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

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).

Adolescent↗

Involvement of a circadian rhythm in the photoperiodic ovarian response of the yellow-throated sparrow, Gymnorhis xanthocollis.

Groups of the photosensitive female yellow-throated sparrow were placed under various light-dark cycles, in which a fixed ultrashort photophase of 3 h was combined with dark phases of varying duration, resulting in cycles of 18-30 h. Simultaneously, two groups of birds, one in short days (8L/16D) and the other in long days (15L/9D), were kept as controls. Significant ovarian growth, observed at 30 and 60 days, was induced by 3 h ultrashort photophase only if it was introduced in the cycles of 18 h (3L/15D), 20 h (3L/17D), 26 h (3L/23D), 28 h (3L/25D) and 30 h (3L/27D) as well as under long days (15L/9D), whereas there was no response to the ultrashort photophase in cycles of 22 h (3L/19D) and 24 h (3L/21D) and in short days (8L/16D). It seems that there is an ovarian response to the ultrashort day cycles when a phase advance or delay of photosensitivity of the response system repeatedly produces coincidence of the external photophase (3 h) with the photosensitive phase of an endogenous circadian rhythm. The results are thus consistent with the Bünning hypothesis, which suggests the involvement of an endogenous circadian rhythm in photoperiodic time measurement.

Acclimatization↗

The throat culture in Kawasaki disease.

Recently, Kawasaki disease has been attracting more attention as a new acquired heart disease in pediatrics, but the etiology of this disease has still not been established. In this study, the authors performed throat cultures not only on the patients themselves but also on their parents in order to investigate its etiology. No abnormal and specific bacterium was found in the present study. However, there have been many reports which may suggest bacterial or viral involvement at the onset of this disease. Therefore, it may be necessary to continue bacteriological analysis more systematically.

Bacteria↗

Evaluation of direct and rapid identification of group A streptococci from throat swabs by Culturette 10-Minute Group A Strep ID test kit.

The Culturette Brand 10-Minute Group A Strep ID test kit (Marion Scientific, Division of Marion Laboratories, Inc., Kansas City, Mo.) was evaluated for its sensitivity and specificity in identifying the group A streptococci directly from 96 throat swabs, against the conventional culture method and serological grouping test. Our results indicated that the rapid test kit and conventional method are 93.8% accurate; percent sensitivity and specificity of the rapid test was 80.6% and 100%, respectively. None of the false-positive observed in rapid test kits occurred with the heterogeneous microorganisms. More than 8 X 10(4) colony forming unit per swab was required for the positive latex agglutination of the test kit. Since the Culturette method is simple to perform and correctly identifies group A streptococcal antigen, and also required no special instruments, it appears to be applicable in hospital laboratories and outpatients clinics.

Bacteriological Techniques↗

Clinical evaluation of the electronic nose in the diagnosis of ear, nose and throat infection: a preliminary study.

The term electronic nose describes an electronic system that is able to mimic the human sense of smell. Electronic noses have been developed over the last 10 or more years to perform a variety of identification tasks in various industries. More recently electronic noses have attracted new interest in their application in the field of medical diagnosis. The aim of this study is to explore the use of an electronic nose to identify and classify pathogens associated with ear, nose and throat (ENT) infections. In this study 90 bacterial swab samples were collected from 90 patients with ENT infections. Some of these samples were analysed immediately with a commercial electronic nose (Cyranose C320). Similar numbers of swabs were also taken from the same site of infection and were sent for microbiology culture and sensitivity. The electronic nose diagnosis was compared with the microbiology diagnosis and it was found that the electronic nose diagnosis was correct in 88.2 per cent of the cases, which is an encouraging result.

Bacterial Infections↗

Implementation by Scottish otolaryngologists of the Scottish Intercollegiate Guidelines Network document Management of Sore Throats and the Indications for Tonsillectomy: four years on.

A postal survey was undertaken to assess otolaryngologists' awareness, implementation and perceived weaknesses of the Scottish Intercollegiate Guidelines Network (SIGN) clinical guideline for the Management of Sore Throat and Indications for Tonsillectomy. The reply rate was 77 per cent. There was high awareness of the guideline and while 84 per cent of the correspondents felt that they followed the guideline, or a guideline based on it, only 35 per cent were able to accurately recall the four main criteria recommended for listing for tonsillectomy. Twenty-five per cent of the surgeons were in departments that had ongoing implementation programmes for these guidelines but only 10 per cent of surgeons were in departments that had audited their compliance. The most common criticism of the guideline (22 per cent) was that it failed to consider the impact of the disease process on the patient's quality of life. Suggestions made to improve the guideline are included.

Guideline Adherence↗

The bifid uvula in ear, nose and throat practice.

Out of 2,000 consecutive ear, nose and throat patients, 44 were found with bifid uvulas. Five of the cleft uvulas were associated with submucous cleft palate, and eight were associated with short palates; however, dyslalia was evident in only one case. Compensation for the wide palato-pharyngeal space can occur by hyperplasia of the nasopharyngeal tonsil and hypertrophy and increased mobility of the pharyngeal constrictors and Passavant's ridge. On the other hand, otologic manifestations were complained of in 13 cases. The asymptomatic cases were examined under magnification and audiometrically and a further three cases were, then, diagnosed as secretory otitis media. Hypoplasia of the tensor palati is the probable explanation of otologic manifestations in bifid uvula.

Abnormalities, Multiple↗

Life-threatening necrotizing fasciitis of the neck: an unusual consequence of a sore throat.

BACKGROUND: Necrotizing fasciitis is life-threatening bacterial infection which spreads with frightening speed along the fascial planes resulting in extensive tissue necrosis and often death. The infection is caused by either Group A streptococci or a combination of aerobic and anaerobic bacteria. Necrotizing fasciitis of the neck is rare and commonly has a dental origin. CASE REPORT: Here we present a unique case of the condition that was preceded by a sore throat in a young immunocompetent woman. We also describe, for the first time, a successful outcome involving primary skin closure and daily irrigation of the wound with hydrogen peroxide.

Adult↗

Primary structure of adult hemoglobin of white-throated capuchin, Cebus capucinus.

The alpha and beta chains of White-Throated Capuchin (Cebus capucinus) hemoglobin were separated and digested by trypsin. The tryptic peptides were isolated and sequenced by conventional methods. The peptides in each chain were aligned by the homology of their sequences with those of human adult hemoglobin. The primary structures thus deduced are compared with those of other primate hemoglobins, and we discuss the molecular evolution of hemoglobins, in particular the rate of evolution in New World monkey hemoglobins.

Amino Acid Sequence↗

The primary structure of pale-throated three-toed sloth (Bradypus tridactylus, Xenarthra) hemoglobin.

The hemoglobin of the Pale-Throated Three-Toed Sloth (Bradypus tridactylus, Xenarthra) was separated into two components (ratio 4:1) with identical amino-acid analyses for the alpha- and beta-chains. The primary structures of both chains from the major component are given. They could be isolated by chromatography on carboxymethyl cellulose CM-52. The sequences have been determined by automatic Edman degradation of the native chains and their tryptic peptides. The comparison with human hemoglobin showed 27 substitutions in the alpha-chains and 33 in the beta-chains. In the alpha-chains one amino-acid exchange involves an alpha 1/beta 1-contact. In the beta-chains two heme- and four alpha 1/beta 1-contacts are substituted. The hemoglobin of the Sloth is compared to that of the Nine-Banded Armadillo (Dasypus novemcinctus), another representative of the order Xenerthra.

Amino Acid Sequence↗

Isospora araponga sp. n. (Apicomplexa: Eimeriidae), a new species of Isospora Schneider from a bare-throated bellbird, Procnias nudicollis (Vieillot, 1817) (Passeriformes: Cotingidae) from Brazil.

Faecal samples from a couple of bare-throated bellbirds Procnias nudicollis imported from Brazil to Barcelona Zoo contained oocysts of Isospora araponga n. sp. Sporulated oocysts were subspherical to broadly ellipsoidal, 19.5 (17-22) x 15.5 (14-16.5) microm, shape index (length:width ratio) 1.26 (1.13-1.38) with smooth and colourless bilayered wall, about 1 microm thick, and with varying number (1-3) of polar granule, but without a micropyle or residuum. The sporocysts were ellipsoidal, slightly asymmetric, 12.5 (12-13) x 8.5 (7.5-9) microm with barely visible Stieda body and indistinguishable substieda body. Sporozoites were elongated, possessing smooth surface and two distinct refractile bodies.

Animals↗

Double-blind study of nimesulide in divers with inflammatory disorders of the ear, nose and throat.

200 divers of either sex, aged 18 to 54 years, entered a double-blind study to compare the efficacy and tolerability of nimesulide 200 mg/day with those of seaprose S 60 mg/day in the treatment of nonbacterial inflammatory disorders of the ear, nose, and throat. At the end of the 1-week treatment period, both drugs were judged to be effective, with improvements and, in most cases, complete remission of all symptoms observed. Nimesulide showed greater clinical efficacy, and both drugs were well tolerated.

Adult↗

Nimesulide granules for the treatment of acute inflammation of the ear, nose or throat.

The efficacy of nimesulide (100mg twice daily) was compared with that of naproxen (500mg twice daily) in 53 adult patients with nonbacterial acute inflammation of the ear, nose or throat in a double-blind phase III clinical investigation. Both drugs were administered orally after meals for a mean duration of 8.7 days. In this setting, nimesulide was associated with relief of pain and inflammatory signs (exudation and swelling). Indeed, treatment with nimesulide led to clinical improvement superior to that obtained with naproxen in terms of both rapidity of action and improvement of the symptoms at the end of therapy. Nimesulide therapy was also very well tolerated and no patient reported an adverse event. In contrast, 2 naproxen-treated patients reported episodic gastralgia of moderate intensity.

Acute Disease↗

A comparison of nimesulide and ketoprofen in the prevention and treatment of painful postoperative inflammatory complications of ear, nose and throat surgery.

In a randomised double-blind clinical study, 76 patients undergoing major ear, nose or throat (ENT) surgery (including 45 for cancer) were treated with nimesulide (200mg twice daily) or ketoprofen (100mg twice daily) administered rectally for 5 days. Pain intensity was significantly and similarly reduced in both treatment groups compared with baseline (p = 0.0001). A significant reduction in oedema and hyperaemia was observed on the second day for nimesulide-treated patients and on the third day for those treated with ketoprofen, with complete relief being noted for almost all patients by the fifth day. Fever was resolved in all patients. Adverse events attributable to treatment were observed for 1 patient in each group. These results suggest that nimesulide provides a worthwhile alternative to other NSAIDs in the treatment of postoperative pain and inflammation associated with ENT surgery.

Adult↗

Economic evaluation of immunoprophylaxis in children with recurrent ear, nose and throat infections.

This study compares the costs of immunoprophylaxis versus no immunoprophylaxis in children with recurrent ear, nose and throat (ENT) infections (otitis media and rhinopharyngitis) using ribosomal immunotherapy ('Ribomunyl'). The per-patient cost of ribosomal immunotherapy (FF297) is offset by direct savings garnered through the prevention of many acute infectious episodes. The net 6-month per-patient savings associated with immunoprophylaxis range from FF272 to FF1704, depending on the indication and the type of treatment-cost estimate. Saved healthcare resources include physician consultations and visits, laboratory tests, medicotechnical services (audiometric tests) and antibiotic therapy. Sensitivity analysis of efficacy and treatment-cost estimates enabled threshold ranges of incremental efficacy to be identified. Cost-equivalence between the 2 treatment options was found to exist when the incremental efficacy of immunoprophylaxis lay between 7.4 and 17.5% (recurrent otitis media), and between 8.9 and 26.1% (recurrent rhinopharyngitis). Thus, even when clearly lower incremental efficacy rates than those reported in controlled clinical trials (approximately 40 to 60%) are assumed, ribosomal immunotherapy can still be expected to be cost effective. An analysis of the perspectives of the various payers in the French healthcare system demonstrated that net savings occurred for all payers involved. However, social security insurance would gain most from an immunoprophylaxis programme. Based on the evidence presented here for France, physicians and payers should give increased attention to this treatment option.

Adjuvants, Immunologic↗

[Otologic surgical procedures in an Ear, Nose and Throat Department in Subotica from 1987 to 2001].

INTRODUCTION: This paper deals with otologic surgical procedures performed in a an Ear, Nose and Throat Department during a 15-year period. The authors compared the number of otologic surgical procedures with the number of laryngomicroscopies and procedures performed in Waldeyer's ring. RESULTS: From January 1, 1987 to December 31, 2001, 1184 patients underwent the following surgical procedures in total endotracheal anesthesia: 285 paracenteses, 473 ventilation tubes insertions, 175 antrotomies or mastoidectomies, 194 tympanoplasties, 34 radical mastoidectomies, 4 facial nerve decompressions, 5 exostoses or osteoma of the external auditory canal operations and 14 stapedectomies. DISCUSSION: Otologic surgical procedures are presented in table 1. In Yugoslav literature Topolac reports approximately 700 tympanoplasties in a 10-year period (1968-1978). Radonjić and associates report 2272 ear operations in the period 1975-1985. Distribution of operations is presented in table 2, whereas in table 3 we can see that the number of operated ears is much greater than the number of operated patients. CONCLUSION: We think that the number of operations is not bigger, because we operate only in critical cases. Our human and technical resources should provide advanced ear microsurgery, but only with financial and organizational support.

Hospital Departments↗