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At least 415 records · Page 23Linked to original sources
PubMed1991

TestPack Strep A kit for the rapid detection of group A streptococci on 11,088 throat swabs in a clinical pathology laboratory.

Results obtained with Abbott Laboratories' TestPack Strep A, a rapid test kit to detect group A streptococcal antigen on throat swabs, were compared with the culture results. All tests were performed by American Society of Clinical Pathology-registered technologists in a large clinical laboratory. A total of 11,088 throat swabs were tested; 9,161 belonged to pediatric patients and 1,927 to adults. For TestPack Strep A, the study demonstrated a sensitivity value of 0.91 and a specificity value of 0.96; positive predictive value and negative predictive values were 0.82 and 0.98, respectively. These data indicate that even when performed by experienced technologists, in a laboratory setting, approximately 1 of 10 patients with group A streptococcal tonsillopharyngitis will be missed if physicians rely solely on this direct antigen test. A backup culture on all patients who are negative by a rapid antigen detection test is recommended.

Adolescent↗
PubMed1982

Sore throat after operation: influence of tracheal intubation, intracuff pressure and type of cuff.

One hundred and eighty-four patients were studied to elucidate the contribution of intracuff pressure and cuff type to the occurrence of sore throat and hoarseness after operation. The patients were allocated to one of the following groups: A = mask only; B = reusable Rüsch tube with intermittent cuff volume adjustment; C = reusable Rüsch tube without cuff volume adjustment; D = disposable Portex Blue Line tube with intermittent cuff volume adjustment; E = disposable Shiley Low Pressure tube with intermittent cuff volume adjustment. Nitrous oxide was a component of anaesthesia in all patients. Moderate or severe symptoms were recorded in 30-33% of the patients in groups C, D and E, contrasting with group B, in which these sequelae were seen in only 10% of patients (P less than 0.025). All sequelae occurred less frequently in group A than in any of the other groups (P less than 0.025). Women were more likely to develop sore throat after intubation than were men (P less than 0.01). A possible relationship between differences in cuff-trachea contact area is postulated.

Adolescent↗
PubMedDate not supplied

Clinical infections and nonsurgical treatment of parapharyngeal space infections complicating throat infection.

The clinical features and management of eight patients with parapharyngeal space infection who presented with swelling of the neck subsequent to sore throat are described. In four patients the interval between the initial throat symptoms and swelling was 2 days or less, and the disease was rapidly progressive with stridor or a descending mediastinitis. In the other four cases, this interval was longer (4 to 14 days) and the infection was fairly localized. Computed tomography was useful for making the diagnosis, establishing that the infection had spread into other deep neck spaces and the mediastinum, distinguishing abscesses from diffuse cellulitis, guiding drainage aspiration, and assessing the response to therapy. None of the patients underwent extensive surgical drainage of the deep neck spaces. A nonsurgical approach with antibiotics, including high doses of benzylpenicillin, and computed tomography-guided selective needle aspirations proved successful. Even patients with distinct abscesses were completely cured.

Abscess↗
PubMed2003

Understanding variation in quality improvement: the treatment of sore throats in primary care.

BACKGROUND: In 1988, two practices attempted to improve the prescribing of antibiotics for sore throat. The initiative produced only modest improvements in prescribing practice, a finding the authors found difficult to explain. This paper reanalyses the data from an audit of antibiotic prescribing for sore throat in general practice. OBJECTIVE: Our aim was to demonstrate the use of Shewhart control charts and to obtain fresh insight into the variations in clinical practice revealed in clinical audit data. METHODS: We use Shewhart control charts to explore variation in antibiotic prescribing between GPs and to suggest the action most likely to result in improvement. RESULTS: Using control charts, it is possible to distinguish two categories of GPs: low prescribers of antibiotics and high prescribers of antibiotics. Low prescribers of antibiotics show common cause variation, indicating that their prescribing is a stable process. Among low prescribers, improvement can best be achieved by changing the common underlying process. One high prescriber of antibiotics is affected by special cause variation. Among high prescribers, improvement can best be achieved by investigating the special causes affecting this GP and learning lessons from the findings. CONCLUSION: The original improvement effort took the same action on all GPs in both practices. Our analysis suggests that such an approach was unlikely to be successful and that different actions were needed for high and low prescribers. The control charts provide fresh insights on the original data and guide improvement efforts.

Anti-Bacterial Agents↗
PubMed1988

Antibiotics and the adult sore throat--an unnecessary ceremony.

Antibiotics are overprescribed for patients with sore throats for many reasons, including the difficulties in diagnosing the cause of the symptom, as well as the pharmacological and placebo strength of antibiotics. Two hundred adult patients presenting to one general practitioner were divided into two groups. One group was given an antibiotic, the efficacy of which was stressed, and the other group was given symptomatic treatment with an explanation that no antibiotic was needed. Six months after the initial consultation the patients' notes were checked for return visits with respiratory complaints. Significantly more patients who received an antibiotic returned to the doctor with respiratory problems, especially young men. During the study, few patients resisted either a high or low prescribing policy. It is concluded that antibiotic treatment for sore throats did not prevent complication for the patient. Furthermore, high antibiotic prescribing created more work for the doctor by increasing the repeat visit rate. Patients were equally compliant with a high or low antibiotic prescribing policy.

Adult↗
PubMed2005

The prevalence of ear, nose and throat problems in the community: results from a national cross-sectional postal survey in Scotland.

OBJECTIVE: To assess the prevalence of ear, nose and throat (ENT) symptoms experienced by individuals living in Scotland, and their use of GP or hospital services for these problems. METHODS: A cross-sectional postal self-completed questionnaire was sent to a random sample of 12,100 households throughout Scotland. 15,788 individuals aged 14+ years living in the 7244 households who returned the questionnaire (adjusted response rate 64.2%) participated in the study. RESULTS: Roughly a fifth of respondents reported currently having hearing difficulties, including difficulty following conversations when there is background noise and hearing problems causing worry or upset; few wore a hearing aid regularly. A fifth reported noises in head or ears (tinnitus) lasting more than five minutes. In the previous year, between 13 and 18% of respondents reported persistent nasal symptoms or hayfever, 7% sneezing or voice problems and 31% had at least one episode of severe sore throat or tonsillitis. Nearly 21% of all respondents reported ever having had dizziness in which things seemed to spin around the individual; 29% unsteadiness, light-headedness or feeling faint; 13% dizziness in which the respondent seemed to move. Important gender, age, occupation and deprivation differences existed in the occurrence of these ENT symptoms. There was considerable variation in the proportion of individuals consulting their GP or being referred to hospital for different problems. CONCLUSIONS: ENT problems occur frequently in the community, and most are managed without consulting medical services. Whilst reasonable for many problems, there are likely to be important groups in the community with ENT problems that might benefit from modern interventions.

Adolescent↗
PubMed1989

Hepatitis A virus infection in a chimpanzee: duration of viremia and detection of virus in saliva and throat swabs.

The pathogenesis of hepatitis A virus was studied by orally inoculating a chimpanzee with wild-type virus. The virus was initially detected in the animal's serum (day 14 after inoculation); then viral antigen was detected in the tonsils (day 16), virus in the saliva and throat swabs (day 18), and viral antigen in the liver (day 21). The animal was viremic for 2 w. While this study involved a single animal, the presence of hepatitis A virus in saliva and throat swabs suggests a possible oropharyngeal site for viral replication.

Alanine Transaminase↗
PubMed1996

Genetic correlates of throat and skin isolates of group A streptococci.

The existence of discrete populations of throat and skin strains of group A streptococci has long been recognized; however, a molecular basis for this distinction is not known. The emm gene structure was analyzed for 105 isolates obtained from patients with well-defined group A streptococcal diseases: uncomplicated pharyngitis, impetigo, and acute rheumatic fever. Four emm gene sub-family forms, defined by nucleotide sequence differences in regions encoding the peptidoglycan-spanning domain of M and M-like surface proteins, were found to exist in five different chromosomal patterns among naturally occurring isolates. Strong correlations were made between disease and the number and arrangement of emm subfamily genes. These findings provide a genetic basis for the historical references to "throat," "skin," and "rheumatogenic" types.

Bacterial Outer Membrane Proteins↗
PubMed1998

Members of the throat microflora among infants with different feeding methods.

Normal throat microflora have an important role of antagonistic activity against pathogenic bacteria. We studied members of throat microflora of 30 exclusively breastfed, 15 mixed-fed and 15 exclusively formula-fed infants at the age of 1 month. All infants harboured alpha haemolytic Streptococcus. The incidence of gamma Streptococcus and coagulase negative Staphylococcus's isolation from breastfed infants was higher. We also found that coagulase negative Staphylococcus is one of three predominant bacterial species in breastfed infants.

Analysis of Variance↗
PubMed1999

Isolation of respiratory bacterial pathogens from the throats of healthy infants fed by different methods.

Most bacterial infections are caused by organisms that have already colonized the host. Bacterial attachment to pharyngeal cells and proliferation may be necessary to infect the lower respiratory tract or middle ear. We investigated the incidence of pathogenic bacteria isolated from the throat of healthy infants with different feeding methods. The protecting role of breastmilk is also discussed. The incidence of respiratory bacterial pathogens isolated from the oropharynx of 113 normal infants with different feeding methods was investigated. Group A beta haemolytic Streptococcus, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis were selected as respiratory bacterial pathogens. No respiratory bacterial pathogens were detected in breastfed and mixed-fed infants. Haemophilus influenzae and Moraxella catarrhalis were isolated from the oropharynx of formula-fed infants. The incidence of respiratory bacterial pathogens did differ among infants with different feeding methods. These results suggest that breastmilk may inhibit the colonization by respiratory bacterial pathogens of the throat of infants, by enhancing mucosal immunity against respiratory tract infection.

Bacteria↗
PubMed2002

Analgesic effects of rofecoxib in ear-nose-throat surgery.

UNLABELLED: In this study we evaluated the analgesic efficacy and the opioid-sparing effect of rofecoxib in ear-nose-throat surgery patients. Patients undergoing nasal septal or sinus surgery were randomized to receive either oral placebo or rofecoxib 50 mg 1 h before surgery. All patients received propofol 0.8 mg/kg, fentanyl 1 microg/kg, and local anesthesia at the operative site. Sedation was maintained by a continuous infusion of propofol adjusted to maintain sedation at a 2-3 level on the Ramsey scale. Additional fentanyl 0.5-1 microg/kg was administered at the patient's request or if the verbal rating scale score was >4. Patient sedation and pain scores were obtained at 5, 15, 30 45, and 60 min during surgery and 30 min and 2, 4, 6, 12, and 24 h after completion of the procedure. During the postoperative period, diclofenac 75 mg IM was administered for analgesia at the patient's request or if the visual analog scale (VAS) rating for pain was more than 4. VAS pain scores, intraoperative fentanyl, and postoperative diclofenac requirements were significantly smaller in the rofecoxib group compared with the placebo group (P < 0.001). The times to first analgesic request were also significantly less in the rofecoxib group. We conclude that the preoperative administration of oral rofecoxib provided a significant analgesic benefit and decreased the need for opioids in patients undergoing nasal septal and nasal sinus surgery. IMPLICATIONS: The aim of this study was to evaluate the analgesic efficacy and opioid-sparing effect of rofecoxib, a new selective cyclooxygenase-2 inhibitor drug, in ear-nose-throat surgery patients. Preoperative administration of oral rofecoxib provided a significant analgesic benefit and decreased the need for opioids in patients undergoing nasal septal and nasal sinus surgery.

Adult↗
PubMedDate not supplied

Comparison of a miniaturized culture test and sheep blood agar for the recovery of Group A streptococci from throat cultures.

A miniaturized culture test (strep test) was compared with conventional sheep blood agar (SBA) for the detection of Group A streptococci (GAS) from throat swabs. A total of 355 throat cultures were obtained in duplicate from symptomatic children and assessed by the two methods after overnight incubation. GAS were detected in 109 specimens by the strep test, in 100 specimens by SBA and in 118 specimens by both methods. There was no significant difference between the recovery rate of GAS by the strep test (92.4%) and SBA (84.7%) (0.1 greater than P greater than 0.05). The strep test was 85.2% specific for detection of GAS. The rates of false positive and false negative reactions with the strep test were 24.3 and 4.3%, respectively. Beta-hemolytic streptococci other than Group A, Staphylococcus aureus and alpha-hemolytic streptococci produced false positive reactions. The viability of GAS on the strep test was also tested. GAS were recovered from 27 of 28 (96.4%) strep tests at 24 hours and 25 of 27 (92.6%) tests at 72 hours after inoculation. These results indicate that strep test is as sensitive as the conventional SBA method in recovering GAS. The strep test is simple to use, is easy to interpret and has a long shelf life. Because of the high rate of false positive results (24.3%), this test may not be the best alternative method to SBA for use in office practice.

Agar↗
PubMed1989

Can parents do a throat culture?

Throat swabs for Group A beta-hemolytic Streptococcus were obtained from 98 patients, ages 4 to 17 years, both by their parents and by physician investigators. Compared with results obtained by physicians, there was a false negative rate of 32% (P less than 0.001) for the parents. The discrepancy was greater in the youngest age group (38% false negative rate in the 4- to 8-year-olds) compared with older children (P less than 0.001). The overall sensitivity and negative predictive value for the parent-obtained swabs were 68 and 45%, respectively. In the 4- to 8-year-old group, these values were 62 and 37%, respectively. Because there were no false positives the positive predictive value was 100%. We conclude that the false negative rate for untrained parents obtaining throat swabs is too high to warrant the implementation of home testing for Group A streptococci.

Adolescent↗
PubMed1984

Throat culture in impending peritonsillar abscess.

Throat cultures done immediately before the development of a peritonsillar abscess were positive for beta-hemolytic streptococci in only one of 12 cases. To prevent suppurative complications such as peritonsillar abscess, treatment with antibiotics may be indicated in selected severe cases of tonsillar infections despite negative throat cultures.

Anti-Bacterial Agents↗
PubMed2002

Adult acute epiglottitis and foreign body in the throat - chicken or egg?

A 53 year old man presented with the chief complaint of having a fish bone stuck in the throat for about 1 h. There was no dysphagia or respiratory symptoms. Plain lateral neck X-ray, direct laryngoscopy and oesophagogastroduodenoscopy showed a grossly swollen epiglottis with narrowing of the laryngeal lumen. No foreign body was found. His condition improved rapidly with intravenous antibiotic therapy. As acute epiglottitis may be a sudden life-threatening condition, a high index of suspicion should be maintained for patients who present with alleged foreign bodies in the throat.

Acute Disease↗
PubMed1999

A study of small-colony, beta-haemolytic, Lancefield group C streptococci within the anginosus group: description of Streptococcus constellatus subsp. pharyngis subsp. nov., associated with the human throat and pharyngitis.

beta-Haemolytic, Lancefield group C streptococci within the anginosus-species group were shown by genetic and phenotypic criteria to be heterogeneous and to constitute two distinct taxa related at subspecies level to Streptococcus constellatus and Streptococcus anginosus, respectively. The first group, referred to here as DNA group 1, comprised six strains with 86-100% intragroup overall genomic DNA relatedness; five of the strains were originally isolated from the human throat and one was from an abdominal mass. They shared 61-77% DNA relatedness (delta Tm values = 1.2-1.5 degrees C) with reference strains of S. constellatus and were clearly differentiated from S. constellatus (now named Streptococcus constellatus subsp. constellatus) by the ability to produce beta-N-acetylgalactosaminidase, beta-N-acetylglucosaminidase, beta-D-fucosidase, beta-D-galactosidase and beta-D-glucosidase. The name S. constellatus subsp. pharyngis is proposed for these strains on the grounds that they are genetically and phenotypically distinct and exhibit a predeliction for the human throat, being isolated also from cases of pharyngitis. The DNA G + C content is 35-37 mol%. The type strain is MM9889aT (= NCTC 13122T). The second group (DNA group 2) was formed by five beta-haemolytic, Lancefield group C strains originally isolated from various human infections. DNA group 2 strains (81-100% intragroup DNA relatedness) shared 60-72% DNA relatedness (delta Tm values = 2.1-4.1 degrees C) with S. anginosus strains NCTC 10713T and MAS 283 but were not clearly differentiated phenotypically from S. anginosus, showed no clear pattern of clinical association, and therefore are not formally proposed as a new subspecies here.

Bacterial Typing Techniques↗
PubMed1991

Detection of influenza viruses in throat swab by using polymerase chain reaction.

An assay protocol based on exploiting the polymerase chain reaction (PCR) for the direct detection of influenza virus in throat swab is described. By use of the mixture of H1 and H3 primers, it was possible to determine the subtype of the influenza A viruses simultaneously. No visible band was detected after PCR of influenza B or A (H2N2) viruses with a pair of H1 or H3 primers. The dilution experiment showed that the influenza viruses, as few as 1.3-6 plaque-forming units, were sufficient for detecting the HA gene by PCR. All throat swab samples from which influenza viruses had been isolated by conventional method were also positively detected by PCR method.

Electrophoresis, Agar Gel↗
PubMed2002

emm Typing of group A streptococcus clinical isolates: identification of dominant types for throat and skin isolates.

T and emm types were determined for group A streptococci isolated from patients with various infections during 1990-1999 in Toyama Prefecture, Japan. Out of 906 isolates, 872 isolates were divided into 20 T serotypes, and 34 isoltes were T nontypeable (TNT). T12, T1, and T4 were dominant among 699 throat isolates; on the other hand, T11, T28, TB3264, and TNT were dominant among 80 skin isolates. The emm types of 190 isolates were determined following specific PCR amplification and sequencing of the products. Twenty T serotypes were divided into 34 T type/emm type combinations. Thirty-four TNT isolates were divided into 14 emm types, in which emm58 was the most common (38%). Among 82 throat isolates randomly selected, predominant T types T12, T1, and T4 isolates were of the respective same numbers in emm type. T11/emm89, T28/emm28, TB3264/emm13w, and TNT/emm58 were predominant among 80 skin isolates. emm-type distribution observed in the present study was that usually reported in the western world. To our knowledge, 3 T/emm is a novel combination. These results show that emm typing allows the characterization of group A streptococci from various sources.

Antigens, Bacterial↗