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[PMID]:29267506
[Au] Autor:Zhang ZJ; Zheng ML; Nie Y; Niu ZQ
[Ad] Endereço:Department of Anesthesiology, the Cangzhou Central Hospital, Cangzhou, Hebei, China.
[Ti] Título:Comparison of Arndt-endobronchial blocker plus laryngeal mask airway with left-sided double-lumen endobronchial tube in one-lung ventilation in thoracic surgery in the morbidly obese.
[So] Source:Braz J Med Biol Res;51(2):e6825, 2017 Dec 18.
[Is] ISSN:1414-431X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:This study aimed to evaluate the feasibility and performance of Arndt-endobronchial blocker (Arndt) combined with laryngeal mask airway (LMA) compared with left-sided double-lumen endobronchial tube (L-DLT) in morbidly obese patients in one-lung ventilation (OLV). In a prospective, randomized double-blind controlled clinical trial, 80 morbidly obese patients (ASA I-III, aged 20-70) undergoing general anesthesia for elective thoracic surgeries were randomly allocated into groups Arndt (n=40) and L-DLT (n=40). In group Arndt, a LMA™ Proseal was placed followed by an Arndt-endobronchial blocker. In group L-DLT, patients were intubated with a left-sided double-lumen endotracheal tube. Primary endpoints were the airway establishment, ease of insertion, oxygenation, lung collapse and surgical field exposure. Results showed similar ease of airway establishment and tube/device insertion between the two groups. Oxygen arterial pressure (PaO2) of patients in the Arndt group was significantly higher than L-DLT (154±46 vs 105±52 mmHg; P<0.05). Quality of lung collapse and surgical field exposure in the Arndt group was significantly better than L-DLT (effective rate 100 vs 90%; P<0.05). Duration of surgery and anesthesia were significantly shorter in the Arndt group (2.4±1.7 vs 3.1±1.8 and 2.8±1.9 vs 3.8±1.8 h, respectively; P<0.05). Incidence of hoarseness of voice and incidence and severity of throat pain at the post-anesthesia care unit and 12, 24, 48, and 72 h after surgery were significantly lower in the Arndt group (P<0.05). Findings suggested that Arndt-endobronchial blocker combined with LMA can serve as a promising alternative for morbidly obese patients in OLV in thoracic surgery.
[Mh] Termos MeSH primário: Intubação Intratraqueal/instrumentação
Máscaras Laríngeas/normas
Obesidade Mórbida/cirurgia
Ventilação Monopulmonar/instrumentação
Procedimentos Cirúrgicos Torácicos/instrumentação
[Mh] Termos MeSH secundário: Adulto
Idoso
Método Duplo-Cego
Desenho de Equipamento
Feminino
Seres Humanos
Intubação Intratraqueal/métodos
Masculino
Meia-Idade
Ventilação Monopulmonar/métodos
Duração da Cirurgia
Dor Pós-Operatória/etiologia
Faringite/etiologia
Estudos Prospectivos
Atelectasia Pulmonar
Reprodutibilidade dos Testes
Procedimentos Cirúrgicos Torácicos/métodos
Fatores de Tempo
Resultado do Tratamento
Ventiladores Mecânicos/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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[PMID]:29260224
[Au] Autor:Gerber JS; Ross RK; Bryan M; Localio AR; Szymczak JE; Wasserman R; Barkman D; Odeniyi F; Conaboy K; Bell L; Zaoutis TE; Fiks AG
[Ad] Endereço:Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
[Ti] Título:Association of Broad- vs Narrow-Spectrum Antibiotics With Treatment Failure, Adverse Events, and Quality of Life in Children With Acute Respiratory Tract Infections.
[So] Source:JAMA;318(23):2325-2336, 2017 12 19.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Acute respiratory tract infections account for the majority of antibiotic exposure in children, and broad-spectrum antibiotic prescribing for acute respiratory tract infections is increasing. It is not clear whether broad-spectrum treatment is associated with improved outcomes compared with narrow-spectrum treatment. Objective: To compare the effectiveness of broad-spectrum and narrow-spectrum antibiotic treatment for acute respiratory tract infections in children. Design, Setting, and Participants: A retrospective cohort study assessing clinical outcomes and a prospective cohort study assessing patient-centered outcomes of children between the ages of 6 months and 12 years diagnosed with an acute respiratory tract infection and prescribed an oral antibiotic between January 2015 and April 2016 in a network of 31 pediatric primary care practices in Pennsylvania and New Jersey. Stratified and propensity score-matched analyses to account for confounding by clinician and by patient-level characteristics, respectively, were implemented for both cohorts. Exposures: Broad-spectrum antibiotics vs narrow-spectrum antibiotics. Main Outcomes and Measures: In the retrospective cohort, the primary outcomes were treatment failure and adverse events 14 days after diagnosis. In the prospective cohort, the primary outcomes were quality of life, other patient-centered outcomes, and patient-reported adverse events. Results: Of 30 159 children in the retrospective cohort (19 179 with acute otitis media; 6746, group A streptococcal pharyngitis; and 4234, acute sinusitis), 4307 (14%) were prescribed broad-spectrum antibiotics including amoxicillin-clavulanate, cephalosporins, and macrolides. Broad-spectrum treatment was not associated with a lower rate of treatment failure (3.4% for broad-spectrum antibiotics vs 3.1% for narrow-spectrum antibiotics; risk difference for full matched analysis, 0.3% [95% CI, -0.4% to 0.9%]). Of 2472 children enrolled in the prospective cohort (1100 with acute otitis media; 705, group A streptococcal pharyngitis; and 667, acute sinusitis), 868 (35%) were prescribed broad-spectrum antibiotics. Broad-spectrum antibiotics were associated with a slightly worse child quality of life (score of 90.2 for broad-spectrum antibiotics vs 91.5 for narrow-spectrum antibiotics; score difference for full matched analysis, -1.4% [95% CI, -2.4% to -0.4%]) but not with other patient-centered outcomes. Broad-spectrum treatment was associated with a higher risk of adverse events documented by the clinician (3.7% for broad-spectrum antibiotics vs 2.7% for narrow-spectrum antibiotics; risk difference for full matched analysis, 1.1% [95% CI, 0.4% to 1.8%]) and reported by the patient (35.6% for broad-spectrum antibiotics vs 25.1% for narrow-spectrum antibiotics; risk difference for full matched analysis, 12.2% [95% CI, 7.3% to 17.2%]). Conclusions and Relevance: Among children with acute respiratory tract infections, broad-spectrum antibiotics were not associated with better clinical or patient-centered outcomes compared with narrow-spectrum antibiotics, and were associated with higher rates of adverse events. These data support the use of narrow-spectrum antibiotics for most children with acute respiratory tract infections.
[Mh] Termos MeSH primário: Antibacterianos/efeitos adversos
Otite Média/tratamento farmacológico
Qualidade de Vida
Infecções Respiratórias/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Combinação Amoxicilina e Clavulanato de Potássio/efeitos adversos
Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico
Antibacterianos/uso terapêutico
Cefalosporinas/efeitos adversos
Cefalosporinas/uso terapêutico
Criança
Pré-Escolar
Feminino
Seres Humanos
Macrolídeos/efeitos adversos
Macrolídeos/uso terapêutico
Masculino
Faringite/tratamento farmacológico
Atenção Primária à Saúde
Estudos Retrospectivos
Sinusite/tratamento farmacológico
Infecções Estreptocócicas/tratamento farmacológico
Streptococcus pyogenes
Falha de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cephalosporins); 0 (Macrolides); 74469-00-4 (Amoxicillin-Potassium Clavulanate Combination)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.18715


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[PMID]:29384933
[Au] Autor:Jin Y; Ying J; Zhang K; Fang X
[Ad] Endereço:Department of Anesthesiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou.
[Ti] Título:Endotracheal intubation under video laryngoscopic guidance during upper gastrointestinal endoscopic surgery in the left lateral position: A randomized controlled trial.
[So] Source:Medicine (Baltimore);96(52):e9461, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients undergoing upper gastrointestinal endoscopic surgeries are generally placed in the left lateral position and require endotracheal intubation to maintain airway patency. We conducted a prospective, randomized, controlled study to evaluate the feasibility of intubation under video laryngoscopic guidance in the left lateral position during upper gastrointestinal endoscopic surgery. METHODS: We compared the data of patients (n = 120) who underwent intubation under video laryngoscopic guidance in the supine or left lateral position. Patients in Group S (n = 59) were initially placed in the supine position and then shifted to the left lateral position after airway establishment. Patients in Group L (n = 61) were placed in the left decubitus position during both induction and intubation. Laryngoscopic view, intubation time, success rate, hemodynamic changes, adverse effects, and complications of intubation were compared between the groups. RESULTS: The 2 groups showed no difference in terms of time required for intubation (Group L, 23.95 ±â€Š4.43 seconds and Group S, 23.44 ±â€Š4.78 seconds; P = .545) and number of intubation attempts. Further, the overall rate of intubation success was 100% in both groups. However, Group S exhibited significant hemodynamic changes during shift of decubitus (P < .001) and severe sore throat (P = .030). The incidences of other adverse effects such as productive cough, dryness of mouth, hoarseness, oral mucosal injury, dental injury, and hypoxia in the 2 groups were comparable. CONCLUSION: We concluded that intubation in the lateral position under video laryngoscopic guidance is safe and feasible performed in the left lateral position and prevents the hemodynamic change and sore throat resulting from change in decubitus.
[Mh] Termos MeSH primário: Endoscopia Gastrointestinal/métodos
Intubação Intratraqueal/efeitos adversos
Intubação Intratraqueal/métodos
Laringoscopia/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Manuseio das Vias Aéreas/instrumentação
Manuseio das Vias Aéreas/métodos
Feminino
Hemodinâmica
Rouquidão
Seres Humanos
Laringoscopia/instrumentação
Masculino
Meia-Idade
Faringite
Estudos Prospectivos
Decúbito Dorsal
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009461


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[PMID]:29351278
[Au] Autor:Atkinson TP; Centor RM; Xiao L; Wang F; Cui X; Van Der Pol W; Morrow CD; Ratliff AE; Crabb DM; Totten AH; Estrada CA; Faircloth MB; Waites KB
[Ad] Endereço:Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
[Ti] Título:Analysis of the tonsillar microbiome in young adults with sore throat reveals a high relative abundance of Fusobacterium necrophorum with low diversity.
[So] Source:PLoS One;13(1):e0189423, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Fusobacterium necrophorum (Fn), a gram-negative anaerobe, is increasingly implicated as an etiologic agent in older adolescents and young adults with sore throat. Inadequately treated Fn pharyngitis may result in suppurative complications such as peritonsillar abscess and Lemierre's syndrome. Data from the literature suggest that the incidence of life-threating complications in these age groups from Fn pharyngitis (Lemierre's syndrome) in the United States exceeds those associated with group A beta-hemolytic streptococcal (GAS) pharyngitis (acute rheumatic fever). Using real-time PCR, we previously reported about a 10% prevalence of Fn in asymptomatic medical students and about 20% in students complaining of sore throat at a university student health clinic (p = 0.009). In this study, a comprehensive microbiome analysis of the same study samples confirms that Fn pharyngitis was more common than GAS pharyngitis. Eighteen patients were found to have Fn OTU values exceeding an arbitrary cutoff value of 0.1, i.e. greater than 10% of total sequences, with five subjects reaching values above 0.7. By contrast only 9 patients had GAS OTU values greater than 0.1 and none exceeded 0.6. When the data were analyzed using five separate assessments of alpha diversity, in each case for Fn there were statistically significant differences between Fn positive_high (OTU abundance > 0.1) vs control, Fn positive_high vs Fn negative (OTU abundance = 0), Fn positive_high vs Fn positive_low (OTU abundance > 0 and < 0.1). When the data were analyzed using three beta diversity indexes (Bray-Curtis, weighted unifrac, and unweighted unifrac), there were statistically significant differences between Fn positive_high (OTU abundance ≥ 0.1) vs control for all three. Statistically significant differences remained if we chose somewhat different OTU abundance cutoffs of 0.05 or 0.15. We conclude that Fn appears to play a dominant role in bacterial pharyngitis in the older adolescent and young adult age groups and that the development of a productive mucosal infection with Fn is linked to a significant decrease in the diversity of the associated tonsillar microbiome.
[Mh] Termos MeSH primário: Fusobacterium necrophorum/fisiologia
Microbiota
Tonsila Palatina/microbiologia
Faringite/microbiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Casos e Controles
Feminino
Fusobacterium necrophorum/genética
Sequenciamento de Nucleotídeos em Larga Escala
Seres Humanos
Masculino
RNA Ribossômico 16S/genética
Reação em Cadeia da Polimerase em Tempo Real
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (RNA, Ribosomal, 16S)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189423


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[PMID]:29255098
[Au] Autor:Little P; Stuart B; Wingrove Z; Mullee M; Thomas T; Johnson S; Leydon G; Richards-Hall S; Williamson I; Yao L; Zhu S; Moore M
[Ad] Endereço:Primary Care Group (Little, Stuart, Wingrove, Mullee, Thomas, Johnson, Leydon, Williamson, Moore); Health Economic Analyses Team (Yao, Zhu), Primary Care and Population Sciences Unit, University of Southampton; Patient and Public Involvement Collaborator (Richards-Hall), Southampton, UK P.Little@sot
[Ti] Título:Probiotic capsules and xylitol chewing gum to manage symptoms of pharyngitis: a randomized controlled factorial trial.
[So] Source:CMAJ;189(50):E1543-E1550, 2017 Dec 18.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Reducing the use of antibiotics for upper respiratory tract infections is needed to limit the global threat of antibiotic resistance. We estimated the effectiveness of probiotics and xylitol for the management of pharyngitis. METHODS: In this parallel-group factorial randomized controlled trial, participants in primary care (aged 3 years or older) with pharyngitis underwent randomization by nurses who provided sequential intervention packs. Pack contents for 3 kinds of material and advice were previously determined by computer-generated random numbers: no chewing gum, xylitol-based chewing gum (15% xylitol; 5 pieces daily) and sorbitol gum (5 pieces daily). Half of each group were also randomly assigned to receive either probiotic capsules (containing 24 × 10 colony-forming units of lactobacilli and bifidobacteria) or placebo. The primary outcome was mean self-reported severity of sore throat and difficulty swallowing (scale 0-6) in the first 3 days. We used multiple imputation to avoid the assumption that data were missing completely at random. RESULTS: A total of 1009 individuals consented, 934 completed the baseline assessment, and 689 provided complete data for the primary outcome. Probiotics were not effective in reducing the severity of symptoms: mean severity scores 2.75 with no probiotic and 2.78 with probiotic (adjusted difference -0.001, 95% confidence interval [CI] -0.24 to 0.24). Chewing gum was also ineffective: mean severity scores 2.73 without gum, 2.72 with sorbitol gum (adjusted difference 0.07, 95% CI -0.23 to 0.37) and 2.73 with xylitol gum (adjusted difference 0.01, 95% CI -0.29 to 0.30). None of the secondary outcomes differed significantly between groups, and no harms were reported. INTERPRETATION: Neither probiotics nor advice to chew xylitol-based chewing gum was effective for managing pharyngitis. ISRCTN, no. ISRCTN51472596.
[Mh] Termos MeSH primário: Anti-Infecciosos Locais/uso terapêutico
Goma de Mascar
Faringite/tratamento farmacológico
Probióticos/uso terapêutico
Xilitol/uso terapêutico
[Mh] Termos MeSH secundário: Bifidobacterium bifidum
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactobacillus acidophilus
Masculino
Faringite/prevenção & controle
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Infective Agents, Local); 0 (Chewing Gum); VCQ006KQ1E (Xylitol)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.170599


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[PMID]:28469122
[Au] Autor:Adoga AA; Okwori ET; Yaro JP; Iduh AA
[Ad] Endereço:Department of Otorhinolaryngology, Head and Neck Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
[Ti] Título:Pediatric otorhinolaryngology emergencies at the Jos University Teaching Hospital: Study of frequency, management, and outcomes.
[So] Source:Ann Afr Med;16(2):81-84, 2017 Apr-Jun.
[Is] ISSN:0975-5764
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Studies from Nigeria on pediatric otorhinolaryngology (ORL) emergencies are rare in literature with most focusing on emergencies involving individual systems. OBJECTIVE: The aim of this study is to determine the prevalence of all ORL emergencies among children in our region to provide a baseline data for future health planning. PATIENTS AND METHODS: This is a 1-year retrospective cross-sectional study of patients aged 16 years and below presenting to the Accident and Emergency Department of the Jos University Teaching Hospital, Jos, Nigeria. RESULTS: A total of 203 otolaryngology emergencies were attended of which 129 (63.5%) were pediatric emergencies. Records of 87 patients were retrievable with age range 2 months to 15 years (mean 3.44 years; standard deviation ± 3.35). There were 55 males and 32 females with a male to female ratio of 1.7:1. The majority of cases were aged under 5 years (64; 73.6%). Acute tonsillitis accounted for 32 (36.7%) cases with 6 (6.9%) having peritonsillar abscesses. Acute pharyngitis accounted for 11 (12.6%) presentations followed closely by foreign bodies (FBs) in the ear with 10 (11.5%) presentations. FB in the throat occurred in 4 (4.6%) patients who had removal under general anesthesia. Three (3.4%) cases of maxillofacial injuries occurred as a result of insurgent terror attacks and 3.4% presented following corrosive substance ingestion. Conservative management was commenced in 76 (87.4%) patients, 23 (26.4%) had surgery with 68 (78.2%) admitted and discharged, 18 (20.7%) treated as outpatients, and 1 (1.1%) died on admission. Otolaryngologists attended most (95.4%) patients. CONCLUSION: Pediatric ORL emergencies are common in our region involving a wide range of pathologies. Expansion is required in the ORL training of the emergency room physician to enhance emergency services.
[Mh] Termos MeSH primário: Emergências/epidemiologia
Corpos Estranhos/epidemiologia
Otolaringologia
Faringite/epidemiologia
Tonsilite/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Estudos Transversais
Serviço Hospitalar de Emergência
Feminino
Hospitais de Ensino
Hospitais Universitários
Seres Humanos
Masculino
Nigéria/epidemiologia
Estudos Retrospectivos
Distribuição por Sexo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.4103/aam.aam_21_16


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[PMID]:27772680
[Au] Autor:Wawrzyniak M; Eilbert W
[Ad] Endereço:University of Illinois Affiliate Hospitals Residency Program, University of Illinois at Chicago College of Medicine, Chicago, IL.
[Ti] Título:Child With Sore Throat.
[So] Source:Ann Emerg Med;68(5):638-647, 2016 Nov.
[Is] ISSN:1097-6760
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Faringite/etiologia
Infecções Estreptocócicas/diagnóstico
Streptococcus pyogenes
[Mh] Termos MeSH secundário: Criança
Seres Humanos
Masculino
Faringite/patologia
Faringite/terapia
Infecções Estreptocócicas/complicações
Infecções Estreptocócicas/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28931508
[Au] Autor:Sadeghirad B; Siemieniuk RAC; Brignardello-Petersen R; Papola D; Lytvyn L; Vandvik PO; Merglen A; Guyatt GH; Agoritsas T
[Ad] Endereço:Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada sadeghb@mcmaster.ca.
[Ti] Título:Corticosteroids for treatment of sore throat: systematic review and meta-analysis of randomised trials.
[So] Source:BMJ;358:j3887, 2017 Sep 20.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo: To estimate the benefits and harms of using corticosteroids as an adjunct treatment for sore throat. Systematic review and meta-analysis of randomised control trials. Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), trial registries up to May 2017, reference lists of eligible trials, related reviews. Randomised controlled trials of the addition of corticosteroids to standard clinical care for patients aged 5 or older in emergency department and primary care settings with clinical signs of acute tonsillitis, pharyngitis, or the clinical syndrome of sore throat. Trials were included irrespective of language or publication status. Reviewers identified studies, extracted data, and assessed the quality of the evidence, independently and in duplicate. A parallel guideline committee ( Rapid Recommendation) provided input on the design and interpretation of the systematic review, including the selection of outcomes important to patients. Random effects model was used for meta-analyses. Quality of evidence was assessed with the GRADE approach. 10 eligible trials enrolled 1426 individuals. Patients who received single low dose corticosteroids (the most common intervention was oral dexamethasone with a maximum dose of 10 mg) were twice as likely to experience pain relief after 24 hours (relative risk 2.2, 95% confidence interval 1.2 to 4.3; risk difference 12.4%; moderate quality evidence) and 1.5 times more likely to have no pain at 48 hours (1.5, 1.3 to 1.8; risk difference 18.3%; high quality). The mean time to onset of pain relief in patients treated with corticosteroids was 4.8 hours earlier (95% confidence interval -1.9 to -7.8; moderate quality) and the mean time to complete resolution of pain was 11.1 hours earlier (-0.4 to -21.8; low quality) than in those treated with placebo. The absolute pain reduction at 24 hours (visual analogue scale 0-10) was greater in patients treated with corticosteroids (mean difference 1.3, 95% confidence interval 0.7 to 1.9; moderate quality). Nine of the 10 trials sought information regarding adverse events. Six studies reported no adverse effects, and three studies reported few adverse events, which were mostly complications related to disease, with a similar incidence in both groups. Single low dose corticosteroids can provide pain relief in patients with sore throat, with no increase in serious adverse effects. Included trials did not assess the potential risks of larger cumulative doses in patients with recurrent episodes of acute sore throat. PROSPERO CRD42017067808.
[Mh] Termos MeSH primário: Corticosteroides/uso terapêutico
Faringite/tratamento farmacológico
[Mh] Termos MeSH secundário: Corticosteroides/efeitos adversos
Dexametasona/efeitos adversos
Dexametasona/uso terapêutico
Esquema de Medicação
Seres Humanos
Faringite/complicações
Tonsilite/complicações
Tonsilite/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 7S5I7G3JQL (Dexamethasone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170922
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j3887


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[PMID]:28906414
[Au] Autor:Lee J; Lee YC; Son JD; Lee JY; Kim HC
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
[Ti] Título: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.
[So] Source:Medicine (Baltimore);96(37):e8094, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo: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.
[Mh] Termos MeSH primário: Anestesia Geral/instrumentação
Anestésicos Locais/administração & dosagem
Intubação Intratraqueal/efeitos adversos
Lidocaína/administração & dosagem
Faringite/tratamento farmacológico
Complicações Pós-Operatórias/tratamento farmacológico
[Mh] Termos MeSH secundário: Anestesia Geral/efeitos adversos
Tosse/tratamento farmacológico
Tosse/epidemiologia
Tosse/etiologia
Feminino
Rouquidão/tratamento farmacológico
Rouquidão/epidemiologia
Rouquidão/etiologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Faringite/epidemiologia
Faringite/etiologia
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Local); 98PI200987 (Lidocaine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008094


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[PMID]:28904657
[Au] Autor:Gemechu BM; Gebremedhn EG; Melkie TB
[Ad] Endereço:Department of Anaesthesia, School of Medicine, Gondar College of Medicine and Health Sciences, the University of Gondar, Gondar, Ethiopia.
[Ti] Título:Risk factors for postoperative throat pain after general anaesthesia with endotracheal intubation at the University of Gondar Teaching Hospital, Northwest Ethiopia, 2014.
[So] Source:Pan Afr Med J;27:127, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo: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.
[Mh] Termos MeSH primário: Anestesia Geral/métodos
Intubação Intratraqueal/efeitos adversos
Faringite/epidemiologia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Estudos Transversais
Etiópia
Feminino
Hospitais Universitários
Seres Humanos
Intubação Intratraqueal/métodos
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.127.10566



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