Neck
A Sahib El-Radhi, James Carroll in Paediatric Symptom Sorter, 2017
Sore throat and mouth are usually due to inflammatory or infective causes. The most common cause in young children is by far a viral upper respiratory tract infection (URTI). An infection rate of 6–8 infections a year is very common. Higher incidence is found in infants and children who attend daycare and whose siblings attend daycare or school. Acute tonsillopharyngitis refers to the tonsilo-pharynx as the principal site of the inflammatory process. Viruses (e.g. adenoviruses, Epstein-Barr viruses (EBV)) and bacteria (e.g. group A β-haemolytic streptococci (GAHS)) have overlapping symptoms and signs, and clinically they are often indistinguishable from one another. Tonsillopharyngitis is uncommon in children younger than 1 year of age; it peaks at the age of 4–7 years and continues throughout later childhood. Examination of the mouth should include the gingiva, buccal mucosa, tongue, teeth, hard and soft palate and posterior pharyngeal wall.
What Promotes Joy
Eve Shapiro in Joy in Medicine?, 2020
I don’t feel burned out now. Number one, I reduced my workload. Instead of seeing 24–30 patients a day I see close to only 16 patients a day. I can sit and listen to my patients, discuss with them and sort out their problems. I have modified my schedule. My schedule is 20/40: I see one patient for 20 minutes, the next one for 40 minutes. So even if a patient comes in with a small problem like a sore throat, I take advantage of the time. Sore throat treatment may take three to five minutes. But I take the next 15 minutes to talk to the patient and identify those clinical gaps that need to be filled: we talk about their need for a colonoscopy or a mammogram, for example. I have more time now. I don’t have to rush through and write notes and all those other things.
Decision analysis and decision-making in medicine: Beyond intuition, guts and flair
Milos Jenicek in Foundations of Evidence-Based Medicine, 2019
Clinical algorithms arestep-by-step written protocols for health management.80They consist ofan explicit description of steps to be taken in patient care in specified circumstances.12 What diagnostic and therapeutic steps should be taken to properly treat a sore throat? How should a case of multiple trauma in (and en route to) an emergency room be managed? Clinical algorithms are a specific category of algorithms in general. Algorithm is defined as ‘an alteration’. It is derived from arithmetic, and algorism, from edictal Latin algorismus, the latter derived from the Arabic Al-Khuwarizmi, system of numerals, identified by the name of Al-Khuwarizmi, a ninth-century Persian mathematician.81 It is ‘a set of rules for approaching the solution to a complex problem by setting down individual steps and delineating how each step follows from the preceding one’.82 Its character as a ‘uniform procedure’82 and a ‘finite number of steps’ for a solution of a given specific problem83 are usually stressed. An algorithm, or a process that is ‘in one's head’, may be made concrete through different forms: Algebraic notation, computer program or graphical form. The two most widely used graphical forms of algorithms are flowcharts and decision tables. The term ‘algorithm’ will be used here to refer to its flowchart form, which is best known to nonmathematical minds.
Complaint-driven preferences & trust: patient’s views on consulting GP trainees
Published in Education for Primary Care, 2022
Sarah de Bever, Suzanne C. van Rhijn, Anneke Wilhelmina Maria Kramer, Jettie Bont, Nynke van Dijk, Mechteld Renée Maria Visser
For this study we define a presenting complaint as the reason why a patient visits a GP. This can be related to a symptom, like a sore throat, or to a specific disease, such as a review of diabetes. Every complaint is related to specific preferences regarding timeliness, availability, gender concordance or having a longitudinal, personal relationship with the doctor. Patients attending with a minor ailment prioritise the timeliness of their appointment. If a complaint is urgent, availability is prioritised. Patients with sexual health problems tended to prefer gender concordance when choosing a doctor. It depends on the urgency. For urgent matters you have to consult the substitute, whoever that may be. For matters that can wait, if the preferred doctor is on a skiing holiday, you wait until he is back. (Participant 2)I find a female doctor a little more pleasant [to consult], but that’s personal. Because she understands better how females and hormones work and what troubles you have if you’re going through menopause. (Participant 15)
Non-interventional observational study broadens positive benefit-risk assessment of an immunomodulating herbal remedy in the common cold
Published in Current Medical Research and Opinion, 2019
Hans-Heinrich Henneicke-von Zepelin, Petra Nicken, Belal Naser, Jennifer-Christin Kuchernig, Nicole Brien, Annette Holtdirk, Jörg Schnitker, Klaus-Ulrich Nolte
The primary outcome was the risk-benefit ratio of the herbal remedy under everyday conditions. The “benefit” was based on the diary records of the cold symptoms and overall assessment of efficacy. The cold symptoms were combined into a global cold score (item “overall severity of the cold”), a rhinitis score (mean of items “blocked nose”, “runny nose”, “I often have to blow my nose” and “I often have to sneeze”), a bronchitis score (mean of items “cough”, “hoarseness”, “productive cough” and “pain in the chest area”), a general complaints score (item “aching head and limbs”) and a total score. The symptom “sore throat/swallowing difficulties” was analyzed separately. The “risk” comprised adverse drug reactions during the treatment and the patient’s overall assessment of tolerability.
Novel approaches to decrease inappropriate ambulatory antibiotic use
Published in Expert Review of Anti-infective Therapy, 2019
Theresa A. Rowe, Jeffrey A. Linder
These data suggesting that delayed prescriptions reduce antibiotic prescriptions, but for most ambulatory patients, the use of delayed antibiotic prescriptions is conceptually flawed[78]. First, delayed antibiotic prescriptions are often used for viral infections like the common cold, acute bronchitis, and viral pharyngitis. Second, guidelines are clear about which patients with respiratory infections should receive antibiotics [76,79–82]. Third, delayed antibiotic prescriptions – most often given with the instructions to use the antibiotic if the patient is not feeling better ‘in a few days’ – ignores the natural history of viral infections. For example, the common cold can last 2 weeks. Acute bronchitis lasts 3 weeks. The sore throat from viral pharyngitis typically lasts 5 days. Fourth, delayed antibiotics place the clinical decision-making burden of antibiotic use on patients. Fifth, some patients may fill the prescription regardless of the progression of their symptoms. Sixth, delayed antibiotic prescriptions introduce the risk that patients with worsening or changing symptoms will take the antibiotics rather than seeking medical care. Finally, and perhaps most importantly, delayed antibiotic prescriptions send a mixed message to patients and confuses patients about the appropriate use of antibiotics[83].
Related Knowledge Centers
- Antibiotic
- Antimicrobial Resistance
- Dehydration
- Inflammation
- Pharyngitis
- Tonsillitis
- Tonsil
- Throat
- Viral Disease
- Group A Streptococcal Infection