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Handy health guide to sore throats
\"An overview of what causes sore throats and other illnesses such as tonsillitis and strep throat\"-- Provided by publisher.
Book
Reviewing the epidemiology of head and neck cancer: definitions, trends and risk factors
Introduction
Head and neck cancer appears to be increasing in incidence, with potential changes in aetiology proposed. This paper aims to provide a narrative overview of the epidemiological literature to describe the disease burden and trends in terms of incidence and mortality both in the UK and globally and to review the evidence on current risk factors.
Methods
A search was performed on multiple databases (PubMed and Epistemonikos), applying filters to identify systematic reviews and meta-analyses which investigated head and neck cancer incidence, mortality and risk factors. International and UK cancer registries and sources were searched for incidence and mortality data.
Results
Multiple definitions of head and neck cancer are employed in epidemiology. Globally, incidence rates have increased in recent decades, largely driven by oropharyngeal cancer. Mortality rates over the last decade have also started to rise, reflecting the disease incidence and static survival rates. Major risk factors include tobacco smoking alone and in combination with alcohol consumption, betel chewing (particularly in Southeast Asian populations) and the human papillomavirus in oropharyngeal cancer.
Conclusions
These epidemiological data can inform clinical and preventive service planning for head and neck cancer.
Key points
Head and neck cancer incidence is increasing and is projected to continue to rise, largely driven by increases in oropharyngeal cancer.
Mortality rates have started to increase within the last decade, reflecting a rising incidence and static survival rates.
Major risk factors that are associated with the risk of head and neck cancer are tobacco smoking and tobacco used in combination with alcohol consumption. Human papillomavirus is an additional major risk factor for oropharyngeal cancer. Cancers of the head and neck are clearly socioeconomically patterned but this socioeconomic risk is not entirely explained by smoking and alcohol behaviours.
Journal Article
Swallow : foreign bodies, their ingestion, inspiration, and the curious doctor who extracted them
Discusses what it means to ingest things humans weren't meant to eat, and how the line between human bodies and foreign bodies can sometimes blur.
Book
Techniques of Fluidic Thrust Vectoring in Jet Engine Nozzles: A Review
Thrust vectoring innovations are demonstrated ideas that improve the projection of aerospace power with enhanced maneuverability, control effectiveness, survivability, performance, and stealth. Thrust vector control systems following a variety of concepts have been considered for modern aircraft and missiles to enhance their military performance. Short Take-off and Landing (STOL) and control effectiveness at lower aircraft speeds can be achieved by employing Fluidic Thrust Vectoring Control (FTVC). This paper summarizes a range of ideas for FTVC that have been designed and tested both computationally and experimentally to determine the thrust vectoring performance of supersonic propulsion system nozzles. The conventional method of thrust vectoring involves mechanical means to deflect the direction of flow of the exhaust gases, whereas the most recent method involves fluidic-based thrust vectoring techniques. Fluid-based thrust vectoring has the advantages of simplicity and low weight over mechanical-based thrust vectoring, which has complex geometry and adds extra weight to the aircraft. The fluidic vectoring control nozzles are divided into seven categories: shock vector, bypass shock vector, counterflow, co-flow, throat skewing, dual throat, and bypass dual throat nozzle control. This paper provides a summary of each fluidic thrust vectoring technique with its characteristics, design, classification, and different operational criteria developed to date and compares the intrinsic characteristics of each technique. Based on the present literature, it is concluded that among all the fluidic control techniques, the bypass dual-throat nozzle control can achieve better thrust vectoring performance with large vector angles and low thrust loss.
Journal Article
Acute pharyngitis in children and adults: descriptive comparison of current recommendations from national and international guidelines and future perspectives
This study aims to provide a comparison of the current recommendations about the management of acute pharyngitis. A literature search was conducted from January 2009 to 2023. Documents reporting recommendations on the management of acute pharyngitis were included, pertinent data were extracted, and a descriptive comparison of the different recommendations was performed. The quality of guidelines was assessed through the AGREE II instrument. Nineteen guidelines were included, and an overall moderate quality was found. Three groups can be distinguished: one group supports the antibiotic treatment of group A β-hemolytic Streptococcus (GABHS) to prevent acute rheumatic fever (ARF); the second considers acute pharyngitis a self-resolving disease, recommending antibiotics only in selected cases; the third group recognizes a different strategy according to the ARF risk in each patient. An antibiotic course of 10 days is recommended if the prevention of ARF is the primary goal; conversely, some guidelines suggest a course of 5–7 days, assuming the symptomatic cure is the goal of treatment. Penicillin V and amoxicillin are the first-line options. In the case of penicillin allergy, first-generation cephalosporins are a suitable choice. In the case of beta-lactam allergy, clindamycin or macrolides could be considered according to local resistance rates.
Conclusion
: Several divergencies in the management of acute pharyngitis were raised among guidelines (GLs) from different countries, both in the diagnostic and therapeutic approach, allowing the distinction of 3 different strategies. Since GABHS pharyngitis could affect the global burden of GABHS disease, it is advisable to define a shared strategy worldwide. It could be interesting to investigate the following issues further: cost-effectiveness analysis of diagnostic strategies in different healthcare systems; local genomic epidemiology of GABHS infection and its complications; the impact of antibiotic treatment of GABHS pharyngitis on its complications and invasive GABHS infections; the role of GABHS vaccines as a prophylactic measure. The related results could aid the development of future recommendations.
What is Known:
• GABHS disease spectrum ranges from superficial to invasive infections and toxin-mediated diseases
.
• GABHS accounts for about 25% of sore throat in children and its management is a matter of debate
.
What is New:
• Three strategies can be distinguished among current GLs: antibiotic therapy to prevent ARF, antibiotics only in complicated cases, and a tailored strategy according to the individual ARF risk
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• The impact of antibiotic treatment of GABHS pharyngitis on its sequelae still is the main point of divergence; further studies are needed to achieve a global shared strategy
.
Journal Article
Prevalence and determinants of oral and cervicogenital HPV infection: Baseline analysis of the Michigan HPV and Oropharyngeal Cancer
We determined baseline oral and cervicogenital human papillomavirus (HPV) prevalence and determinants of infection in the Michigan HPV and Oropharyngeal Cancer (MHOC) study. We enrolled 394 college-age and older participants of both sexes in Ann Arbor, Michigan and the surrounding area. All participants provided an oral sample at baseline, and 130 females provided a cervicogenital sample. Samples were tested for 18 HPV genotypes using polymerase chain reaction (PCR) MassArray. Participants filled out sociodemographic and behavioral questionnaires. Prevalence ratios for HPV oral or cervicogenital prevalence by predictor variables were estimated in univariable log-binomial models. Analysis was conducted 2018-20. In the full cohort, baseline oral HPV prevalence was 10.0% for any detected genotype (among the 338 valid oral tests at baseline) and 6.5% for high-risk types, and cervicogenital prevalence was 20.0% and 10.8%, respectively (among the 130 first valid cervicogenital tests). Oral HPV prevalence did not vary by sex, with 10.5% of women and 9.0% of men having an infection. We found a high prevalence of oral and cervicogenital HPV infection in college-age participants reporting no lifetime sexual partners. Reporting a single recent partner was associated with a lower oral HPV prevalence (PR 0.39, 95% CI: 0.16, 0.96) than reporting no recent (but at least one ever) partner. No similar protective effect was seen for cervicogenital HPV. Both oral and cervicogenital prevalence increased with the number of recent partners for most sexual behaviors. We observed an ecological fallacy masking the direction of impact of vaccination on HPV prevalence in the full cohort compared to the college-aged and the age 23+ populations considered separately. Substance use was not significantly associated with oral or cervicogenital HPV infection. Many studies report substantially higher oral HPV infection prevalence in men than in women. That difference may not be uniform across populations in the US.
Journal Article
Successful Dilation and Stenting of Severe Tracheal Stenosis Following Brief Intubation
Tracheal stenosis following brief intubation is a relatively rare but serious problem. However, some degree of airway injury is common following intubation, regardless of the duration. We herein report a rare case of a female patient in her late sixties, who developed severe tracheal stenosis following just a weeklong intubation. The tracheal stenosis was successfully treated via dilation and stenting using a self-expanding metal stent.
Journal Article
Nasopharyngeal carcinoma
Nasopharyngeal carcinoma is characterised by distinct geographical distribution and is particularly prevalent in east and southeast Asia. Epidemiological trends in the past decade have shown that its incidence has declined gradually but progressively, and mortality has been reduced substantially. These findings probably reflect lifestyle and environmental changes, enhanced understanding of the pathogenesis and risk factors, population screening, advancements in imaging techniques, and individualised comprehensive chemoradiotherapy strategies. In particular, plasma Epstein-Barr virus (EBV) DNA has been used for population screening, prognostication, predicting treatment response for therapeutic adaptation, and disease surveillance. Moreover, the widespread application of intensity-modulated radiotherapy and optimisation of chemotherapy strategies (induction, concurrent, adjuvant) have contributed to improved survival with reduced toxicities. Among the existing developments in novel therapeutics, immune checkpoint therapies have achieved breakthroughs for treating recurrent or metastatic disease and represent a promising future direction in nasopharyngeal carcinoma.
Journal Article