multiforme major, in most cases a self-limiting disease.

  15. [Prevalence and prevention and treatment modalities for pressure sores. Study of the Emilia-Romagna region].

    PubMed

    Melotti, Rita Maria; Fortuna, Daniela; Chiari, Paolo; Cavicchioli, Andrea; Mongardi, Maria; Santullo, Antonella; Grilli, Roberto

    2003-01-01

    This audit initiative aimed at assessing the prevalence of pressure sores in the public hospitals of Emilia-Romagna, and at monitoring the rate of use of specific modalities of prevention and cure. The design was cross-sectional, with information collected on three index days during 2000 by trained personnel. Overall, the prevalence of pressure sores at the regional level was 7.1%, with remarkable variation across hospitals (from 2.9% to 9.7%), also after adjustment for case mix. As for patterns of prevention and cure, 74% of patients at risk (according to the Braden scale) of developing a pressure sores received only standard low technology devices, and 50% of those in need were included in a systematic programme of postural change. Adequate (according to the available evidence) medications were used in 45% of patients with a pressure sore. The overall prevalence of pressure sore is close (or even inferior) to that observed in similar studies. However, variation between hospitals indicates that the current health services ability to deal with pressure sore is variable and often suboptimal. This evaluation is also supported by the limited adoption of adequate preventive and curative modalities.

  16. Pressure sore--the problem.

    PubMed

    Brand, P W

    2006-05-01

    The problem is that when the surface of the body is denervated, it is liable to break down from a number of widely different mechanical stresses. The obvious common factor of denervation or loss of sensation has allowed many workers to assume that loss of nerves is the most significant element in the aetiology of these pressure sores. Hence, the term 'trophic' ulcer, which suggests that some trophic, or nourishing, element is missing from tissues which are not supported by intact nerves. The nature of this trophic factor is not understood and therefore its influence is difficult to measure and still more difficult to control. We have found that a more fruitful approach to the problem is to concentrate upon the biology and the mechanics of the breakdown of normal surface tissues, and then see if it is very different from the biology and mechanics of the breakdown of denervated tissues.

  17. A hospital-based study to evaluate the incidence pattern of group A streptococcal throat infections from different age group patients.

    PubMed

    Ray, Dipanwita; Banerjee, Surajita; Bhattacharya, Sujata; Sinha, Sukanta; Bandyopadhyay, Debasis; Ghosal, Chaitry; Gupta, Siddhartha; Majumdar, Pallav Kumar; Saha, Somnath; Gupta, Soma; Bhattacharya, Basudev

    2010-02-01

    Streptococcus pyogenes(group A) is a major pathogen capable of causing a wide range of diseases in different age group of people. In this study 100 patients were selected who presented with the complaint of sore throat. All the patients were divided in four age groups. Streptococcus pyogenes colonies were confirmed on the basis of beta-haemolysis, bacitracin sensitivity test, and latex agglutination test for group A. Out of a total of 100 samples, 42 were confirmed as group A streptococcus. From this study, it has been observed that all age groups, with maximum occurrence in 5-15 years age group, were suffering from group A streptococcal pharyngitis. Therefore every case of sore throat especially affecting children should be investigated to detect the causative agent for initiation of proper therapy so that the more serious outcome like acute rheumatic fever (ARF) and acute glomerulonephritis (AGN) can be prevented.

  18. Small Numbers From Tunneling Between Brane Throats

    SciTech Connect

    Kachru, Shamit

    2001-07-25

    Generic classes of string compactifications include ''brane throats'' emanating from the compact dimensions and separated by effective potential barriers raised by the background gravitational fields. The interaction of observers inside different throats occurs via tunneling and is consequently weak. This provides a new mechanism for generating small numbers in Nature. We apply it to the hierarchy problem, where supersymmetry breaking near the unification scale causes TeV sparticle masses inside the standard model throat. We also design naturally long-lived cold dark matter which decays within a Hubble time to the approximate conformal matter of a long throat. This may soften structure formation at galactic scales and raises the possibility that much of the dark matter of the universe is conformal matter. Finally, the tunneling rate shows that the coupling between throats, mediated by bulk modes, is stronger than a naive application of holography suggests.

  19. Pressure sore prevention in nursing homes.

    PubMed

    Clay, M

    Staff working in nursing homes are caring for ever more dependent residents who are consequently at great risk of developing pressure sores. Mary Clay offers a guide to the essential principles as a teaching aid for all caring staff.

  20. Free flaps for pressure sore coverage.

    PubMed

    Lemaire, Vincent; Boulanger, Kevin; Heymans, Oliver

    2008-06-01

    Management of pressure sores still represents a major challenge in plastic surgery practice due to recurrence. The surgeon may have to face multiple or recurrent pressure ulcerations without any local flap left. In this very limited indication, free flap surgery appears to be a useful adjunct in the surgical treatment. We reviewed our charts looking for patients operated for a pressure sore of the sacral, ischial, or trochanteric region. We found 88 consecutive patients representing 108 different pressure sores and 141 flap procedures. Among these patients, 6 presented large sores that could not be covered with a pedicled flap and benefited from free flap surgery (4.2% of all procedures). Stable coverage was achieved in 80% of these patients after a mean follow-up of 32 months. Comparison between pedicled and free flaps groups showed a trend in the latest concerning the presence of diabetes, incontinence, paraplegia, and male sex.

  1. Pressure sore risk assessment in palliative care.

    PubMed

    Chaplin, J

    2000-01-01

    Pressure sore prevention in palliative care is recognized as being an essential element of holistic care, with the primary goal of promoting quality of life for patient and family. Little is known about the incidence of pressure sore development and the use of pressure sore risk assessment tools in palliative care settings. The development of a risk assessment tool specifically for palliative care patients in a 41-bedded specialist palliative care unit is described. The risk assessment tool was developed as part of a tissue viability practice development initiative. The approach adopted in the validation of the Hunters Hill Marie Curie Centre pressure sore risk assessment tool was the comparative analysis of professional judgment of experienced palliative care nurses with the numerical scores achieved during the assessment of risk on 291 patients (529 risk assessment events). This comparative analysis identified the threshold for different degrees of risk for the patient group involved: low risk, medium risk, high risk and very high risk. Further work is being undertaken to evaluate the inter-rater reliability of the new tool. A number of issues are explored in this paper in relation to pressure sore prevention in palliative care: the role of risk assessment tools, the sometimes conflicting aims of trying to ensure comfort and prevent pressure sore damage, and the uncertainties faced by palliative care nurses when they are trying to maintain quality of life for the dying.

  2. [Delayed post effort muscle soreness].

    PubMed

    Coudreuse, J M; Dupont, P; Nicol, C

    2004-08-01

    Muscle intolerance to exercise may result from different processes. Diagnosis involves confirming first the source of pain, then potential pathological myalgia. Delayed-onset muscle soreness (DOMS), commonly referred as tiredness, occurs frequently in sport. DOMS usually develops 12-48 h after intensive and/or unusual eccentric muscle action. Symptoms usually involve the quadriceps muscle group but may also affect the hamstring and triceps surae groups. The muscles are sensitive to palpation, contraction and passive stretch. Acidosis, muscle spasm and microlesions in both connective and muscle tissues may explain the symptoms. However, inflammation appears to be the most common explanation. Interestingly, there is strong evidence that the progression of the exercise-induced muscle injury proceeds no further in the absence of inflammation. Even though unpleasant, DOMS should not be considered as an indicator of muscle damage but, rather, a sign of the regenerative process, which is well known to contribute to the increased muscle mass. DOMS can be associated with decreased proprioception and range of motion, as well as maximal force and activation. DOMS disappears 2-10 days before complete functional recovery. This painless period is ripe for additional joint injuries. Similarly, if some treatments are well known to attenuate DOMS, none has been demonstrated to accelerate either structural or functional recovery. In terms of the role of the inflammatory process, these treatments might even delay overall recovery.

  3. Orientifolds of warped throats from toric Calabi-Yau singularities

    NASA Astrophysics Data System (ADS)

    Retolaza, Ander; Uranga, Angel

    2016-07-01

    We study the complex deformations of orientifolds of D3-branes at toric CY singularities, using their description in terms of dimer diagrams. We describe orientifold quotients that have fixed lines or fixed points in the dimer, and characterize the possibilities to deform them in terms of the behaviour of zig-zag paths under the orientifold symmetry. The resulting models are holographic duals to warped throats with orientifold planes. Our systematic construction provides a general class of configurations which includes models recently appeared in the context of de Sitter uplift by nilpotent goldstino or dynamical supersymmetry breaking.

  4. Throat Culture from Patients with Meningococcal Meningitis

    DTIC Science & Technology

    1990-01-01

    THROAT CULTURE FROM PATIENTS-’WITH MENINGOCOCCAL MENINGITIS BY J.E. Sippel and N.I. Girigs U.S. NAVAL MEDICAL RESEARCH UNIT NO. 3 (CAIRO, ARAB REPUBLIC...lowv albumin eoncen rations, characteristically, have a centra fpit and are throat swabs from teenage or young dults but that it als’q underestimites...8217described would’/cletzrly facilitate recognition read at 590 tim against commensal staphylococci and strep - NP IIRENWALD The procedure is linear t thie

  5. Perceived Muscle Soreness in Recreational Female Runners.

    PubMed

    Burnett, D; Smith, K; Smeltzer, C; Young, K; Burns, S

    The purpose of this study was to determine if rating of perceived exertion correlated with perceived muscle soreness during delayed onset muscle soreness (DOMS) in female runners. This study examined the pre and post running economy measures and perceived muscle soreness before and after a 30-min downhill run (DHR) at -15% grade and 70% of the subjects predetermined maximum oxygen uptake (VO2 peak). Six female recreational runners (mean age = 24.5) performed level running at 65%, 75%, and 85% of their VO2 peak prior to DHR (baseline economy runs), as well as, immediately following and 4 successive days after the DHR. Subjective response related to perceived muscle soreness increased significantly from a mean of 2 (pre DHR) to 62 (2 days post DHR) on a scale of 1-100. Creatine kinase levels and oxygen consumption increased post DHR compared to pre DHR. Rating of perceived exertion did not change between the economy runs performed prior to or at any point after the DHR. Perceived muscle soreness is a better tool than the RPE scale to monitor exercise intensity for recreational female runners during periods of DOMS and running economy is adversely affected by DOMS.

  6. Perceived Muscle Soreness in Recreational Female Runners

    PubMed Central

    Burnett, D.; Smith, K.; Smeltzer, C.; Young, K.; Burns, S.

    2010-01-01

    The purpose of this study was to determine if rating of perceived exertion correlated with perceived muscle soreness during delayed onset muscle soreness (DOMS) in female runners. This study examined the pre and post running economy measures and perceived muscle soreness before and after a 30-min downhill run (DHR) at −15% grade and 70% of the subjects predetermined maximum oxygen uptake (VO2 peak). Six female recreational runners (mean age = 24.5) performed level running at 65%, 75%, and 85% of their VO2 peak prior to DHR (baseline economy runs), as well as, immediately following and 4 successive days after the DHR. Results: Subjective response related to perceived muscle soreness increased significantly from a mean of 2 (pre DHR) to 62 (2 days post DHR) on a scale of 1–100. Creatine kinase levels and oxygen consumption increased post DHR compared to pre DHR. Rating of perceived exertion did not change between the economy runs performed prior to or at any point after the DHR. Conclusion: Perceived muscle soreness is a better tool than the RPE scale to monitor exercise intensity for recreational female runners during periods of DOMS and running economy is adversely affected by DOMS. PMID:27182336

  7. Nozzle Aerodynamic Stability During a Throat Shift

    NASA Technical Reports Server (NTRS)

    Kawecki, Edwin J.; Ribeiro, Gregg L.

    2005-01-01

    An experimental investigation was conducted on the internal aerodynamic stability of a family of two-dimensional (2-D) High Speed Civil Transport (HSCT) nozzle concepts. These nozzles function during takeoff as mixer-ejectors to meet acoustic requirements, and then convert to conventional high-performance convergent-divergent (CD) nozzles at cruise. The transition between takeoff mode and cruise mode results in the aerodynamic throat and the minimum cross-sectional area that controls the engine backpressure shifting location within the nozzle. The stability and steadiness of the nozzle aerodynamics during this so called throat shift process can directly affect the engine aerodynamic stability, and the mechanical design of the nozzle. The objective of the study was to determine if pressure spikes or other perturbations occurred during the throat shift process and, if so, identify the caused mechanisms for the perturbations. The two nozzle concepts modeled in the test program were the fixed chute (FC) and downstream mixer (DSM). These 2-D nozzles differ principally in that the FC has a large over-area between the forward throat and aft throat locations, while the DSM has an over-area of only about 10 percent. The conclusions were that engine mass flow and backpressure can be held constant simultaneously during nozzle throat shifts on this class of nozzles, and mode shifts can be accomplished at a constant mass flow and engine backpressure without upstream pressure perturbations.

  8. 21 CFR 874.4140 - Ear, nose, and throat bur.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4140 Ear, nose, and throat bur. (a) Identification. An ear, nose, and throat bur is a device consisting of an interchangeable drill bit that is... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat bur. 874.4140 Section...

  9. 21 CFR 874.4140 - Ear, nose, and throat bur.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4140 Ear, nose, and throat bur. (a) Identification. An ear, nose, and throat bur is a device consisting of an interchangeable drill bit that is... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear, nose, and throat bur. 874.4140 Section...

  10. 21 CFR 874.4140 - Ear, nose, and throat bur.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ear, nose, and throat bur. 874.4140 Section 874...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4140 Ear, nose, and throat bur. (a) Identification. An ear, nose, and throat bur is a device consisting of an interchangeable drill bit that...

  11. 21 CFR 874.4140 - Ear, nose, and throat bur.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ear, nose, and throat bur. 874.4140 Section 874...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4140 Ear, nose, and throat bur. (a) Identification. An ear, nose, and throat bur is a device consisting of an interchangeable drill bit that...

  12. 21 CFR 874.4140 - Ear, nose, and throat bur.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ear, nose, and throat bur. 874.4140 Section 874...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4140 Ear, nose, and throat bur. (a) Identification. An ear, nose, and throat bur is a device consisting of an interchangeable drill bit that...

  13. Pressure sore risk assessment in children.

    PubMed

    Waterlow, J A

    1997-07-01

    A multi-centred study was undertaken involving 300 children ranging from neonates to children aged 16 years. The purpose of the study was to investigate the possibility of designing a pressure sore risk assessment scoring system suitable for the paediatric area of care. It was found that the following conclusions can be drawn: (i) Children are at risk of developing pressure sores; (ii) A version of the adult Waterlow card was not appropriate, especially at the younger end of the scale; (iii) There are identifiable situations and treatments which do pose a risk of pressure sore development. Admission documentation and a care plan within a hospital policy is recommended as the best method of drawing nurses' attention to the risk factors involved and the measures which need to be taken to alleviate the risk of tissue damage.

  14. Pressure sore survey. Part 3: Locus of control.

    PubMed

    Maylor, M; Torrance, C

    1999-03-01

    This is the third in a three-part article which investigates the prevalence, knowledge and attitudes to pressure sores in one NHS trust. This study describes the methodology used in choosing and developing attitude scales to explore whether there are any relationships between the locus of control and pressure sore prevention. Factors to do with attitude and the value associated with pressure sore prevention have a central role. Attitudes and beliefs affect what we do and may contribute to pressure sore development.

  15. Throat related symptoms and voice: development of an instrument for self assessment of throat-problems.

    PubMed

    Lyberg-Åhlander, Viveka; Rydell, Roland; Eriksson, Jacqueline; Schalén, Lucyna

    2010-05-27

    Symptoms from throat (sensation of globus; frequent throat clearing; irritated throat) are common in patients referred to voice clinics and to ENT specialists. The relation to symptoms of voice discomfort is unclear and in some cases patients do not have voice problems at all. Instruments for patients' self-reporting of symptoms, and assessment of handicap, such as the Voice Handicap Index (VHI), are in common use in voice clinics. Symptoms from throat are however only marginally covered. To develop and evaluate an instrument that could make the patients' estimation of symptoms from the throat possible. Further to facilitate the consideration of the relation between throat- and voice problems with the Throat subscale together with a Swedish translation of the Voice Handicap Index. Finally to try the VHI with the Throat subscale: the VHI-T, for test-retest reliability and validity. A subscale with 10 throat related items was developed for appliance with the VHI. The VHI was translated to Swedish and retranslated to English. The questionnaire was tried in two phases on a total of 23+144 patients and 12+58 voice healthy controls. The reliability was calculated with Cronbach's alpha, ICC and Pearson's correlation coefficient. The validity was estimated by independent T-test. The difference in VHI-T scores between the patients and the voice-healthy controls was significant (p = < 0,01) and there was a good correlation of the test- retest occasions. The reliability testing of the entire questionnaire showed an alpha value of r = 0,90 and that for the Throat subscale separately a value of r = 0,87 which shows a high degree of reliability. For the estimation of self-perceived throat and voice problems the scale on throat related problems together with the present Swedish translation of the Voice Handicap Index, (VHI) the VHI-Throat, proves to be a valid and reliable instrument. The throat subscale seems to help revealing a category of symptoms that are common in our

  16. [Increased throat symptoms in Japanese cypress pollinosis].

    PubMed

    Ogihara, Hitomi; Yuta, Atsushi; Miyamoto, Yukiko; Kitano, Masako; Takeo, Tetsu; Takeuchi, Kazuhiko

    2011-02-01

    Seasonal allergic rhinitis caused by Japanese cypress pollen is highly associated with that by Japanese cedar pollen, due to the similar antigen of the two pollens. Clinically, patients with cypress pollinosis complain of strong throat symptoms. Weekly nasal and throat symptoms during the pollen season in patients with Japanese cedar-cypress pollinosis were measured using a visual analog scale (VAS). Symptoms other than rhinoconjuctivitis by Japanese rhinitis quality of life questionnaire No2 were compared in two different pollen scattering-seasons. VAS showed that nasal symptoms appeared parallel with pollen scattering, and that they were severe in the cedar season more than in the cypress season. On the other hand, throat disco,fort and cough were worse in the cypress season, even though this study took place of during a year when there was only a small amount of cypress-pollen scattering. The severity of symptoms other than rhinoconjunctivitis in cedar pollinosis depended on the total amount of pollen, however, cypress pollinosis showed severe throat symptoms in both a small and a mass scattering year. Although cypress and cedar pollinosis is considered as the same disease, cypress pollinosis showed more severe symptoms other than rhinoconjunctivitis. Throat symptoms in particular are more severe in cypress pollinosis, even in the year of a small amount of scattering.

  17. Silicone moulding for pressure sore debridement.

    PubMed

    Erba, P; Wettstein, R; Schumacher, R; Schwenzer-Zimmerer, K; Pierer, G; Kalbermatten, D F

    2010-03-01

    The radicality of wound debridement is an important feature of the surgical treatment of pressure sores. Several methods such as injection of methylene blue or hydrogen peroxide have been proposed to facilitate and optimise the surgical debridement technique, but none of them proved to be sufficient. We present an innovative modification of the pseudo-tumour technique consisting in the injection of fluid silicone. Vulcanization of the silicone leads to pressure-sore moulding, permitting a more radical and sterile excision. In a series of 10 paraplegic patients presenting with ischial pressure sores, silicone moulding was used to facilitate debridement. Radical en bloc debridement was achieved in all patients. After a minimal follow-up of 2 years, no complications and recurrences occurred. A three-dimensional (3D) analysis of the silicone prints objectified the pyramidal shape of ischial pressure sores. Our study showed that complete resection without capsular lesion can be easily achieved. Further, it allows the surgeon to analyse the shape and size of the resected defect, which might be helpful to select the appropriate defect coverage technique. (c) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Transpiration cooled throat for hydrocarbon rocket engines

    NASA Technical Reports Server (NTRS)

    May, Lee R.; Burkhardt, Wendel M.

    1991-01-01

    The objective for the Transpiration Cooled Throat for Hydrocarbon Rocket Engines Program was to characterize the use of hydrocarbon fuels as transpiration coolants for rocket nozzle throats. The hydrocarbon fuels investigated in this program were RP-1 and methane. To adequately characterize the above transpiration coolants, a program was planned which would (1) predict engine system performance and life enhancements due to transpiration cooling of the throat region using analytical models, anchored with available data; (2) a versatile transpiration cooled subscale rocket thrust chamber was designed and fabricated; (3) the subscale thrust chamber was tested over a limited range of conditions, e.g., coolant type, chamber pressure, transpiration cooled length, and coolant flow rate; and (4) detailed data analyses were conducted to determine the relationship between the key performance and life enhancement variables.

  19. Dual-throat thruster thermal model

    NASA Technical Reports Server (NTRS)

    Ewen, R. L.; Obrien, C. J.; Matthews, L. W.

    1986-01-01

    The dual-throat engine is one of the dual nozzle engine concepts studied for advanced space transportation applications. It provides a thrust change and an in-flight area ratio change through the use of two concentric combustors with their throats arranged in series. Test results are presented for a dual throat thruster burning gaseous oxygen and hydrogen at primary (inner) chamber pressures from 380 to 680 psia. Heat flux profiles were obtained from calorimetric cooling channels in the inner nozzle, outer or secondary chamber and the tip of the inner nozzle. Data were obtained for two nozzle spacings over a chamber pressure ratio (secondary/primary) range of 0.45 to 0.83 with both chambers firing (Mode I). Fluxes near the end of the inner nozzle were significantly higher than in Mode II when only the inner chamber was fired, due to the flow separation and recirculation caused by the back pressure imposed by the secondary chamber. As the pressure ratio increased, these heat fluxes increased and the region of high heat flux relative to Mode II extended farther upstream. The use of the gaseous hydrogen bleed flow in the secondary chamber to control heat fluxes in the primary plume attachment region was investigated in Mode II testing. A thermal model of a dual throat thruster was developed and upgraded using the experimental data.

  20. Significance of Hemolytic Colonies in Throat Cultures

    PubMed Central

    Quinn, Robert W.; Lowry, P. Nye

    1969-01-01

    These studies indicate that a single strain of hemolytic streptococci almost exclusively predominates the bacterial flora in patients with streptococcal infections and in the carrier state. One can proceed with confidence that, in isolating streptococci from throat swabs cultured on blood-agar plates, only a single hemolytic colony need be picked for serological grouping and typing. PMID:4888863

  1. A Stereolithography Pore-Throat Model

    NASA Astrophysics Data System (ADS)

    Crandall, D.; Ahmadi, G.; Ferer, M.; Smith, D. H.

    2007-12-01

    A new experimental, heterogeneous pore-throat model has been designed and fabricated using stereolithography (SL). In SL production, a laser cures a thin layer of photo-sensitive resin on the surface of a vat of liquid resin; a moveable platform then submerges the cured layer and a new layer is cured on top of the previous one, creating a physical model from a computer generated model. This layered fabrication of a computer generated model has enabled the production of an experimental porous medium with improved fluid resistance properties, as compared to previously studied, constant-height etched cells. A uniform distribution of throat widths was randomly placed throughout the pore-throat matrix and the throat height of each throat was assigned to increase the range of viscous and capillary resistances within the physical model. This variation in both throat height and width generated a porous medium with fairly low porosity (43%), permeability (~400 D), and wide range of geometric resistance properties. Experimental, two-phase immiscible drainage studies in the porous flowcell were performed. Analysis of the captured images was performed with open-source image processing software. These analysis techniques utilized the capability of both ImageJ and the Gnu Image Manipulation Program to be customized with ancillary codes. This enabled batch procedures to be created that converted the original grey-scale bitmaps to binary data sets, which were then analyzed with in-house codes. The fractal dimension, Df, (measured with box-counting) and percent saturation of these experiments were calculated and shown to compare favorably to fractal predictions and previous flowcell studies. Additionally, using the computer generated pore-throat geometry, a computational fluid dynamics model of two- phase flow through the porous medium was created. This model was created using FLUENT code and the Volume of Fluid method. The percent saturation of the less-viscous invading fluid

  2. Dual-fuel, dual-throat engine preliminary analysis

    NASA Technical Reports Server (NTRS)

    Obrien, C. J.

    1979-01-01

    A propulsion system analysis of the dual fuel, dual throat engine for launch vehicle applications was conducted. Basic dual throat engine characterization data were obtained to allow vehicle optimization studies to be conducted. A preliminary baseline engine system was defined.

  3. Optimal site for throat culture: tonsillar surface versus posterior pharyngeal wall.

    PubMed

    van der Veen, E L; Sanders, E A M; Videler, W J M; van Staaij, B K; van Benthem, P P G; Schilder, A G M

    2006-08-01

    To determine the optimal site of throat culture for the detection of potential pathogens by comparing culture results from the tonsillar surface and the posterior pharyngeal wall in children selected for adenotonsillectomy and in children without upper respiratory disease. Cotton culture swabs were taken from the tonsillar surface and the posterior pharyngeal wall of 50 children selected for adenotonsillectomy for symptoms of recurrent tonsillitis and/or adenotonsillar hypertrophy and of 50 children without upper respiratory disease. Potential respiratory pathogens were identified. In the overall group (n = 100), positive culture results were found in 67 posterior pharyngeal wall samples and 47 tonsillar surface samples (P = 0.001). Haemophilus influenzae was the most frequently isolated micro-organism both in the posterior pharyngeal wall and the tonsillar surface samples; 55 and 35%, respectively (P = 0.001). Group A beta-haemolytic streptococci were found in the samples of the posterior pharyngeal wall and the tonsillar surface in 17 and 13%, respectively (P = 0.2). When dealing with patients with sore throat, sampling both tonsillar surfaces is enough for the detection of group A beta-haemolytic streptococci. When detection of other bacteria is also important, such as for research purposes, the posterior pharyngeal wall should be sampled as well.

  4. Delayed onset muscle soreness: is massage effective?

    PubMed

    Nelson, Nicole

    2013-10-01

    Despite the widespread occurrence of delayed onset muscle soreness (DOMS), there is little consensus as to the exact cause or which treatments may be most effective at alleviating symptoms. Greater understanding of DOMS can give sports medicine and fitness professionals an opportunity to help prevent or speed recovery of this performance limiting condition. This article will review the DOMS literature, including the potential role of psychosocial factors and explore studies which involve massage therapy as a treatment modality. Articles from PubMed, MEDLINE, Google Scholar, and references from articles are included in this review. Search words and phrases included delayed onset muscle soreness, repeated bout effect, massage effectiveness, exercise induced muscle damage, and eccentric exercise.

  5. The principles of pressure sore prevention.

    PubMed

    Quinn, D

    In the first Practice Profile to be published in Nursing Standard, Debbie Quinn demonstrates how studying a Continuing Education reader helped to develop an area of clinical practice--the prevention of pressure sores. Continuing Education Readers are made up of between four and six CPD (previously CE) articles and Debbie based her Profile on one of these. We will be publishing further Practice Profiles related to CPD articles.

  6. Delayed onset muscle soreness: mechanisms and management.

    PubMed

    Cleak, M J; Eston, R G

    1992-08-01

    This review describes the phenomenon of delayed onset muscle soreness (DOMS), concentrating upon the types of muscle contraction most likely to produce DOMS and the theories underlying the physiological mechanisms of DOMS. Ways of attempting to reduce the effects of DOMS are also summarized, including the application of physical and pharmacological therapies to reduce the effects of DOMS and training for reduction or prevention of DOMS.

  7. 14 CFR 67.205 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Ear, nose, throat, and equilibrium. 67.205... (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.205 Ear, nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a second-class...

  8. 14 CFR 67.105 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Ear, nose, throat, and equilibrium. 67.105... (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.105 Ear, nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a first-class...

  9. 14 CFR 67.105 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Ear, nose, throat, and equilibrium. 67.105... (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION First-Class Airman Medical Certificate § 67.105 Ear, nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a first-class...

  10. 14 CFR 67.305 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Ear, nose, throat, and equilibrium. 67.305... (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.305 Ear, nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a third-class...

  11. 14 CFR 67.305 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Ear, nose, throat, and equilibrium. 67.305... (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Third-Class Airman Medical Certificate § 67.305 Ear, nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a third-class...

  12. 14 CFR 67.205 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Ear, nose, throat, and equilibrium. 67.205... (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.205 Ear, nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a second-class...

  13. 14 CFR 67.305 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Ear, nose, throat, and equilibrium. 67.305..., nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a third-class airman... by, or that may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium....

  14. 14 CFR 67.205 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Ear, nose, throat, and equilibrium. 67.205..., nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a second-class airman..., vertigo or a disturbance of equilibrium....

  15. 14 CFR 67.205 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Ear, nose, throat, and equilibrium. 67.205..., nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a second-class airman..., vertigo or a disturbance of equilibrium....

  16. 14 CFR 67.105 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Ear, nose, throat, and equilibrium. 67.105..., nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a first-class airman... may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium....

  17. 14 CFR 67.305 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Ear, nose, throat, and equilibrium. 67.305..., nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a third-class airman... by, or that may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium....

  18. 14 CFR 67.305 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Ear, nose, throat, and equilibrium. 67.305..., nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a third-class airman... by, or that may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium....

  19. 14 CFR 67.105 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Ear, nose, throat, and equilibrium. 67.105..., nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a first-class airman... may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium....

  20. 14 CFR 67.205 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Ear, nose, throat, and equilibrium. 67.205..., nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a second-class airman..., vertigo or a disturbance of equilibrium....

  1. 14 CFR 67.105 - Ear, nose, throat, and equilibrium.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Ear, nose, throat, and equilibrium. 67.105..., nose, throat, and equilibrium. Ear, nose, throat, and equilibrium standards for a first-class airman... may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium....

  2. The 'reading man flap' for pressure sore reconstruction.

    PubMed

    Sapountzis, Stamatis; Park, Hyoung Joon; Kim, Ji Hoon; Chantes, Achilleas; Beak, Rong Min; Heo, Chan Yeong

    2011-09-01

    The treatment of pressure sores represents a significant challenge to health care professionals. Although, pressure wound management demands a multidisciplinary approach, soft tissue defects requiring reconstruction are often considered for surgical management. Myocutaneous and fasciocutaneous flaps can provide stable coverage of pressure sores. Here, we describe our experience using a recent fasciocutaneous flap, which is named 'reading man' flap, in sacral, ischial, and trochanteric pressure sores. During a period of 1 year the authors operated 16 patients, 11 men, and 5 women, using the reading man flap. The ages of the patients ranged from 24 to 78 years. The location of pressure sores was 8 sacral, 5 ischial, and 3 trochanteric pressure sores. The mean size of pressure sores was 8 cm × 9 cm. All pressure sores covered bt the Reading Man flap healed asymptomatically. After follow-up of 2-8 months, no recurrences were encountered and no further surgical intervention was required. The reading man flap was found to be a useful technique for the closure of pressure sore in different anatomic locations. The advantage of tension-free closure and the minimal additional healthy skin excision made this flap a useful tool in pressure sore reconstructions.

  3. Pressure sore prevention in hospital patients: a clinical audit.

    PubMed

    Grewal, P S; Sawant, N H; Deaney, C N; Gibson, K M; Gupta, A M; Haverty, P F; Panditaratne, H G; Samarasinghe, S R; Sharma, A; Singh, S; Turner, S A; Wilkinson, S L; Wood, S P; Glickman, S

    1999-03-01

    Pressure sores cause significant mortality and morbidity as well as being a financial burden on health-care services. Reduction of pressure sore incidence is a Department of Health priority. Pressure sores are accepted as largely preventable complications of illness and disability and the means to achieve prevention are available. The aim of this clinical audit was to identify potential contributing factors to pressure sore acquisition in an acute hospital setting. The results suggest that substantial changes in the approach to clinical management may be needed.

  4. The effects of ice massage on delayed muscle soreness.

    PubMed

    Yackzan, L; Adams, C; Francis, K T

    1984-01-01

    The following hypotheses were tested in the present study: (1) cryotherapy would reduce delayed muscle soreness (DMS) in eccentrically exercised muscles; (2) early cold treatment would reduce this soreness more than later postexercise treatment times; and (3) joint range of motion (ROM) would be inversely related to the subjective soreness ratings. Subjective sensations of muscular soreness and changes in elbow joint ROM were assessed in 30 subjects at 0, 24, 48, and 72 hours following eccentric-biased exercise in the elbow flexors. Cold treatments were applied immediately, 24 or 48 hours following a single exercise session. In response to the eccentric exercise, significant muscle soreness increases and elbow ROM decreases were observed in all exercised muscles from 24 to 48 hours postexercise. No differences in muscle soreness or elbow ROM changes were observed between treated and untreated arms except for one. Subjects treated at 24 hours postexercise reported greater soreness in their arms compared to untreated arms just prior to treatment (24 hour postexercise). The results do not support the efficacy of cold in reducing DMS. A negative correlation between muscle soreness and elbow ROM at 48 and 72 hours postexercise indicated that an increase in soreness was associated with a decrease in ROM.

  5. The ‘reading man flap’ for pressure sore reconstruction

    PubMed Central

    Sapountzis, Stamatis; Park, Hyoung Joon; Kim, Ji Hoon; Chantes, Achilleas; Beak, Rong Min; Heo, Chan Yeong

    2011-01-01

    Background: The treatment of pressure sores represents a significant challenge to health care professionals. Although, pressure wound management demands a multidisciplinary approach, soft tissue defects requiring reconstruction are often considered for surgical management. Myocutaneous and fasciocutaneous flaps can provide stable coverage of pressure sores. Purpose: Here, we describe our experience using a recent fasciocutaneous flap, which is named ‘reading man’ flap, in sacral, ischial, and trochanteric pressure sores. Materials and Methods: During a period of 1 year the authors operated 16 patients, 11 men, and 5 women, using the reading man flap. The ages of the patients ranged from 24 to 78 years. The location of pressure sores was 8 sacral, 5 ischial, and 3 trochanteric pressure sores. The mean size of pressure sores was 8 cm × 9 cm. Results: All pressure sores covered bt the Reading Man flap healed asymptomatically. After follow-up of 2-8 months, no recurrences were encountered and no further surgical intervention was required. Conclusion: The reading man flap was found to be a useful technique for the closure of pressure sore in different anatomic locations. The advantage of tension-free closure and the minimal additional healthy skin excision made this flap a useful tool in pressure sore reconstructions. PMID:22279278

  6. Throat Disorders - Multiple Languages: MedlinePlus

    MedlinePlus

    ... List of All Topics All Throat Disorders - Multiple Languages To use the sharing features on this page, please enable JavaScript. Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Russian (Русский) Somali (af Soomaali) Spanish (español) Ukrainian (Українська) ...

  7. Pressure sores and pressure sore prevention in a rehabilitation setting: building information for improving outcomes and allocating resources.

    PubMed

    Baggerly, J; DiBlasi, M

    1996-01-01

    Quantifiable information regarding pressure sore prevention and management is a prerequisite for program development, outcome evaluation, and resource allocation. In this study, all patients admitted to an acute rehabilitation setting (N = 446) during a 2-month period were assessed for the presence of a pressure sore, the risk for developing a pressure sore, the rate of agreement between "objective" (Braden scale) and "subjective" (standard nursing admission data) measures of risk and outcome, and the status of pressure sores at discharge. This article provides the details of the project and implications for rehabilitation nursing practice.

  8. Study into the correlation of dominant pore throat size and SIP relaxation frequency

    NASA Astrophysics Data System (ADS)

    Kruschwitz, Sabine; Prinz, Carsten; Zimathies, Annett

    2016-12-01

    There is currently a debate within the SIP community about the characteristic textural length scale controlling relaxation time of consolidated porous media. One idea is that the relaxation time is dominated by the pore throat size distribution or more specifically the modal pore throat size as determined in mercury intrusion capillary pressure tests. Recently new studies on inverting pore size distributions from SIP data were published implying that the relaxation mechanisms and controlling length scale are well understood. In contrast new analytical model studies based on the Marshall-Madden membrane polarization theory suggested that two relaxation processes might compete: the one along the short narrow pore (the throat) with one across the wider pore in case the narrow pores become relatively long. This paper presents a first systematically focused study into the relationship of pore throat sizes and SIP relaxation times. The generality of predicted trends is investigated across a wide range of materials differing considerably in chemical composition, specific surface and pore space characteristics. Three different groups of relaxation behaviors can be clearly distinguished. The different behaviors are related to clay content and type, carbonate content, size of the grains and the wide pores in the samples.

  9. New concepts in the prevention of pressure sores.

    PubMed

    Bogie, Kath; Powell, Heather L; Ho, Chester H

    2012-01-01

    Pressure sores are a serious, and costly, complication for many patients with reduced mobility and sensation. Some populations, such as those with spinal cord injury (SCI), remain at high risk throughout their lifetime. Prevention is highly preferable and while the concept is readily definable, it is much more challenging to develop valid preventative measures. Subjective and objective approaches to risk factor assessment before pressure sores develop are reviewed, including risk status scales and emerging techniques to assess deep tissue injury. Devices to prevent pressure sores have traditionally focused on pressure-relieving cushions and mattresses. Technological advances being applied in the development of new pressure sore prevention devices are presented. Clinical evidence-based practice is integral to pressure sore prevention. Comprehensive assessment must include evaluation of systemic diseases, anatomical and physiological factors, together with environmental and psychosocial factors, which can all contribute to pressure sore development. Extrinsic factors need to be considered in conjunction with intrinsic tissue health factors and are reviewed together with an evaluation of currently available clinical practice guidelines. This chapter presents the broad diversity of factors associated with pressure sore development and highlights the need for an interdisciplinary team approach in order to maximize successful prevention of pressure sores. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Does Postexercise Static Stretching Alleviate Delayed Muscle Soreness?

    ERIC Educational Resources Information Center

    Buroker, Katherine C.; Schwane, James A.

    1989-01-01

    Because many experts recommend stretching after exercise to relieve muscle soreness, 23 subjects performed a 30-minute step test to induce delayed muscle soreness. There was neither temporary relief of pain immediately after stretching nor a reduction in pain during the 3-day postexercise period. (Author/SM)

  11. Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score

    PubMed Central

    2011-01-01

    Background Stratifying patients with a sore throat into the probability of having an underlying bacterial or viral cause may be helpful in targeting antibiotic treatment. We sought to assess the diagnostic accuracy of signs and symptoms and validate a clinical prediction rule (CPR), the Centor score, for predicting group A β-haemolytic streptococcal (GABHS) pharyngitis in adults (> 14 years of age) presenting with sore throat symptoms. Methods A systematic literature search was performed up to July 2010. Studies that assessed the diagnostic accuracy of signs and symptoms and/or validated the Centor score were included. For the analysis of the diagnostic accuracy of signs and symptoms and the Centor score, studies were combined using a bivariate random effects model, while for the calibration analysis of the Centor score, a random effects model was used. Results A total of 21 studies incorporating 4,839 patients were included in the meta-analysis on diagnostic accuracy of signs and symptoms. The results were heterogeneous and suggest that individual signs and symptoms generate only small shifts in post-test probability (range positive likelihood ratio (+LR) 1.45-2.33, -LR 0.54-0.72). As a decision rule for considering antibiotic prescribing (score ≥ 3), the Centor score has reasonable specificity (0.82, 95% CI 0.72 to 0.88) and a post-test probability of 12% to 40% based on a prior prevalence of 5% to 20%. Pooled calibration shows no significant difference between the numbers of patients predicted and observed to have GABHS pharyngitis across strata of Centor score (0-1 risk ratio (RR) 0.72, 95% CI 0.49 to 1.06; 2-3 RR 0.93, 95% CI 0.73 to 1.17; 4 RR 1.14, 95% CI 0.95 to 1.37). Conclusions Individual signs and symptoms are not powerful enough to discriminate GABHS pharyngitis from other types of sore throat. The Centor score is a well calibrated CPR for estimating the probability of GABHS pharyngitis. The Centor score can enhance appropriate prescribing of

  12. Laser homeostatics on delayed onset muscle soreness

    NASA Astrophysics Data System (ADS)

    Liu, T. C. Y.; Fu, D. R.; Liu, X. G.; Tian, Z. X.

    2011-01-01

    Delayed onset muscle soreness (DOMS) and its photobiomodulation were reviewed from the viewpoint of function-specific homeostasis (FSH) in this paper. FSH is a negative-feedback response of a biosystem to maintain the function-specific fluctuations inside the biosystem so that the function is perfectly performed. A stressor may destroy a FSH. A stress is a response of a biosystem to a stressor and may also be in stress-specific homeostasis (StSH). A low level light (LLL) is so defined that it has no effects on a function in its FSH or a stress in its StSH, but it modulate a function far from its FSH or a stress far from its StSH. For DOMS recovery, protein metabolism in the Z-line streaming muscular cell is the essential process, but the inflammation, pain and soreness are non-essential processes. For many DOMS phenomena, protein metabolism in the Z-line streaming muscular cell is in protein metabolism-specific homeostasis (PmSH) so that there are no effects of LLL although the inflammation can be inhibited and the pain can be relieved. An athlete or animal in the dysfunctional conditions such as blood flow restriction and exercise exhaustion is far from PmSH and the protein metabolism can be improved with LLL.

  13. Tissue electrical properties monitoring for the prevention of pressure sore.

    PubMed

    Ching, Congo Tak-Shing; Chou, Mei-Yun; Jiang, Siou-Jhen; Huang, Su-Hua; Sun, Tai-Ping; Liu, Wei-Hao; Liu, Chia-Ming

    2011-12-01

    Pressure sores are a significant problem in the healthcare sector. Although they may cause considerable morbidity, they are preventable. The objectives of this study are to (1) investigate the electrical properties of a tissue close to and away from the pressure sore site, and (2) establish a new approach for objective, reliable, low-cost and noninvasive screening or detection of pressure sore in its early stage. Randomised controlled trial. Fifteen patients participated in this study. They all had stage I or stage II sacral pressure sores. Tiny surface electrodes in four-electrode configuration were used for all tissue electrical properties measurements recorded over the frequency range of 30-10 MHz. Intraclass correlation coefficient (ICC) showed that all measurements (ICC > 0.90 for all measurements) had good reliability and validity. The real part of impedance (R) and the imaginary part of impedance (X) of a tissue measured close to the pressure sore site was found to be significantly smaller (p < 0.05 in all cases) than that measured away from the pressure sore site at a specific frequency range (R: 30.00-38.55 Hz; X: 43.95-606.40 Hz). It was also found that the extracellular resistance (R(e)) and the ratio of extracellular resistance to intracellular resistance (R(e)/R(i)) of a tissue measured close to the pressure sore site were significantly smaller (p < 0.05 in all cases) than that measured away from the pressure sore site. Since the electrical properties (R, X, R(e), R(e)/R(i) ) of a tissue close to, and away from, the pressure sore site can be significantly distinguished, a potentially promising method for the screening of pressure sores at an early stage has been proposed.

  14. Exclusive Staphylococcus aureus throat carriage: at-risk populations.

    PubMed

    Mertz, Dominik; Frei, Reno; Periat, Nadine; Zimmerli, Melanie; Battegay, Manuel; Flückiger, Ursula; Widmer, Andreas F

    2009-01-26

    Approximately 25% of Staphylococcus aureus carriers have exclusive throat carriage. We aimed to identify the populations at risk for exclusive throat carriage to improve sensitivity to detect carriers. Four groups underwent nasal and throat screening for S. aureus. Three groups of individuals in the community (n = 2632) with different estimated levels of exposure to the health care system (HCS) were screened, including 1500 healthy blood donors, 498 patients from a school of dental medicine, and 634 health care workers (HCWs) at a trade fair. The fourth group comprised in-hospital patients and HCWs (n = 832) and was considered the group with the highest estimated exposure to the HCS. As a primary outcome, we analyzed risk factors for exclusive throat carriage in exclusive throat carriers vs all nasal carriers. Of 3464 individuals screened, 428 (12.4%) had exclusive throat carriage, and 1260 (36.4%) had carriage in the nares only or in the nares and the throat. The most important independent risk factor for exclusive throat carriage was age 30 years or younger (odds ratio, 1.66; P < .001). Exposure to the HCS was a significant protective factor for exclusive throat carriage (odds ratio, 0.67; P = .001). Healthy blood donors were almost twice as likely to have exclusive throat carriage than in-hospital patients and HCWs (30.2% vs 18.4% of all carriers, P < .001). Absence of exposure to the HCS and younger age predicted exclusive throat carriers, a population at high risk for community-onset methicillin-resistant S. aureus. Screening for S. aureus should include swabs from the anterior nares and from the throat to improve the likelihood of detecting carriers.

  15. RSRM Nozzle Anomalous Throat Erosion Investigation Overview

    NASA Technical Reports Server (NTRS)

    Clinton, R. G., Jr.; Wendel, Gary M.

    1998-01-01

    In September, 1996, anomalous pocketing erosion was observed in the aft end of the throat ring of the nozzle of one of the reusable solid rocket motors (RSRM 56B) used on NASA's space transportation system (STS) mission 79. The RSRM throat ring is constructed of bias tape-wrapped carbon cloth/ phenolic (CCP) ablative material. A comprehensive investigation revealed necessary and sufficient conditions for occurrence of the pocketing event and provided rationale that the solid rocket motors for the subsequent mission, STS-80, were safe to fly. The nozzles of both of these motors also exhibited anomalous erosion similar to, but less extensive than that observed on STS-79. Subsequent to this flight, the investigation to identify both the specific causes and the corrective actions for elimination of the necessary and sufficient conditions for the pocketing erosion was intensified. A detailed fault tree approach was utilized to examine potential material and process contributors to the anomalous performance. The investigation involved extensive constituent and component material property testing, pedigree assessments, supplier audits, process audits, full scale processing test article fabrication and evaluation, thermal and thermostructural analyses, nondestructive evaluation, and material performance tests conducted using hot fire simulation in laboratory test beds and subscale and full scale solid rocket motor static test firings. This presentation will provide an over-view of the observed anomalous nozzle erosion and the comprehensive, fault-tree based investigation conducted to resolve this issue.

  16. RSRM Nozzle Anomalous Throat Erosion Investigation Overview

    NASA Technical Reports Server (NTRS)

    Clinton, R. G., Jr.; Wendel, Gary M.

    1998-01-01

    In September, 1996, anomalous pocketing erosion was observed in the aft end of the throat ring of the nozzle of one of the reusable solid rocket motors (RSRM 56B) used on NASA's space transportation system (STS) mission 79. The RSRM throat ring is constructed of bias tape-wrapped carbon cloth/ phenolic (CCP) ablative material. A comprehensive investigation revealed necessary and sufficient conditions for occurrence of the pocketing event and provided rationale that the solid rocket motors for the subsequent mission, STS-80, were safe to fly. The nozzles of both of these motors also exhibited anomalous erosion similar to, but less extensive than that observed on STS-79. Subsequent to this flight, the investigation to identify both the specific causes and the corrective actions for elimination of the necessary and sufficient conditions for the pocketing erosion was intensified. A detailed fault tree approach was utilized to examine potential material and process contributors to the anomalous performance. The investigation involved extensive constituent and component material property testing, pedigree assessments, supplier audits, process audits, full scale processing test article fabrication and evaluation, thermal and thermostructural analyses, nondestructive evaluation, and material performance tests conducted using hot fire simulation in laboratory test beds and subscale and full scale solid rocket motor static test firings. This presentation will provide an over-view of the observed anomalous nozzle erosion and the comprehensive, fault-tree based investigation conducted to resolve this issue.

  17. [Experience in the treatment of severe pressure sore].

    PubMed

    Xu, Xi-Sheng; ma, Zheng-Zheng; Zhou, Yong-Sheng; Ou, Cai-Sheng; Cheng, Yong; Chen, Kai; Li, Bo-Tong; Zhou, Hai-Yang; Hu, Yong-Cai

    2011-11-01

    To summarize the experience in the treatment of severe pressure sore. From Aug. 2007 to Jun. 2011, 21 cases of severe pressure sore with 43 III-IV degree lesions were treated with combination treatment, including vacuum sealing drainage technique, local fascia flaps, upper or lower gluteus maximus island myocutaneous flaps, lower gluteus maximus myocutaneous flap, neurocutaneous femoris posterior flaps, tensor fascia lata island myocutaneous flaps, free latissimus dorsi myocutaneous flaps, and skin graft, combined with stryker frame and nursing tracking guidance. 13 of 21 cases had multiple pressure sore. Among them, 5 III degree pressure sores were covered by skin grafting and 3 non-caudal III degree pressure sores (< 2 cm in width) were directly closed after debridement. 8 of 21 cases had single IV degree pressure sore. All the 43 wounds healed completely. 5 wounds in 3 cases had effusion under flap which healed after re-drainage. The wounds were not healed in 3 cases with flap transposition which were also healed after re-debridement. All the flaps survived completely. 16 cases were followed up for 2-26 months. Recurrence happened in 4 cases after discharge because of not following the required nursing care. Comprehensive application of vacuum sealing drainage technique, multiple myocutaneous flaps and skin grafting, combined with stryker frame and nursing tracking guidance after discharge can be used for the treatment of severe pressure sore with satisfactory results.

  18. Can electric beds aid pressure sore prevention in hospitals?

    PubMed

    Hampton, S

    The purchase, cleaning and maintenance of air mattresses can be an expensive part of pressure sore prevention and repositioning of patients can be time consuming and costly in terms of possible nursing injuries. The King's Fund bed has been a friend to the health service for many years but the time has come to look for an alternative system that will support patient comfort and independence, will assist nurses in implementation of a no-lifting policy and aid pressure sore prevention policies. This article describes a study that was undertaken in two medical wards to assess the value of electrically controlled beds in relation to the prevention of pressure sores, implementation of a no-lifting policy and quality of patient care. A total of 782 patients took part in the study over a 6-month period and 726 replies were obtained from nurses. The ward had similar profiles of patients' medical conditions and age; they were being medically managed by the same consultants. Results showed that patients experienced greater comfort on beds with the electric facility, produced less pressure sores, mobilized easily and pressure sore prevention costs could be reduced. There is a need to be proactive in prevention of pressure sores and not reactive to a pressure sore that is already developing.

  19. Trunk, abdomen, and pressure sore reconstruction.

    PubMed

    Rubayi, Salah; Chandrasekhar, Bala S

    2011-09-01

    After reading this article, the participant should be able to: 1. Describe the principles of wound closure, torso reconstruction, and pressure sore reconstruction. 2. Outline standard options to treat defects of the chest, abdomen, and back and pressure ulcers in all anatomical areas. 3. Manage and prevent pressure ulcers. Chest wall reconstruction is indicated following tumor resection, radiation wound breakdown, or intrathoracic sepsis. Principles of wound closure and chest wall stabilization, where indicated, are discussed. Principles of abdominal wall reconstruction continue to evolve with the introduction of newer bioprosthetics and the application of functional concepts for wound closure. The authors illustrate these principles using commonly encountered clinical scenarios and guidelines to achieve predictable results. Pressure ulcers continue to be devastating complications to patients' health and a functional hazard when they occur in the bedridden, in patients with spinal cord injuries, and in patients with neuromuscular disease. Management of pressure ulcers is also very expensive. The authors describe standard options to treat defects of the chest, abdomen, and back and pressure ulcers in all anatomical areas. A comprehensive understanding of principles and techniques will allow practitioners to approach difficult issues of torso reconstruction and pressure sores with a rational confidence and an expectation of generally satisfactory outcomes. With pressure ulcers, prevention remains the primary goal. Patient education and compliance coupled with a multidisciplinary team approach can reduce their occurrence significantly. Surgical management includes appropriate patient selection, adequate débridement, soft-tissue coverage, and use of flaps that will not limit future reconstructions if needed. Postoperatively, a strict protocol should be adapted to ensure the success of the flap procedure. Several myocutaneous flaps commonly used for the surgical

  20. Time course of muscle soreness following different types of exercise

    PubMed Central

    Vickers, Andrew J

    2001-01-01

    Background Post-exercise muscle soreness is a dull, aching sensation that follows unaccustomed muscular exertion. Primarily on the basis of previous laboratory-based research on eccentric exercise, soreness is usually said to follow an inverted U-shaped curve over time, peaking 24 – 48 hours after exercise. As such, it is often described as "delayed-onset" muscle soreness. In a study of long-distance runners, soreness seemed to peak immediately and then reduce gradually over time. The study is a secondary analysis of clinical trial data that aims to determine whether the time course of soreness following a natural exercise, long-distance running, is different from that following a laboratory-based exercise, bench-stepping. Methods This is a reanalysis of data from three previous clinical trials. The trials included 400 runners taking part in long-distance races and 82 untrained volunteers performing a bench-stepping test. Subjects completed a Likert scale of muscle soreness every morning and evening for the five days following their exercise. Results Interaction between trial and time is highly significant, suggesting a different time course of soreness following running and bench-stepping. 45% of subjects in the bench-stepping trial experienced peak soreness at the third or fourth follow-up (approximately 36 – 48 hours after exercise) compared to only 14% of those in the running trial. The difference between groups is robust to multivariate analysis incorporating possible confounding variables. Conclusion Soreness in runners following long-distance running follows a different time course to that in untrained individuals undertaking bench-stepping. Research on exercise taking place in the laboratory context does not necessarily generalize to exercise undertaken by trained athletes when engaged in their chosen sport. PMID:11701094

  1. Do Shale Pore Throats Have a Threshold Diameter for Oil Storage?

    PubMed

    Zou, Caineng; Jin, Xu; Zhu, Rukai; Gong, Guangming; Sun, Liang; Dai, Jinxing; Meng, Depeng; Wang, Xiaoqi; Li, Jianming; Wu, Songtao; Liu, Xiaodan; Wu, Juntao; Jiang, Lei

    2015-08-28

    In this work, a nanoporous template with a controllable channel diameter was used to simulate the oil storage ability of shale pore throats. On the basis of the wetting behaviours at the nanoscale solid-liquid interfaces, the seepage of oil in nano-channels of different diameters was examined to accurately and systematically determine the effect of the pore diameter on the oil storage capacity. The results indicated that the lower threshold for oil storage was a pore throat of 20 nm, under certain conditions. This proposed pore size threshold provides novel, evidence-based criteria for estimating the geological reserves, recoverable reserves and economically recoverable reserves of shale oil. This new understanding of shale oil processes could revolutionize the related industries.

  2. Do Shale Pore Throats Have a Threshold Diameter for Oil Storage?

    NASA Astrophysics Data System (ADS)

    Zou, Caineng; Jin, Xu; Zhu, Rukai; Gong, Guangming; Sun, Liang; Dai, Jinxing; Meng, Depeng; Wang, Xiaoqi; Li, Jianming; Wu, Songtao; Liu, Xiaodan; Wu, Juntao; Jiang, Lei

    2015-08-01

    In this work, a nanoporous template with a controllable channel diameter was used to simulate the oil storage ability of shale pore throats. On the basis of the wetting behaviours at the nanoscale solid-liquid interfaces, the seepage of oil in nano-channels of different diameters was examined to accurately and systematically determine the effect of the pore diameter on the oil storage capacity. The results indicated that the lower threshold for oil storage was a pore throat of 20 nm, under certain conditions. This proposed pore size threshold provides novel, evidence-based criteria for estimating the geological reserves, recoverable reserves and economically recoverable reserves of shale oil. This new understanding of shale oil processes could revolutionize the related industries.

  3. Stress-testing of the throat of a rocket's nozzle

    NASA Technical Reports Server (NTRS)

    Estes, E. G.

    1969-01-01

    Test motor in which high initial pressure can be reduced suddenly provides a method of testing stress effects in the throat of a rockets nozzle. Motors operating pressure is increased to aggravate tensile stresses in a submerged throat. Opposing compression stresses are limited by control of the operating pressure.

  4. Dual throat thruster cold flow analysis

    NASA Technical Reports Server (NTRS)

    Lundgreen, R. B.; Nickerson, G. R.; Obrien, C. J.

    1978-01-01

    The concept was evaluated with cold flow (nitrogen gas) testing and through analysis for application as a tripropellant engine for single-stage-to-orbit type missions. Three modes of operation were tested and analyzed: (1) Mode 1 Series Burn, (2) Mode 1 Parallel Burn, and (3) Mode 2. Primary emphasis was placed on the Mode 2 plume attachment aerodynamics and performance. The conclusions from the test data analysis are as follows: (1) the concept is aerodynamically feasible, (2) the performance loss is as low as 0.5 percent, (3) the loss is minimized by an optimum nozzle spacing corresponding to an AF-ATS ratio of about 1.5 or an Le/Rtp ratio of 3.0 for the dual throat hardware tested, requiring only 4% bleed flow, (4) the Mode 1 and Mode 2 geometry requirements are compatible and pose no significant design problems.

  5. An unusual pressure sore of the nasal bridge.

    PubMed

    Sleilati, Fadi H; Stephan, Henri A; Nasr, Marwan W; Riachy, Moussa A

    2008-07-01

    We report an unusual pressure sore of the nasal bridge caused by a non-invasive ventilation mask. Conservative treatment was unsuccessful, and the defect had to be repaired, with a good postoperative result.

  6. Can You Get Genital Herpes from a Cold Sore?

    MedlinePlus

    ... Lucy* Yes — it is possible to get genital herpes from oral sex. Genital herpes is caused by the herpes ... Genital herpes is usually caused by HSV-2; oral herpes (cold sores) is usually caused by HSV-1. ...

  7. β-Hemolytic streptococcal throat carriage and tonsillopharyngitis: a cross-sectional prevalence study in Gabon, Central Africa.

    PubMed

    Bélard, Sabine; Toepfner, Nicole; Arnold, Benjamin; Alabi, Abraham Sunday; Berner, Reinhard

    2015-04-01

    Group A streptococcus (GAS) and possibly other β-hemolytic streptococci (BHS) account for a considerable morbidity and mortality burden in African populations; however, disproportionately little is known about the epidemiology of BHS in sub-Saharan Africa. This study assessed the prevalence of GAS, group G streptococcus (GGS) and group C streptococcus (GCS) carriage and tonsillopharyngitis in a Central African population. A prospective cross-sectional study was performed to assess the prevalence of and risk factors for BHS carrier status and tonsillopharyngitis in children and adults in Gabon. The overall BHS carrier prevalence was 135/1,005 (13.4%); carrier prevalence of GAS, GGS, and GCS was 58/1,005 (5.8%), 50/1,005 (5.0%), and 32/1,005 (3.2%), respectively. Streptococcal carriage was associated with school and pre-school age (adjusted OR 2.65, 95% CI 1.62-4.36, p = 0.0001 and 1.90, 95% CI 1.14-3.17, p = 0.0141, respectively). Participants residing in urban areas were less likely carriers (OR 0.52, p = 0.0001). The point-prevalence of BHS-positive tonsillopharyngitis was 1.0% (9/1,014) and 15.0% (6/40) in school children with sore throat. Non-GAS exceeded GAS throat carriage and tonsillopharyngitis suggesting a yet underestimated role of non-GAS streptococci in BHS diseases.

  8. Effects of Fish Oil Supplementation on Postresistance Exercise Muscle Soreness.

    PubMed

    Tinsley, Grant M; Gann, Joshua J; Huber, Stefan R; Andre, Thomas L; La Bounty, Paul M; Bowden, Rodney G; Gordon, Paul M; Grandjean, Peter W

    2016-07-21

    The aim of this study was to examine the effects of fish oil supplementation on the magnitude and time-course of postresistance exercise muscle soreness. This study was a randomized, placebo-controlled, double-blind trial. Nonresistance trained females were randomized into one of two groups: fish oil supplementation (6 g/day; 5:1 eicosapentaenoic acid to docosahexaenoic acid (EPA:DHA)) or placebo (6 g/day corn/soy oil). After consuming the supplements for one week, participants underwent a single bout of resistance exercise consisting of 10 sets to failure of elbow flexion and leg extension machines. Muscle soreness was measured daily over the next week via grounded visual analog scale while participants continued to consume their assigned supplement. At 48 hours and one week postexercise, soreness during functional movements and limb circumferences were measured. The fish oil group perceived less static and functional muscle soreness than placebo, although the differences were not statistically significant. Effect sizes for resistance exercise-induced static and functional soreness responses were 33 to 42% lower in fish oil versus placebo without changes in upper arm and thigh circumferences. Supplementing the diet with 6 g per day of fish oil may alleviate muscle soreness experienced after resistance training in young untrained females.

  9. Factors in delayed onset muscular soreness of man.

    PubMed

    Bobbert, M F; Hollander, A P; Huijing, P A

    1986-02-01

    In this study 11 subjects performed exercise resulting in delayed onset muscular soreness in m. gastrocnemius with one leg, the experimental leg. The other leg served as control. Pre-exercise and 24, 48 and 72 h postexercise, soreness perception, resting EMG level of m. gastrocnemius, and volume and skin temperature of both legs were measured, and a leukocyte count was performed. Perception of soreness in m. gastrocnemius reported 24, 48, and 72 h postexercise was not accompanied by an increase in resting EMG level. This result indicates that soreness perception is not related to a tonic localized spasm in sore muscles. A rise in volume of the experimental leg relative to volume of the control leg was found 24, 48, and 72 h postexercise (P less than 0.05). It is suggested that the volume rise is due to edema formation in the experimental leg and that this edema formation is responsible for soreness perception. Since granulocytosis was not found, the hypothesis that edema formation reflects muscle inflammation is not substantiated.

  10. [Six treatment principles of the basle pressure sore concept].

    PubMed

    Rieger, U; Scheufler, O; Schmid, D; Zweifel-Schlatter, M; Kalbermatten, D; Pierer, G

    2007-06-01

    The treatment of pressure sores has gained importance due to the increase of geriatric patients and general life expectancy as well as improved therapeutic options in patients with spinal cord injuries. The aetiology of pressure sores is multifactorial. Risk factors such as immobility, malnutrition, and other co-morbidities have to be considered. Therapy of pressure sores is time- and cost-consuming and recurrence rates are high. Successful treatment is based on the interdisciplinary cooperation between conservative and surgical disciplines, nursing, as well as on continuous patient education. The Basle pressure sore concept consists of six principles. Over a total treatment period of approximately three months usually two operative interventions are performed. For effective relief of pressure (1st principle) patients are placed on low-airloss beds. Operative debridement of pressure sores is performed early and systemic or local infection is treated (2nd principle). The wound is then conditioned with moist dressings or VAC (3rd principle). Simultaneously concomitant malnutrition is quantified clinically and chemically and treated by oral or, if necessary, parenteral nutrition. Other risk factors are optimised as well as possible (4th principle). Hereby optimal conditions for plastic-surgical coverage are provided (5th principle). Postoperatively a standardised concept of pressure relief and mobilisation is adhered to (6th principle). This multimodal treatment concept is well established at the University Hospital of Basle for many years. Combined with an effective prevention, the rate of pressure sores could be significantly reduced, wounds could be healed, and the number of recurrences diminished. In a two-year period between January 2004 and December 2005 the Basle plastic surgery team treated 170 pressure sores in 142 patients according to this concept in the Swiss paraplegic centre in Nottwil. In 2006, 78 % of these patients (111 patients) were followed up and

  11. Diagnosis of Group A Streptococcal Infections Directly From Throat Gargle.

    DTIC Science & Technology

    1981-06-01

    Streptococcal Infection Strep Throat Latex agglutination 20. ARVAT(Continue an revere side it neessar and identify by block num~ber) The diagnosis of... THROAT GARGLE ,-I E. A. EDWARDS, 1. A. PH1WPS & W. C. SUITER REPORT NO. 81-20 DTIC IELECTE VAL A11OCT I lSlt P.O. BOX 8022 SAN DIEGO, CALIFORNIA 92138...AVAL MICAL RESEARCH AND DEVELOPMENT COMMAND BE0hESDA, MARYLAND £ 81 9 30 069 (. DIAGNOSIS OF QROUP A STREPTOCOCCAL INFECTIONS ~1IRECTLY FROM ThROAT

  12. Inertial forces affect fluid front displacement dynamics in a pore-throat network model.

    PubMed

    Moebius, Franziska; Or, Dani

    2014-08-01

    The seemingly regular and continuous motion of fluid displacement fronts in porous media at the macroscopic scale is propelled by numerous (largely invisible) pore-scale abrupt interfacial jumps and pressure bursts. Fluid fronts in porous media are characterized by sharp phase discontinuities and by rapid pore-scale dynamics that underlie their motion; both attributes challenge standard continuum theories of these flow processes. Moreover, details of pore-scale dynamics affect front morphology and subsequent phase entrapment behind a front and thereby shape key macroscopic transport properties of the unsaturated zone. The study presents a pore-throat network model that focuses on quantifying interfacial dynamics and interactions along fluid displacement fronts. The porous medium is represented by a lattice of connected pore throats capable of detaining menisci and giving rise to fluid-fluid interfacial jumps (the study focuses on flow rate controlled drainage). For each meniscus along the displacement front we formulate a local inertial, capillary, viscous, and hydrostatic force balance that is then solved simultaneously for the entire front. The model enables systematic evaluation of the role of inertia and boundary conditions. Results show that while displacement patterns are affected by inertial forces mainly by invasion of throats with higher capillary resistance, phase entrapment (residual saturation) is largely unaffected by inertia, limiting inertial effects on hydrological properties behind a front. Interfacial jump velocities are often an order of magnitude larger than mean front velocity, are strongly dependent on geometrical throat dimensions, and become less predictable (more scattered) when inertia is considered. Model simulations of the distributions of capillary pressure fluctuations and waiting times between invasion events follow an exponential distribution and are in good agreement with experimental results. The modeling approach provides insights

  13. The use of argon beam coagulation in pressure sore reconstruction.

    PubMed

    Buck, Donald W; Lewis, Victor L

    2009-12-01

    Pressure sores are a significant source of physical and financial burden for debilitated patients. When conservative measures fail, surgical reconstruction with myocutaneous flaps may be the last hope for cure and/or improved quality of life in these patients. Adequate haemostasis is an integral component of these reconstructive procedures, as bleeding and haematoma formation can lead to increased morbidity. This study was designed to investigate the use of argon beam coagulation in patients undergoing bony debridement and subsequent pressure sore reconstruction with myocutaneous flaps. The clinical records of 34 patients undergoing pressure sore reconstruction with the use of argon beam coagulation from 2004 to 2006 at an academic institution were reviewed and outcomes were assessed. Reconstruction was performed by a single surgeon on 34 patients (31 men, three women; mean age 41+/-15 years), with a total of 41 pressure sores. Thirteen (32.5%) patients had evidence of osteomyelitis preoperatively and five (12.5%) had previous coccygectomies secondary to infection. Twenty-six (65%) of the pressure sores were treated with hamstring V-Y musculocutaneous flaps, 10 (25%) with gluteal flaps, and four (10%) with tensor fascia lata flaps. Overall, suture line dehiscence occurred in six (15%) cases, flap failure and pressure sore recurrence occurred in six (15%) cases, an abscess developed in one (2.5%) case, and a sinus tract with a superficial wound developed in one (2.5%) case. There were no complications related to haemostasis, including excessive bleeding or haematoma formation. Argon beam coagulation is an efficacious tool for achieving adequate haemostasis during pressure sore reconstruction, particularly when significant bony debridement is involved. The use of argon beam coagulation does not result in an increased complication or recurrence rate when compared with conventional electrocautery methods.

  14. Nipple care, sore nipples, and breastfeeding: a randomized trial.

    PubMed

    Centuori, S; Burmaz, T; Ronfani, L; Fragiacomo, M; Quintero, S; Pavan, C; Davanzo, R; Cattaneo, A

    1999-06-01

    Sore and cracked nipples are common and may represent an obstacle to successful breastfeeding. In Italy, it is customary for health professionals to prescribe some type of ointment to prevent or treat sore and cracked nipples. The efficacy of these ointments is insufficiently documented. The incidence of sore and cracked nipples was compared between mothers given routine nipple care, including an ointment (control group), and mothers instructed to avoid the use of nipple creams and other products (intervention group). Breastfeeding duration was also compared between the two groups. Eligible mothers were randomly assigned, after informed consent, to one of the two groups. No difference was found between the control (n = 96) and the intervention group (n = 123) in the incidence of sore and cracked nipples and in breastfeeding duration. However, several factors were associated with sore nipples and with breastfeeding duration. The use of a pacifier and of a feeding bottle in the hospital were both associated with sore nipples at discharge (p = 0.02 and p = 0.03, respectively). Full breastfeeding up to 4 months postpartum was significantly associated with the following early practices: breastfeeding on demand, rooming-in at least 20 hours/day, non-use of formula and pacifier, no test-weighing at each breastfeed. The incidence of sore and cracked nipples and the duration of breastfeeding were not influenced by the use of a nipple ointment. Other interventions, such as providing the mother with guidance and support on positioning and latching, and modifications of hospital practices may be more effective in reducing nipple problems.

  15. The effect of caffeine ingestion on delayed onset muscle soreness.

    PubMed

    Hurley, Caitlin F; Hatfield, Disa L; Riebe, Deborah A

    2013-11-01

    The beneficial effects of caffeine on aerobic activity and resistance training performance are well documented. However, less is known concerning caffeine's potential role in reducing perception of pain and soreness during exercise. In addition, there is no information regarding the effects of caffeine on delayed onset muscle soreness (DOMS). The primary purpose of this study was to examine the effect of caffeine ingestion on muscle soreness, blood enzyme activity, and performance after a bout of elbow flexion/extension exercise. Nine low-caffeine-consuming males (body mass: 76.68 ± 8.13 kg; height: 179.18 ± 9.35 cm; age: 20 ± 1 year) were randomly assigned to ingest either caffeine or placebo 1 hour before completing 4 sets of 10 bicep curls on a preacher bench, followed by a fifth set in which subjects completed as many repetitions as possible. Soreness and soreness on palpation intensity were measured using three 0-10 visual analog scales before exercise, and 24, 48, 72, 96, and 120 hours after exercise. After a washout period, subjects crossed over to the other treatment group. Caffeine ingestion resulted in significantly (p ≤ 0.05) lower levels of soreness on day 2 and day 3 compared with placebo. Total repetitions in the final set of exercise increased with caffeine ingestion compared with placebo. This study demonstrates that caffeine ingestion immediately before an upper-body resistance training out enhances performance. A further beneficial effect of sustained caffeine ingestion in the days after the exercise bout is an attenuation of DOMS. This decreased perception of soreness in the days after a strenuous resistance training workout may allow individuals to increase the number of training sessions in a given time period.

  16. Dual throat engine design for a SSTO launch vehicle

    NASA Technical Reports Server (NTRS)

    Obrien, C. J.; Salmon, J. W.

    1980-01-01

    A propulsion system analysis of a dual fuel, dual throat engine for launch vehicle application was conducted. Basic dual throat engine characterization data are presented to allow vehicle optimization studies to be conducted. A preliminary baseline engine system was defined. Dual throat engine performance, envelope, and weight parametric data were generated over the parametric range of thrust from 890 to 8896 KN (200K to 2M lb-force), chamber pressure from 6.89 million to 34.5 million N/sq m (1000 to 5000 psia) thrust ratio from 1.2 to 5, and a range of mixture ratios for the two tripropellant combinations: LO2/RP-1 + LH2 and LO2/LCH4 + LH2. The results of the study indicate that the dual fuel dual throat engine is a viable single stage to orbit candidate.

  17. Pediatric Obesity and Ear, Nose, and Throat Disorders

    MedlinePlus

    ... Marketplace Find an ENT Doctor Near You Pediatric Obesity and Ear, Nose, and Throat Disorders Pediatric Obesity ... self-esteem, and isolation from their peers. Pediatric obesity and otolaryngic problems Otolaryngologists, or ear, nose, and ...

  18. Response to nestling throat ligatures by three songbirds

    USGS Publications Warehouse

    Robinson, G.L.; Conway, C.J.; Kirkpatrick, C.; Laroche, D.D.

    2010-01-01

    We attempted to collect diet samples using throat ligatures from nestlings of three songbird species in a riparian woodland in southeastern Arizona from May to August 2009. We had success with Song Sparrows (Melospiza melodia), observed adult Yellow-breasted Chats (Icteria virens) reclaim food from nestlings, and discontinued the use of throat ligatures when we observed an adult Abert's Towhee (Pipilo aberti) remove two, 34-day-old ligatured nestlings from its nest. Previous studies have reported problems (e.g., aggression toward nestlings by adults) with throat ligatures, but we are the first to document removal (and subsequent nestling mortality) in response to this technique. We urge investigators to exercise caution when using throat ligatures on species for which evidence of the safety and efficacy of this method are lacking, especially when nestlings are small in size relative to adults. ?? 2010 by the Wilson Ornithological Society.

  19. Mouthwash Helps Kill Gonorrhea Germs in Mouth, Throat: Study

    MedlinePlus

    ... gov/news/fullstory_162649.html Mouthwash Helps Kill Gonorrhea Germs in Mouth, Throat: Study Listerine's maker has ... A commercial brand of mouthwash can help control gonorrhea bacteria in the mouth, and daily use may ...

  20. Stretching Before and After Exercise: Effect on Muscle Soreness and Injury Risk

    PubMed Central

    Andersen, J. C

    2005-01-01

    Reference: Herbert RD, Gabriel M. Effects of stretching before and after exercise on muscle soreness and risk of injury: systematic review. BMJ. 2002;325:468. Clinical Question: Among physically active individuals, does stretching before and after exercise affect muscle soreness and risk of injury? Data Sources: Studies were identified by searching MEDLINE (1966–February 2000), EMBASE (1988–February 2000), CINAHL (1982–1999), SPORT Discus (1949–1999), and PEDro (to February 2000). I searched the reference lists of identified studies manually until no further studies were identified. The search terms stretch, exercise, warm-up, and cool down were used in all databases except MEDLINE. In MEDLINE, an optimized OVID search strategy was used. This strategy included the terms searched in the other databases as well as terms such as flexibility, athletic injuries, sports, soreness, and muscle. Study Selection: The search was limited to English-language articles obtained from the electronic searches and the subsequent manual searches. This review included randomized or quasirandomized investigations that studied the effects of any stretching technique, before or after exercise, on delayed-onset muscle soreness, risk of injury, or athletic performance. Studies were included only if stretching occurred immediately before or after exercising. Data Extraction: Data extraction and assessment of study quality were well described. The principal outcome measures were measurements of muscle soreness and indices of injury risk. Results from the soreness studies were pooled by converting the numeric scores to percentages of the maximum possible score. These data were then reported as millimeters on a 100-mm visual analogue scale. Results of comparable studies were pooled using a fixed-effects model meta-analysis. Survival analysis using a Cox regression model was calculated on the time-to-event (injury) data. Main Results: The total number of articles identified using the

  1. Microbiota in the Throat and Risk Factors for Laryngeal Carcinoma

    PubMed Central

    Gong, Hongli; Zhou, Xia; Wu, Chunping; Cao, Pengyu; Xu, Chen; Hou, Dongsheng; Wang, Yuezhu

    2014-01-01

    The compositions and abundances of the microbiota in the ecological niche of the human throat and the possible relationship between the microbiota and laryngeal cancer are poorly understood. To obtain insight into this, we enrolled 27 laryngeal carcinoma patients and 28 subjects with vocal cord polyps as controls. For each subject, we simultaneously collected swab samples from the upper throat near the epiglottis (site I) and tissue samples from the vestibulum laryngis to the subglottic region (site II). The microbiota of the throat were fully characterized by pyrosequencing of barcoded 16S rRNA genes. We found 14 phyla, 20 classes, 38 orders, 85 families, and 218 genera in the throats of enrolled subjects. The main phyla were Firmicutes (54.7%), Fusobacteria (14.8%), Bacteroidetes (12.7%), and Proteobacteria (10.6%). Streptococcus (37.3%), Fusobacterium (11.3%), and Prevotella (10.6%) were identified as the three most predominant genera in the throat. The relative abundances of 23 bacterial genera in site I were significantly different from those in site II (P < 0.05). The relative proportions of 12 genera largely varied between laryngeal cancer patients and control subjects (P < 0.05). Collectively, this study outlined the spatial structure of microbial communities in the human throat. The spatial structure of bacterial communities significantly varied in two anatomical sites of the throat. The bacterial profiles of the throat of laryngeal cancer patients were strongly different from those of control subjects, and several of these microorganisms may be related to laryngeal carcinoma. PMID:25239901

  2. Microbiota in the Throat and Risk Factors for Laryngeal Carcinoma.

    PubMed

    Gong, Hongli; Shi, Yi; Zhou, Xia; Wu, Chunping; Cao, Pengyu; Xu, Chen; Hou, Dongsheng; Wang, Yuezhu; Zhou, Liang

    2014-12-01

    The compositions and abundances of the microbiota in the ecological niche of the human throat and the possible relationship between the microbiota and laryngeal cancer are poorly understood. To obtain insight into this, we enrolled 27 laryngeal carcinoma patients and 28 subjects with vocal cord polyps as controls. For each subject, we simultaneously collected swab samples from the upper throat near the epiglottis (site I) and tissue samples from the vestibulum laryngis to the subglottic region (site II). The microbiota of the throat were fully characterized by pyrosequencing of barcoded 16S rRNA genes. We found 14 phyla, 20 classes, 38 orders, 85 families, and 218 genera in the throats of enrolled subjects. The main phyla were Firmicutes (54.7%), Fusobacteria (14.8%), Bacteroidetes (12.7%), and Proteobacteria (10.6%). Streptococcus (37.3%), Fusobacterium (11.3%), and Prevotella (10.6%) were identified as the three most predominant genera in the throat. The relative abundances of 23 bacterial genera in site I were significantly different from those in site II (P < 0.05). The relative proportions of 12 genera largely varied between laryngeal cancer patients and control subjects (P < 0.05). Collectively, this study outlined the spatial structure of microbial communities in the human throat. The spatial structure of bacterial communities significantly varied in two anatomical sites of the throat. The bacterial profiles of the throat of laryngeal cancer patients were strongly different from those of control subjects, and several of these microorganisms may be related to laryngeal carcinoma. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  3. Modified lumbar artery perforator flaps for gluteal pressure sore reconstruction.

    PubMed

    Yoon, Chi Sun; Yim, Ji Hong; Kim, Min Ho; Ha, Won; Kim, Kyu Nam

    2016-03-21

    Gluteal perforator flaps (GPFs) are the most useful for gluteal region pressure sore reconstruction. However, application is difficult if the surrounding area has scar tissue from previous operations or trauma, especially with recurrent sores. We describe the use of modified lumbar artery perforator flaps when GPFs cannot be used. Between May 2009 and April 2014, 51 patients underwent gluteal pressure sore reconstructions with gluteal (n = 39) or modified lumbar artery (n = 12) perforator flaps. Patients in the modified lumbar artery perforator group had scar tissue from trauma or previous surgery. In this retrospective review, we analyzed patient age and sex, defect size and location, operative time, follow-up duration, immediate postoperative issues, flap necrosis, dehiscence, re-operation, donor-site morbidity and recurrence. Complications and clinical outcomes were compared between groups. We found no significant differences in patient demographics, surgical complications or clinical outcomes. There were eight cases of temporary congestion (20.51%) and four of partial flap necrosis (10.25%) in the gluteal perforator group. In the modified lumbar artery perforator group, there were three cases of temporary congestion (25%) and one of partial flap necrosis (8.33%). No pressure sores recurred during follow-up in either group. GPFs are the gold standards for gluteal pressure sores, but modified lumbar artery perforator flaps are relatively easy and useful when GPFs cannot be used due to scar tissue. © 2016 Royal Australasian College of Surgeons.

  4. Nursing aspects of pressure sore prevention and therapy.

    PubMed

    Culley, F

    Pressure sores remain a significant problem in hospitals and domestic settings, affecting people of all ages, social class and race. Associated complications may be life threatening, e.g. sepsis and osteomyelitis. Other less dangerous, but nevertheless compromising outcomes such as pain, discomfort and low self-esteem and body image can cause personal suffering, and may add extra demand for limited resources. The exact state of pressure sore occurrence remains difficult to determine, particularly in the community. Recent trends in pressure area management present a multidisciplinary approach, eroding traditional perceptions of pressure sores as a solely nursing problem. Written from nursing perspective, this article summarizes principles of good practice relating to pressure sore prevention and therapy, emphasizing the importance of documenting observed events, rather than assumptions or opinions, and the need for healthcare professionals to approach problems and needs from a collaborative stance. Pressure sore risk assessment and classification are discussed, and an overview of nutrition, moving a handling, selecting support surfaces, principles of wound management, and skin care are considered.

  5. The effects of massage on delayed onset muscle soreness

    PubMed Central

    Hilbert, J; Sforzo, G; Swensen, T

    2003-01-01

    Objectives: The purpose of this study was to investigate the physiological and psychological effects of massage on delayed onset muscle soreness (DOMS). Methods: Eighteen volunteers were randomly assigned to either a massage or control group. DOMS was induced with six sets of eight maximal eccentric contractions of the right hamstring, which were followed 2 h later by 20 min of massage or sham massage (control). Peak torque and mood were assessed at 2, 6, 24, and 48 h postexercise. Range of motion (ROM) and intensity and unpleasantness of soreness were assessed at 6, 24, and 48 h postexercise. Neutrophil count was assessed at 6 and 24 h postexercise. Results: A two factor ANOVA (treatment v time) with repeated measures on the second factor showed no significant treatment differences for peak torque, ROM, neutrophils, unpleasantness of soreness, and mood (p > 0.05). The intensity of soreness, however, was significantly lower in the massage group relative to the control group at 48 h postexercise (p < 0.05). Conclusions: Massage administered 2 h after exercise induced muscle injury did not improve hamstring function but did reduce the intensity of soreness 48 h after muscle insult. PMID:12547748

  6. Pressure sores in intensive care: defining their incidence and associated factors and assessing the utility of two pressure sore risk assessment tools.

    PubMed

    Boyle, M; Green, M

    2001-02-01

    Patients in intensive care units (ICU) are at high risk of developing pressure sores and the use of pressure sore risk tools has been advocated as a means of identifying patients at risk. A prospective multi-site observational study was conducted to define the incidence of pressure sores, assess two pressure sore risk scales and to define risk factors relevant to intensive care. Patients (n = 534) were assessed for the presence of pressure sores. The Waterlow and Jackson/Cubbin risk scales were completed each day for 314 and 188 of these patients respectively. A total of 75 pressure sores were recorded. Of these, 34 were present on admission. Of the remaining 41, 16 were classified as Grade 1 and 24 as Grade 2 sores. The pressure sore (PS) incidence was 5.2 per cent. Expressed as PS/1000 patient days there were 18.48 pressure sores per 1000 patient days. The ability of the risk scores to predict pressure sores was tested using a Receiver Operating Characteristic (ROC) analysis. The association of risk score with pressure sores was analysed using a survival function (Kaplan Meier) and variables compared using a logrank test (Mantel-Cox). Factors associated with pressure sore occurrence were developed and tested using a survival regression model. Both risk scales were poor predictors of pressure sores (ROC curve area approximately 70 per cent for both). The factors, coma/unresponsiveness/paralysed & sedated and cardiovascular instability were significantly associated with pressure sores with relative risks of 4.2 and 2.5 respectively. Risk increased as a function of time such that the cumulative risk was 50 per cent at 20 days.

  7. Observation of the laryngeal movements for throat singing

    NASA Astrophysics Data System (ADS)

    Sakakibara, Ken-Ichi; Konishi, Tomoko; Murano, Emi Z.; Imagawa, Hiroshi; Kumada, Masanobu; Kondo, Kazumasa; Niimi, Seiji

    2002-11-01

    Throat singing is a traditional singing style of people who live around the Altai Mountains. Khoomei in Tyva and Khoomij in Mongolia are representative styles of throat singing. The laryngeal voices of throat singing is classified into (i) a drone voice which is the basic laryngeal voice in throat singing and used as drone and (ii) a kargyraa voice which is very low pitched with the range outside the modal register. In throat singing, the special features of the laryngeal movements are observed by using simultaneous recording of high-speed digital images, EGG, and sound wave forms. In the drone voice, the ventricular folds (VTFs) vibrate in the same frequency as the vocal folds (VFs) but in opposite phases. In the kargyraa voice, the VTFs can be assumed to close once for every two periods of closure of the VFs, and this closing blocks airflow and contributes to the generation of the subharmonic tone of kargyraa. Results show that in throat singing the VTFs vibrate and contribute to producing the laryngeal voice, which generates the special timbre and whistle-like overtone.

  8. Review of the use of throat packs in nasal surgery.

    PubMed

    Jaiswal, V; Bedford, G C

    2009-07-01

    Throat packs are employed in nasal surgery to prevent contamination of the upper aerodigestive tract. Their use is thought to reduce the risk of aspiration and post-operative nausea and vomiting. However, use of throat packs may also be accompanied by increased throat pain. In order to inform our clinical practice, the evidence base for throat pack insertion was reviewed. A search was made of the Pubmed database from the 1950s to March 2008. Four randomised, controlled, clinical trials were reviewed. All the trials had significant methodological weakness. In all but one, no power calculations were done. There were inconsistencies in the measurement of pain and heterogeneity of rhinological procedures. The one adequately powered trial could not demonstrate a difference in post-operative nausea and vomiting with the use of throat packs (beta error = 20 per cent). Further, adequately powered trials are required involving patients undergoing rhinological procedures with a higher risk of blood contamination (e.g. functional endoscopic sinus surgery), in order to provide definitive evidence on the morbidity of throat packs in rhinological procedures.

  9. Generating Small Numbers by Tunneling in Multi-Throat Compactifications

    SciTech Connect

    Silverstein, Eva M

    2001-07-25

    A generic F-theory compactification containing many D3 branes develops multiple brane throats. The interaction of observers residing inside different throats involves tunneling suppression and, as a result, is very weak. This suggests a new mechanism for generating small numbers in Nature. One application is to the hierarchy problem: large supersymmetry breaking near the unification scale inside a shallow throat causes TeV-scale SUSY-breaking inside the standard-model throat. Another application, inspired by nuclear-decay, is in designing naturally long-lived particles: a cold dark matter particle residing near the standard model brane decays to an approximate CFT-state of a longer throat within a Hubble time. This suggests that most of the mass of the universe today could consist of CFT-matter and may soften structure formation at sub-galactic scales. The tunneling calculation demonstrates that the coupling between two throats is dominated by higher dimensional modes and consequently is much larger than a naive application of holography might suggest.

  10. 21 CFR 874.4350 - Ear, nose, and throat fiberoptic light source and carrier.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4350 Ear, nose, and throat fiberoptic light source and carrier. (a) Identification. An ear, nose, and throat... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear, nose, and throat fiberoptic light source...

  11. 21 CFR 874.5300 - Ear, nose, and throat examination and treatment unit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5300 Ear, nose, and throat examination and treatment unit. (a) Identification. An ear, nose, and throat... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat examination and...

  12. 21 CFR 874.5220 - Ear, nose, and throat drug administration device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5220 Ear, nose, and throat drug administration device. (a) Identification. An ear, nose, and throat drug... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat drug administration...

  13. 21 CFR 874.5220 - Ear, nose, and throat drug administration device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5220 Ear, nose, and throat drug administration device. (a) Identification. An ear, nose, and throat drug... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear, nose, and throat drug administration...

  14. 21 CFR 874.5300 - Ear, nose, and throat examination and treatment unit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5300 Ear, nose, and throat examination and treatment unit. (a) Identification. An ear, nose, and throat... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear, nose, and throat examination and...

  15. 21 CFR 874.4350 - Ear, nose, and throat fiberoptic light source and carrier.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4350 Ear, nose, and throat fiberoptic light source and carrier. (a) Identification. An ear, nose, and throat... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat fiberoptic light source...

  16. 21 CFR 874.5220 - Ear, nose, and throat drug administration device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ear, nose, and throat drug administration device... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5220 Ear, nose, and throat drug administration device. (a) Identification. An ear, nose, and throat...

  17. 21 CFR 874.5220 - Ear, nose, and throat drug administration device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ear, nose, and throat drug administration device... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5220 Ear, nose, and throat drug administration device. (a) Identification. An ear, nose, and throat...

  18. 21 CFR 874.5220 - Ear, nose, and throat drug administration device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ear, nose, and throat drug administration device... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5220 Ear, nose, and throat drug administration device. (a) Identification. An ear, nose, and throat...

  19. Beds, mattresses and cushions for pressure sore prevention and treatment.

    PubMed

    Cullum, N; Deeks, J; Sheldon, T A; Song, F; Fletcher, A W

    2000-01-01

    To assess the effectiveness of pressure relieving beds, mattresses and cushions (support surfaces) in the prevention and treatment of pressure sores. Searches of 19 databases, hand searching of journals, conference proceedings, and bibliographies. Randomised controlled trials evaluating support surfaces for the prevention or treatment of pressure sores. There was no restriction on articles based on language or publication status. Data extraction and assessment of study quality was undertaken by two reviewers independently. Trials with similar patients, comparisons, and outcomes were pooled. Where pooling was inappropriate, trials are discussed in a narrative review. 29 RCTs of support surfaces for pressure sore prevention were identified. Some high specification foam mattresses were more effective than 'standard' hospital foam mattresses in moderate-high risk patients. Pressure relieving mattresses in the operating theatre reduced the incidence of pressure sores post-operatively. The relative merits of alternating and constant low pressure, and of the different alternating pressure devices are unclear. Seat cushions and simple, constant low-pressure devices have not been adequately evaluated. Limited evidence suggests that low air loss beds reduce the incidence of pressure sores in intensive care. 6 RCTs of support surfaces for pressure sore treatment were identified. There is good evidence that air-fluidised and low air loss beds improve healing rates. Seat cushions have not been adequately evaluated. 2 RCTs evaluated surfaces for both prevention and treatment in the same trial. PREVENTION - There is good evidence of the effectiveness of high specification foam over standard hospital foam, and pressure relief in the operating theatre. Treatment - There is good evidence of the effectiveness of air-fluidised and low air loss devices as treatments. Overall, however, it is impossible to determine the most effective surface for either prevention or treatment.

  20. Medial circumflex femoral artery flap for ischial pressure sore

    PubMed Central

    Palanivelu, S.

    2009-01-01

    A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The skin redundancy below the gluteal fold allows a primary closure of the donor defect. It can also be used in combination with biceps femoris muscle flap. PMID:19881020

  1. [Clinical typing and surgical principle of pressure sore].

    PubMed

    Liu, Yi; Zhang, Xusheng; Zhang, Cheng

    2007-09-01

    To investigate the clinical typing and their relevant surgical treatment principle and method of pressure sore. From January 1983 to April 2006, 122 patients with 179 pressure sores were treated. There were 93 males and 29 females, aging 15-68 years. The pressure sores were located at sacrococcygeus (54 lesions), petrochanteric region (37 lesions), ischial tuberosity (30 lesions), heel (17 lesions), olecranon (15 lesions), scapula (9 lesions), lateral malleolar (7 lesions), caput fibulace (4 lesions), pretibial (3 lesions), and lumbar region (3 lesims) respectivly. The disease course was from 2 months to 11 years. The areas of pressure sores were from 1.5 cm x 1.0 cm to 20.0 cm x 18.0 cm. According to the wound characteristics, the pressure sores were divided into three types: sinus type (12/179), ulcer type (74/179) and mixed type (93/179). Aimed at different types of pressure sore, skin grafting, skin flap and myocutaneous flap were employed to repair wound. The areas of flaps were from 5.0 cm x 3.5 cm to 26.0 cm x 14.5 cm. The areas of skin grafting were from 7 cm x 5 cm to 23 cm x 12 cm. All wounds of sinus type healed by first intention except one; and all flaps survived. All wounds of uler type healed by first intention; and the flaps survived completely except two which had a partial necrosis. All flaps which harvested to repair 93 pressure sores of mixed type were survived. But one or two sinus occurred in 8 cases. Two healed by operation, and the others healed by dressing exchange. The wounds healed by first intention. The donor sites healed by first intention. The routine follow-up in 73 patients after 6 months showed that the recurrence appeared in 4 mixed type. The recurrence rate was 5.5% and the other patients had good outcome. Clinical typing of pressure sore is helpful to select the suitable operation method and improve the rate of success.

  2. [An assessment scale for the prevention of pressure sores in children].

    PubMed

    Chauvet, Corinne; Poirier, Marie-Renée; Sourisseau, Petronela Rachieru; Béduneau, Denis; Soulard, Anthony; Delacroix, Delphine

    2015-04-01

    Pressure sores in children are rare. However, when they do occur they can have significant consequences. Professionals in paediatric units realised the importance of assessing the risk of pressure sores and developed a pressure sore assessment scale specific to children. This project, carried out through a hospital-training school partnership, emphasises the importance of clinical reasoning in nursing practices.

  3. Investigation on Composite Throat Insert For Cryogenic Engines

    NASA Astrophysics Data System (ADS)

    Ayyappan, G.; Tiwari, S. B.; Praveen, RS; Mohankumar, L.; Jathaveda, M.; Ganesh, P.

    2017-02-01

    Injector element testing is an important step in the development and qualification of the cryogenic rocket engines. For the purpose of characterising the injectors, sub scale chambers are used. In order to assess the performance of the injectors, different configurations of the injectors are tested using a combustion chamber and a convergent-divergent nozzle. Pressure distribution along the wall of the chamber and throat insert is obtained from the CFD analysis and temperature distribution is obtained from thermal analysis. Thermo-structural analysis is carried out for the sub-scale model of throat inert using temperature dependent material properties. For the experiments a sub-scale model of the thrust chamber is realised. Injector element tests are carried out for the studies. The objective of the present study is to investigate the behaviour of different throat inserts, mainly graphite, 2-D Carbon-Carbon(2D C-C), 4-D Carbon-Carbon (4D C-C) and Silica Phenolic (SP), under pressure and thermal load for repeated operation of the engine. Analytical results are compared with the test results. The paper gives the results of theoretical studies and experiments conducted with all the four type of throat material. It is concluded that 2D C-C is superior in terms of throat erosion being the least under specified combustion environment.

  4. Computation of the throat area of a turbine blade ring

    NASA Astrophysics Data System (ADS)

    Mamaev, B. I.; Murashko, V. L.

    2016-01-01

    The throat area is a geometric parameter of the blade ring necessary to profile its blades and compute the turbine capacity. As applied to the filament flow model, the area is defined by the involute of the throat solid figure onto the plane formed by the cascade throat located on one of the cylindrical sections of the blade ring and the radius. An equation is derived for computing the area of the involute, which considers the effect of the shape of the ring's tailing outlines and the fillets at the transition from the outlines to the blade feather. Comparison of the area values for several turbines computed by the derived equation and by a more complex method based on a search for the minimum distances from the tailing edge of the blade to the suction surface of the neighboring blade in the channel revealed slight differences. The fluid-dynamic 2D analysis determined the radial boundaries of the filament bands, the parameters of the cascade that lie on a filament's cylindrical surfaces, and the flow velocity normal to the throat section of the filament. The proposed approach to computation of the throat area is common for problems of both designing and analyzing the turbine operation and allows for excluding, in practice, methodological differences in determination of the flow rate and the flow angles at the outlet of the blade ring.

  5. On wormholes with long throats and the stability problem

    NASA Astrophysics Data System (ADS)

    Bronnikov, K. A.; Korolyov, P. A.

    2017-07-01

    We construct explicit examples of globally regular static, spherically symmetric solutions of general relativity with a phantom scalar field as the source of gravity, describing traversable wormholes with flat asymptotic regions on both sides of the throat as well as regular black holes, in particular, those called black universes. To explain why such phantom fields are not observed under usual conditions, we invoke the concept of "invisible ghosts," which means that the phantom field decays quickly enough at infinity and is there too weak to be observed. This approach leads to wormhole models in which the spherical radius is almost constant in some range of the radial coordinate near the throat, forming a "long throat". We discuss the peculiar features and difficulties of the stability problem for such configurations. It is shown that the limiting case of a "maximally long throat" has the form of an unstable model with the Nariai metric. This allows us to conjecture that a long throat does not stabilize wormholes with a scalar source.

  6. Pedicled fillet of leg flap for extensive pressure sore coverage.

    PubMed

    Jandali, Shareef; Low, David W

    2009-10-27

    Multiple large decubitus ulcers present a reconstructive challenge to the plastic surgeon. When stage IV pressure sores become recurrent or extensive, traditional flaps either have already been exhausted or would not be sufficient to cover the defect. A retrospective review was performed on all paraplegic patients who had chronic, extensive, and stage IV decubitus ulcers, and underwent reconstruction using a pedicled continuous musculocutaneous flap of the entire leg between 1998 and 2007. The extent and size of the debrided pressure sores, number of previous flap reconstructions, intraoperative blood loss, postoperative complications, and years of follow-up were all recorded. A description of the operative technique is also given. Four patients underwent a total leg fillet flap in the study period, with follow-up ranging from 2 to 7 years. Indications included extensive and bilateral trochanteric, sacral, and ischial pressure sores. Complications included intraoperative blood loss and postoperative heterotopic calcification. The total leg fillet flap is a very large and robust flap that offers paraplegic patients coverage of extensive stage IV pressure sores of the trochanteric, sacral, and ischial areas.

  7. Hemispheric Asymmetry and Pun Comprehension: When Cowboys Have Sore Calves

    ERIC Educational Resources Information Center

    Coulson, Seana; Severens, Els

    2007-01-01

    Event-related potentials (ERPs) were recorded as healthy participants listened to puns such as ''During branding, cowboys have sore calves.'' To assess hemispheric differences in pun comprehension, visually presented probes that were either highly related (COW), moderately related (LEG), or unrelated, were presented in either the left or right…

  8. Recommendations for the Avoidance of Delayed-Onset Muscle Soreness.

    ERIC Educational Resources Information Center

    Szymanski, David J.

    2001-01-01

    Describes the possible causes of delayed-onset muscle soreness (DOMS), which include buildup of lactic acid in muscle, increased intracellular calcium concentration, increased intramuscular inflammation, and muscle fiber and connective tissue damage. Proposed methods to reduce DOMS include warming up before exercise and performing repeated bouts…

  9. Recommendations for the Avoidance of Delayed-Onset Muscle Soreness.

    ERIC Educational Resources Information Center

    Szymanski, David J.

    2001-01-01

    Describes the possible causes of delayed-onset muscle soreness (DOMS), which include buildup of lactic acid in muscle, increased intracellular calcium concentration, increased intramuscular inflammation, and muscle fiber and connective tissue damage. Proposed methods to reduce DOMS include warming up before exercise and performing repeated bouts…

  10. Hemispheric Asymmetry and Pun Comprehension: When Cowboys Have Sore Calves

    ERIC Educational Resources Information Center

    Coulson, Seana; Severens, Els

    2007-01-01

    Event-related potentials (ERPs) were recorded as healthy participants listened to puns such as ''During branding, cowboys have sore calves.'' To assess hemispheric differences in pun comprehension, visually presented probes that were either highly related (COW), moderately related (LEG), or unrelated, were presented in either the left or right…

  11. The effects of three modalities on delayed onset muscle soreness.

    PubMed

    Weber, M D; Servedio, F J; Woodall, W R

    1994-11-01

    Delayed onset muscle soreness is a common problem that can interfere with rehabilitation as well as activities of daily living. The purpose of this study was to test the impact of therapeutic massage, upper body ergometry, or microcurrent electrical stimulation on muscle soreness and force deficits evident following a high-intensity eccentric exercise bout. Forty untrained, volunteer female subjects were randomly assigned to one of three treatment groups or to a control group. Exercise consisted of high-intensity eccentric contractions of the elbow flexors. Resistance was reduced as subjects fatigued, until they reached exhaustion. Soreness rating was determined using a visual analog scale. Force deficits were determined by measures of maximal voluntary isometric contraction at 90 degrees of elbow flexion and peak torque for elbow flexion at 60 degrees/sec on a Cybex II isokinetic dynamometer. Maximal voluntary isometric contraction and peak torque were determined at the 0 hour (before exercise) and again at 24 and 48 hours postexercise. Treatments were applied immediately following exercise and again at 24 hours after exercise. The control group subjects rested following their exercise bout. Statistical analysis showed significant increases in soreness rating and significant decreases in force generated when the 0 hour was compared with 24- and 48-hour measures. Further analysis indicated no statistically significant differences between massage, microcurrent electrical stimulation, upper body ergometry, and control groups.

  12. Polymer quantization of the Einstein-Rosen wormhole throat

    NASA Astrophysics Data System (ADS)

    Kunstatter, Gabor; Louko, Jorma; Peltola, Ari

    2010-01-01

    We present a polymer quantization of spherically symmetric Einstein gravity in which the polymerized variable is the area of the Einstein-Rosen wormhole throat. In the classical polymer theory, the singularity is replaced by a bounce at a radius that depends on the polymerization scale. In the polymer quantum theory, we show numerically that the area spectrum is evenly spaced and in agreement with a Bohr-Sommerfeld semiclassical estimate, and this spectrum is not qualitatively sensitive to issues of factor ordering or boundary conditions except in the lowest few eigenvalues. In the limit of small polymerization scale we recover, within the numerical accuracy, the area spectrum obtained from a Schrödinger quantization of the wormhole throat dynamics. The prospects of recovering from the polymer throat theory a full quantum-corrected spacetime are discussed.

  13. Diagnosis of group A streptococcal infections directly from throat secretions.

    PubMed Central

    Edwards, E A; Phillips, I A; Suiter, W C

    1982-01-01

    The diagnosis of group A streptococcal disease still relies on isolation of group A streptococcal strains on sheep blood agar followed by presumptive identification based on bacitracin sensitivity or the results of the more precise serogrouping methods such as the Lancefield precipitin test. A technique that would permit rapid identification of streptococcal infections directly from throat secretions would allow immediate appropriate antimicrobial therapy for the management of streptococcal infections to be started. We have been able to identify soluble group A antigen directly from throat secretions by using a latex agglutination test. In a clinical trial in which latex (Streptex group A) and conventional culturing techniques were used, 53 throat secretion cultures were tested: 26 were positive by both procedures, 5 were positive by culture only, 3 were positive by the latex agglutination test only, and 19 were negative by both tests. Images PMID:7042747

  14. Polymer quantization of the Einstein-Rosen wormhole throat

    SciTech Connect

    Kunstatter, Gabor; Peltola, Ari; Louko, Jorma

    2010-01-15

    We present a polymer quantization of spherically symmetric Einstein gravity in which the polymerized variable is the area of the Einstein-Rosen wormhole throat. In the classical polymer theory, the singularity is replaced by a bounce at a radius that depends on the polymerization scale. In the polymer quantum theory, we show numerically that the area spectrum is evenly spaced and in agreement with a Bohr-Sommerfeld semiclassical estimate, and this spectrum is not qualitatively sensitive to issues of factor ordering or boundary conditions except in the lowest few eigenvalues. In the limit of small polymerization scale we recover, within the numerical accuracy, the area spectrum obtained from a Schroedinger quantization of the wormhole throat dynamics. The prospects of recovering from the polymer throat theory a full quantum-corrected spacetime are discussed.

  15. Assessment of postexercise muscle soreness by electromyography and mechanomyography.

    PubMed

    Bajaj, Prem; Madeleine, Pascal; Sjøgaard, Gisela; Arendt-Nielsen, Lars

    2002-04-01

    Mechanomyography (MMG) and electromyography (EMG) recordings from the first dorsal interosseous muscle of the hand were compared for pre-exercise and immediately after, 24-hour, and 48-hour postexercise muscle soreness. Thirteen healthy male subjects performed progressively increasing number of eccentric contractions from bout 1 (10.34 +/- 1.96) to bout 6 (27.46 +/- 5.01) (P < .03) with 116% maximum voluntary contraction (MVC) for provocation of postexercise muscle soreness. Increased areas of pain, reduced pressure pain threshold, reduced MVC, and reduced range of motion were present immediately after as compared with pre-exercise (P < .05). During intense eccentric exercise, root mean squared amplitude values of MMG increased progressively from bout 1 to bout 6, but EMG root mean squared amplitude decreased as the muscle fatigued (P < .05). Time course changes of MMG and EMG root mean squared amplitude values during single concentric, isometric, and eccentric contractions at 0%, 25%, 50%, 75%, and 100% MVC weights were measured in relation to postexercise muscle soreness. The EMG root mean squared amplitude values showed insignificant changes for concentric, isometric, and eccentric contractions between pre-exercise, immediately after, 24 hours, and 48 hours. MMG root mean squared amplitude values increased during concentric, isometric, and eccentric contractions at immediately after as compared to pre-exercise, 24 hours, and 48 hours. At immediately after, 24 hours, and 48 hours the maximum EMG root mean squared amplitude values were achieved at lower MVC levels as compared with pre-exercise (P < .05). MMG root mean squared amplitude findings suggest changes in viscoelastic properties resulting in significant mechanical muscle vibrations after intense eccentric exercise. This may suggest a role of stimulation of mechanosensitive nociceptors in relation to postexercise muscle soreness. It is concluded that simultaneous recordings of MMG and EMG may serve as an

  16. Meta-analysis of trials of streptococcal throat treatment programs to prevent rheumatic fever.

    PubMed

    Lennon, Diana; Kerdemelidis, Melissa; Arroll, Bruce

    2009-07-01

    Rheumatic fever (RF) is the commonest cause of pediatric heart disease globally. Penicillin for streptococcal pharyngitis prevents RF. Inequitable access to health care persists. To investigate RF prevention by treating streptococcal pharyngitis in school- and/or community-based programs. Medline, Old Medline, the Cochrane Library, DARE, Central, NHS, EED, NICE, NRMC, Clinical Evidence, CDC website, PubMed, and reference lists of retrieved articles. Known researchers in the field were contacted where possible. Randomized, controlled trials or trials of before/after design examining treatment of sore throats in schools or communities with RF as an outcome where data were able to be pooled for analysis. Two authors examined titles, abstracts, selected articles, and extracted data. Disagreements were resolved by consensus. QUANTITATIVE ANALYSIS TOOL: Review Manager version 4.2 to assess pooled relative risks and 95% confidence intervals. Six studies (of 677 screened) which met the criteria and could be pooled were included. Meta-analysis of these trials for RF control produced a relative risk of 0.41 (95% CI: 0.23-0.70). There was statistical heterogeneity (I = 70.5%). Hence a random effects analysis was conducted. Many studies were poor quality. Title and available abstracts of non-English studies were checked. There may be publication bias. This is the best available evidence in an area with imperfect information. It is expected acute RF cases would diminish by about 60% using a school or community clinic to treat streptococcal pharyngitis. This should be considered in high-risk populations.

  17. The practical evaluation and management of patients with symptoms of a sore burning mouth.

    PubMed

    Steele, John C

    2016-01-01

    There are many etiologic factors to consider in a patient who presents with symptoms or sensations of a sore burning mouth. These range from local causes within the oral cavity to underlying systemic disease, including psychologic factors. This paper aims to describe the different clinical presentations and to outline a systematic approach to the evaluation and management of such patients. The clinician will be directed to the relevant diagnosis by following the traditional medical model of taking a focused history, performing a thorough clinical examination, considering the potential differential diagnoses, and requesting pertinent and appropriate investigations. The various differential diagnoses and broad treatment options will also be discussed and outlined. This paper will not, however, discuss burning mouth syndrome (oral dysesthesia), which is a diagnosis of exclusion, whereby the oral mucosa is clinically normal and there are no identifiable medical or dental causes to account for the patient's symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Comparison of laryngeal mask airway vs tracheal intubation: a systematic review on airway complications.

    PubMed

    van Esch, Babette F; Stegeman, Inge; Smit, Adriana L

    2017-02-01

    To determine whether the laryngeal mask airway (LMA) has advantages over the tracheal tube (TT) in terms of incidence of cough, sore throat, laryngospasm, dysphagia, dysphonia, and blood staining. This is a systematic literature review performed at the Universtity Medical Center of Utrecht. The online databases PubMed, Embase, and the Cochrane Library were searched for relevant randomized controlled trials. Two independent reviewers selected relevant articles after title, abstract, and full text screening. Articles were assessed on risk of bias in accordance with the Cochrane risk of bias tool. Study results of the LMA and the TT were related to the method of selection of the device size and the method for cuff inflation. Of the 1718 unique articles, we included 19 studies which used the LMA Classic, the LMA Proseal, the Flexible Reinforced LMA, and the LMA Supreme compared with TT. After methodological inspection, data could not be pooled due to heterogeneity among the selected studies. Overall, no clear advantage of the LMA over the TT was found but the LMA Supreme was related to the lowest incidence of airway complications. In this review, no clear difference in incidence of postoperative airway complications could be demonstrated between LMA and TT. The LMA Supreme may reduce the incidence of airway complication in comparison to the TT but high quality randomized trials are recommended to further objectify if use of the LMA decreases the risk on postoperative airway complications.

  19. Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review

    PubMed Central

    Wallace, Emma; Uijen, Maike J M; Clyne, Barbara; Zarabzadeh, Atieh; Keogh, Claire; Galvin, Rose; Smith, Susan M; Fahey, Tom

    2016-01-01

    Objectives Following appropriate validation, clinical prediction rules (CPRs) should undergo impact analysis to evaluate their effect on patient care. The aim of this systematic review is to narratively review and critically appraise CPR impact analysis studies relevant to primary care. Setting Primary care. Participants Adults and children. Intervention Studies that implemented the CPR compared to usual care were included. Study design Randomised controlled trial (RCT), controlled before–after, and interrupted time series. Primary outcome Physician behaviour and/or patient outcomes. Results A total of 18 studies, incorporating 14 unique CPRs, were included. The main study design was RCT (n=13). Overall, 10 studies reported an improvement in primary outcome with CPR implementation. Of 6 musculoskeletal studies, 5 were effective in altering targeted physician behaviour in ordering imaging for patients presenting with ankle, knee and neck musculoskeletal injuries. Of 6 cardiovascular studies, 4 implemented cardiovascular risk scores, and 3 reported no impact on physician behaviour outcomes, such as prescribing and referral, or patient outcomes, such as reduction in serum lipid levels. 2 studies examined CPRs in decision-making for patients presenting with chest pain and reduced inappropriate admissions. Of 5 respiratory studies, 2 were effective in reducing antibiotic prescribing for sore throat following CPR implementation. Overall, study methodological quality was often unclear due to incomplete reporting. Conclusions Despite increasing interest in developing and validating CPRs relevant to primary care, relatively few have gone through impact analysis. To date, research has focused on a small number of CPRs across few clinical domains only. PMID:27008685

  20. Clinical and laboratory characteristics, epidemiology, and outcomes of murine typhus: A systematic review.

    PubMed

    Tsioutis, Constantinos; Zafeiri, Maria; Avramopoulos, Asimakis; Prousali, Efthymia; Miligkos, Michael; Karageorgos, Spyridon A

    2017-02-01

    Murine or endemic typhus, a febrile disease caused by Rickettsia typhi, is often misdiagnosed due to its non-specific presentation. We sought to evaluate all available evidence in the literature regarding the clinical and laboratory manifestations, epidemiological characteristics, and outcomes of murine typhus. Pubmed was searched for all articles providing available data. In an effort to incorporate contemporary data, only studies from 1980 were included. Thirty-three case series including 2074 patients were included in final analysis. Available evidence suggests that the classic triad of fever, headache and rash is encountered in only one-third of patients. Other frequent symptoms were chills, malaise, myalgia, and anorexia. A tetrad of reported laboratory abnormalities consisting of elevated liver enzymes, lactate dehydrogenase, erythrocyte sedimentation rate and hypoalbuminemia was detected. Complications were observed in one-fourth of patients, reported mortality was extremely low, but untreated patients had notably longer duration of fever. Among epidemiological characteristics, a seasonal distribution with most cases reported during warmer months, was the most prominent finding. Murine typhus in children exhibits several different characteristics, with abdominal pain, diarrhea, and sore throat reported more commonly, higher frequency of anemia, lower frequency of hypoalbuminemia, hematuria and proteinuria and a much lower rate of complications. This systematic review of published evidence provides a thorough description of the clinical and laboratory features of murine typhus and highlights important differences in children.

  1. Pore-throat sizes in sandstones, tight sandstones, and shales

    USGS Publications Warehouse

    Nelson, Philip H.

    2009-01-01

    Pore-throat sizes in silidclastic rocks form a continuum from the submillimeter to the nanometer scale. That continuum is documented in this article using previously published data on the pore and pore-throat sizes of conventional reservoir rocks, tight-gas sandstones, and shales. For measures of central tendency (mean, mode, median), pore-throat sizes (diameters) are generally greater than 2 μm in conventional reservoir rocks, range from about 2 to 0.03 μm in tight-gas sandstones, and range from 0.1 to 0.005 μm in shales. Hydrocarbon molecules, asphaltenes, ring structures, paraffins, and methane, form another continuum, ranging from 100 Å (0.01 μm for asphaltenes to 3.8 A (0.00038 μm) for methane. The pore-throat size continuum provides a useful perspective for considering (1) the emplacement of petroleum in consolidated siliciclastics and (2) fluid flow through fine-grained source rocks now being exploited as reservoirs.

  2. Trying Not to "Shove Religion down Their Throats"

    ERIC Educational Resources Information Center

    King, Jason

    2015-01-01

    This article attempts two tasks. First, to clarify how the claim that colleges and universities may "shove religion down students' throats" has a historical background. Second, to indicate how pedagogical strategies--like service learning, discussions, paper revisions, and "Just in Time Teaching" exercises--can be used in ways…

  3. Trying Not to "Shove Religion down Their Throats"

    ERIC Educational Resources Information Center

    King, Jason

    2015-01-01

    This article attempts two tasks. First, to clarify how the claim that colleges and universities may "shove religion down students' throats" has a historical background. Second, to indicate how pedagogical strategies--like service learning, discussions, paper revisions, and "Just in Time Teaching" exercises--can be used in ways…

  4. Acquisition of plumage polymorphism in white-throated sparrows

    Treesearch

    Carter T. Atkinson; C. John Ralph

    1980-01-01

    The White-throated Sparrow (Zonotrichia albicollis) was thought to be polymorphic in breeding plumage, having distinct white and tan phases that are bimodal in distribution and independent of sex. Vardy (1971), however, submitted evidence that plumage type is determined primarily by age, sex, and molt cycle. We reexamined this question by measuring plumage...

  5. Ear, nose and throat problems in Accident and Emergency.

    PubMed

    Reynolds, Tanya

    Nurses working in A&E departments throughout the UK frequently encounter patients with ear, nose and throat conditions. While the majority of these are straightforward, a small number are serious and even life-threatening. Tanya Reynolds discusses the nursing management of this group of patients and stresses the importance of appropriate assessment, pain management and referral.

  6. 21 CFR 874.4420 - Ear, nose, and throat manual surgical instrument.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... device includes the esophageal dilator; tracheal bistour (a long, narrow surgical knife); tracheal dilator; tracheal hook; laryngeal injection set; laryngeal knife; laryngeal saw; laryngeal trocar...; wire ear loop; microrule; mirror; mobilizer; ear, nose, and throat punch; ear, nose and throat...

  7. 21 CFR 874.4420 - Ear, nose, and throat manual surgical instrument.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... device includes the esophageal dilator; tracheal bistour (a long, narrow surgical knife); tracheal dilator; tracheal hook; laryngeal injection set; laryngeal knife; laryngeal saw; laryngeal trocar...; wire ear loop; microrule; mirror; mobilizer; ear, nose, and throat punch; ear, nose and throat...

  8. 21 CFR 874.4420 - Ear, nose, and throat manual surgical instrument.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... device includes the esophageal dilator; tracheal bistour (a long, narrow surgical knife); tracheal dilator; tracheal hook; laryngeal injection set; laryngeal knife; laryngeal saw; laryngeal trocar...; wire ear loop; microrule; mirror; mobilizer; ear, nose, and throat punch; ear, nose and throat...

  9. Open-label taste-testing study to evaluate the acceptability of both strawberry-flavored and orange-flavored amylmetacresol/2,4-dichlorobenzyl alcohol throat lozenges in healthy children.

    PubMed

    Thompson, Alex; Reader, Sandie; Field, Emma; Shephard, Adrian

    2013-06-01

    Acute sore throat (pharyngitis) is one of the most common illnesses for which children are seen by primary care physicians. Most cases are caused by viruses and are benign and self-limiting. Clinically proven, over-the-counter throat lozenges provide rapid and effective relief of acute sore throat symptoms, and are increasingly important in self-management of this condition. The purpose of this study (International Standard Randomized Controlled Trial Number: ISRCTN34958871) was to evaluate the acceptability of two licensed, commercially available sore throat lozenges containing amylmetacresol and 2,4-dichlorobenzyl (AMC/DCBA)--one strawberry flavored and the other orange flavored--in healthy children. This was an open-label, single-dose, crossover, taste-testing study in children recruited via a clinical database and advertisements over a 3.5-week period. Potentially eligible participants were invited to attend the taste-testing session at a clinic. At the screening session, which took place either before or on the day of taste testing, details of relevant medical history, medication, and demographics were recorded. Of the 108 screened subjects, 102 were recruited. These were healthy male and female children aged 6-12 years. Each child cleansed their palate with water and water biscuits before tasting a strawberry-flavored lozenge (Strepsils® strawberry sugar free, Reckitt Benckiser Healthcare Limited, Nottingham, UK; PL 00063/0395), which was sucked for 1 minute and then expelled. The orange-flavored lozenge (Strepsils® orange with vitamin C, Reckitt Benckiser Healthcare Limited, Nottingham, UK; PL 016242152) was tasted at least 15 minutes later following further cleansing of the palate. The spontaneous reaction of the child on tasting each lozenge was observed and recorded. Subjects were asked to indicate their liking for each lozenge, using a 7-point hedonic facial scale, and were required to answer a series of questions relating to what they liked and

  10. Endoscopic removal of throat-packing gauze swallowed during general anesthesia.

    PubMed

    Iwai, Toshinori; Goto, Takahisa; Matsui, Yoshiro; Tohnai, Iwai

    2012-09-01

    Throat packing is commonly placed in the pharynx before starting oral and maxillofacial surgery under general anesthesia to protect the airway from aspiration of blood and surgical debris. Complications such as airway obstruction may arise if any of the throat packing is retained after extubation, and less commonly, swallowing of the throat packing has been reported. We report endoscopic removal of throat packing gauze swallowed during general anesthesia.

  11. 21 CFR 874.4500 - Ear, nose, and throat microsurgical carbon dioxide laser.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat microsurgical carbon dioxide..., nose, and throat microsurgical carbon dioxide laser. (a) Identification. An ear, nose, and throat microsurgical carbon dioxide laser is a device intended for the surgical excision of tissue from the ear, nose...

  12. 21 CFR 874.4500 - Ear, nose, and throat microsurgical carbon dioxide laser.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ear, nose, and throat microsurgical carbon dioxide..., nose, and throat microsurgical carbon dioxide laser. (a) Identification. An ear, nose, and throat microsurgical carbon dioxide laser is a device intended for the surgical excision of tissue from the ear, nose...

  13. 21 CFR 874.4500 - Ear, nose, and throat microsurgical carbon dioxide laser.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear, nose, and throat microsurgical carbon dioxide..., nose, and throat microsurgical carbon dioxide laser. (a) Identification. An ear, nose, and throat microsurgical carbon dioxide laser is a device intended for the surgical excision of tissue from the ear, nose...

  14. 21 CFR 874.4500 - Ear, nose, and throat microsurgical carbon dioxide laser.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ear, nose, and throat microsurgical carbon dioxide..., nose, and throat microsurgical carbon dioxide laser. (a) Identification. An ear, nose, and throat microsurgical carbon dioxide laser is a device intended for the surgical excision of tissue from the ear, nose...

  15. 21 CFR 874.4500 - Ear, nose, and throat microsurgical carbon dioxide laser.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ear, nose, and throat microsurgical carbon dioxide..., nose, and throat microsurgical carbon dioxide laser. (a) Identification. An ear, nose, and throat microsurgical carbon dioxide laser is a device intended for the surgical excision of tissue from the ear, nose...

  16. 21 CFR 874.3620 - Ear, nose, and throat synthetic polymer material.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ear, nose, and throat synthetic polymer material. 874.3620 Section 874.3620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN..., and throat synthetic polymer material. (a) Identification. Ear, nose, and throat synthetic...

  17. 21 CFR 874.3620 - Ear, nose, and throat synthetic polymer material.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ear, nose, and throat synthetic polymer material. 874.3620 Section 874.3620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN..., and throat synthetic polymer material. (a) Identification. Ear, nose, and throat synthetic...

  18. 21 CFR 874.3620 - Ear, nose, and throat synthetic polymer material.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ear, nose, and throat synthetic polymer material. 874.3620 Section 874.3620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN..., and throat synthetic polymer material. (a) Identification. Ear, nose, and throat synthetic...

  19. 21 CFR 874.3620 - Ear, nose, and throat synthetic polymer material.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat synthetic polymer material. 874.3620 Section 874.3620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN..., and throat synthetic polymer material. (a) Identification. Ear, nose, and throat synthetic...

  20. 21 CFR 874.3620 - Ear, nose, and throat synthetic polymer material.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear, nose, and throat synthetic polymer material. 874.3620 Section 874.3620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN..., and throat synthetic polymer material. (a) Identification. Ear, nose, and throat synthetic...

  1. 21 CFR 874.4420 - Ear, nose, and throat manual surgical instrument.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4420 Ear, nose...; and ear, nose, and throat trocar. (b) Classification Class I (general controls). The device is exempt... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear, nose, and throat manual surgical...

  2. 21 CFR 874.4250 - Ear, nose, and throat electric or pneumatic surgical drill.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874... throat electric or pneumatic surgical drill is a rotating drilling device, including the handpiece, that... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ear, nose, and throat electric or...

  3. 21 CFR 874.4420 - Ear, nose, and throat manual surgical instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4420 Ear, nose...; and ear, nose, and throat trocar. (b) Classification Class I (general controls). The device is exempt... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat manual surgical...

  4. 21 CFR 874.4350 - Ear, nose, and throat fiberoptic light source and carrier.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ear, nose, and throat fiberoptic light source and... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4350 Ear, nose, and throat fiberoptic light source and carrier. (a) Identification. An ear, nose, and...

  5. 21 CFR 874.4250 - Ear, nose, and throat electric or pneumatic surgical drill.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ear, nose, and throat electric or pneumatic... AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4250 Ear, nose, and throat electric or pneumatic surgical drill. (a) Identification. An ear, nose,...

  6. 21 CFR 874.5300 - Ear, nose, and throat examination and treatment unit.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ear, nose, and throat examination and treatment... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5300 Ear, nose, and throat examination and treatment unit. (a) Identification. An ear, nose, and...

  7. 21 CFR 874.5300 - Ear, nose, and throat examination and treatment unit.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ear, nose, and throat examination and treatment... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5300 Ear, nose, and throat examination and treatment unit. (a) Identification. An ear, nose, and...

  8. 21 CFR 874.4350 - Ear, nose, and throat fiberoptic light source and carrier.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ear, nose, and throat fiberoptic light source and... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4350 Ear, nose, and throat fiberoptic light source and carrier. (a) Identification. An ear, nose, and...

  9. 21 CFR 874.5300 - Ear, nose, and throat examination and treatment unit.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Ear, nose, and throat examination and treatment... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5300 Ear, nose, and throat examination and treatment unit. (a) Identification. An ear, nose, and...

  10. 21 CFR 874.4350 - Ear, nose, and throat fiberoptic light source and carrier.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ear, nose, and throat fiberoptic light source and... HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4350 Ear, nose, and throat fiberoptic light source and carrier. (a) Identification. An ear, nose, and...

  11. 21 CFR 874.4250 - Ear, nose, and throat electric or pneumatic surgical drill.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Ear, nose, and throat electric or pneumatic... AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4250 Ear, nose, and throat electric or pneumatic surgical drill. (a) Identification. An ear, nose,...

  12. 21 CFR 874.4250 - Ear, nose, and throat electric or pneumatic surgical drill.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Ear, nose, and throat electric or pneumatic... AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Surgical Devices § 874.4250 Ear, nose, and throat electric or pneumatic surgical drill. (a) Identification. An ear, nose,...

  13. Perforator-based fasciocutaneous flap for pressure sore reconstruction.

    PubMed

    Lin, Chih-Hsun; Ma, Hsu

    2012-12-01

    Pressure sore reconstruction is always a challenge for plastic surgeons due to its high recurrence rate. In addition to the myocutaneous flap, the perforator-based fasciocutaneous flap has become a new entity used for pressure sore reconstruction. This study presents a series of 26 perforator-based fasciocutaneous flaps for pressure sore reconstruction, with good outcomes in 21 patients from July 2008 to April 2011. The flaps were advanced, transposed, or rotated to obliterate the defects. Twenty of 26 flaps healed uneventfully without complication. One patient had a flap that totally necrosed, one had partial flap necrosis (flap rotated 180° in the above two cases), one had infection and healed by a secondary flap, one had minor wound dehiscence, one died of pneumonia 1 week postoperatively, and recurrence developed in one patient. The perforator-based fasciocutaneous flap is a reliable method and produced good results in this series. These flaps are well vascularised, have enough soft tissue bulk, and have a high degree of mobilisation freedom.

  14. Electrical stimulation for pressure sore prevention and wound healing.

    PubMed

    Bogie, K M; Reger, S I; Levine, S P; Sahgal, V

    2000-01-01

    This paper reviews applications of therapeutic electrical stimulation (ES) specific to wound healing and pressure sore prevention. The application of ES for wound healing has been found to increase the rate of healing by more than 50%. Furthermore, the total number of wounds healed is also increased. However, optimal delivery techniques for ES therapy have not been established to date. A study of stimulation current effects on wound healing in a pig model has shown that direct current (DC) stimulation is most effective in wound area reduction and alternating current (AC) stimulation for wound volume reduction at current densities of 127 microA/cm2 and 1,125 microA/cm2, respectively. Preliminary studies have been carried out at two research centers to assess the role of ES in pressure sore prevention. Surface stimulation studies have shown that ES can produce positive short-term changes in tissue health variables such as regional blood flow and pressure distribution. The use of an implanted stimulation system consisting of intramuscular electrodes with percutaneous leads has been found to produce additional long-term changes. Specifically, gluteal muscle thickness increased by 50% with regular long-term ES application concurrent with a 20% decrease in regional interface pressures and increased tissue oxygen levels. These findings indicate that an implantable ES system may have great potential for pressure sore prevention, particularly for individuals who lack sensation or who are physically unable to perform regular independent pressure relief.

  15. Modulation in voluntary neural drive in relation to muscle soreness

    PubMed Central

    Bringard, A.; Puchaux, K.; Noakes, T. D.; Perrey, S.

    2007-01-01

    The aim of this study was to investigate whether (1) spinal modulation would change after non-exhausting eccentric exercise of the plantar flexor muscles that produced muscle soreness and (2) central modulation of the motor command would be linked to the development of muscle soreness. Ten healthy subjects volunteered to perform a single bout of backward downhill walking exercise (duration 30 min, velocity 1 ms−1, negative grade −25%, load 12% of body weight). Neuromuscular test sessions [H-reflex, M-wave, maximal voluntary torque (MVT)] were performed before, immediately after, as well as 1–3 days after the exercise bout. Immediately after exercise there was a −15% decrease in MVT of the plantar flexors partly attributable to an alteration in contractile properties (−23% in electrically evoked mechanical twitch). However, MVT failed to recover before the third day whereas the contractile properties had significantly recovered within the first day. This delayed recovery of MVT was likely related to a decrement in voluntary muscle drive. The decrease in voluntary activation occurred in the absence of any variation in spinal modulation estimated from the H-reflex. Our findings suggest the development of a supraspinal modulation perhaps linked to the presence of muscle soreness. PMID:17978834

  16. Risk factors for pressure sores in adult patients with myelomeningocele – a questionnaire-based study

    PubMed Central

    Plaum, Pål-Erik; Riemer, Gunnar; Frøslie, Kathrine Frey

    2006-01-01

    Background Myelomeningocele (MMC) is a part of a complex neural tube defect and a disorder of the cerebrospinal fluid system. Pressure sores are a frequent complication for patients with MMC. Little is known about the risk factors for pressure sores in adults with MMC. The aim of this study was to investigate an association between the presence of pressure sores and other patient characteristics, in order to develop an improved strategy for the management of sores. Methods A structured questionnaire regarding sores, medical condition, function and living factors was designed and sent to the 193 patients with MMC registered in the year 2003 at TRS, a National Centre for Rare Disorders in Norway. Results Out of 193 total, 87 patients participated and 71 patients (82%) reported sores; 26 (30%) at the time of the interview and 45 (52%) during the last 5 years. Sores were mostly localized on toes and feet and occurred exclusively in regions with reduced or missing sensibility. A significant association was found between sores and memory deficit (p = 0.02), Arnold Chiari malformation (p = 0.02) and a record of previous sores (p = 0.004). Sores were not significantly associated with hydrocephalus, syringomyelia, nutrition, body mass index, smoking, physical activity, employment or living together with other persons. Some patients (18, 21%) reported skin inspection by others and the remainder relied on self-inspection. Conclusion Patients with sensory deficit, memory problems, and Arnold Chiari malformation had a higher risk of having pressure sores. This patient group needs improved skin inspection routines and sore treatment. PMID:17196099

  17. Defining 'open throat' through content analysis of experts' pedagogical practices.

    PubMed

    Mitchell, Helen F; Kenny, Dianna T; Ryan, Maree; Davis, Pamela J

    2003-01-01

    'Open throat' is a term regularly used in the singing studio, but agreement across pedagogues as to its definition and function has not yet been assessed. Fifteen expert singing pedagogues participated in a qualitative study involving a semi-structured interview to explore current thinking regarding terminology, pedagogy, sound quality and the perceived physiology to achieve open throat, as used in the singing studio. Most teachers included the use of the technique as a fundamental in singing training, and were positive about the sound quality it achieved, especially in classical singing. The purpose of the technique was described as a way of maximizing pharyngeal space and/or achieving abduction of the ventricular folds.

  18. Engine throat/nozzle optics for plume spectroscopy

    NASA Technical Reports Server (NTRS)

    Bickford, R. L.; Duncan, D. B.

    1991-01-01

    The Task 2.0 Engine Throat/Nozzle Optics for Plume Spectroscopy, effort was performed under the NASA LeRC Development of Life Prediction Capabilities for Liquid Propellant Rocket Engines program. This Task produced the engineering design of an optical probe to enable spectroscopic measurements within the SSME main chamber. The probe mounts on the SSME nozzle aft manifold and collects light emitted from the throat plane and chamber. Light collected by the probe is transferred to a spectrometer through a fiber optic cable. The design analyses indicate that the probe will function throughout the engine operating cycle and is suitable for both test stand and flight operations. By detecting metallic emissions that are indicative of component degradation or incipient failure, engine shutdown can be initiated before catastrophic failure. This capability will protect valuable test stand hardware and provide enhanced mission safety.

  19. Laryngeal mask airways in ear, nose, and throat procedures.

    PubMed

    Mandel, Jeff E

    2010-09-01

    The use of laryngeal mask airway (LMA) and its variants in ear, nose, and throat procedures have been extensively described in case reports, retrospective reviews, and randomized clinical trials. The LMA has developed a considerable following because of its lack of tracheal stimulation, which can be a considerable advantage in ear, nose, and throat (ENT) procedures. The incidence of coughing on emergence has been shown to be lower with the LMA than with the endotracheal tube (ETT). Although other approaches to smooth emergence have been described, few would argue that it is as easy to achieve a smooth emergence with an ETT as with an LMA. Although patients certainly exist for whom the LMA is contraindicated, many will experience better results with the LMA because of the features delineated in this article.

  20. Adult NREM parasomnia associated with lancinating throat pain.

    PubMed

    Bušková, Jitka; Sonka, Karel

    2014-08-15

    We report the case of a 30-year-old woman presenting with dangerous nocturnal NREM episodes with the clinical feature of lancinating throat pain. We hypothesize that the pain may have represented sensory hallucination analogous to commonly recognized visual images associated with NREM parasomnias. This case is also unusual for probable psychological triggers that could play a role in the pathogenesis of the disease, as evidenced by successful psychotherapy.

  1. Warped throat solutions in string theory and their cosmological applications

    NASA Astrophysics Data System (ADS)

    Dymarsky, Anatoly

    2007-12-01

    This thesis is devoted to a study of certain examples of gauge/string duality related to warped throat backgrounds in string theory. Namely, we consider a family of IIB SUGRA solutions dual to a moduli space of certain cascading N = 1 gauge theory. This theory exhibits rich low-energy behavior, including chiral symmetry breaking and confinement. The first part of this thesis is focused on the gravity dual description of these phenomena. In particular, we discuss string theory description of the continuous gauge theory moduli space, evaluate the tension of BPS domain wall, and calculate baryonic condensates. The second part of the thesis is devoted to the embedding of the warped throat backgrounds into flux compactifications. To this end we calculate the nonperturbative superpotential of the D3-D7 system on warped conic geometries. This superpotential plays an important role in fixing Kahler moduli and is an important ingredient in constructing consistent compactification scenarios. In the last part of the thesis we apply this superpotential to a particular cosmological inflation scenario based on the dynamics of a D3-brane moving along the throat. We conclude that the realization of stringy inflation within this scenario is possible only around an inflection point of the potential and requires a fine tuning of the parameters.

  2. In vivo-in vitro comparison of deposition in three mouth-throat models with Qvar and Turbuhaler inhalers.

    PubMed

    Zhang, Yu; Gilbertson, Kyle; Finlay, Warren H

    2007-01-01

    In vitro polydisperse aerosol deposition in three mouth-throat models, namely, the USP (United States Pharmacopeia) mouth-throat (induction port), idealized mouth-throat, and highly idealized mouth-throat, was investigated experimentally. Aerosol particles emitted from two commercial inhalers, Qvar (pMDI) and Turbuhaler (DPI), were used. The in vitro deposition results in these three mouth-throat models were compared with in vivo data available from the literature. For the DPI, mouth-throat deposition was 57.3 +/- 4.5% for the USP mouth-throat, 67.8 +/- 2.2% for the idealized mouth-throat, and 69.3 +/- 1.1% for the highly idealized mouth-throat, which are all relatively close to the in vivo value of 65.8 +/- 10.1%. In contrast, for the pMDI, aerosol deposition in the idealized mouth-throat (25.8 +/- 4.2%) and the highly idealized mouth-throat (24.9 +/- 2.8%) agrees with the in vivo data (29.0 +/- 18.0%) reported in the literature better than that for the USP mouth-throat (12.2 +/- 2.7%). In both cases, the USP mouth-throat gives the lowest deposition among the three mouth-throat models studied. In summary, both the idealized mouth-throat and highly idealized mouth-throat improve the accuracy of predicted mean in vivo deposition in the mouth-throat region. This result hints at the potential applicability of either the idealized mouth-throat or highly idealized mouth-throat as a future USP mouth-throat standard to provide mean value prediction of in vivo mouth-throat deposition.

  3. Pressure-induced referred pain is expanded by persistent soreness.

    PubMed

    Doménech-García, V; Palsson, T S; Herrero, P; Graven-Nielsen, T

    2016-05-01

    Several chronic pain conditions are accompanied with enlarged referred pain areas. This study investigated a novel method for assessing referred pain. In 20 healthy subjects, pressure pain thresholds (PPTs) were recorded and pressure stimuli (120% PPT) were applied bilaterally for 5 and 60 seconds at the infraspinatus muscle to induce local and referred pain. Moreover, PPTs were measured bilaterally at the shoulder, neck, and leg before, during, and after hypertonic saline-induced referred pain in the dominant infraspinatus muscle. The pressure and saline-induced pain areas were assessed on drawings. Subsequently, delayed onset muscle soreness was induced using eccentric exercise of the dominant infraspinatus muscle. The day-1 assessments were repeated the following day (day 2). Suprathreshold pressure stimulations and saline injections into the infraspinatus muscle caused referred pain to the frontal aspect of the shoulder/arm in all subjects. The 60-second pressure stimulation caused larger referred pain areas compared with the 5-second stimulation (P < 0.01). Compared with pressure stimulation, the saline-induced referred pain area was larger (P < 0.02). After saline-induced pain, the PPTs at the infraspinatus and supraspinatus muscles were reduced (P < 0.05), and the 5-second pressure-induced referred pain area was larger than baseline. Pressure pain thresholds at the infraspinatus and supraspinatus muscles were reduced at day 2 in the delayed onset muscle soreness side (P < 0.05). Compared with day 1, larger pressure and saline-induced referred pain areas were observed on day 2 (P < 0.05). Referred pain to the shoulder/arm was consistently induced and enlarged after 1 day of muscle soreness, indicating that the referred pain area may be a sensitive biomarker for sensitization of the pain system.

  4. Pain reduction and treatment of sore nipples in nursing mothers.

    PubMed

    Cadwell, Karin; Turner-Maffei, Cynthia; Blair, Anna; Brimdyr, Kajsa; Maja McInerney, Zoë

    2004-01-01

    Health-promotion goals include increasing the duration of breastfeeding because of its irrefutable advantages to the mother and baby, society, and the environment. However, many mothers experience painful, sore nipples during breastfeeding and stop nursing before they intended (Livingstone & Stringer, 1999). The experimental trial described in this paper randomized 94 breastfeeding women with sore nipples into three treatment groups. Midwives practicing in hospitals in Latvia assessed the participants' breastfeeding practices, then gave the mothers individualized education and corrective interventions using a guided documentation form, the Lactation Assessment Tool (LATtrade mark). In addition, two groups were instructed to use commercial products on their breasts and nipples: breast shells and lanolin cream for one group, and glycerin gel therapy for the other. Nipple pain during breastfeeding was rated by the mothers on a 5-point verbal descriptor scale at each visit, and pain at the start of treatment was compared to pain at the last visit. Analysis of variance (using Fisher's Exact Test) determined that no significant differences existed between the groups: F(2, 86) = 1.34, p > .05. Almost all of the mothers experienced nipple healing, as assessed by the midwife. Mothers in the glycerin gel group were more satisfied with their treatment method, but this finding was not statistically significant. The results of this study indicate that effective care and perinatal education for nursing mothers with sore nipples should include assessment of breastfeeding positioning and latch-on, as well as education and corrective interventions using a guidance tool, whether or not commercial preparations are used.

  5. Pain Reduction and Treatment of Sore Nipples in Nursing Mothers

    PubMed Central

    Cadwell, Karin; Turner-Maffei, Cynthia; Blair, Anna; Brimdyr, Kajsa; Maja McInerney, Zoë

    2004-01-01

    Health-promotion goals include increasing the duration of breastfeeding because of its irrefutable advantages to the mother and baby, society, and the environment. However, many mothers experience painful, sore nipples during breastfeeding and stop nursing before they intended (Livingstone & Stringer, 1999). The experimental trial described in this paper randomized 94 breastfeeding women with sore nipples into three treatment groups. Midwives practicing in hospitals in Latvia assessed the participants' breastfeeding practices, then gave the mothers individualized education and corrective interventions using a guided documentation form, the Lactation Assessment Tool (LAT™). In addition, two groups were instructed to use commercial products on their breasts and nipples: breast shells and lanolin cream for one group, and glycerin gel therapy for the other. Nipple pain during breastfeeding was rated by the mothers on a 5-point verbal descriptor scale at each visit, and pain at the start of treatment was compared to pain at the last visit. Analysis of variance (using Fisher's Exact Test) determined that no significant differences existed between the groups: F(2, 86) = 1.34, p > .05. Almost all of the mothers experienced nipple healing, as assessed by the midwife. Mothers in the glycerin gel group were more satisfied with their treatment method, but this finding was not statistically significant. The results of this study indicate that effective care and perinatal education for nursing mothers with sore nipples should include assessment of breastfeeding positioning and latch-on, as well as education and corrective interventions using a guidance tool, whether or not commercial preparations are used. PMID:17273373

  6. Vibration Therapy in Management of Delayed Onset Muscle Soreness (DOMS)

    PubMed Central

    Imtiyaz, Shagufta

    2014-01-01

    Both athletic and nonathletic population when subjected to any unaccustomed or unfamiliar exercise will experience pain 24-72 hours postexercise. This exercise especially eccentric in nature caused primarily by muscle damage is known as delayed-onset muscle soreness (DOMS). This damage is characterized by muscular pain, decreased muscle force production, reduce range of motion and discomfort experienced. DOMS is due to microscopic muscle fiber tears. The presence of DOMS increases risk of injury. A reduced range of motion may lead to the incapability to efficiently absorb the shock that affect physical activity. Alterations to mechanical motion may increase strain placed on soft tissue structures. Reduced force output may signal compensatory recruitment of muscles, thus leading to unaccustomed stress on musculature. Differences in strength ratios may also cause excessive strain on unaccustomed musculature. A range of interventions aimed at decreasing symptoms of DOMS have been proposed. Although voluminous research has been done in this regard, there is little consensus among the practitioners regarding the most effective way of treating DOMS. Mechanical oscillatory motion provided by vibration therapy. Vibration could represent an effective exercise intervention for enhancing neuromuscular performance in athletes. Vibration has shown effectiveness in flexibility and explosive power. Vibration can apply either local area or whole body vibration. Vibration therapy improves muscular strength, power development, kinesthetic awareness, decreased muscle sore, increased range of motion, and increased blood flow under the skin. VT was effective for reduction of DOMS and regaining full ROM. Application of whole body vibration therapy in postexercise demonstrates less pressure pain threshold, muscle soreness along with less reduction maximal isometric and isokinetic voluntary strength and lower creatine kinase levels in the blood. PMID:25121012

  7. Vibration Therapy in Management of Delayed Onset Muscle Soreness (DOMS).

    PubMed

    Veqar, Zubia; Imtiyaz, Shagufta

    2014-06-01

    Both athletic and nonathletic population when subjected to any unaccustomed or unfamiliar exercise will experience pain 24-72 hours postexercise. This exercise especially eccentric in nature caused primarily by muscle damage is known as delayed-onset muscle soreness (DOMS). This damage is characterized by muscular pain, decreased muscle force production, reduce range of motion and discomfort experienced. DOMS is due to microscopic muscle fiber tears. The presence of DOMS increases risk of injury. A reduced range of motion may lead to the incapability to efficiently absorb the shock that affect physical activity. Alterations to mechanical motion may increase strain placed on soft tissue structures. Reduced force output may signal compensatory recruitment of muscles, thus leading to unaccustomed stress on musculature. Differences in strength ratios may also cause excessive strain on unaccustomed musculature. A range of interventions aimed at decreasing symptoms of DOMS have been proposed. Although voluminous research has been done in this regard, there is little consensus among the practitioners regarding the most effective way of treating DOMS. Mechanical oscillatory motion provided by vibration therapy. Vibration could represent an effective exercise intervention for enhancing neuromuscular performance in athletes. Vibration has shown effectiveness in flexibility and explosive power. Vibration can apply either local area or whole body vibration. Vibration therapy improves muscular strength, power development, kinesthetic awareness, decreased muscle sore, increased range of motion, and increased blood flow under the skin. VT was effective for reduction of DOMS and regaining full ROM. Application of whole body vibration therapy in postexercise demonstrates less pressure pain threshold, muscle soreness along with less reduction maximal isometric and isokinetic voluntary strength and lower creatine kinase levels in the blood.

  8. Nutritional status, pressure sores, and mortality in elderly patients with cancer.

    PubMed

    Waltman, N L; Bergstrom, N; Armstrong, N; Norvell, K; Braden, B

    1991-07-01

    This prospective study aimed to determine differences in nutritional status, incidence of pressure sores, and incidence of mortality between two groups, one composed of 33 elderly, institutionalized patients with cancer and the other a matched group of 33 patients without cancer. Subjects with cancer were paired with subjects without cancer based on age (mean = 78), sex, and pressure sore risk. Skin breakdown, dietary intake, and blood and serum indices of nutritional status were studied for 12 weeks. Of the subjects with cancer, 85% developed pressure sores, compared to 70% of the subjects without cancer. Hemoglobin (Hgb) (female), serum total protein, total lymphocyte count, serum albumin, serum total iron binding capacity, and serum transferrin were significantly lower in subjects with cancer with pressure sores than in subjects without cancer with pressure sores. Total lymphocyte count and serum total protein were significantly lower in subjects with cancer with pressure sores than in subjects with cancer without pressure sores. Kwashiorkor was found in 70% of the subjects with cancer, compared to 21% of the subjects without cancer. During the study, 39% of the subjects with cancer and 15% of the subjects without cancer died. All 13 of the subjects with cancer who died had kwashiorkor and pressure sores and had died an average of three weeks after developing pressure sores. These results implicate that elderly patients with cancer who have protein deficiencies should be considered to be at risk of pressure sore development. Frequent repositioning and mattress overlays that reduce pressure and increase comfort may delay development of pressure sores.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Development of a cushion to prevent ischial pressure sores.

    PubMed Central

    Bowker, P; Davidson, L M

    1979-01-01

    A study was carried out jointly by nursing staff and technologists in an attempt to develop a cushion based on scientific principles and measurement that might prevent pressure sores. At each stage in the development clinical trials were carried out, and using the results of these together with the opinions of medical staff and patients who used the cushion the design was suitably modified. Over four years a seat was evolved that was simple to construct and fulfilled the clinical requirements for a wide range of patients while providing maximum relief of high-pressure points. The design was subsequently taken up commercially. Images Fig 3 PMID:509176

  10. Prevention is better than cure. A survey of the use of Pegasus Airwave System in pressure sore treatment.

    PubMed

    Winman, G; Ashley, L

    1992-12-01

    Pressure relieving mattresses play an important role in pressure sore prevention and healing. This study describes the current use and reported effectiveness of the Pegasus Airwave System in pressure sore prevention.

  11. Cold sore susceptibility gene-1 genotypes affect the expression of herpes labialis in unrelated human subjects.

    PubMed

    Kriesel, John D; Bhatia, Amiteshwar; Thomas, Alun

    2014-01-01

    Our group has recently described a gene on human chromosome 21, the Cold Sore Susceptibility Gene-1 (CSSG-1, also known as C21orf91), which may confer susceptibility to frequent cold sores in humans. We present here a genotype-phenotype analysis of CSSG-1 in a new, unrelated human population. Seven hundred fifty-eight human subjects were enrolled in a case/control Cold Sore Study. CSSG-1 genotyping, herpes simplex virus 1 (HSV1) serotyping, demographic and phenotypic data was available from 622 analyzed subjects. Six major alleles (H1-H6) were tested for associations with each of the self-reported phenotypes. The statistical analysis was adjusted for age, sex and ethnicity. Genotype-phenotype associations were analyzed from 388 HSV1-seropositive subjects. There were significant CSSG-1 haplotype effects on annual cold sore outbreaks (P=0.006), lifetime cold sores (P=0.012) and perceived cold sore severity (P=0.012). There were relatively consistent trends toward protection from frequent and severe cold sores among those with the H3 or H5/6 haplotypes, whereas those with H1, H2, and H4 haplotypes tended to have more frequent and more severe episodes. Different alleles of the newly described gene CSSG-1 affect the expression of cold sore phenotypes in this new, unrelated human population, confirming the findings of the previous family-based study.

  12. Convergent evidence for construct validity of a 7-point likert scale of lower limb muscle soreness.

    PubMed

    Impellizzeri, Franco M; Maffiuletti, Nicola A

    2007-11-01

    The aim of this study was to examine the construct validity of the 7-point Likert scale of muscle soreness, assessing its relationship with Visual Analogue Scale (VAS). An additional aim was to examine its sensitivity as measure of symptom of eccentric-contraction muscle damage. Correlational study. Self-administered questionnaires collected in field setting. Twenty-six soccer players. 4-week preseason training camp, which included high-intensity plyometric training sessions. Players self-reported the perceived muscle soreness of the lower limbs using the VAS (criterion measure) and the 7-point Likert scale of muscle soreness. Significant individual correlations were found between the 2 muscle soreness scales (mean r=0.80+/-0.07; range, 0.65 to 0.94). The correlation using the pooled data was 0.81. No significant muscle soreness scale x time interaction was found for standardized measures of muscle soreness (P=0.98). The main factor for time (24, 48, 72, and 96 hours after the first plyometric training session) was significant (P=0.0001). Effect sizes for the changes in the Likert and VAS absolute scores during the first 96 hours were similar (partial eta=0.13). The results of this study provide further convergent evidence for the construct validity of the 7-point Likert scale of muscle soreness. The 2 scales showed similar sensitivity to muscle soreness caused by eccentric contractions during the first 96 hours after plyometric exercises.

  13. Homoeopathy for delayed onset muscle soreness: a randomised double blind placebo controlled trial.

    PubMed Central

    Vickers, A J; Fisher, P; Smith, C; Wyllie, S E; Lewith, G T

    1997-01-01

    OBJECTIVE: To pilot a model for determining whether a homoeopathic medicine is superior to placebo for delayed onset muscle soreness (DOMS). DESIGN: Randomised double blind placebo controlled trial. SETTING: Physiotherapy department of a homoeopathic hospital. SUBJECTS: Sixty eight healthy volunteers (average age 30; 41% men) undertook a 10 minute period of bench stepping carrying a small weight and were randomised to a homoeopathic medicine or placebo. OUTCOME MEASURES: Mean muscle soreness in the five day period after the exercise test, symptom free days, maximum soreness score, days to no soreness, days on medication. RESULTS: The difference between group means was 0.17 in favour of placebo with 95% confidence intervals +/- 0.50. Similar results were found for other outcome measures. CONCLUSION: The study did not find benefit of the homoeopathic remedy in DOMS. Bench stepping may not be an appropriate model to evaluate the effects of a treatment on DOMS because of wide variation between subject soreness scores. PMID:9429007

  14. [Resurfacing of an ischial and trochanteric recurrent pressure sore by a pedicled fasciocutaneous anterolateral thigh flap].

    PubMed

    Moullot, P; Philandrianos, C; Casanova, D

    2014-10-01

    Ischial pressure sores, common in paraplegic patient, are the most difficult to treat, and poor prognosis associated with a high rate of postoperative recurrence. Many surgical techniques by muscular or myocutaneous flap coverage have been described. We report an original use of a fasciocutaneous pedicled anterolateral thigh (ALTp) flap for coverage of an ischial pressure sore combined with a trochanteric pressure sore, exceeded beyond any conventional therapeutic solution. A 45-year-old paraplegic patient suffered from a trochanteric and ischial pressure sore, which had already received coverage by a muscular flap of biceps femoris and gluteus maximus. At 1 year, the result is satisfactory, with good coverage without recurrence. The fasciocutaneous ALTp flap can be a solution to cover recurrent ischial pressure sores beyond conventional methods. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  15. The effects of game and training loads on perceptual responses of muscle soreness in Australian football.

    PubMed

    Montgomery, Paul G; Hopkins, Will G

    2013-05-01

    Australian Football is an intense team sport played over ~120 min on a weekly basis. To determine the effects of game and training load on muscle soreness and the time frame of soreness dissipation, 64 elite Australian Football players (age 23.8 ± 1.8 y, height 183.9 ± 3.8 cm, weight 83.2 ± 5.0 kg; mean ± SD) recorded perceptions of muscle soreness, game intensity, and training intensity on scales of 1-10 on most mornings for up to 3 competition seasons. Playing and training times were also recorded in minutes. Data were analyzed with a mixed linear model, and magnitudes of effects on soreness were evaluated by standardization. All effects had acceptably low uncertainty. Game and training-session loads were 790 ± 182 and 229 ± 98 intensity-minutes (mean ± SD), respectively. General muscle soreness was 4.6 ± 1.1 units on d 1 postgame and fell to 1.9 ± 1.0 by d 6. There was a small increase in general muscle soreness (0.22 ± 0.07-0.50 ± 0.13 units) in the 3 d after high-load games relative to low-load games. Other soreness responses showed similar timelines and magnitudes of change. Training sessions made only small contributions to soreness over the 3 d after each session. Practitioners should be aware of these responses when planning weekly training and recovery programs, as it appears that game-related soreness dissipates after 3 d regardless of game load and increased training loads in the following week produce only small increases in soreness.

  16. Male tawny dragons use throat patterns to recognize rivals.

    PubMed

    Osborne, Louise; Umbers, Kate D L; Backwell, Patricia R Y; Keogh, J Scott

    2012-10-01

    The ability to distinguish between familiar and unfamiliar conspecifics is important for many animals, especially territorial species since it allows them to avoid unnecessary interactions with individuals that pose little threat. There are very few studies, however, that identify the proximate cues that facilitate such recognition in visual systems. Here, we show that in tawny dragons (Ctenophorus decresii), males can recognize familiar and unfamiliar conspecific males based on morphological features alone, without the aid of chemical or behavioural cues. We further show that it is the colour pattern of the throat patches (gular) that facilitates this recognition.

  17. Observational properties of dayside throat aurora and implications on the possible generation mechanisms

    NASA Astrophysics Data System (ADS)

    Han, D.-S.; Hietala, H.; Chen, X.-C.; Nishimura, Y.; Lyons, L. R.; Liu, J.-J.; Hu, H.-Q.; Yang, H.-G.

    2017-02-01

    Observational properties of throat aurora are investigated in detail by using 7 year continuous auroral observations obtained at Yellow River Station (magnetic latitude 76.24°N). From our inspection, throat aurora is often observed under the condition of stripy diffuse aurora contacting with the persistent discrete auroral oval, and the long-period throat aurora observations generally consist of intermittent subsequences of throat aurora brightening followed by poleward moving auroral form and throat aurora dimming. We also noticed that the orientation of throat aurora is aligned along the ionospheric convection flow, and its local time distribution shows clear dependence on the interplanetary magnetic field (IMF) By component. These observational results indicate that factors inside the magnetosphere may play important role on occurrence of throat aurora. We thus suggest that throat aurora may present the ionospheric signature of redistribution of reconnection rate on the magnetopause by cold magnetospheric plasma flowing into the reconnection site. In addition, we also found that the occurrence rate of throat aurora clearly decreases with increase of the IMF cone angle (arccos(|Bx|/B)), which is very similar with the occurrence rate of high-speed jet (HSJ) observed in magnetosheath depending on the IMF cone angle. This is suggested as that the HSJs occurred outside the magnetosphere may also play important role for generation of throat aurora by triggering magnetopause reconnection or by direct impacting. Although further studies are needed to clarify how the throat auroras are generated in detail, the relevant observations about throat aurora have presented important implications on a variety open questions, such as distribution and generation of cold plasma structures in the outer magnetosphere, magnetopause deformation, and possible relation between HSJ and reconnection.

  18. Phylogeography and population genetics of the Amethyst-throated Hummingbird (Lampornis amethystinus).

    PubMed

    Cortés-Rodríguez, Nandadevi; Hernández-Baños, Blanca E; Navarro-Sigüenza, Adolfo G; Townsend Peterson, A; García-Moreno, Jaime

    2008-07-01

    We analyzed mitochondrial DNA sequence variation across 69 Amethyst-throated Hummingbirds (Lampornis amethystinus), comparing with samples of related taxa. Although this group shows discrete phenotypic variation in throat color among populations in Oaxaca and Guerrero (Mexico), the only phylogeographic structure observed was between phenotypically similar populations north and south of the Isthmus of Tehuantepec. As such, it appears that throat color variation is of recent origin and likely based only on minor genetic differences.

  19. Which medical device and/or which local treatment for prevention in patients with risk factors for pressure sores in 2012? Developing French guidelines for clinical practice.

    PubMed

    Nicolas, B; Moiziard, A S; Barrois, B; Colin, D; Michel, J M; Passadori, Y; Ribinik, P

    2012-10-01

    Implementation of a prevention strategy after the identification of risk factors is essential at the entrance in a care unit or in a medical-social unit. Determine which medical devices and which treatments may be used in order to prevent pressure sore in 2012. Systematic review of the literature using databases: Pascal, Biomed, PubMed, and Cochrane library between 2000 and 2010. Nursing care including use of soft product, non-irritating for the cleaning, hydration of the skin with emollients, protection of fragile skin in case of incontinence by applying a skin protector and application of dressings in front of bony prominences to reduce shear forces, remain valid (level C). Nursing cares and use of dressing in patients with high risks of pressure sores are the responsibility of the nurses. The engagement of health care teams involves screening of risk factors and the knowledge of treatments and local devices. Local preventive treatment in a patient with risk factors of pressure sore is of great interest at entrance in a care unit or in a medical-social unit. Copyright © 2012. Published by Elsevier Masson SAS.

  20. Passive Rocket Diffuser Theory: A Re-Examination of Minimum Second Throat Size

    NASA Technical Reports Server (NTRS)

    Jones, Daniel R.

    2016-01-01

    Second-throat diffusers serve to isolate rocket engines from the effects of ambient back pressure during testing without using active control systems. Among the most critical design parameters is the relative area of the diffuser throat to that of the nozzle throat. A smaller second throat is generally desirable because it decreases the stagnation-to-ambient pressure ratio the diffuser requires for nominal operation. There is a limit, however. Below a certain size, the second throat can cause pressure buildup within the diffuser and prevent it from reaching the start condition that protects the nozzle from side-load damage. This paper presents a method for improved estimation of the minimum second throat area which enables diffuser start. The new 3-zone model uses traditional quasi-one-dimensional compressible flow theory to approximate the structure of two distinct diffuser flow fields observed in Computational Fluid Dynamics (CFD) simulations and combines them to provide a less-conservative estimate of the second throat size limit. It is unique among second throat sizing methods in that it accounts for all major conical nozzle and second throat diffuser design parameters within its limits of application. The performance of the 3-zone method is compared to the historical normal shock and force balance methods, and verified against a large number of CFD simulations at specific heat ratios of 1.4 and 1.25. Validation is left as future work, and the model is currently intended to function only as a first-order design tool.

  1. -dimensional thin shell wormhole with deformed throat can be supported by normal matter

    NASA Astrophysics Data System (ADS)

    Mazharimousavi, S. Habib; Halilsoy, M.

    2015-06-01

    From the physics standpoint the exotic matter problem is a major difficulty in thin shell wormholes (TSWs) with spherical/cylindrical throat topologies. We aim to circumvent this handicap by considering angle dependent throats in dimensions. By considering the throat of the TSW to be deformed spherical, i.e., a function of and , we present general conditions which are to be satisfied by the shape of the throat in order to have the wormhole supported by matter with positive density in the static reference frame. We provide particular solutions/examples to the constraint conditions.

  2. Effectiveness of using wearable vibration therapy to alleviate muscle soreness.

    PubMed

    Cochrane, Darryl J

    2017-03-01

    To examine the acute and short-term effect of a wearable vibration device following strenuous eccentric exercise of the elbow flexors. Physically active males (n = 13) performed vibration therapy (VT) and control following eccentric exercise. The arms were randomised and counterbalanced, separated by 14 days. 15 min of VT (120 Hz) was applied immediately and 24, 48, and 72 h after eccentric exercise while the contralateral arm performed no VT (control). Muscle (isometric and concentric) strength, range of motion, electromyography (EMG), muscle soreness and creatine kinase were taken pre-exercise, immediately and 24, 48, and 72 h post-eccentric exercise. Additionally, the acute effect of VT of muscle strength, range of motion, EMG, muscle soreness was also investigated immediately after VT. In the short-term VT was able to significantly reduce the level of biceps brachii pain at 24 h (p < 0.05) and 72 h (p < 0.01), enhance pain threshold at 48 h (p < 0.01) and 72 h (p < 0.01), improve range of motion at 24 h (p < 0.05), 48 h (p < 0.01) and 72 h (p < 0.01) and significantly (p < 0.05) reduced creatine kinase at 72 h compared to control. Acutely, following VT treatment muscle pain and range of motion significantly improved (p < 0.05) at 24 h post, 48 h post, and 72 h post but no significant changes in muscle strength and EMG were reported acutely or short-term. Acute and short-term VT attenuated muscle soreness, creatine kinase and improved range of motion; however, there was no improvement of muscle strength recovery compared to control following eccentric exercise of the elbow flexors.

  3. Delayed onset muscle soreness : treatment strategies and performance factors.

    PubMed

    Cheung, Karoline; Hume, Patria; Maxwell, Linda

    2003-01-01

    Delayed onset muscle soreness (DOMS) is a familiar experience for the elite or novice athlete. Symptoms can range from muscle tenderness to severe debilitating pain. The mechanisms, treatment strategies, and impact on athletic performance remain uncertain, despite the high incidence of DOMS. DOMS is most prevalent at the beginning of the sporting season when athletes are returning to training following a period of reduced activity. DOMS is also common when athletes are first introduced to certain types of activities regardless of the time of year. Eccentric activities induce micro-injury at a greater frequency and severity than other types of muscle actions. The intensity and duration of exercise are also important factors in DOMS onset. Up to six hypothesised theories have been proposed for the mechanism of DOMS, namely: lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. However, an integration of two or more theories is likely to explain muscle soreness. DOMS can affect athletic performance by causing a reduction in joint range of motion, shock attenuation and peak torque. Alterations in muscle sequencing and recruitment patterns may also occur, causing unaccustomed stress to be placed on muscle ligaments and tendons. These compensatory mechanisms may increase the risk of further injury if a premature return to sport is attempted.A number of treatment strategies have been introduced to help alleviate the severity of DOMS and to restore the maximal function of the muscles as rapidly as possible. Nonsteroidal anti-inflammatory drugs have demonstrated dosage-dependent effects that may also be influenced by the time of administration. Similarly, massage has shown varying results that may be attributed to the time of massage application and the type of massage technique used. Cryotherapy, stretching, homeopathy, ultrasound and electrical current modalities have demonstrated no effect on the alleviation of

  4. Performance predictions for an SSME configuration with an enlarged throat

    NASA Technical Reports Server (NTRS)

    Nickerson, G. R.; Dang, L. D.

    1985-01-01

    The Two Dimensional Kinetics (TDK) computer program that was recently developed for NASA was used to predict the performance of a Large Throat Configuration of the Space Shuttle Main Engine (SSME). Calculations indicate that the current design SSME contains a shock wave that is induced by the nozzle wall shape. In the Large Throat design an even stronger shock wave is predicted. Because of the presence of this shock wave, earlier performance predictions that have neglected shock wave effects have been questioned. The JANNAF thrust chamber performance prediction procedures given in a reference were applied. The analysis includes the effects of two dimensional reacting flow with a shock wave. The effects of the boundary layer with a regenatively cooled wall are also included. A Purdue computer program was used to compute axially symmetric supersonic nozzle flows with an induced shock, but is restricted to flows with a constant ratio of specific heats. Thus, the TDK program was also run with ths assumption and the results of the two programs were compared.

  5. Sepsis of the hip due to pressure sore in spinal cord injured patients: advocacy for a one-stage surgical procedure.

    PubMed

    Le Fort, M; Rome-Saulnier, J; Lejeune, F; Bellier-Waast, F; Touchais, S; Kieny, P; Duteille, F; Perrouin-Verbe, B

    2014-11-04

    Study design:Retrospective study reporting characteristics and management of septic arthritis of the hip due to pressure sores in spinal cord-injured patients.Objectives:To describe clinical and biological data of septic arthritis of the hip and its treating management.Setting:The database of the regional SCI referral center, Nantes, France.Methods:We retrospectively collected data from 33 cases of septic arthritis of the hip in the medical files of 26 patients.Results:We analyzed 33 cases of septic arthritis of the hip treated in one French referent center for spinal cord-injured patients from January 1988 to December 2009. Most patients had a thoracic complete paraplegia and nearly two-third (17 out of 26) had no systematic follow-up. In 25 out of 33 cases, the septic arthritis of the hip was due to a trochanteric pressure sore. The causal pressure sore was most frequently associated with a persistent drainage. The standard radiological examination led to the diagnosis in 30 cases and, in 7 questionable cases, magnetic resonance imaging was more contributory. Surgery always consisted of a wide carcinological-like excision and of a subtrochanteric proximal femoral resection including both greater and lesser trochanters. A musculocutaneous flap was realized for all cases and the choice of the muscle depended on the localization of the causal pressure sore but also of the remaining choices, as most of the patients had already undergone a prior surgery. An antibiotic treatment was adapted to multiple samples during surgery.Conclusion:We do advocate for a one-stage procedure including a subtrochanteric proximal femoral resection and a musculocutaneous flap.Spinal Cord advance online publication, 4 November 2014; doi:10.1038/sc.2014.170.

  6. [The Development of a Care Protocol for Postoperative Pressure Sore Prevention].

    PubMed

    Huang, Yu-Ling; Lin, Hui-Ling; Wang, Fang; Wu, Shu-Fang Vivienne

    2015-12-01

    Pressure sores are a common complication caused by long periods of bed rest following major surgery. These sores may increase patient postoperative pain, increase the risk of infections, lengthen the pe-riod of hospitalization, and increase the duration and costs of nursing care. Therefore, maintaining the skin integrity of surgical patients is an important responsibility for operating room nurses and an indicator of nursing care quality. While pressure-sore risk assessment tools and interoperative strategies are available and used in foreign countries, there has been little related research conducted in Taiwan. After examining the relevant literature and considering the current postoperative pressure sore situation in Taiwan, the author developed a postoperative pressure sore care protocol as a reference for clinical staff. Protocol procedures include major breakthrough developments in areas such as post-survey risk assessment for pressure ulcers, pressure ulcer prevention strategies that take surgery-related risk factors into consideration, extra care and protection measures for surgical supine patients, and post-pressure sores. The developed postoperative pressure sore protocol may be incorporated into surgical care procedures during the post-surgical care period in order to effectively prevent the occurrence of post-surgery pressure ulcers. Furthermore, the developed protocol offers the potential to improve and strengthen the quality of surgical care in terms of both healthcare and post-surgical care.

  7. Total bed management: the way forward in pressure sore prevention.

    PubMed

    Preece, J

    King's College Hospital, London, is the first trust to implement total bed management (TBM) to assist in the reduction and prevention of pressure sores. TBM is a new concept, whereby the tissue viability, manual handling and therapy needs of the trust are met at reduced costs through a partnership with a contractor. The introduction of a large number of electric bed frames and foam mattress replacements, with the availability of dynamic pressure-relieving equipment and a service agreement, has led to an expected trust saving of 86,000 Pounds in 1998/1999 and 100,000 Pounds in 1999/2000 onwards. This article outlines the perceived benefits of this approach.

  8. Ultrasound Findings of Delayed-Onset Muscle Soreness.

    PubMed

    Longo, Victor; Jacobson, Jon A; Fessell, David P; Mautner, Kenneth

    2016-11-01

    The purpose of this series was to retrospectively characterize the ultrasound findings of delayed-onset muscle soreness (DOMS). The Institutional Review Board approved our study, and informed consent was waived. A retrospective search of radiology reports using the key phrase "delayed-onset muscle soreness" and key word "DOMS" from 2001 to 2015 and teaching files was completed to identify cases. The sonograms were reviewed by 3 fellowship-trained musculoskeletal radiologists by consensus. Sonograms were retrospectively characterized with respect to echogenicity (hypoechoic, isoechoic, or hyperechoic), distribution of muscle involvement, and intramuscular pattern (focal versus diffuse and well defined versus poorly defined). Images were also reviewed for muscle enlargement, fluid collection, muscle fiber disruption, and increased flow on color or power Doppler imaging. There were a total of 6 patients identified (5 male and 1 female). The average age was 22 years (range, 7-44 years). Of the 6 patients, there were a total of 11 affected muscles in 7 extremities (1 bilateral case). The involved muscles were in the upper extremity: triceps brachii in 27% (3 of 11), biceps brachii in 18% (2 of 11), brachialis in 18% (2 of 11), brachioradialis in 18% (2 of 11), infraspinatus in 9% (1 of 11), and deltoid in 9% (1 of 11). On ultrasound imaging, the abnormal muscle was hyperechoic in 100% (11 of 11), well defined in 73% (8 of 11), poorly defined in 27% (3 of 11), diffuse in 73% (8 of 11), and focal in 27% (3 of 11). Increased muscle size was found in 82% (9 of 11) and minimal hyperemia in 87.5% (7 of 8). The ultrasound findings of DOMS include hyperechoic involvement of an upper extremity muscle, most commonly appearing well defined and diffuse with increased muscle size and minimal hyperemia.

  9. Moist Heat or Dry Heat for Delayed Onset Muscle Soreness

    PubMed Central

    Petrofsky, Jerrold; Berk, Lee; Bains, Gurinder; Khowailed, Iman Akef; Hui, Timothy; Granado, Michael; Laymon, Mike; Lee, Haneul

    2013-01-01

    Background Heat is commonly used in physical therapy following exercise induced delayed onset muscle soreness (DOMS). Most heat modalities used in a clinical setting for DOMS are only applied for 5 to 20 minutes. This minimal heat exposure causes little, if any, change in deep tissue temperature. For this reason, long duration dry chemical heat packs are used at home to slowly and safely warm tissue and reduce potential heat damage while reducing pain associated from DOMS. Clinically, it has been shown that moist heat penetrates deep tissue faster than dry heat. Therefore, in home use chemical moist heat may be more efficacious than dry heat to provide pain relief and reduce tissue damage following exercise DOMS. However, chemical moist heat only lasts for 2 hours compared to the 8 hours duration of chemical dry heat packs. The purpose of this study was to compare the beneficial effect of dry heat versus moist heat on 100 young subjects after exercise induce DOMS. Methods One hundred subjects exercised for 15 minutes accomplishing squats. Before and for 3 days after, strength, muscle soreness, tissue resistance, and the force to passively move the knee were recorded. Heat and moist heat were applied in different groups either immediately after exercise or 24 hours later. Results The research results of this study showed that immediate application of heat, either dry (8 hours application) or moist (2 hours application), had a similar preservation of quadriceps muscle strength and muscle activity. Results also revealed that the greatest pain reduction was shown after immediate application of moist heat. Never the less, immediate application of dry heat had a similar effect but to a lesser extent. Conclusion It should be noted that moist heat had not only similar benefits of dry heat but in some cases enhanced benefits, and with only 25% of the time of application of the dry heat. PMID:24171053

  10. Influence of throat configuration and fish density on escapement of channel catfish from hoop nets

    USGS Publications Warehouse

    Porath, Mark T.; Pape, Larry D.; Richters, Lindsey K.

    2011-01-01

    In recent years, several state agencies have adopted the use of baited, tandemset hoop nets to assess lentic channel catfish Ictalurus punctatus populations. Some level of escapement from the net is expected because an opening exists in each throat of the net, although factors influencing rates of escapement from hoop nets have not been quantified. We conducted experiments to quantify rates of escapement and to determine the influence of throat configuration and fish density within the net on escapement rates. An initial experiment to determine the rate of escapement from each net compartment utilized individually tagged channel catfish placed within the entrance (between the two throats) and cod (within the second throat) compartments of a single hoop net for overnight sets. From this experiment, the mean rate (±SE) of channel catfish escaping was 4.2% (±1.5) from the cod (cod throat was additionally restricted from the traditionally manufactured product), and 74% (±4.2) from the entrance compartments. In a subsequent experiment, channel catfish were placed only in the cod compartment with different throat configurations (restricted or unrestricted) and at two densities (low [6 fish per net] and high [60 fish per net]) for overnight sets to determine the influence of fish density and throat configuration on escapement rates. Escapement rates between throat configurations were doubled at low fish density (13.3 ± 5.4% restricted versus 26.7 ± 5.6% unrestricted) and tripled at high fish density (14.3 ± 4.9% restricted versus 51.9 ± 5.0% unrestricted). These results suggest that retention efficiency is high from cod compartments with restricted throat entrances. However, managers and researchers need to be aware that modification to the cod throats (restrictions) is needed for hoop nets ordered from manufacturers. Managers need to be consistent in their use and reporting of cod end throat configurations when using this gear.

  11. Sacral pressure sore reconstruction -- the pedicled superior gluteal artery perforator flap.

    PubMed

    Hurbungs, A; Ramkalawan, H

    2012-02-14

    To report the use of the pedicled superior gluteal artery perforator (SGAP) fasciocutaneous flap as a reliable surgical option for sacral pressure sore reconstruction. A prospective study was conducted between September 2008 and September 2010 of 10 patients with stage 3 or 4 sacral pressure sores treated with a unilateral pedicled SGAP flap. All flaps survived completely with no complications in 9 patients. One patient had a haematoma below the flap that was easily drained. No recurrence of the bedsore occurred during follow-up. We suggest that the pedicled SGAP fasciocutaneous flap is a reliable surgical option for sacral pressure sore reconstruction.

  12. 21 CFR 874.4250 - Ear, nose, and throat electric or pneumatic surgical drill.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... surgical drill. 874.4250 Section 874.4250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH....4250 Ear, nose, and throat electric or pneumatic surgical drill. (a) Identification. An ear, nose, and throat electric or pneumatic surgical drill is a rotating drilling device, including the handpiece, that...

  13. Automatic speech segmentation using throat-acoustic correlation coefficients

    NASA Astrophysics Data System (ADS)

    Mussabayev, Rustam Rafikovich; Kalimoldayev, Maksat N.; Amirgaliyev, Yedilkhan N.; Mussabayev, Timur R.

    2016-11-01

    This work considers one of the approaches to the solution of the task of discrete speech signal automatic segmentation. The aim of this work is to construct such an algorithm which should meet the following requirements: segmentation of a signal into acoustically homogeneous segments, high accuracy and segmentation speed, unambiguity and reproducibility of segmentation results, lack of necessity of preliminary training with the use of a special set consisting of manually segmented signals. Development of the algorithm which corresponds to the given requirements was conditioned by the necessity of formation of automatically segmented speech databases that have a large volume. One of the new approaches to the solution of this task is viewed in this article. For this purpose we use the new type of informative features named TAC-coefficients (Throat-Acoustic Correlation coefficients) which provide sufficient segmentation accuracy and effi- ciency.

  14. Upscaling soil saturated hydraulic conductivity from pore throat characteristics

    NASA Astrophysics Data System (ADS)

    Ghanbarian, Behzad; Hunt, Allen G.; Skaggs, Todd H.; Jarvis, Nicholas

    2017-06-01

    Upscaling and/or estimating saturated hydraulic conductivity Ksat at the core scale from microscopic/macroscopic soil characteristics has been actively under investigation in the hydrology and soil physics communities for several decades. Numerous models have been developed based on different approaches, such as the bundle of capillary tubes model, pedotransfer functions, etc. In this study, we apply concepts from critical path analysis, an upscaling technique first developed in the physics literature, to estimate saturated hydraulic conductivity at the core scale from microscopic pore throat characteristics reflected in capillary pressure data. With this new model, we find Ksat estimations to be within a factor of 3 of the average measured saturated hydraulic conductivities reported by Rawls et al. (1982) for the eleven USDA soil texture classes.

  15. Anterior throat pain syndromes: causes for undiagnosed craniofacial pain.

    PubMed

    Shankland, Wesley E

    2010-01-01

    It is not uncommon for practitioners who treat craniofacial pain to see patients with undiagnosed throat and submandibular pain. Usually, these patients will already have been seen by their primary care physician and frequently, several others doctors including otolaryngologists, oral and maxillofacial surgeons, and even neurologists. Far too often these patients have three common features: 1. they have endured multiple expensive diagnostic tests; 2. they have received treatment of multiple courses of antibiotics; and 3. no specific diagnosis for their pain complaints has been determined and their pain persists. In this article, five disorders, Ernest syndrome, Eagle's syndrome, carotid artery syndrome, hyoid bone syndrome and superior pharyngeal constrictor syndrome are briefly described. All five produce common symptoms, making diagnosis difficult, which is often followed by ineffective or no treatment being provided to the patient. Diagnostic criteria and suggested treatment modalities are also presented.

  16. Simulated flight effects on noise characteristics of a fan inlet with high throat Mach number

    NASA Technical Reports Server (NTRS)

    Wesoky, H. L.; Dietrich, D. A.; Abbott, J. M.

    1978-01-01

    An anechoic wind tunnel experiment was conducted to determine the effects of simulated flight on the noise characteristics of a high throat Mach number fan inlet. Comparisons were made with the performance of a conventional low throat Mach number inlet with the same 50.8 cm fan noise source. Simulated forward velocity of 41 m/sec reduced perceived noise levels for both inlets, the largest effect being more than 3 db for the high throat Mach number inlet. The high throat Mach number inlet was as much as 7.5 db quieter than the low throat Mach number inlet with tunnel airflow and about 6 db quieter without tunnel airflow. Effects of inlet flow angles up to 30 deg were seemingly irregular and difficult to characterize because of the complex flow fields and generally small noise variations. Some modifications of tones and directivity at blade passage harmonics resulting from inlet flow angle variation were noted.

  17. Pharyngeal Neisseria gonorrhoeae detection in oral-throat wash specimens of male patients with urethritis.

    PubMed

    Takahashi, Satoshi; Kurimura, Yuichiro; Hashimoto, Jiro; Takeyama, Koh; Koroku, Mikio; Tanda, Hitoshi; Nishimura, Masahiro; Tsukamoto, Taiji

    2008-12-01

    Detection of Neisseria gonorrhoeae and Chlamydia trachomatis in the pharynx has been highlighted in the prevention of the unexpected spread of sexually transmitted diseases. We tried to clarify the detection rate of Neisseria gonorrhoeae in the pharynx and the clinical relevance of oral-throat wash specimens to detect the organism in heterosexual men with gonococcal and nongonococcal urethritis. In our cohort of 79 male patients with urethritis, oral throat wash specimens were collected after they had gargled with normal saline for approximately 30 to 60 s. Positive pharyngeal N. gonorrhoeae was defined as a positive result on the strand displacement amplification test for the specimen from the oral-throat wash. N. gonorrhoeae was detected in the oral-throat wash specimens of 13 (31.7%) of the 41 male patients with gonococcal urethritis. Oral-throat wash with a nucleic acid amplification test can detect pharyngeal N. gonorrhoeae easily and efficiently.

  18. Absence of Neisseria meningitidis from throat swabs of Kuwaiti pilgrims after returning from the Hajj.

    PubMed

    Husain, Entesar H; Dashti, Ali A; Electricwala, Qudsiya Y; Abdulsamad, Abdulsamad M; Al-Sayegh, Safeya

    2010-01-01

    To investigate whether or not Neisseria meningitidis was present in the throat of Kuwaiti pilgrims after returning from the Hajj. Throat swabs were taken from 177 participants 1 week after returning from the Hajj. The participants were asked about: associated medical conditions, meningococcal vaccination status and the intake of ciprofloxacin before leaving Mecca for Kuwait. There was no throat colonization with N. meningitidis on any of the throat swabs. Of the 177 pilgrims, 163 (92%) were vaccinated with meningococcal quadrivalent vaccine before leaving to Saudi Arabia. Ninety-seven of the pilgrims (83%) had received one dose of ciprofloxacin before leaving Mecca. The result showed that vaccination before leaving Kuwait and ciprofloxacin prophylaxis were effective in preventing throat colonization with Neisseria meningitidis. Copyright 2010 S. Karger AG, Basel.

  19. A life history study of the yellow throat

    USGS Publications Warehouse

    Stewart, R.E.

    1953-01-01

    Investigations concerning the life history of the Yellow-throat were made in southern Michigan during the spring and summer of 1938. Supplementary information was also obtained at Arlington, Virginia, in 1940 and at the Patuxent Research Refuge, Maryland, in 1947.....Resident males established territories almost immediately upon arrival in spring. In southern Michigan some resident males arrived at least as soon as, if not before, transient males. Most females appeared on their nesting ground about a week later. Adults were engaged in nesting activities from the time of their arrival in spring until the advent of the post-nuptial molt in late summer.....Typical Yellow-throat habitat consists of a mixture of a dense herbaceous vegetation and small woody plants in damp or wet situations. At Ann Arbor, the Yellow-throat was a common breeding species in its restricted suitable habitat. The population density in one area of suitable habitat was about 69 territorial males per 100 acres. Of 11 territorial males that were intensively studied, one was polygamous (with two mates), nine were monogamous, and one was probably monogamous (with at least one mate).....The song of the individual Yellow-throat was heard throughout the breeding season except for the courtship period. Two major types of song were the common song given while perched, and an occasional, more elaborate, flight song. Most males sing in spurts, singing at fairly regular intervals for a considerable period and then abruptly ceasing for another period. The vocabulary of both sexes included several types of call notes that appeared either to have special functions or to represent outward expressions of distinct emotional states of the bird.....Resident males were antagonistic toward each other throughout the breeding season. Most remained on well-established territories during this period. Territories of 10 monogamous males ranged in size from .8 to 1.8 acres but the territory of one polygamous male occupied

  20. An ideal method for pressure sore reconstruction: a freestyle perforator-based flap.

    PubMed

    Yang, Ching-Hsiang; Kuo, Yur-Ren; Jeng, Seng-Feng; Lin, Pao-Yuan

    2011-02-01

    Pressure sore reconstruction is quite difficult for plastic surgeons because of long-term high recurrence rates. We designed a freestyle perforator-based flap for pressure sore reconstruction considering pressure sore recurrence and further reconstruction. We used a handheld Doppler device to locate a perforator position just adjacent to the pressure ulcer. In a series of 34 patients, we used 37 perforator-based flaps to reconstruct 25 sacral, 5 ischial, and 4 trochanteric ulcers. Twenty-eight of 37 flaps healed uneventfully without complication. One patient had a flap that totally necrosed, 3 had partial flap necrosis, 3 had wound dehiscence, 1 died 3 days postoperatively, and recurrence developed in 1 patient. We used the freestyle perforator-based fasciocutaneous flap for pressure sore management with good success. These flaps are easy to design and provide good versatility for coverage. Cooperation of surgical skills and good postoperative care also contributed to the lower recurrence rates and satisfactory results.

  1. Effects of ibuprofen on exercise-induced muscle soreness and indices of muscle damage.

    PubMed Central

    Donnelly, A E; Maughan, R J; Whiting, P H

    1990-01-01

    Thirty-two volunteers participated in a two-period crossover study in which ibuprofen was tested against an identical placebo for its effectiveness in reducing muscle soreness and damage after two bouts of downhill running. Subjective soreness, quadriceps isometric strength and isometric endurance time at 50 percent of maximum strength, serum activities of creatine kinase, lactate dehydrogenase and aspartate transaminase and serum levels of creatinine and urea were recorded at intervals up to 72 hours after exercise. Each downhill run produced muscle soreness, and a decline in muscle strength and 50 percent endurance time, although these parameters were unaffected by ibuprofen treatment. All serum parameters measured increased after both runs, but for the three enzymes this increase was smaller after the second run. Serum creatine kinase and urea levels were higher in the ibuprofen group after both runs. These results indicate that ibuprofen is not an appropriate treatment for delayed onset muscle soreness and damage. PMID:2078806

  2. The effects of land vs. aquatic plyometrics on power, torque, velocity, and muscle soreness in women.

    PubMed

    Robinson, Leah E; Devor, Steven T; Merrick, Mark A; Buckworth, Janet

    2004-02-01

    The purpose of this study was to compare changes in performance indicators (power, torque, and velocity) and muscle soreness between plyometric training on land and in water. Thirty-two college age women were randomly assigned to 8 weeks of an identical plyometric training program on land or in an aquatic setting. Performance indicators were assessed pretraining, midtraining, and posttraining. Muscle soreness (ordinal scale) and pain sensitivity (palpation) were assessed after a training bout (0, 48, and 96 hours) during the first week of training and when training intensity was increased (weeks 3 and 6). Performance indictors increased for both groups (pretraining < midtraining < posttraining, p < or = 0.001). Muscle soreness was significantly greater in the land compared to the aquatic plyometric training group at baseline and each time training intensity was increased, p = 0.01. Aquatic plyometrics provided the same performance enhancement benefits as land plyometrics with significantly less muscle soreness.

  3. Tonsillectomy

    MedlinePlus

    Tonsils removal; Tonsillitis - tonsillectomy; Pharyngitis - tonsillectomy; Sore throat - tonsillectomy ... can lead to frequent or very painful sore throats. In either of these cases, the child's tonsils ...

  4. Using a modified nasotracheal tube to prevent nasal ala pressure sore during prolonged nasotracheal intubation.

    PubMed

    Cherng, Chen-Hwan; Chen, Yuan-Wu

    2010-12-01

    Nasotracheal tube induced nasal ala pressure sores or necrosis during prolonged nasotracheal intubation have been reported, and it is a serious but preventable complication. Here we introduce a modified nasotracheal tube to prevent this complication. This modified nasotracheal tube is composed of two parts, an oral endotracheal tube and a proximal part of a preformed nasotracheal tube, which are linked by a connector. The use of this modified nasotracheal tube can prevent nasal ala pressure sores during prolonged nasotracheal intubation.

  5. Behavioral characterization of a white-throated sparrow homozygous for the ZAL2(m) chromosomal rearrangement.

    PubMed

    Horton, Brent M; Hu, Yuchen; Martin, Christa L; Bunke, Brian P; Matthews, Beth S; Moore, Ignacio T; Thomas, James W; Maney, Donna L

    2013-01-01

    The white-throated sparrow is rapidly becoming an important model in the genetics of social behavior because of a chromosomal rearrangement that segregates with a behavioral phenotype. Within a population, 50 % of individuals are heterozygous for a rearranged chromosome 2 (ZAL2(m)). These birds sing more and are more aggressive than the other 50 %, who lack the rearrangement. A disassortative mating system, in which heterozygotes almost never interbreed, ensures that ZAL2(m)/2(m) homozygotes are extremely rare. Here, we provide the first systematic characterization of such a homozygote, a hatch-year female. Her plumage was atypical of her age and sex, resembling that of an adult male. She was extremely vocal and aggressive, dominating her opponents in behavioral tests. Her phenotype was thus an exaggerated version of a typical ZAL2/2(m) heterozygote, supporting the hypothesis that alleles inside the ZAL2(m) rearrangement confer high aggression and further emphasizing this species' value as a model of social behavior.

  6. [Indication of sclerotherapy in the treatment of ischiatic pressure sore: about 13 cases].

    PubMed

    Bahé, L; Prud'homme, A; Penaud, A; Formé, N; Zakine, G

    2012-12-01

    Ischiatic pressure sore is a common pathology of the paraplegic patient. Usually treated after medical therapy, with fasciocutaneous or musculocutaneous local flaps, despite this treatment the recurrence rate is high. Sclerotherapy, injection of pure ethanol in the cavity of the pressure sore could be an interesting solution in the armentarium of the plastic surgeon in some indications. Sclerotherapy was used for 13 patients in the plastic surgery department to treat ischiatic pressure sores with a cavity, beneath the defect. The mean length of stay was 24 days. The ischiatic pressure sore was completely healed with no skin defect or cavity for nine patients (65%). For two patients, there was a delay of healing of the skin defect but no cavity beneath. There were two early recurrences of the pressure sore. They were treated by sclerotherapy with a complete recovery in 2 months with simple hydrocolloid dressings. The mean post op follow-up was 14,6 months (4 to 24). Only one recurrence was observed after 12 months. The injection of pure ethanol in the cavity of specifics ischiatics pressure sores is a simple, fast and effective technique with a good and stable long term wound healing. The mean length of stay is shorter and the recurrence rate is equivalent to other techniques. Copyright © 2009 Elsevier Masson SAS. All rights reserved.

  7. [Giant recurrent trochanteric pressure sore: A complex medico-surgical care].

    PubMed

    Pesenti, S; Ciceron, C; Toledano, E; Niddam, J; Tournebise, H

    2016-12-01

    Pressure sores are a frequent complication in spinal injured people. Their treatment is often long and complex. We report the case of a 60-year-old man affected with complete paraplegia who developed a right trochanteric pressure ulcer complicated with osteoarthritis of the coxofemoral joint. The treatment was done in three steps. First, a large excision of necrotic tissues and a femoral head-neck resection is performed. Then, the defect is partly covered with a Gluteus Maximus and a Biceps Femoris myocutaneous flaps. Finally, the residual defect is covered with a cutaneous pedicled groin flap called McGregor's flap. Later, the patient showed a right para-scrotal pressure sore on a heterotopic ossification of the ischial tuberosity. McGregor's flap is rarely employed for treating trochanteric pressure sores. It was here the only pedicled flap available. It was necessary to autonomize it in order to get enough length and to place a hip external fixation. The para-scrotal pressure sore illustrates the fact that bone resection surgery lifts the weight-bearing zones and can lead to pressure sores in unusual locations. The surgical treatment of these "giant" pressure sores requires a perfect collaboration between teams of rehabilitation and several surgical areas. Without a good adherence of the patient, the treatment is doomed to fail. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. The evaluation of daily living activities, pressure sores and risk factors.

    PubMed

    Aydın, Gökçen; Mucuk, Salime

    2015-01-01

    This study was conducted to assess daily living activities, pressure sores and risk factors. This was a descriptive study. The study was conducted at a rehabilitation center with 188 individuals participating in the study. Data were collected with a questionnaire form, Activities of Daily Living Scale (ADLS), Instrumental Activities of Daily Living Scale (IADLS) and Braden Risk Assessment Scale (BRAS). Among the participants, 48.9% were dependent according to activities of daily living and 71.8% were dependent on instrumental activities of daily living. It was noted that 4.8% had pressure sores and 38.8% were at high risk. A strong and positive correlation was found among ADLS, IADLS, and BRAS scores (p < .001). Participants who had a low body mass index, had lived at the rehabilitation center for a long time, and were fed on regime 1 or 2, had a higher risk of developing pressure sores (p < .001). Individuals who were dependent according to ADLS and IADLS were at increased risk for the development of pressure sores. Individuals who are treated at rehabilitation centers should be periodically assessed in terms of risk. Pressure sore development can be prevented with appropriate nursing interventions. To reduce the risk of developing pressure sores, nurses should describe the individual's degree of dependency according to ADLS and IADLS and initiate preventive nursing care. © 2014 Association of Rehabilitation Nurses.

  9. Pulsed Ultrasound Fails To Diminish Delayed-Onset Muscle Soreness Symptoms

    PubMed Central

    Stay, Jeffrey C.; Richard, Mark D.; Draper, David O.; Schulthies, Shane S.; Durrant, Earlene

    1998-01-01

    Objective: We investigated the effects of pulsed ultrasound on swelling, muscle soreness perception, relaxed-elbow extension angle, and muscular strength. Design and Setting: Eight sets of concentric and eccentric actions induced delayed-onset muscle soreness of the elbow flexors. Group 1 received 20% pulsed ultrasound treatments (1-MHz, 7 minutes, 1.5 W/ cm2 temporal peak intensity) twice a day immediately after postexercise assessments and at 3, 24, 27, 48, 51, 72, and 75 hours postexercise. Group 2 received sham treatments immediately after postexercise assessments and at 3,27, 51, and 75 hours postexercise and true treatments of pulsed ultrasound at 24, 48, and 72 hours postexercise. Group 3 received sham treatments of no ultrasonic output immediately after postexercise assessments and at 3, 24, 27, 48, 51, 72, and 75 hours postexercise. Subjects: Thirty-six college-age females. Measurements: We recorded upper-arm circumference, perceived soreness, relaxed-elbow extension angle, and elbow-flexion strength before (pretest), immediately postexercise, and at 24, 48, 72, and 96 hours postexercise. Results: We noted differences over time but no treatment effect between groups or interactions between time and group for upper-arm circumference, perceived soreness, relaxed-elbow extension angle, or elbow-flexion strength. Conclusions: Pulsed ultrasound as used in this study did not significantly diminish the effects of delayed-onset muscle soreness on soreness perception, swelling, relaxed-elbow extension angle, and strength. PMID:16558532

  10. A new postoperative management scheme for preventing sacral pressure sores in patients with spinal cord injuries.

    PubMed

    Kato, H; Inoue, T; Torii, S

    1998-01-01

    Although the reliability of pressure sore surgery has improved with the advent of many different types of flaps, it is well known that the recurrence rate of pressure sores is still remarkably high in spinal cord-injured patients. This article reports the very low relapse rate of postsurgical pressure sores using air mattresses, which also helps relieve manpower requirements for care. We measured interface pressures at the sacrum for 18 spinal cord-injured patients with a ROHO air mattress (ROHO International, Inc, Belleville, IL). Based on the results, we used this mattress immediately after surgery for 19 spinal cord-injured patients with sacral pressure sores. Minimal repositioning was performed for each patient during the hospital stay. Minimal repositioning was similarly performed at home. All pressure sores healed, regardless of the type of surgical procedure, size, and degree of sore. No relapse has been found, with an average of 33.4 months after surgery. With this management, we could achieve a very low recurrence rate, require less manpower for postoperative management, as well as minimize stress for the patients.

  11. Survival of red-throated loons (Gavia stellata) may be linked to marine conditions

    USGS Publications Warehouse

    Schmutz, Joel A.

    2014-01-01

    Large variations in the summering population size of Red-throated Loons (Gavia stellata) have occurred in recent decades in Alaska. Little information exists about annual or seasonal survival rates of adult Red-throated Loons. This study used tracking data from satellite transmitters implanted into 33 Red-throated Loons captured on breeding areas in Alaska to estimate annual survival with the sampling effort split between two study periods: 2000–2002 and 2008–2010. Mortality was inferred from transmitted sensor data that indicated body temperature of the Red-throated Loon and voltage of the transmitter's battery. Two definitive mortalities occurred, resulting in an annual survival estimate of 0.920 (SE = 0.054). The fates of two additional Red-throated Loons were ambiguous and, when treated as mortalities, the annual survival estimate was 0.838 (SE = 0.074). All four putative mortalities occurred during the non-breeding season in the early study period. Oceanic conditions, indexed by the Pacific Decadal Oscillation, appeared to differ between the study periods with higher Pacific Decadal Oscillation values associated with the early study period. Given that high values for Pacific Decadal Oscillation were also associated with the large decline of Red-throated Loons observed in Alaska during 1977–1993, this study suggests that survival of adult Red-throated Loons may vary in relation to the state of the marine ecosystem and thus contribute to long-term variation in population trends.

  12. Marjolin's Ulcer Complicating a Pressure Sore: The Clock is Ticking.

    PubMed

    Khan, Kamran; Giannone, Anna Lucia; Mehrabi, Erfan; Khan, Ayda; Giannone, Roberto E

    2016-02-22

    Malignant degeneration in any chronic wound is termed a Marjolin's ulcer (MU). The overall metastatic rate of MU is approximately 27.5%. However, the prognosis of MU specific to pressure sores is poor, with a reported metastatic rate of 61%. This is due to insidious, asymptomatic malignant degeneration, a lack of healthcare provider awareness, and, ultimately, delayed management. An 85-year-old white male was noted by his wound-care nurse to have a rapidly developing growth on his lower back over a period of 4 months. There was history of a non-healing, progressive pressure ulcer of the lower back for the past 10 years. On examination, there was a 4 × 4 cm pressure ulcer of the lower back, with a superimposed 1.5 × 2 cm growth in the superior region. There was an absence of palpable regional lymphadenopathy. Punch biopsy revealed squamous cell carcinoma consistent with Marjolin's ulcer. The ulcer underwent excision with wide margins, and a skin graft was placed. Due to the prompt recognition of an abnormality by the patient's wound-care nurse, metastasis was not evident on imaging. There are no signs of recurrence at 1-year follow-up. Marjolin's ulcer has a rapid progression from local disease to widespread metastasis. Therefore, it is essential that wound-care providers are aware of the clinical signs and symptoms of malignant degeneration in chronic wounds.

  13. Delayed onset muscle soreness: Involvement of neurotrophic factors.

    PubMed

    Mizumura, Kazue; Taguchi, Toru

    2016-01-01

    Delayed-onset muscle soreness (DOMS) is quite a common consequence of unaccustomed strenuous exercise, especially exercise containing eccentric contraction (lengthening contraction, LC). Its typical sign is mechanical hyperalgesia (tenderness and movement related pain). Its cause has been commonly believed to be micro-damage of the muscle and subsequent inflammation. Here we present a brief historical overview of the damage-inflammation theory followed by a discussion of our new findings. Different from previous observations, we have observed mechanical hyperalgesia in rats 1-3 days after LC without any apparent microscopic damage of the muscle or signs of inflammation. With our model we have found that two pathways are involved in inducing mechanical hyperalgesia after LC: activation of the B2 bradykinin receptor-nerve growth factor (NGF) pathway and activation of the COX-2-glial cell line-derived neurotrophic factor (GDNF) pathway. These neurotrophic factors were produced by muscle fibers and/or satellite cells. This means that muscle fiber damage is not essential, although it is sufficient, for induction of DOMS, instead, NGF and GDNF produced by muscle fibers/satellite cells play crucial roles in DOMS.

  14. SPECIFIC AND CROSS OVER EFFECTS OF MASSAGE FOR MUSCLE SORENESS: RANDOMIZED CONTROLLED TRIAL

    PubMed Central

    Sundstrup, Emil; Søndergaard, Stine D.; Behm, David; Brandt, Mikkel; Særvoll, Charlotte A.; Jakobsen, Markus D.; Andersen, Lars L.

    2014-01-01

    Purpose/Background: Muscle soreness can negatively interfere with the activities of daily living as well as sports performance. In the working environment, a common problem is muscle tenderness, soreness and pain, especially for workers frequently exposed to unilateral high repetitive movements tasks. The aim of the study is therefore to investigate the acute effect of massage applied using a simple device Thera‐band roller Massager on laboratory induced hamstring muscle soreness, and the potential cross over effect to the non‐massaged limb. Methods: 22 healthy untrained men (Mean age 34 +/− 7 years; mean height 181.7 +/− 6.9 cm; mean weight 80.6 +/− 6.4 kg; BMI: 24.5 +/− 1.3) with no prior history of knee, low back or neck injury or other adverse health issues were recruited. Participants visited the researchers on two separate occasions, separated by 48 hours, each time providing a soreness rating (modified visual analog scale 0‐10), and being tested for pressure pain threshold (PPT) and active range of motion (ROM) of the hamstring muscles. During the first visit, delayed onset muscular soreness of the hamstring muscles was induced by 10 x 10 repetitions of the stiff‐legged dead‐lift. On the second visit participants received either 1) 10 minutes of roller massage on one leg, while the contralateral leg served as a cross over control, or 2) Resting for 10 minutes with no massage at all. Measurement of soreness, PPT and ROM were taken immediately before and at 0, 10, 30 and 60 min. after treatment. Results: There was a significant group by time interaction for soreness (p < 0.0001) and PPT (p = 0.0007), with the massage group experiencing reduced soreness and increasing PPT compared with the control group. There was no group by time interaction for ROM (p = 0.18). At 10 min. post massage there was a significant reduction in soreness of the non‐massaged limb in the cross over control group compared to controls but this effect was lost 30

  15. Dynamic properties of throat aurora revealed by simultaneous ground and satellite observations

    NASA Astrophysics Data System (ADS)

    Chen, X.-C.; Han, D.-S.; Lorentzen, D. A.; Oksavik, K.; Moen, J. I.; Baddeley, L. J.

    2017-03-01

    Throat aurora is defined as south-north aligned auroral arcs equatorward of the dayside cusp aurora and was suggested to be the results of cold magnetospheric plasma interaction with magnetopause reconnection, but its observational properties have not yet been well established. In this paper we carefully examine a sequence of throat auroras observed over Svalbard on 27 December 2003. Observations from 630.0 nm [OI] show that poleward moving throat auroras frequently show brightening followed by dimming in auroral intensity, and sometimes, the brightening throat aurora is a precursor of poleward moving auroral forms. Simultaneous all-sky images and HF radar backscatter observations along geomagnetic meridian show that the throat aurora brightening is drifting with ionospheric E × B convection and is colocated with enhanced spectral width poleward of the convection reversal boundary (CRB), while its dimming tends to be in the vicinity of the CRB. This leads us to propose that the throat aurora brightening and dimming may be on the open and closed field lines, respectively. Particle data from NOAA 16 confirm that the dimming throat aurora is associated with precipitation of magnetosheath-like particles mixed with magnetospheric ions (>30 keV), which is characteristic of the low-latitude boundary layer. For particle data from Defense Meteorological Satellite Program F16, we notice that the dimming throat aurora is associated with lower fluxes of magnetosheath-like electrons accompanied with magnetospheric electrons, which is most likely on closed field lines. The dynamic properties of throat aurora presented in this paper are thus important to understand its generation mechanisms.

  16. Does a foamy-block mattress system prevent pressure sores ? A prospective randomised clinical trial in 1729 patients.

    PubMed

    Berthe, J V; Bustillo, A; Mélot, C; de Fontaine, S

    2007-01-01

    Pressure ulcers are a frequent complication of bed rest. The development of an efficient and low cost pressure relieving system for the prevention of bed-sores would be of considerable hospital health and economic interest. Our study was designed to determine the effectiveness in pressure-sore prevention of an interface pressure-decreasing mattress, the Kliniplot mattress, used in our institution since 1978. In a prospective randomised controlled 7-month clinical trial we compared the Kliniplot mattress with our standard hospital mattress in 1729 patients admitted to medical and surgical departments (neurology, cardiology, oncology-haematology, neurosurgery, thoracic surgery and orthopaedic surgery). Two groups (Klinipot mattress and standard hospital mattress) were monitored for the prevention of pressure sores. The patients were evaluated on a daily basis from their admission until the eventual occurrence of a bed-sore. Patients' characteristics and pressure-sore risk factors were similar at the baseline in both groups. Patients presenting with a pressure sore at the time of admission were excluded. Forty-two of the 1729 patients (2.4%) who entered the study developed at least one pressure sore. Twenty-one of the 657 patients (3.2%) nursed on the Kliniplot mattress, and 21 of the 1072 patients (1.9%) on the standard mattress developed bed-sores (p = 0.154). The median time for the occurrence of pressure sores was 31 days (range 6-87) with the Kliniplot mattress and 18 days (range 2 to 38) with the standard mattress (p < 0.001). The risk categories for developing bed-sores using the modified Ek's scale were no different at the baseline between both groups (p = 0.764). The severity of the pressure sores was no different between both groups (p = 0.918). Our results show that the occurrence of pressure sores is not reduced but is delayed when patients are nursed on a Kliniplot pressure-decreasing mattress.

  17. [Application of tensor fascia lata pedicled flap in reconstructing trochanteric pressure sore defects].

    PubMed

    Karabeg, Reuf; Dujso, Vanis; Jakirlić, Malik

    2008-01-01

    Tensor fascia lata pedicled flap is one of the most useful flaps for reconstruction pressure sore defects on trochanteric region. Debate exists on the safe dimension of the flap, as distal tip necrosis can be encountered. The aim of the current study is to report experience of Clinic for Plastic and Reconstructive Surgery, Clinical University Center of Sarajevo, with tensor fascia lata pedicled flap in reconstructing trochanteric pressure sore defects. From January 1993 to December 2007, 39 pedicled TFL flaps were used for reconstruction trochanteric pressure sore defects in 34 patients. We used 3 local flaps for reconstruction of small trochanteric defects and one direct suture. In our study we had 43 trochanteric pressure sores and in 9 patients pressure sores were bilateral. The age ranged from 9 to 65, with average age 41,2. The resulting trochanteric defects in this study were due to debridement of pressure sore. The size of the flaps used ranged from 15 x 6 cm to 30 x 15 cm. All flaps survived. Distal tip necrosis occurred in 4 cases. All 4 cases developed in a very large flap beyond the safe limits. Wound dehiscence occurs in 3 cases. There was minimal donor side morbidity in the form of partial skin loss in 1 case. The average follow up period in this study ranged from 6 months to 15 years. Tensor fascia lata flap is reliable flap. Donor site morbidity is minimal. Problem with the flap can be encountered if the flap is not harvested with the safe limits and properly designed. Proper preoperative preparations must be taken into consideration. Chronic skin ulcers, such as pressure sores, that are refractory to conventional local wound therapies, are good examples of potential beneficiaries of the TFL musculocutaneous flap.

  18. A reusable perforator-preserving gluteal artery-based rotation fasciocutaneous flap for pressure sore reconstruction.

    PubMed

    Lin, Pao-Yuan; Kuo, Yur-Ren; Tsai, Yun-Ta

    2012-03-01

    Perforator-based fasciocutaneous flaps for reconstructing pressure sores can achieve good functional results with acceptable donor site complications in the short-term. Recurrence is a difficult issue and a major concern in plastic surgery. In this study, we introduce a reusable perforator-preserving gluteal artery-based rotation flap for reconstruction of pressure sores, which can be also elevated from the same incision to accommodate pressure sore recurrence. The study included 23 men and 13 women with a mean age of 59.3 (range 24-89) years. There were 24 sacral ulcers, 11 ischial ulcers, and one trochanteric ulcer. The defects ranged in size from 4 × 3 to 12 × 10 cm(2) . Thirty-six consecutive pressure sore patients underwent gluteal artery-based rotation flap reconstruction. An inferior gluteal artery-based rotation fasciocutaneous flap was raised, and the superior gluteal artery perforator was preserved in sacral sores; alternatively, a superior gluteal artery-based rotation fasciocutaneous flap was elevated, and the inferior gluteal artery perforator was identified and dissected in ischial ulcers. The mean follow-up was 20.8 (range 0-30) months in this study. Complications included four cases of tip necrosis, three wound dehiscences, two recurrences reusing the same flap for pressure sore reconstruction, one seroma, and one patient who died on the fourth postoperative day. The complication rate was 20.8% for sacral ulcers, 54.5% for ischial wounds, and none for trochanteric ulcer. After secondary repair and reconstruction of the compromised wounds, all of the wounds healed uneventfully. The perforator-preserving gluteal artery-based rotation fasciocutaneous flap is a reliable, reusable flap that provides rich vascularity facilitating wound healing and accommodating the difficulties of pressure sore reconstruction. Copyright © 2011 Wiley Periodicals, Inc.

  19. Treatment with a novel topical nanoemulsion (NB-001) speeds time to healing of recurrent cold sores.

    PubMed

    Kircik, Leon; Jones, Terry M; Jarratt, Michael; Flack, Mary R; Ijzerman, Marian; Ciotti, Susan; Sutcliffe, Joyce; Boivin, Guy; Stanberry, Lawrence R; Baker, James R

    2012-08-01

    Current topical therapies for cold sores are only marginally beneficial due to poor skin penetration. We assessed the safety and efficacy of a novel topical antiviral nanoemulsion (NB-001) with high tissue bioavailability. The primary endpoint was the time to lesion healing. 482 subjects with recurrent cold sores were randomized to self-initiate treatment with either vehicle or NB-001 (0.1%, 0.3% or 0.5%) at the first signs or symptoms of a cold sore episode. Lotion was applied 5 times per day, approximately 3 to 4 hours apart, for 4 days. Time to lesion healing was correlated with NB-001 bioavailability determined in human cadaver skin. Subjects treated with 0.3% NB-001 showed a 1.3-day improvement in the mean time to healing compared to vehicle (P=0.006). This was consistent with human cadaver skin data indicating that the 0.3% nanoemulsion had the highest bioavailability, compared to 0.1% and 0.5% emulsions. No significant safety or dermal irritation concerns or systemic absorption were noted with any of the doses. Topical NB-001 (0.3%) was well tolerated and highly efficacious in shortening the time to healing of cold sores. The improvement in time to healing was similar to that reported for oral nucleoside analogues, but without systemic exposure. Topical agents for recurrent herpes labialis (cold sores) reduce healing time by one half day, compared to oral therapies that speed healing by a day or more. A topical antiviral nanoemulsion was well tolerated and improved cold sore healing time by over a day compared to vehicle control. Nanoemulsion (NB-001) could represent a more efficacious topical treatment for recurrent cold sores.

  20. Quantum dynamics of the Einstein-Rosen wormhole throat

    NASA Astrophysics Data System (ADS)

    Kunstatter, Gabor; Louko, Jorma; Peltola, Ari

    2011-02-01

    We consider the polymer quantization of the Einstein wormhole throat theory for an eternal Schwarzschild black hole. We numerically solve the difference equation describing the quantum evolution of an initially Gaussian, semiclassical wave packet. As expected from previous work on loop quantum cosmology, the wave packet remains semiclassical until it nears the classical singularity at which point it enters a quantum regime in which the fluctuations become large. The expectation value of the radius reaches a minimum as the wave packet is reflected from the origin and emerges to form a near-Gaussian but asymmetrical semiclassical state at late times. The value of the minimum depends in a nontrivial way on the initial mass/energy of the pulse, its width, and the polymerization scale. For wave packets that are sufficiently narrow near the bounce, the semiclassical bounce radius is obtained. Although the numerics become difficult to control in this limit, we argue that for pulses of finite width the bounce persists as the polymerization scale goes to zero, suggesting that in this model the loop quantum gravity effects mimicked by polymer quantization do not play a crucial role in the quantum bounce.

  1. Stable Non-Supersymmetric Throats in String Theory

    SciTech Connect

    Kachru, Shamit; Simic, Dusan; Trivedi, Sandip P.; /Tata Inst. /Stanford U., ITP /SLAC

    2011-06-28

    We construct a large class of non-supersymmetric AdS-like throat geometries in string theory by taking non-supersymmetric orbifolds of supersymmetric backgrounds. The scale of SUSY breaking is the AdS radius, and the dual field theory has explicitly broken supersymmetry. The large hierarchy of energy scales in these geometries is stable. We establish this by showing that the dual gauge theories do not have any relevant operators which are singlets under the global symmetries. When the geometries are embedded in a compact internal space, a large enough discrete subgroup of the global symmetries can still survive to prevent any singlet relevant operators from arising. We illustrate this by embedding one case in a non-supersymmetric orbifold of a Calabi-Yau manifold. These examples can serve as a starting point for obtaining Randall-Sundrum models in string theory, and more generally for constructing composite Higgs or technicolor-like models where strongly coupled dynamics leads to the breaking of electro-weak symmetry. Towards the end of the paper, we briefly discuss how bulk gauge fields can be incorporated by introducing D7-branes in the bulk, and also show how the strongly coupled dynamics can lead to an emergent weakly coupled gauge theory in the IR with matter fields including scalars.

  2. Streptococcus rubneri sp. nov., isolated from the human throat.

    PubMed

    Huch, Melanie; De Bruyne, Katrien; Cleenwerck, Ilse; Bub, Achim; Cho, Gyu-Sung; Watzl, Bernhard; Snauwaert, Isabel; Franz, Charles M A P; Vandamme, Peter

    2013-11-01

    The novel, Gram-stain-positive, ovoid, lactic acid bacterial isolates LMG 27205, LMG 27206, LMG 27207(T) and MRI-F 18 were obtained from throat samples of healthy humans. 16S rRNA gene sequence analyses indicated that these isolates belong to the genus Streptococcus, specifically the Streptococcus mitis group, with Streptococcus australis and Streptococcus mitis as the nearest neighbours (99.45 and 98.56 % 16S rRNA gene sequence similarity to the respective type strains). Genotypic fingerprinting by fluorescent amplified fragment length polymorphism (FAFLP) and pulsed-field gel electrophoresis (PFGE), DNA-DNA hybridizations, comparative sequence analysis of pheS, rpoA and atpA and physiological and biochemical tests revealed that these bacteria formed a taxon well separated from its nearest neighbours and other species of the genus Streptococcus with validly published names and, therefore, represent a novel species, for which the name Streptococcus rubneri sp. nov. is proposed, with LMG 27207(T) ( = DSM 26920(T)) as the type strain.

  3. Quantum dynamics of the Einstein-Rosen wormhole throat

    SciTech Connect

    Kunstatter, Gabor; Peltola, Ari; Louko, Jorma

    2011-02-15

    We consider the polymer quantization of the Einstein wormhole throat theory for an eternal Schwarzschild black hole. We numerically solve the difference equation describing the quantum evolution of an initially Gaussian, semiclassical wave packet. As expected from previous work on loop quantum cosmology, the wave packet remains semiclassical until it nears the classical singularity at which point it enters a quantum regime in which the fluctuations become large. The expectation value of the radius reaches a minimum as the wave packet is reflected from the origin and emerges to form a near-Gaussian but asymmetrical semiclassical state at late times. The value of the minimum depends in a nontrivial way on the initial mass/energy of the pulse, its width, and the polymerization scale. For wave packets that are sufficiently narrow near the bounce, the semiclassical bounce radius is obtained. Although the numerics become difficult to control in this limit, we argue that for pulses of finite width the bounce persists as the polymerization scale goes to zero, suggesting that in this model the loop quantum gravity effects mimicked by polymer quantization do not play a crucial role in the quantum bounce.

  4. Local flap therapy for the treatment of pressure sore wounds.

    PubMed

    Wettstein, Reto; Tremp, Mathias; Baumberger, Michael; Schaefer, Dirk J; Kalbermatten, Daniel F

    2015-10-01

    The aim of this study was to analyse the effectiveness of an interdisciplinary cooperation between conservative and surgical disciplines for the treatment of pressure sores (PS). From January 2004 to December 2005, a single-centre study was performed with paraplegic and tetraplegic patients presenting with PS grades III-V. Outcome measures were defect size, grade, method of reconstruction, complication and recurrence rate as well as average length of hospitalisation. A total of 119 patients aged 22-84 years with totally 170 PS were included. The most common PS were located in the ischial region (47%), followed by the sacral (18%), trochanteric (11%), foot (9%) and the malleolar (8%) regions. Defect sizes ranged between 4 and 255 cm(2) . Grade IV was the most common PS (68%), followed by grade III (30%) and grade V (2%) PS. For wound closure, fasciocutaneous flaps were used most frequently (71%), followed by skin grafts (10%) and myocutaneous flaps (7%). Postoperative follow-up ranged between 6 and 38 months. The overall complication and recurrence rate was 26% and 11%, respectively. If no complication occurred, the average duration of hospitalisation stay after the first debridement was 98 ± 62 days. In conclusion, our treatment concept is reliable, effective and results in a low recurrence rate. The complication rate, even though favourable when compared with the literature, still needs to be improved. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  5. Nutritional status and evolution of pressure sores in geriatric patients.

    PubMed

    Donini, L M; De Felice, M R; Tagliaccica, A; De Bernardini, L; Cannella, C

    2005-01-01

    The prevalence of pressure sores (PS) ranges from 1 to 18% of in-patients and from 3 to 28% of those admitted to long-term settings. The aim of our study was to verify, a posteriori, how nutritional status influenced the evolution of PS in a population of elderly subjects hospitalised in a long-term care setting. The charts of 125 patients with ulcerative or necrotic pressure ulcers were evaluated retrospectively. For each subject we took note of: PS characteristics (stage, ulcer surface, evolution), clinical characteristics (comorbidity, adverse clinical events, cognitive, functional and nutritional status). In 58 patients (46.4%) there was overall healing of the lesions while in 39 patients (31.2%) we had however an "improvement" of PS. The course of PS was not significantly influenced by the patient's physiological characteristics, by cognitive status or by initial characteristics of PS. Instead, we noticed a significant difference in the course of PS as a function of the level of autonomy and clinical status. The course of PS, and in particular the Healing Index, were influenced by the Nutritional Status and, above all, by its course during the treatment period. The development of PS is multifactorial. Whereas, it is clear that factors other than nutrition influence the risk of developing PS, an important role for nutrition in the development and resolution of PS is suggested. Our data certainly confirm the "Quality indicators for prevention and management of pressure ulcers in vulnerable elders", especially were they say "if a vulnerable elder is identified as at risk for pressure ulcer development and has malnutrition, then nutritional intervention or dietary consultation should be instituted because poor diet, particularly low dietary protein intake, is an independent predictor of pressure ulcer development".

  6. An intelligent artificial throat with sound-sensing ability based on laser induced graphene

    PubMed Central

    Tao, Lu-Qi; Tian, He; Liu, Ying; Ju, Zhen-Yi; Pang, Yu; Chen, Yuan-Quan; Wang, Dan-Yang; Tian, Xiang-Guang; Yan, Jun-Chao; Deng, Ning-Qin; Yang, Yi; Ren, Tian-Ling

    2017-01-01

    Traditional sound sources and sound detectors are usually independent and discrete in the human hearing range. To minimize the device size and integrate it with wearable electronics, there is an urgent requirement of realizing the functional integration of generating and detecting sound in a single device. Here we show an intelligent laser-induced graphene artificial throat, which can not only generate sound but also detect sound in a single device. More importantly, the intelligent artificial throat will significantly assist for the disabled, because the simple throat vibrations such as hum, cough and scream with different intensity or frequency from a mute person can be detected and converted into controllable sounds. Furthermore, the laser-induced graphene artificial throat has the advantage of one-step fabrication, high efficiency, excellent flexibility and low cost, and it will open practical applications in voice control, wearable electronics and many other areas. PMID:28232739

  7. An intelligent artificial throat with sound-sensing ability based on laser induced graphene.

    PubMed

    Tao, Lu-Qi; Tian, He; Liu, Ying; Ju, Zhen-Yi; Pang, Yu; Chen, Yuan-Quan; Wang, Dan-Yang; Tian, Xiang-Guang; Yan, Jun-Chao; Deng, Ning-Qin; Yang, Yi; Ren, Tian-Ling

    2017-02-24

    Traditional sound sources and sound detectors are usually independent and discrete in the human hearing range. To minimize the device size and integrate it with wearable electronics, there is an urgent requirement of realizing the functional integration of generating and detecting sound in a single device. Here we show an intelligent laser-induced graphene artificial throat, which can not only generate sound but also detect sound in a single device. More importantly, the intelligent artificial throat will significantly assist for the disabled, because the simple throat vibrations such as hum, cough and scream with different intensity or frequency from a mute person can be detected and converted into controllable sounds. Furthermore, the laser-induced graphene artificial throat has the advantage of one-step fabrication, high efficiency, excellent flexibility and low cost, and it will open practical applications in voice control, wearable electronics and many other areas.

  8. Analytical study of striated nozzle flow with small radius of curvature ratio throats

    NASA Technical Reports Server (NTRS)

    Norton, D. J.; White, R. E.

    1972-01-01

    An analytical method was developed which is capable of estimating the chamber and throat conditions in a nozzle with a low radius of curvature throat. The method was programmed using standard FORTRAN 4 language and includes chemical equilibrium calculation subprograms (modified NASA Lewis program CEC71) as an integral part. The method determines detailed and gross rocket characteristics in the presence of striated flows and gives detailed results for the motor chamber and throat plane with as many as 20 discrete zones. The method employs a simultaneous solution of the mass, momentum, and energy equations and allows propellant types, 0/F ratios, propellant distribution, nozzle geometry, and injection schemes to be varied so to predict spatial velocity, density, pressure, and other thermodynamic variable distributions in the chamber as well as the throat. Results for small radius of curvature have shown good comparison to experimental results. Both gaseous and liquid injection may be considered with frozen or equilibrium flow calculations.

  9. An intelligent artificial throat with sound-sensing ability based on laser induced graphene

    NASA Astrophysics Data System (ADS)

    Tao, Lu-Qi; Tian, He; Liu, Ying; Ju, Zhen-Yi; Pang, Yu; Chen, Yuan-Quan; Wang, Dan-Yang; Tian, Xiang-Guang; Yan, Jun-Chao; Deng, Ning-Qin; Yang, Yi; Ren, Tian-Ling

    2017-02-01

    Traditional sound sources and sound detectors are usually independent and discrete in the human hearing range. To minimize the device size and integrate it with wearable electronics, there is an urgent requirement of realizing the functional integration of generating and detecting sound in a single device. Here we show an intelligent laser-induced graphene artificial throat, which can not only generate sound but also detect sound in a single device. More importantly, the intelligent artificial throat will significantly assist for the disabled, because the simple throat vibrations such as hum, cough and scream with different intensity or frequency from a mute person can be detected and converted into controllable sounds. Furthermore, the laser-induced graphene artificial throat has the advantage of one-step fabrication, high efficiency, excellent flexibility and low cost, and it will open practical applications in voice control, wearable electronics and many other areas.

  10. Shock position sensor for supersonic inlets. [measuring pressure in the throat of a supersonic inlet

    NASA Technical Reports Server (NTRS)

    Dustin, M. O. (Inventor)

    1975-01-01

    Static pressure taps or ports are provided in the throat of a supersonic inlet, and signals indicative of the pressure at each of the ports is fed to respective comparators. Means are also provided for directing a signal indicative of the total throat pressure to the comparators. A periodic signal is superimposed on the total throat pressure so that the signal from the static pressure tabs is compared to a varying scan signal rather than to total throat pressure only. This type of comparison causes each comparator to provide a pulse width modulated output which may vary from 0% 'time on' to 100% 'time on'. The pulse width modulated outputs of the comparators are summed, filtered, and directed to a controller which operates a bypass valve such as a door whereby air is dumped from the inlet to prevent the shock wave from being expelled out the front.

  11. Extreme throat initial data set and horizon area-angular momentum inequality for axisymmetric black holes

    SciTech Connect

    Dain, Sergio

    2010-11-15

    We present a formula that relates the variations of the area of extreme throat initial data with the variation of an appropriate defined mass functional. From this expression we deduce that the first variation, with fixed angular momentum, of the area is zero and the second variation is positive definite evaluated at the extreme Kerr throat initial data. This indicates that the area of the extreme Kerr throat initial data is a minimum among this class of data. And hence the area of generic throat initial data is bounded from below by the angular momentum. Also, this result strongly suggests that the inequality between area and angular momentum holds for generic asymptotically flat axially symmetric black holes. As an application, we prove this inequality in the nontrivial family of spinning Bowen-York initial data.

  12. 78 FR 61208 - Endangered and Threatened Wildlife and Plants; Listing the Blue-throated Macaw

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-03

    ... protected species is not permissible under the ESA. Species Information Taxonomy The taxonomic status of...-throated macaws; it also has local, commercial, and ecosystem importance (Kyle 2005, p. 3; Moraes et al...

  13. [Clinical characteristics and surgical management of 17 patients with pressure sore of sinus type].

    PubMed

    Liu, Yi; Zhang, Xianying; Xiao, Bin; Song, Mei; Liu, Ping; Jiang, Jiang; Zhang, Cheng; Zhang, Xusheng; Chen, Liming

    2014-08-01

    To sum up the clinical characteristics, surgical management, and effectiveness of pressure sore of sinus type. Between January 2009 and April 2013, 17 patients with 19 pressure sores of sinus type after traumatic paraplegia were treated, and the clinical data were analyzed retrospectively. There were 11 males and 6 females with an average age of 27.4 years (range, 17-49 years). The median disease duration was 1.5 years (range, 6 months to 7 years). Of 17 cases, there were 14 primary cases and 3 recurrent cases; 10 focuses of 8 cases were classified as simple sinus type, and 9 focuses of 9 cases as complex sinus type, which had a false synovial sheath complicated with one to four "second sinus". The pressure sore of sinus type majorly located at the ischial tuberosity. The size of pressure sore ranged from 1.5 cm x 1.0 cm to 3.0 cm X 2.0 cm, and the length of "second sinus" ranged from 8 to 32 cm with an average of 17 cm. After the false synovial sheath was totally excised, the wound was repaired by local sliding or rhombus flaps at the first or second stage in patients with simple sinus type pressure sore. On the basis of excising the false synovial sheath, the "second sinus" was totally removed in the patients with complex sinus type pressure sore. Wound dehiscence occurred in 1 case of simple sinus type pressure sore at 4 days, which was cured after it was sutured again. Wound infection occurred at 9, 17, and 23 days respectively in 3 cases of complex sinus type pressure sore, which was cured after second debridement and necrosis tissues removal. The other wounds healed by first intention, and the flaps totally survived. All patients were followed up 6-12 months (mean, 9.3 months). No recurrence was observed. According to the clinical characteristics, pressure sore of sinus type could be divided into simple sinus type and complex sinus type. The key of successful treatment is to thoroughly excise false synovial sheath and "second sinus".

  14. Acute effects of massage or active exercise in relieving muscle soreness: randomized controlled trial.

    PubMed

    Andersen, Lars L; Jay, Kenneth; Andersen, Christoffer H; Jakobsen, Markus D; Sundstrup, Emil; Topp, Robert; Behm, David G

    2013-12-01

    Massage is commonly believed to be the best modality for relieving muscle soreness. However, actively warming up the muscles with exercise may be an effective alternative. The purpose of this study was to compare the acute effect of massage with active exercise for relieving muscle soreness. Twenty healthy female volunteers (mean age 32 years) participated in this examiner-blind randomized controlled trial (ClinicalTrials.gov NCT01478451). The participants performed eccentric contractions for the upper trapezius muscle on a Biodex dynamometer. Delayed onset muscle soreness (DOMS) presented 48 hours later, at which the participants (a) received 10 minutes of massage of the trapezius muscle or (b) performed 10 minutes of active exercise (shoulder shrugs 10 × 10 reps) with increasing elastic resistance (Thera-Band). First, 1 treatment was randomly applied to 1 shoulder while the contralateral shoulder served as a passive control. Two hours later, the contralateral resting shoulder received the other treatment. The participants rated the intensity of soreness (scale 0-10), and a blinded examiner took measures of pressure pain threshold (PPT) of the upper trapezius immediately before treatment and 0, 10, 20, and 60 minutes after treatment 48 hours posteccentric exercise. Immediately before treatment, the intensity of soreness was 5.0 (SD 2.2) and PPT was 138 (SD 78) kPa. In response to treatment, a significant treatment by time interaction was found for the intensity of soreness (p < 0.001) and PPT (p < 0.05). Compared with control, both active exercise and massage significantly reduced the intensity of soreness and increased PPT (i.e., reduced pain sensitivity). For both types of treatment, the greatest effect on perceived soreness occurred immediately after treatment, whereas the effect on PPT peaked 20 minutes after treatment. In conclusion, active exercise using elastic resistance provides similar acute relief of muscle soreness as compared with that using massage

  15. Indirect and direct methods for measuring a dynamic throat diameter in a solid rocket motor

    NASA Astrophysics Data System (ADS)

    Colbaugh, Lauren

    In a solid rocket motor, nozzle throat erosion is dictated by propellant composition, throat material properties, and operating conditions. Throat erosion has a significant effect on motor performance, so it must be accurately characterized to produce a good motor design. In order to correlate throat erosion rate to other parameters, it is first necessary to know what the throat diameter is throughout a motor burn. Thus, an indirect method and a direct method for determining throat diameter in a solid rocket motor are investigated in this thesis. The indirect method looks at the use of pressure and thrust data to solve for throat diameter as a function of time. The indirect method's proof of concept was shown by the good agreement between the ballistics model and the test data from a static motor firing. The ballistics model was within 10% of all measured and calculated performance parameters (e.g. average pressure, specific impulse, maximum thrust, etc.) for tests with throat erosion and within 6% of all measured and calculated performance parameters for tests without throat erosion. The direct method involves the use of x-rays to directly observe a simulated nozzle throat erode in a dynamic environment; this is achieved with a dynamic calibration standard. An image processing algorithm is developed for extracting the diameter dimensions from the x-ray intensity digital images. Static and dynamic tests were conducted. The measured diameter was compared to the known diameter in the calibration standard. All dynamic test results were within +6% / -7% of the actual diameter. Part of the edge detection method consists of dividing the entire x-ray image by an average pixel value, calculated from a set of pixels in the x-ray image. It was found that the accuracy of the edge detection method depends upon the selection of the average pixel value area and subsequently the average pixel value. An average pixel value sensitivity analysis is presented. Both the indirect

  16. Does eccentric-exercise-induced jaw muscle soreness influence brainstem reflexes?

    PubMed

    Torisu, Tetsurou; Wang, Kelun; Svensson, Peter; Laat, Antoon De; Yamabe, Yoshihisa; Murata, Hiroshi; Arendt-Nielsen, Lars

    2008-12-01

    To investigate the effects of soreness evoked by eccentric jaw exercises on two types of brainstem reflexes: the short-latency stretch reflex and the longer-latency exteroceptive suppression (ES), and to test for possible relationships between magnitude of soreness and reflex responses. The brainstem reflexes of jaw-closing muscles were recorded before (Baseline), immediately after (Post-task), and 1 day after (1-day-after) a 30-min eccentric exercise in 15 healthy men. All subjects participated in a control session without exercise. Soreness sensations at rest and during maximum biting were significantly elevated until 1-day-after the eccentric exercise (P<0.014). The ES responses tended to be increased (more inhibition) at Post-task and 1-day-after. There was a significant correlation between the ES response and the soreness sensation during maximum biting (P<0.04). The jaw-stretch reflex did not show significant change after the eccentric exercise. Muscle soreness associated with eccentric jaw exercises has a differential impact on the jaw-stretch reflex and the ES response. Experimentally induced acute muscle pain has previously been shown to influence both the ES and the jaw-stretch reflex, thus, different types of muscle pain and symptoms can be speculated to have different effects on a variety of brainstem reflexes.

  17. The treatment of Staphyloccocus aureus infected sore nipples: a randomized comparative study.

    PubMed

    Livingstone, V; Stringer, L J

    1999-09-01

    Sore, cracked nipples are commonly experienced by breastfeeding mothers. We have previously reported a strong correlation between sore, cracked nipples and S. aureus colonization. A prospective, randomized clinical trial was performed to compare four treatment regimes for S. aureus infected sore nipples. Eighty-four breastfeeding mothers were enrolled in the study. After 5 days to 7 days of treatment, only 8% of mothers showed improvement in the "optimal breastfeeding technique alone" group, 16% improved with topical mupiricin, 29% improved with topical fusidic acid, yet 79% improved with oral antibiotics (p < .0001). Optimal breastfeeding techniques and topical antibiotics ointment failed to heal most infected, sore, cracked nipples. Mastitis developed in 12% to 35% of mothers not treated with systemic antibiotics compared to 5% of mothers treated with systemic antibiotics (p < .005). In conclusion, S. aureus infected sore, cracked nipples should be diagnosed as a potentially widespread impetigo vulgaris and treated aggressively with systemic antibiotics in order to improve healing and decrease the risk of developing mastitis due to an ascending lactiferous duct bacterial infection.

  18. Detection and Isolation of Digital Dermatitis Treponemes from Bovine Pressure Sores.

    PubMed

    Clegg, S R; Crosby-Durrani, H E; Bell, J; Blundell, R; Blowey, R W; Carter, S D; Evans, N J

    2016-05-01

    Pressure sores cause severe pain and discomfort in hospitalized people and in farmed cattle and are often infected with unknown bacteria. Pressure sores occur on the upper legs of 6-10% of recumbent cattle and are generally considered to be caused by constant pressure, commonly on bony areas of the limbs. This study analyzed pressure sores taken from the upper limbs of 14 cattle using isolation in culture and nested polymerase chain reaction (PCR) to detect treponemes associated with digital dermatitis (DD). A 100% association of DD treponemes with the pressure sores was demonstrated, but treponemes were shown not to be part of the normal skin microbiota. Immunohistochemistry showed an association of DD treponemes with lesions and particularly with the hair follicles in lesions, identifying the bacteria deep within wounds, thereby suggesting that they could contribute to lesion pathogenesis. The bacteria isolated from the pressure sore lesions were similar or identical on analysis of the 16S rRNA gene to those found in DD foot lesions in cattle, suggesting the same bacteria can infect multiple lesions. Indeed, the results of this study suggest that these spirochaetal bacteria may be expanding in host range and in their ability to colonize different tissues and contribute to a range of disease manifestations in farm animals.

  19. Brain Abscesses of Ear, Nose, and Throat Origin

    PubMed Central

    Couloigner, Vincent; Sterkers, Olivier; Redondo, Aimée; Rey, Alain

    1998-01-01

    This retrospective study analyzed 29 cerebral abscesses of ear, nose, and throat (ENT) origin. The mean follow-up of patients was 37 months. ENT etiologies included 45% otitis media (n = 13), 48% sinusitis (n = 14), and 7% ethmoidal sinus tumors (n = 2). Thirty-eight percent (n = 5) of otogenic abscesses occurred within 15 days after a mastoidectomy. Sinogenic abscesses were never due to surgery but were associated in 31% of cases (n = 5) with anterior skull base defects. The main locations of otogenic abscesses were the temporal lobe (54%; n = 7) and the cerebellum (23%; n = 3), whereas sinogenic abscesses were located in the frontal lobe in 75% of cases (n = 12). Because of this location, sinogenic abscesses were less symptomatic than otogenic ones and had greater size and encapsulation at the time of diagnosis. Thus, they required longer antibiotic treatment (p = 0.05) and more numerous surgical drainages (p = 0.02). Bacteriologic abscesses samples were positive in 90% of cases. Bacteria found in brain abscesses were different from the ones found in ENT samples in 62% of cases. Thus, the results of ENT bacteriologic samples were not helpful for choosing adequate antibiotic agents in case of negative brain abscess samples. Although mortality was not significantly higher in otogenic abscesses (31%; n = 4) than in sinogenic ones (6%; n = 1, p = 0.08), otogenic abscesses appeared more threatening. Indeed, they represented 80% (n = 4) of lethal cases and encompassed more clinical or radiological prognosis pejorative factors than sinogenic ones (p = 0.006). In conclusion, higher danger of otogenic abscesses mainly resulted both from their temporal or cerebellous locations and from the bacteria that were more frequently resistant to antibiotics. PMID:17171060

  20. An Integration of the Turbojet and Single-Throat Ramjet

    NASA Technical Reports Server (NTRS)

    Trefny, C. J.; Benson, T. J.

    1995-01-01

    A turbine-engine-based hybrid propulsion system is described. Turbojet engines are integrated with a single-throat ramjet so as to minimize variable geometry and eliminate redundant propulsion components. The result is a simple, lightweight system that is operable from takeoff to high Mach numbers. Non-afterburning turbojets are mounted within the ramjet duct. They exhaust through a converging-diverging (C-D) nozzle into a common ramjet burner section. At low speed the ejector effect of the C-D nozzle aerodynamically isolates the relatively high pressure turbojet exhaust stream from the ramjet duct. As the Mach number increases, and the turbojet pressure ratio diminishes, the system is biased naturally toward ramjet operation. The common ramjet burner is fueled with hydrogen and thermally choked, thus avoiding the weight and complexity of a variable geometry, split-flow exhaust system. The mixed-compression supersonic inlet and subsonic diffuser are also common to both the turbojet and ramjet cycles. As the compressor face total temperature limit is approached, a two-position flap within the inlet is actuated, which closes off the turbojet inlet and provides increased internal contraction for ramjet operation. Similar actuation of the turbojet C-D nozzle flap completes the enclosure of the turbojet. Performance of the hybrid system is compared herein to that of the discrete turbojet and ramjet engines from takeoff to Mach 6. The specific impulse of the hybrid system falls below that of the non-integrated turbojet and ramjet because of ejector and Rayleigh losses. Unlike the discrete turbojet or ramjet however, the hybrid system produces thrust over the entire Mach number range. An alternate mode of operation for takeoff and low speed is also described. In this mode the C-D nozzle flap is deflected to a third position, which closes off the ramjet duct and eliminates the ejector total pressure loss.

  1. [Resurfacing of a trochanteric pressure sore by a pedicled fasciocutaneous anterolateral thigh flap: a case report].

    PubMed

    Zeitoun, J; Faghahati, S; Burin Des Roziers, B; Daoud, G; Cartier, S

    2013-06-01

    The anterolateral thigh flap is usually used as a free flap for various kinds of reconstruction and resurfacing of distant areas. Cover of a deep trochanteric pressure sore is commonly made by muscular or musculocutaneous flaps such as tensor of fascia lata or vastus lateralis. We report the case of a trochanteric pressure sore covered by a fasciocutaneous pedicled anterolateral thigh flap after negative pressure therapy in a 58-year-old paraplegic patient. After 6 months, a good quality of coverage was obtained with minimal morbidity of donor site. The pedicled fasciocutaneous anterolateral flap appears as a reliable option for the treatment of trochanteric pressure sore. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  2. Pain and soreness associated with a percutaneous electrical stimulation muscle cramping protocol.

    PubMed

    Miller, Kevin C; Knight, Kenneth L

    2007-11-01

    Muscle cramps are difficult to study scientifically because of their spontaneity and unpredictability. Various laboratory techniques to induce muscle cramps have been explored but the best technique for inducing cramps is unclear. Electrical stimulation appears to be the most reliable, but there is a perception that it is extremely painful. Data to support this perception are lacking. We hypothesized that electrical stimulation is a tolerable method of inducing cramps with few side effects. We measured cramp frequency (HZ), pain during electrical stimulation, and soreness before, at 5 s, and 30, 60, and 90 min after cramp induction using a 100-mm visual analog scale. Group 1 received tibial nerve stimulation on 5 consecutive days; Group 2 received it on alternate days for five total treatments. Pain and soreness were mild. The highest ratings occurred on Day 1 and decreased thereafter. Intersession reliability was high. Our study showed that electrical stimulation causes little pain or soreness and is a reliable method for inducing cramps.

  3. Soreness in lower extremities and back is reduced by use of shock absorbing heel inserts.

    PubMed

    Faunø, P; Kålund, S; Andreasen, I; Jørgensen, U

    1993-07-01

    Soccer referees participating in large soccer tournaments may develop overuse injuries. In this study the effect of shock absorbing heel inserts in the incidence of soreness was investigated. Forty-eight referees were randomly selected to wear shock absorbing heel inserts (SAH) in the 5 day-tournament, while 43 referees were the control group. A daily questionnaire inquiring about complaints from the locomotive system was completed for each referee and in case of any soreness they were examined by doctors to document and classify the anatomical site. Calf, thigh, back, achilles tendon and knee were the most common localizations of overuse symptoms. The incidence of soreness in achilles tendon, calf and back were significantly reduced by the use of (SAH) inserts.

  4. Resource defense and monopolization in a marked population of ruby-throated hummingbirds (Archilochus colubris).

    PubMed

    Rousseu, François; Charette, Yanick; Bélisle, Marc

    2014-03-01

    Resource defense behavior is often explained by the spatial and temporal distribution of resources. However, factors such as competition, habitat complexity, and individual space use may also affect the capacity of individuals to defend and monopolize resources. Yet, studies frequently focus on one or two factors, overlooking the complexity found in natural settings. Here, we addressed defense and monopolization of nectar feeders in a population of free-ranging ruby-throated hummingbirds marked with passive integrated transponder (PIT tags). Our study system consisted of a 44 ha systematic grid of 45 feeders equipped with PIT tag detectors recording every visit made at feeders. We modeled the number of visits by competitors (NVC) at feeders in response to space use by a focal individual potentially defending a feeder, number of competitors, nectar sucrose concentration, and habitat visibility. Individuals who were more concentrated at certain feeders on a given day and who were more stable in their use of the grid throughout the season gained higher exclusivity in the use of those feeders on that day, especially for males competing against males. The level of spatial concentration at feeders and its negative effect on NVC was, however, highly variable among individuals, suggesting a continuum in resource defense strategies. Although the apparent capacity to defend feeders was not affected by competition or nectar sucrose concentration, the level of monopolization decreased with increasing number of competitors and higher nectar quality. Defense was enhanced by visibility near feeders, but only in forested habitats. The reverse effect of visibility in open habitats was more difficult to interpret as it was probably confounded by perch availability, from which a bird can defend its feeder. Our study is among the first to quantify the joint use of food resource by overlapping individuals unconstrained in their use of space. Our results show the importance of

  5. Resource defense and monopolization in a marked population of ruby-throated hummingbirds (Archilochus colubris)

    PubMed Central

    Rousseu, François; Charette, Yanick; Bélisle, Marc

    2014-01-01

    Resource defense behavior is often explained by the spatial and temporal distribution of resources. However, factors such as competition, habitat complexity, and individual space use may also affect the capacity of individuals to defend and monopolize resources. Yet, studies frequently focus on one or two factors, overlooking the complexity found in natural settings. Here, we addressed defense and monopolization of nectar feeders in a population of free-ranging ruby-throated hummingbirds marked with passive integrated transponder (PIT tags). Our study system consisted of a 44 ha systematic grid of 45 feeders equipped with PIT tag detectors recording every visit made at feeders. We modeled the number of visits by competitors (NVC) at feeders in response to space use by a focal individual potentially defending a feeder, number of competitors, nectar sucrose concentration, and habitat visibility. Individuals who were more concentrated at certain feeders on a given day and who were more stable in their use of the grid throughout the season gained higher exclusivity in the use of those feeders on that day, especially for males competing against males. The level of spatial concentration at feeders and its negative effect on NVC was, however, highly variable among individuals, suggesting a continuum in resource defense strategies. Although the apparent capacity to defend feeders was not affected by competition or nectar sucrose concentration, the level of monopolization decreased with increasing number of competitors and higher nectar quality. Defense was enhanced by visibility near feeders, but only in forested habitats. The reverse effect of visibility in open habitats was more difficult to interpret as it was probably confounded by perch availability, from which a bird can defend its feeder. Our study is among the first to quantify the joint use of food resource by overlapping individuals unconstrained in their use of space. Our results show the importance of

  6. Throat Swabs and Sputum Culture as Predictors of P. aeruginosa or S. aureus Lung Colonization in Adult Cystic Fibrosis Patients

    PubMed Central

    Seidler, Darius; Griffin, Mary; Nymon, Amanda; Koeppen, Katja; Ashare, Alix

    2016-01-01

    Background Due to frequent infections in cystic fibrosis (CF) patients, repeated respiratory cultures are obtained to inform treatment. When patients are unable to expectorate sputum, clinicians obtain throat swabs as a surrogate for lower respiratory cultures. There is no clear data in adult subjects demonstrating the adequacy of throat swabs as a surrogate for sputum or BAL. Our study was designed to determine the utility of throat swabs in identifying lung colonization with common organisms in adults with CF. Methods Adult CF subjects (n = 20) underwent bronchoscopy with BAL. Prior to bronchoscopy, a throat swab was obtained. A sputum sample was obtained from subjects who were able to spontaneously expectorate. All samples were sent for standard microbiology culture. Results Using BAL as the gold standard, we found the positive predictive value for Pseudomonas aeruginosa to be 100% in both sputum and throat swab compared to BAL. However, the negative predictive value for P. aeruginosa was 60% and 50% in sputum and throat swab, respectively. Conversely, the positive predictive value for Staphylococcus aureus was 57% in sputum and only 41% in throat swab and the negative predictive value of S. aureus was 100% in sputum and throat swab compared to BAL. Conclusions Our data show that positive sputum and throat culture findings of P. aeruginosa reflect results found on BAL fluid analysis, suggesting these are reasonable surrogates to determine lung colonization with P. aeruginosa. However, sputum and throat culture findings of S. aureus do not appear to reflect S. aureus colonization of the lung. PMID:27711152

  7. Throat Swabs and Sputum Culture as Predictors of P. aeruginosa or S. aureus Lung Colonization in Adult Cystic Fibrosis Patients.

    PubMed

    Seidler, Darius; Griffin, Mary; Nymon, Amanda; Koeppen, Katja; Ashare, Alix

    2016-01-01

    Due to frequent infections in cystic fibrosis (CF) patients, repeated respiratory cultures are obtained to inform treatment. When patients are unable to expectorate sputum, clinicians obtain throat swabs as a surrogate for lower respiratory cultures. There is no clear data in adult subjects demonstrating the adequacy of throat swabs as a surrogate for sputum or BAL. Our study was designed to determine the utility of throat swabs in identifying lung colonization with common organisms in adults with CF. Adult CF subjects (n = 20) underwent bronchoscopy with BAL. Prior to bronchoscopy, a throat swab was obtained. A sputum sample was obtained from subjects who were able to spontaneously expectorate. All samples were sent for standard microbiology culture. Using BAL as the gold standard, we found the positive predictive value for Pseudomonas aeruginosa to be 100% in both sputum and throat swab compared to BAL. However, the negative predictive value for P. aeruginosa was 60% and 50% in sputum and throat swab, respectively. Conversely, the positive predictive value for Staphylococcus aureus was 57% in sputum and only 41% in throat swab and the negative predictive value of S. aureus was 100% in sputum and throat swab compared to BAL. Our data show that positive sputum and throat culture findings of P. aeruginosa reflect results found on BAL fluid analysis, suggesting these are reasonable surrogates to determine lung colonization with P. aeruginosa. However, sputum and throat culture findings of S. aureus do not appear to reflect S. aureus colonization of the lung.

  8. Effects of the homeopathic remedy arnica on attenuating symptoms of exercise-induced muscle soreness

    PubMed Central

    Plezbert, Julie A.; Burke, Jeanmarie R.

    2005-01-01

    Abstract Objective To evaluate the clinical efficacy of Arnica at a high potency (200c), on moderating delayed onset muscle soreness and accompanying symptoms of muscle dysfunction. Methods Twenty subjects completed a maximal eccentric exercise protocol with the non-dominate elbow flexors to induce delayed onset muscle soreness. Either Arnica or placebo tablets were administered in a random, double- blinded fashion immediately after exercise and at 24 hours and 72 hours after exercise. Before exercise, immediately post-exercise, and at 24, 48, 72, and 96 hours post-exercise, assessments of delayed onset muscle soreness and muscle function included: 1) muscle soreness and functional impairment; 2) maximum voluntary contraction torque; 3) muscle swelling; and 4) range of motion tests to document spontaneous muscle shortening and muscle shortening ability. Blood samples drawn before exercise and at 24, 48, and 96 hours after exercise were used to measure muscle enzymes as indirect indices of muscle damage. Results Regardless of the intervention, the extent of delayed onset muscle soreness and elevations in muscle enzymes were similar on the days following the eccentric exercise protocol. The post-exercise time profiles of decreases in maximum voluntary contraction torque and muscle shortening ability and increases in muscle swelling and spontaneous muscle shortening were similar for each treatment intervention. Conclusions The results of this study did not substantiate the clinical efficacy of Arnica at a high potency on moderating delayed onset muscle soreness and accompanying symptoms of muscle dysfunction. Despite the findings of this study, future investigations on the clinical efficacy of homeopathic interventions should consider incorporating research strategies that emphasize differential therapeutics for each patient rather than treating a specific disease or symptom complex, such as DOMS, with a single homeopathic remedy. PMID:19674657

  9. Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps

    PubMed Central

    Kim, Chae Min; Yun, In Sik; Lee, Dong Won; Lew, Dae Hyun; Rah, Dong Kyun

    2014-01-01

    Background Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. Methods We retrospectively analyzed data from 14 patients (16 ischial sores) whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. Results All flaps survived the entire follow-up period. Seven patients (50%) had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years). The mean follow-up period was 27.9 months (range, 3-57 months). In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%), wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%), but resolved with conservative treatment. Among 16 cases, there was only one (6%) recurrence at 34 months. Conclusions The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores. PMID:25075362

  10. [Encircling needling combined with physical factor therapy for severe pressure sore].

    PubMed

    Jia, Chengjie; Su, Bin; Gong, Lili; Wang, Wenying; Zhang, Xiuhua

    2015-11-01

    To compare the clinical efficacy difference between encircling needling combined with physical factor therapy and simple physical factor therapy for severe pressure sore, and to explore the optimal method for severe pressure sores. Thirty-four patients with IV-grade pressure sore were randomly divided into an observation group and a control group, 17 cases in each one. Patients in the control group were treated with conventional nursing, ultrasonic wave and short-wave ultraviolet therapy; additionally, the encircling needling was applied in the observation group. All the treatment was given once a day, 5 times a week, and 4-week treatment constituted one session. Totally, two sessions of treatment were performed. Three indices, including the area of pressure sore, 24-h volume of exudates and wound-bed tissue type, were compared between the two groups before and after treatment; the clinical efficacy was evaluated in the two groups. After treatment of one session and two sessions, the area of pressure sore, 24-h volume of exudates and wound-bed tissue type were significantly reduced in the two groups (P < 0.01, P < 0.05), which was more obvious in the observation group (all P < 0.05). The total effective rate in the observation group was 76.5% (13/17) after 1 session and 94.1% (16/17) after 2 sessions, which were superior to 35.3% (6/17) after 1 session and 64.7% (11/17) after 2 sessions in the control group (both P < 0.05). Encircling needling combined with physical factor therapy can obviously reduce the pressure sore area and 24-h volume of exudates and improve wound-bed tissue type, which is superior to simple physical factor therapy.

  11. A new flap alternative for trochanteric pressure sore coverage: distal gluteus maximus musculocutaneous advancement flap.

    PubMed

    Nisanci, Mustafa; Sahin, Ismail; Eski, Muhitdin; Alhan, Dogan

    2015-02-01

    Management of long-term bedridden patients experiencing pressure sores still represents a surgical challenge due to limited flap alternatives and high recurrence rates after the treatment. Fasciocutaneous, musculocutaneous, local perforator-based flaps, and free flaps have all been used for treatment of trochanteric pressure sores. This study presents a new use of distal gluteus maximus (GM) muscle as an advancement musculocutaneous flap for coverage of trochanteric pressure sores in 7 patients. The technique involves design of a long V-shaped skin island over the distal fibers of the GM muscle, beginning from the inferoposterior wound edge and extending inferomedially, almost parallel to the gluteal crease. After its harvest as an island flap on the distal fibers of the GM muscle, the skin paddle can be advanced onto the trochanteric defect, whereas the muscle itself is rotated after severing its insertion to femur. If a second triangular skin island is designed on the proximal fibers of GM muscle to cover an associated sacral defect, 2 coexisting pressure sores can be reconstructed concomitantly with 2 skin paddles on a single muscle belly at 1 surgical setting. Of the 7 patients, 3 had 3 (bilateral trochanteric and sacral), 2 had 2 (sacral and trochanteric), and 2 had 1 (only trochanteric) pressure sores. All ulcers were closed successfully and all of the flaps survived totally without any complication except the one in which we experienced minimal wound dehiscence in the early postoperative period. Conclusively, our current surgical method provided a reliable coverage for trochanteric pressure sores although it was technically straightforward and fast. Additionally, it offers simultaneous closure of 2 pressure ulcers with 2 skin islands on a single muscle flap.

  12. Effects of Zingiber cassumunar (Plai cream) in the treatment of delayed onset muscle soreness.

    PubMed

    Manimmanakorn, Nuttaset; Manimmanakorn, Apiwan; Boobphachart, Disaphon; Thuwakum, Worrawut; Laupattarakasem, Wiroon; Hamlin, Michael J

    2016-03-01

    To evaluate the effects of Zingiber cassumunar (Plai cream) in either 7% or 14% concentration on delayed onset muscle soreness (DOMS). Seventy-five untrained healthy volunteers (28 males and 47 females), performed 4 sets of 25 eccentric repetitions of the dominant quadriceps muscle on an isokinetic dynamometry machine. Participants were then randomized into 3 groups: 14% Plai cream, 7% Plai cream and placebo cream. Two grams of the cream (strips of 5-cm long) were gently rubbed into the quadriceps muscles for 5 min immediately following the exercise and every 8 h thereafter for 7 d in all groups. Muscle soreness, muscle strength, jump height, thigh circumference and creatine kinase were measured before and after eccentric exercise. Compared to the placebo cream the 14% Plai cream substantially reduced muscle soreness over the 7 d by -82% (95% CI = -155% to -6%, P = 0.03), but had similar muscle soreness effects to 7% Plai cream (-34%, -96% to 27%, P = 0.2). Compared to the placebo cream the 7% Plai cream resulted in a small non-significant reduction in muscle soreness levels over the following 7 d (-40%, -116% to 36%, P = 0.3). Compared to placebo cream there was little effect of Plai cream (7% or 14%) on muscle strength, jump height, thigh circumference or creatine kinase concentration. Using 14% Plai cream over a 7-day period substantially reduced muscle soreness symptoms compared to 7% Plai cream or a placebo cream. The authors suggest that the administration of 14% Plai cream is a useful alternative in the management of DOMS. Thai Clinical Trial Registry TCTR20140215001.

  13. [Randomized controlled trial on the effectiveness of Corpitolinol 60 in the prevention of pressure sores in patients undergoing surgery].

    PubMed

    Chiari, Paolo; Giorgi, Sabina; Ugolini, Daniela; Montanari, Morena; Giudanella, Pietro; Gramantieri, Antonella; Collesi, Franca; Pau, Michelina; Smaldone, Maddalena; Matarasso, Maddalena; Mazzini, Cinzia; Russo, Francesca; Gazineo, Domenica; Fontana, Mirella; Taddia, Patrizia

    2012-01-01

    Randomized controlled trial on the effectiveness of Corpitolinol 60 in the prevention of pressure sores in surgical patients. The risk of pressure sores in surgical patients is widely recognised. The Corpitolinol 60 (Sanyréne®) applied on compressed areas seems to reduce the risk of pressure sores. To assess the efficacy of Corpitolinol 60 in preventing pressure sores in the operatory theatre. The open label randomized clinical trial was conducted in 5 operating theatres of Northen Italy. Patients were randomized to receive Corpitolinol 60 in areas undergoing compression. Experimental group and controls were treated with usual measures for preventing pressure sores. The lesions were staged according to NPUAP up to 24 hours after surgery. Three-hundred-one patients were randomized (155 in the Sanyréne® group and 143 controls). The main variables predictive of pressure sores risk (ASA class, sex, age, duration of the surgery, and BMI) were comparable across groups. At the end of the surgery 71 patients (23.8%) in the experimental group and 47 controls (30.8%) had a pressure sore (p 0.006; RR 1.81 IC95% 1.17-2.79). Twelve and 24 hours after surgery the differences between groups were not significant. The aim of reducing pressure sores was not reached for patients treated with Corpitolinol 60.

  14. Management of Marjolin's ulcer in a chronic pressure sore secondary to paraplegia: a radical surgical solution.

    PubMed

    Fairbairn, Neil G; Hamilton, Stuart A

    2011-10-01

    Marjolin's ulcer refers to malignant degeneration in a chronic wound. Although originally described in an area of burns scar, many other chronic wounds such as osteomyelitis sinus tracts, venous stasis ulcers and chronic pressure sores have the potential to undergo malignant transformation. We present an interesting case of malignant degeneration in a male paraplegic patient with chronic sacral and ischial pressure sores. By discussing our radical surgical solution to this problem, we aim to highlight the importance of prompt diagnosis. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  15. Pressure sore and skin tear prevention and treatment during a 10-month program.

    PubMed

    Brillhart, Barbara

    2005-01-01

    This article reports the results of a 10-month skin care program for 30 clients on a residential Alzheimer's disease unit. The majority (n = 26) of the clients were free of pressure sores and skin tears through preventive care during this study. Four clients with Stage I pressure sores and/or skin tears were successfully identified by consistent assessment and healed quickly due to rapidly initiated treatments. This skin care program's success was attributed to consistent education, preventive care, assessment, documentation, and treatment executed by the entire care team under the leadership of nurse practitioners, one of whom was certified as a rehabilitation nurse.

  16. Comparison of different heat modalities for treating delayed-onset muscle soreness in people with diabetes.

    PubMed

    Petrofsky, Jerrold; Batt, Jennifer; Bollinger, Jennifer N; Jensen, Mark C; Maru, Elyse H; Al-Nakhli, Hani H

    2011-06-01

    Delayed-onset muscle soreness (DOMS) is a serious problem for people who do not exercise on a regular basis. Although the best preventive measure for diabetes and for maintaining a low hemoglobin A1c is exercise, muscle soreness is common in people with diabetes. For people with diabetes, DOMS is rarely reported in exercise studies. One hundred twenty subjects participated in three groups (young, older, and type 2 diabetes) and were examined to evaluate the soreness in the abdominal muscles after a matched exercise bout using a p90x exercise video (Beachbody LLC, Los Angeles, CA) for core fitness. Next, three heating modalities were assessed on how well they could reduce muscle soreness: ThermaCare(®) (Pfizer Consumer Healthcare, Richmond, VA) heat wraps, hydrocollator heat wraps, and a chemical moist heat wrap. The results showed that people with diabetes were significantly sorer than age-matched controls (P < 0.05). On a 100-mm VAS (100 mm = sorest), the average soreness for the people with diabetes was 73.3 ± 16.2 mm, for the older group was 56.1 ± 15.1 mm, and for the younger group was 41.5 ± 9.3 mm; these differences were significant (analysis of variance, P < 0.05). The greatest reduction in soreness after applying the modalities was using moist heat, both immediately after the modality and up to 2 days after the exercise. Right after the modality, moist heat reduced pain by 52.3% in the older subjects compared with 30.5% in the subjects with diabetes and 33.3% in the younger subjects. Skin blood flow in the abdominal area before exercise was greatest in the younger subjects and lower in the subjects with diabetes after heat application. Skin temperature at rest and after exercise was greatest in the diabetes group. Muscle soreness following exercise was greatest in people with diabetes, and the best modality of the three studied to reduce this type of soreness was chemical moist heat.

  17. Combined Use of Standard and Throat Microphones for Measurement of Acoustic Voice Parameters and Voice Categorization.

    PubMed

    Uloza, Virgilijus; Padervinskis, Evaldas; Uloziene, Ingrida; Saferis, Viktoras; Verikas, Antanas

    2015-09-01

    The aim of the present study was to evaluate the reliability of the measurements of acoustic voice parameters obtained simultaneously using oral and contact (throat) microphones and to investigate utility of combined use of these microphones for voice categorization. Voice samples of sustained vowel /a/ obtained from 157 subjects (105 healthy and 52 pathological voices) were recorded in a soundproof booth simultaneously through two microphones: oral AKG Perception 220 microphone (AKG Acoustics, Vienna, Austria) and contact (throat) Triumph PC microphone (Clearer Communications, Inc, Burnaby, Canada) placed on the lamina of thyroid cartilage. Acoustic voice signal data were measured for fundamental frequency, percent of jitter and shimmer, normalized noise energy, signal-to-noise ratio, and harmonic-to-noise ratio using Dr. Speech software (Tiger Electronics, Seattle, WA). The correlations of acoustic voice parameters in vocal performance were statistically significant and strong (r = 0.71-1.0) for the entire functional measurements obtained for the two microphones. When classifying into healthy-pathological voice classes, the oral-shimmer revealed the correct classification rate (CCR) of 75.2% and the throat-jitter revealed CCR of 70.7%. However, combination of both throat and oral microphones allowed identifying a set of three voice parameters: throat-signal-to-noise ratio, oral-shimmer, and oral-normalized noise energy, which provided the CCR of 80.3%. The measurements of acoustic voice parameters using a combination of oral and throat microphones showed to be reliable in clinical settings and demonstrated high CCRs when distinguishing the healthy and pathological voice patient groups. Our study validates the suitability of the throat microphone signal for the task of automatic voice analysis for the purpose of voice screening. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Which medical device and/or which local treatment are to be used, as of 2012, in patients with infected pressure sore? Developing French guidelines for clinical practice.

    PubMed

    Arzt, H; Fromantin, I; Ribinik, P; Barrois, B; Colin, D; Michel, J-M; Passadori, Y

    2012-10-01

    Taking care of a patient with an infected pressure sore necessitates a diagnosis allowing for a suitable treatment strategy. To choose the dressings and topical antimicrobial agents that can be used as of 2012 in treatment of an infected pressure sore. A systematic review of the literature with queries to the databases Pascal Biomed, PubMed and Cochrane Library from 2000 through 2010. Diagnosis of local infection is essentially clinical. It is subsequently difficult to destroy and/or permeabilize biofilm by means of mechanical wound debridement. Application of an antimicrobial product and a disinfectant solution are of utmost importance in this respect. The studies do not demonstrate that one topical product is better than another in wound cleaning. The papers recommending antimicrobial topics lead to the conclusion that they may be interesting, but show little clinical evidence of their beneficial effects. Dressings including silver, iodine, polyhexamethylene biguanide (PHMB) and negative pressure wound therapy could likewise be of interest, but once again, existing studies present only a low level of evidence (Grade C). Local antimicrobial treatment can be used when there are signs of local infection (Grade C). Systemic antibiotic treatment is to be used when there are general medical signs of infection (Grade B). Copyright © 2012. Published by Elsevier Masson SAS.

  19. Rapid detection of Streptococcus pyogenes in throat swab specimens by fluorescent in situ hybridization.

    PubMed

    Tajbakhsh, S; Gharibi, S; Zandi, K; Yaghobi, R; Asayesh, G

    2011-03-01

    Streptococcus pyogenes (S. pyogenes) is an important cause of pharyngitis. Rapid detection of this microorganism in throat specimens is essential to promptly start antibiotic therapy which could be lead to prevent complications and stop transmission of infection to other individuals. In the present study, fluorescent in situ hybridization (FISH) was compared with culture method for the detection of S. pyogenes in throat swab specimens. One hundred eleven patients with pharyngitis were included in this study. The throat swab specimens of these patients were investigated by both conventional culturing and FISH. Based on the results of this investigation, the sensitivity and specificity of FISH were 88.9% and 97.8%, respectively. Strikingly, in the specimen of one patient who had received antibiotic previous to clinical sampling, S. pyogenes was detected by means of FISH, whereas the culture method could not detect this bacterium. It seems that FISH is a suitable method for quick identification of S. pyogenes in throat swab specimens. When FISH is positive, culturing is not necessary. But because of the limited sensitivity of FISH for detection of S. pyogenes in throat swab specimens, culturing shoud be performed if FISH was negative.

  20. Impact of an Exhaust Throat on Semi-Idealized Rotating Detonation Engine Performance

    NASA Technical Reports Server (NTRS)

    Paxson, Daniel E.

    2016-01-01

    A computational fluid dynamic (CFD) model of a rotating detonation engine (RDE) is used to examine the impact of an exhaust throat (i.e. a constriction) on performance. The model simulates an RDE which is premixed, adiabatic, inviscid, and which contains an inlet valve that prevents backflow from the high pressure region directly behind the rotating detonation. Performance is assessed in terms of ideal net specific impulse which is computed on the assumption of lossless expansion of the working fluid to the ambient pressure through a notional diverging nozzle section downstream of the throat. Such a semi-idealized analysis, while not real-world, allows the effect of the throat to be examined in isolation from, rather than coupled to (as it actually is) various loss mechanisms. For the single Mach 1.4 flight condition considered, it is found that the addition of a throat can yield a 9.4 percent increase in specific impulse. However, it is also found that when the exit throat restriction gets too small, an unstable type of operation ensues which eventually leads to the detonation failing. This behavior is found to be somewhat mitigated by the addition of an RDE inlet restriction across which there is an aerodynamic loss. Remarkably, this loss is overcome by the benefits of the further exhaust restrictions allowed. The end result is a configuration with a 10.3 percent improvement in ideal net specific thrust.