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At least 775 records · Page 43Linked to original sources
PubMed1994

Influence of late side-effects upon daily life after radiotherapy for laryngeal and pharyngeal cancer.

The influence on daily life from long-term side-effects was studied in patients treated more than 5 years ago with radiotherapy for laryngeal and pharyngeal cancer. Forty-six patients were asked to participate in telephone interviews and 44 participated. Only a minority (10%) stated serious problems related to the treatment. Problems related to the voice and severe xerostomia were especially mentioned. Half of the patients treated for pharyngeal cancer, complained of xerostomia and had occasionally a feeling of being handicapped. Social relations were impaired in 10% of the patients and 10% had retired due to their cancer or therapy related side-effects. It is concluded that radiotherapy seems to be a well tolerated treatment with relatively little impairment of the daily life in patients with laryngeal cancer. In patients with pharyngeal cancer, xerostomia is a major problem, which often persists more than 5 years after treatment.

Activities of Daily Living↗
PubMed2000

Radiotherapy for carcinoma of the posterior pharyngeal wall.

Posterior pharyngeal carcinoma has an extremely poor prognosis regardless of the method of treatment. The purpose of this study was to assess the local control and survival in patients with carcinoma of the posterior pharyngeal wall treated with definitive radiotherapy and to determine prognostic factors which may be relevant to the current UICC staging classification. Between January 1991 and December 1995, 22 patients with a mean age of 60 years (range 44-82) received definitive radiotherapy, using a homogeneous technique, for carcinoma of the posterior pharyngeal wall. The median follow-up was 42 months (range 25-66). The overall 3-year survival and local control for the whole group was 50% and 73% respectively. Patients with early stage (T1 and T2) disease had a significantly better overall 3-year survival rate of 77% compared to 11% for patients with advanced stage (T3 and T4) disease (p=0.0010). Similarly, patients with early stage disease had a significantly improved 3-year local control rate compared to patients with more advanced stage disease (92% and 44% respectively, p=0.0080). Patients with node positive disease had an inferior survival rate of 29% compared to 60% for those with node negative disease though the difference did not reach statistical significance. In addition only one patient with initial node negative disease had isolated nodal relapse. There was no significant late morbidity. For patients with early stage disease we have obtained local control and survival rates comparable to other groups with a once daily, short fractionation radiotherapy scheme but with reduced morbidity. In late stage disease altered fractionation schemes should be considered in order to achieve better local control and survival. Isolated nodal relapse was not a significant problem in this cohort of patients. Outcome correlates with primary tumour size and this is reflected in the current UICC staging classification.

Adult↗
PubMed2006

Microbiological diagnosis of streptococcal pharyngitis: lacunae and their implications.

Post-streptococcal sequelae, especially acute rheumatic fever/rheumatic heart disease continue to occur in significant proportions in many parts of the world. Despite several attempts with various intervention strategies, little success has been achieved in the control of acute rheumatic fever/rheumatic heart disease in India. The success of the control programmes depends upon timely primary prophylaxis with benzathine penicillin for which a microbiological confirmation of group A streptococcal pharyngitis is essential. Isolation of beta hemolytic streptococci from throat cultures and their identification as GAS in the laboratory, clinches the microbiological diagnosis while demonstration of a 'significant rise' in antibody titers such as Anti-streptolysin O and Anti-deoxyribonuclease B differentiates it from a group A streptococcal carrier state or pharyngitis of a viral etiology. Despite the easiness with which these can be achieved, many laboratories in India are not equipped to do so. Enhancing bacteriological and serological facilities in laboratories across the country will drastically improve the clinician's ability to diagnose bona fide GAS pharyngitis and help to institute penicillin prophylaxis at the appropriate time. This will go a long way in enhancing the compliance to penicillin prophylaxis which is the cornerstone of any RF/RHD control program.

Culture Media↗
PubMed1992

Oral, pharyngeal and laryngeal cancer as a cause of death among Swiss cooks.

In an analysis of Swiss mortality data (1979-1987) excess mortality due to oral, pharyngeal and laryngeal cancer was found among cooks, and the rate was very high in the age group < 55 years. The peak number of cases was observed among cooks in the age category 45-49 years. In the standard population the highest number of such deaths was observed between 65 and 69 years of age. The numbers of alcohol-related causes of death were also elevated among the cooks, while the numbers of smoking-related deaths were not. Although the dominant role of combined alcohol and tobacco consumption for the development of oral, pharyngeal and laryngeal cancer has been confirmed by many studies, other factors (eg, volatile carcinogenic compounds formed during the cooking process) may contribute to the excess mortality from oral, pharyngeal and laryngeal cancer among cooks. The question of the relevance of such factors will have to be answered by further studies.

Age Factors↗
PubMed1986

Throat cultures and rapid tests for diagnosis of group A streptococcal pharyngitis.

This article reviews the use of diagnostic tests to guide management of adults with sore throats. Pharyngitis due to group A beta-hemolytic streptococci represents the major diagnostic concern in these patients. Organisms other than group A streptococci can cause pharyngitis, but their clinical importance and their diagnostic tests have not yet been established. For many years, physicians have used routine throat cultures to diagnose group A streptococcal pharyngitis. Rapid tests have recently been introduced that detect the group A streptococcal antigen on throat swab specimens. Because both tests have high sensitivity and specificity, the choice of tests may depend on test turnaround time. Rapid tests should improve management by decreasing both short-term morbidity and inappropriate use of antibiotics.

Antigens, Bacterial↗
PubMed1989

Pharyngitis in adults: the presence and coexistence of viruses and bacterial organisms.

STUDY OBJECTIVE: To determine the presence and coexistence of viruses and bacterial organisms causing pharyngitis in adults. DESIGN: Open study using diagnostic methods, including rapid antigen-detection techniques, to test for the presence of viruses of the respiratory tract, as well as Mycoplasma pneumoniae. Chlamydia trachomatis, the Chlamydia species strain TWAR, and beta-hemolytic streptococci. SETTING: Open health care. PATIENTS: One hundred six consecutive adult patients, 15 to 65 years old, whose chief complaint was sore throat. MAIN RESULTS: Of the 106 patients, beta-hemolytic streptococci were found in only 24 patients (5 patients with group A streptococci, 13 with group C, 5 with group G, and 1 with group F); M. pneumoniae was found in 10 patients, the Chlamydia species strain TWAR in 9 patients, and viruses in 27 patients. Two microbes were simultaneously isolated in 3 patients, and no microbial findings were detected in 33 patients. CONCLUSION: Because 19 patients were infected with the Chlamydia species strain TWAR and M. pneumoniae, and 24 patients were infected with beta-hemolytic streptococci, the diagnostic procedures and therapies for adult patients with pharyngitis need to be reconsidered. The results of our study also confirm earlier suggestions that the Chlamydia species strain TWAR alone is a causative agent for pharyngitis in adults.

Adolescent↗
PubMed1979

Streptococcal pharyngitis: diagnosis by gram stain.

Group A beta-hemolytic streptococci were isolated from 49 (10.4%) of 472 patients with pharyngitis. Throat culture results, interpreted by five observers of varying experience, showed the mean sensitivity, specificity, and predictive value of a positive Gram-stained smear of pharyngeal secretions as 73%, 96%, and 71%. Assignment to a high-risk group by clinical algorithm gave sensitivity, specificity, and predictive value of only 45%, 83%, and 23%. The Gram-stained smear is the most accurate method of early diagnosis of streptococcal pharyngitis.

Adolescent↗
PubMed1981

Pseudodiphtheria: prominent pharyngeal membrane associated with fatal paraquat ingestion.

Three patients presented with prominent pharyngeal membranes suggestive of tonsillar-pharyngeal diphtheria, but later found to be caused by oral ingestion of the herbicide paraquat. In all cases appropriate therapy was delayed because of failure to include paraquat in the differential diagnosis: Paraquat ingestion should be considered in all patients with prominent tongue and pharyngeal membranes.

Adult↗
PubMed1983

Yersinia enterocolitica pharyngitis.

During the investigation of a large multistate outbreak of milk-borne yersiniosis, 14 patients who presented with pharyngitis had Yersinia enterocolitica isolated from the throat. Their illness was characterized by sore throat and fever without enteritis; 3 needed hospitalization. All patients tested had leukocytosis and an elevated convalescent-phase serum titer against the outbreak strain. In contrast to patients with enteritis, who were children, all patients with pharyngitis were adults. Thus, Y. enterocolitica may be responsible for some sporadic cases of pharyngitis in which the throat culture is negative for other pathogens.

Adolescent↗
PubMedDate not supplied

Alternative diagnostic method for streptococcal pharyngitis: Breese scoring system.

This study was performed to determine the effectiveness of the Breese scoring system for the diagnosis of streptococcal pharyngitis with respect to different age groups. Two hundred and two children aged three years and younger (Group 1), and 514 children over three years old (Group 2) with complaints of acute pharyngitis were evaluated by Breese scoring and throat-swab cultures. In Group 1, no significant difference was detected in Breese scoring between subjects who had positive and negative culture for group A beta-hemolytic streptococci (GABHS). However, in Group 2 the mean value of the Breese scores was found to be higher in subjects who had positive GABHS. The diagnostic value of Breese scoring was examined for each group. Its sensitivity, and positive and negative predictive values were higher in Group 2 than in Group 1. In conclusion, Breese scoring was determined to be helpful in the diagnosis of streptococcal pharyngitis in children over three years of age.

Adolescent↗
PubMed1975

Recognition of streptococcal pharyngitis in adults.

In order to devise a strategy for the management of acute pharyngitis, the clinical features of 418 adults with sore throat were noted and throat cultures were obtained. Patients with cultures positive for group A beta-hemolytic streptococci had a significantly higher (P less than or equal to .01) frequency of recent exposure to streptococcal infection, pharyngeal exudate, enlarged or tender cervical nodes, and high fever (greater than or equal to 38.3 C [101 F]. Patients with negative cultures complained more frequently of cough. On the basis of these symptoms and signs, a clinical algorithm was developed and discriminant function scores were computed that identify patient populations with different probabilities of having streptococcal pharyngitis. The patients with moderate and high probabilities included 91% of patients with positive cultures but only 67% of the total patient population. These methods could be the basis for more efficient evaluation of adults with sore throat.

Adolescent↗
PubMed2000

High pharyngeal carriage rates of Streptococcus pyogenes in Dunedin school children with a low incidence of rheumatic fever.

AIM: To document the incidence and type distribution of Streptococcus pyogenes in a group of Dunedin children throughout the 1997 school year. METHODS: The 780 children recruited from ten primary schools had their throats swabbed on each reporting of pharyngitis. Additional pharyngeal swabbings were obtained monthly from a representative subset of these children, referred to as group 1. All swab samples were plated on CNA-P, a blood agar medium that facilitates detection of haemolytic streptococci. S. pyogenes isolates were classified according to the RFLP patterns of PCR products of their emm genes (ERP typing). Representative isolates of each ERP pattern were also emm-typed, a sequence typing method that correlates with serological M-typing. RESULTS: 28% of the group 1 children were found to carry S. pyogenes for more than two months. This carriage rate is similar to that previously detected in Dunedin and Waikato schoolchildren, but is higher than that generally reported in other countries. Although the predominant S. pyogenes types detected in Dunedin are similar to those in North Island populations, some of the types frequently associated with North Island cases of rheumatic fever and glomerulonephritis were absent or isolated infrequently from the Dunedin children. CONCLUSION: The high pharyngeal carriage rates of S. pyogenes in Dunedin schoolchildren, without the concomitant increased occurrence of post-streptococcal sequelae observed in North Island populations may, in part, be due to a relatively lower occurrence of the M-types most commonly implicated in these diseases.

Bacterial Typing Techniques↗
PubMedDate not supplied

Oral and pharyngeal cancer: practices and opinions of dentists in British Columbia and Nova Scotia.

Oral and pharyngeal cancers are associated with high mortality rates, a situation usually attributed to late-stage diagnosis. Dentists in British Columbia and Nova Scotia were surveyed regarding their practices and opinions related to oral and pharyngeal cancer. In February 1998 a pretested, 41-item survey was mailed to a random sample of dentists in British Columbia (n = 817) and the population of dentists in Nova Scotia (N = 423). A reminder postcard and one additional mailing were sent to nonrespondents. Of the 670 dentists supplying usable responses (response rate 55.2%), only 56.7% agreed that their knowledge of the subject was current. Of 8 health history items, dentists assessed 5 on average, with most (88.0%) asking about the patients' current use of tobacco. A total of 72.7% of the responding dentists performed an oral cancer examination for all edentulous patients at every appointment, but 10.9% never did so. Similarly, 70.7% of the dentists always provided an oral cancer examination at the initial appointment for patients 40 years of age and older, but 9.8% never did so. Undergraduate training related to oral cancer examination was reported as good by only 52.2% of the dentists. About three-quarters of all dentists (77.0%) were interested in taking continuing education courses on this subject. Differences between the 2 provinces were not statistically significant (p > 0.01). Dentists in British Columbia and Nova Scotia could benefit from undergraduate and continuing education courses to increase their knowledge of health history assessment, examination for oral and pharyngeal cancers, and risk reduction strategies, such as counselling about tobacco cessation.

Adult↗
PubMed2001

[A report of twice outbreak epidemic of acute tonsillitis and acute pharyngitis].

OBJECTIVE: To discuss the pathogenic factors, prevention and treatment of fulminant epidemic of acute tonsillitis and acute pharyngitis. METHOD: We investigated and analysed the cases of twice fulminant epidemic of acute tonsillitis and acute pharyngitis. RESULT: In the first time, 91 patients among 518 persons were attacted, the sick rate was 17.6%. In the second time, 39 among 295 persons were attacted, the sick rate was 13.2%. The main symptoms were pharyngodynia and fever. Bacterial culture of throat swab of 20 cases of the first time and 17 cases of the second time were carried out. The positive rate of beta-hemolytic streptococcus was 82.5% and 85.3% respectively. CONCLUSION: Environment and individual health condition are important factors in the fulminant epidemic of acute tonsillitis and acute pharyngitis.

Acute Disease↗
PubMed2002

[Analysis of clinical manifestations of pharyngeal and laryngeal amyloidosis].

OBJECTIVE: To study the clinical manifestations of pharyngeal and laryngeal amyloidosis. METHODS: Retrospective analysis of the clinical data of the inpatients with systemic and local amyloidosis. RESULTS: Of the 25 cases, sex ratio was 21:4, and average age was 48 years. Seventeen cases were systemic, of which 7 patients died in 2 years since diagnoses were made. One case was local bronchial amyloidosis. Seven cases were local primary pharyngeal and laryngeal amyloidosis and no affirmative death report was recorded since diagnoses were made. CONCLUSIONS: Amyloidosis occurs more likely in male and middle- and old-aged patients. Pharyngeal and laryngeal local primary amyloidosis have relatively better prognosis than that of systemic amyloidosis. Follow-up is important because local recurrence may be happened.

Adolescent↗
PubMedDate not supplied

Tenascin-C expression and its prognostic significance in oral and pharyngeal squamous cell carcinoma.

BACKGROUND: Tenascin-C (Tn-C) is an extracellular matrix protein with growth-, invasion- and angiogenesis-promoting activities. It is up-regulated in tumorigenesis and has been suggested to correlate with prognosis in various carcinomas, but its significance in squamous cell carcinoma of the head and neck remains unknown. The purpose of this study was to examine the prognostic significance of Tn-C expression in oral and pharyngeal squamous cell carcinomas. PATIENTS AND METHODS: Tn-C expression was determined by immunohistochemistry in 65 consecutive tumors from patients with primary oral and pharyngeal squamous cell carcinoma. Based on staining intensity, both the stroma and invasion border were separately classified into two groups and the results correlated with overall survival (OS) and disease-free survival (DFS). RESULTS: The tumor stroma showed strong Tn-C expression in 56 (86%) samples, and weak Tn-C expression in 9 (14%). At the invasion border, Tn-C expression was strong in 38 (58%) samples and weak in 27 (42%). Tn-C expression was not a statistically significant predictor of survival and there was no correlation between Tn-C expression and tumor or patient characteristics. CONCLUSION: Tn-C protein was overexpressed in the majority of our oral and pharyngeal squamous cell carcinoma samples. The presence of TnC did not appear to predict for OS or DFS.

Adult↗
PubMedDate not supplied

Risk factors for oral and pharyngeal cancer in Shanghai, with emphasis on diet.

A population-based case-control study of oral and pharyngeal cancer was conducted in Shanghai, China, from 1988 to 1990, in which 204 (115 male, 89 female) incident cases and 414 (269 male, 145 female) controls were interviewed. Cigarette smoking and alcohol consumption, as well as occupational exposures to asbestos and to petroleum products and the use of kerosene stoves in cooking, were associated with increased risk of oral and pharyngeal cancer. In addition, more cases than controls reported having chronic oral diseases and false teeth. Dietary intakes of 42 major foods and selected salt-preserved or deep-fried foods during the past 10 years, ignoring any recent changes, were measured by a structured quantitative food questionnaire. After adjusting for known etiological factors, risks decreased with increasing intake of fruits, particularly oranges and tangerines, and some vegetables, including dark yellow vegetables and Chinese white radish. Men in the highest tertile of intake of these fruits and vegetables had about 30-50% the risk of those in the lowest tertile, with a less pronounced effect among women. A new finding was an excess risk associated with high consumption of salt-preserved meat and fish. The findings from this study provide further evidence that dietary factors play an important role in the development of oral and pharyngeal cancer.

Adult↗