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Neck
Published in Keith Hopcroft, Vincent Forte, Symptom Sorter, 2020
In adolescents and young adults whom you decide to treat with antibiotics for ‘strep throat’, explain that the symptoms can also be caused by other infections such as glandular fever. This will help maintain the patients’ confidence in you if they return with the sore throat persisting after the course of antibiotics.
The logic in modern medicine: Reasoning and underlying concepts
Published in Milos Jenicek, Foundations of Evidence-Based Medicine, 2019
In such an argument, cases, causes, differential diagnosis and treatment indications are poorly defined, based on poor criteria and all these considerations are not exhaustive of the reality of sore throats, their candidates, and the whole spectrum of clinical management of this problem. For example, are all cases of sore throat, ‘strep throat’? (i.e. all caused by a bacterial infection treatable by antibiotics). If not, how many patients suffer from late complications when not treated by antibiotics? Is there enough evidence available on how many of these patients benefit from treatment by antibiotics? Our novice also extends what is true of younger sufferers from sore throats to all sore throat sufferers, whatever their age may be. Skilful execution of clinical maneuvers must be based on the mastery of reasoning, which leads to their choice and real and expected performance.
Cardiovascular disorders and hypertension
Published in Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize, Developmental and Adapted Physical Education, 2019
Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize
Rheumatic heart disease can occur at any age, but usually occurs in children between 6 and 12 years of age who have had rheumatic fever. Rheumatic fever develops as a reaction to antibodies formed as a defense against streptococcal bacteria. Damage to the heart may often occur from inflammation, which causes scarring that most notably appears in the heart valves over a period of years. After children have contracted rheumatic fever, they are susceptible to repeated attacks, further increasing the probability of inflammation and scarring that may damage the heart. Rheumatic fever may be identified by symptoms such as pain in joints and muscles, poor appetite, uncontrolled movements of arms, legs, or face (twitching of muscles), frequent nosebleeds, fever, streptococcal infection, sore throat, weakness and shortness of breath, and difficulty in swallowing (World Health Organization, 2018). Penicillin and other antibiotics can usually treat strep throat and prevent acute rheumatic fever from developing. Antibiotic therapy has significantly reduced the incidence and mortality rate of rheumatic fever/rheumatic disease. Rheumatic heart disease, often neglected by the media and policy makers, is a major burden in developing countries where it causes most of the cardiovascular morbidity and mortality in young people, leading to about 250,000 deaths per year worldwide (Marijon et al., 2012).
Forget-me-not: Lemierre’s syndrome, a case report
Published in Journal of American College Health, 2023
Benjamin Silverberg, Melinda J Sharon, Devan Makati, Mariah Mott, William D Rose
The great majority of cases follow infection of the palatine tonsils or peritonsillar tissue,16,17 and there may be an association with other bacterial and viral infections such as Strep throat and Epstein-Barr mononucleosis, though this has yet to be proved conclusively.7,11,16–18,23,28 Less than 2% of cases result from ear or dental infections (e.g., otitis media, sinusitis, mastoiditis, sialadenitis).13,20 These infections are thought to cause immunosuppression and disruption of mucosal barriers, spurning the gram-negative bacillus Fusobacterium necrophorum (an obligate anaerobe previously known as Bacillus fundiliformis) to become pathogenic.9,11,31 High-grade bacteremia and septic seeding of vital organs ensues.
Vocal function exercises for normal voice: The effects of varying dosage
Published in International Journal of Speech-Language Pathology, 2019
Maria Bane, Vrushali Angadi, Emily Dressler, Richard Andreatta, Joseph Stemple
It is beyond the scope of this paper to define and differentiate the numerous terms used to describe treatment quantity. Mention of the varied terminology surrounding treatment quantity serves to illustrate the complexity and disagreement surrounding the topic of measuring behavioural intervention. For the purpose of this study and related discussion, we have chosen to define dose and dosage because they are interdependent and critical to understanding the independent variable in this study’s design. Dose is defined as a specific quantity of a therapeutic agent administered at a point in time. For example, 500 mg of an antibiotic taken for strep throat is a dose, as it represents a specific quantity of a medicine delivered at once. As previously discussed, for many behavioural interventions like VFEs, dose is difficult to define because the active ingredient(s) responsible for physiologic change is/are unknown. In other words, it is not clear whether some elements within VFEs are responsible for improvements in voice production while other elements are superfluous, or whether the entire protocol is essential to efficacy. Bearing this limitation in mind, a single dose of VFEs is defined here as a single set of four exercises consisting of the warm up, stretching, contracting, and low-impact power adductory exercise described by Stemple et al. (1994) and Roy et al. (2001). In this study, VFE dose remained constant for all groups.
Medical migration: A qualitative exploration of the atypical path of Japanese international medical graduates
Published in Medical Teacher, 2018
Brian S. Heist, Haruka Matsubara Torok
Participant 7: I did a 4-year residency at a typical Japanese hospital. Attendings are very smart and good clinicians, but they cannot verbalize what they are doing, and I felt I plateaued in my progress. Then at the ER at [another hospital where I rotated] there was [U.S. trained] Dr. K and he could clearly verbalize his thinking process. That was the first time I heard “What are your differentials?” Without thinking about a differential diagnosis I had been seeing a patient with a sore throat [for example] by looking at the throat and likely giving antibiotics. Dr. K verbalized clearly the things we should rule out: strep throat, acute epiglottitis, retropharyngeal abscess, and so on. It was eye-opening for me. And so I thought, oh, this kind of training exists in the U.S.