Regan Syrup has the effect of clearing heat, releasing exterior, benefiting pharynx and relieving cough, and previous phase Ⅱ clinical trial showed that the efficacy of Regan Syrup high-dose and low-dose groups was better than that of the placebo group, and there was no statistically significant difference in the safety between the three groups. The present study was conducted to further investigate the efficacy and safety of the recommended dose(20 mL) of Regan Syrup in the treatment of common cold(wind-heat syndrome). Patients who met the inclusion and exclusion criteria were selected and divided into the test group(Regan Syrup+Shufeng Jiedu Capsules placebo), positive drug group(Regan Syrup placebo+Shufeng Jiedu Capsules) and placebo group(Regan Syrup placebo+Shufeng Jiedu Capsules placebo) at a 1∶1∶1 using a block randomization method. The course of treatment was 3 days. A total of 119 subjects were included from six study centers, 39 in the test group, 40 in the positive drug group and 40 in the placebo group. The onset time of antipyretic effect was shorter in the test group than in the placebo group(P≤0.01) and the positive drug group, but the difference between the test group and the positive drug group was not significant. The test group was superior to the positive drug group in terms of fever resolution(P<0.05), and had a shorter onset time of fever resolution than the placebo group, but without obvious difference between the two groups. Compared to the positive drug group, the test group had shortened disappearance time of all symptoms(P≤0.000 1). In addition, the test group was better than the positive drug group and the placebo group in relieving symptoms of sore throat and fever(P<0.05), and in terms of clinical efficacy, the recovery rate of common cold(wind-heat syndrome) was improved in the test group compared to that in the placebo group(P<0.05). On the fourth day after treatment, the total TCM syndrome score in both test group and positive drug group was lower than that in the placebo group(P<0.05). There was no significant difference in the incidence of adverse events between three groups and none of them experienced any serious adverse events related to the study drug. The results indicated that Regan Syrup could shorten the onset time of antipyretic effect, reduce the time of fever resolution, alleviate the symptoms such as sore throat and fever caused by wind-heat cold, reduce the total score of Chinese medicine symptoms, and improve the clinical recovery rate with good safety.
Humans ; Antipyretics/therapeutic use* ; Capsules ; Common Cold/diagnosis* ; Double-Blind Method ; Fever/drug therapy* ; Hot Temperature ; Pharyngitis ; Treatment Outcome

This is the first case report about acute suppurative thyroiditis with thyrotoxicosis and pyriform sinus in Korea. A female patient, who was previously healthy, visited our hospital for the treatment of common cold symptoms and neck pain which developed 2 weeks before the visit. The condition of the patient did not improve through the use of antipyretics and even worsened. The patient was admitted to the hospital and was diagnosed with acute suppurative thyroiditis. The culture result of the drained fluid revealed group D Streptococcus. The patients condition was improved after using antibiotics and drainage. After recovery from acute thyroiditis, esophagography was performed and the pyriform sinus was found to be obliterated by chemical cauterization. It is very important yet difficult to differentiate acute thyroiditis with thyrotoxicosis from subacute thyroiditis. In this study, we discussed the differential diagnosis between acute thyroiditis and subacute thyroiditis with a review of literature.
Anti-Bacterial Agents ; Antipyretics ; Cautery ; Common Cold ; Diagnosis, Differential ; Drainage ; Female ; Fistula* ; Humans ; Korea ; Neck Pain ; Pyriform Sinus* ; Streptococcus ; Thyroid Gland ; Thyroiditis ; Thyroiditis, Subacute ; Thyroiditis, Suppurative* ; Thyrotoxicosis*

An international outbreak of severe acute respiratory syndrome (SARS), a recently recognized syndrome caused by the newly identified severe acute respiratory syndrome-associated coronavirus (SARS-CoV), began in November 2002 and ended in July 2003. Coronavirus is a family of enveloped, single stranded-RNA viruses causing disease in humans and animals, but the other known coronaviruses that affect humans cause only the common cold. The number of SARS cases in 2003 was approximately 8000 across the world. Many recent studies have reinforced initial impressions that SARS-CoV is primarily transported via contact and/or droplets and that the combination of standard, contact, and droplet precautions is generally effective for its control. Active surveillance for clusters of cases of severe respiratory disease must be a first priority, especially among health care workers. Such surveillance should include the rapid diagnosis and prevention of other respiratory viruses that cause outbreaks of febrile respiratory disease-notably, influenza. Surveillance on the part of clinicians is the key to the early detection of any reemergence before it regains a foothold in the community. During the outbreak of SARS, ribavirin, steroids, interferon, convalescent plasma, and lopinavir/itonavir were used in varying doses and combinations in different regions of the world. At present no definitive conclusions regarding the efficacy of any of these treatments can be drawn. New findings regarding SARS are continuing to be discovered at an unprecedented pace, permitting a better understanding of the disease and enabling better preparation for its possible returns.
Animals ; Common Cold ; Coronavirus ; Delivery of Health Care ; Diagnosis ; Disease Outbreaks ; Humans ; Influenza, Human ; Interferons ; Plasma ; Ribavirin ; SARS Virus ; Severe Acute Respiratory Syndrome* ; Steroids

BACKGROUND: Antibiotics are often indiscriminately prescribed for respiratory tract infections. This study was conducted to describe the prescription pattern of family physicians for respiratory tract infections. METHODS: In each clinic of 50 representative family practitioners, about 20 consecutive patients with diagnosis of respiratory tract infection were enrolled into the study. The data were collected by questionnaire to physicians just after patient interview. RESULTS: The number of study subjects was 1020, of which 55.7% was less than 15 year old. Antibiotics were prescribed to 73.9% of total subjects. According to diagnosis, the antibiotic prescription rate was 51.5% in common cold, 86.0% in pharyngitis, 88.6% in bronchitis, 98.9% in sinusitis, and 100% in otitis media. In common cold, the factors which significantly increased the antibiotic prescription were 1)patient age less than 15 year old (OR=1.70, CI=1.06-2.73), 2)more than two visits during the same episode(OR=1.95, CI=1.27-2.99), 3)yellow and thick rhinorrhea(OR=2.22, CI=1.16-4.25), 4)yellow and thick sputum(OR=3.31, CI=1.34-8.19), and 5)throat injection(OR=2.50, CI=1.42-4.39). Among patients to whom antibiotics were prescribed, 48.7% of patients were given the antibiotics by intramuscular injection. The most frequently prescribed antibiotics were penicillin and macroride among per-oral medicine and ribostamycin and lincomycin among intramuscular medicine. The reason for antibiotic prescription were 1)posssibility of bacterial infection(43.4%), 2)prevention of bacterial complication(23.7%), and 3)definite evidence of bacterial infection(22.5%). CONCLUSION: Family practitioners prescribe antibiotics indiscriminately for the respiratory tract infection. The prescription was influence by patient's age, number of clinic-visit, and clinical symptoms and signs.
Adolescent ; Anti-Bacterial Agents* ; Bronchitis ; Common Cold ; Diagnosis ; Humans ; Injections, Intramuscular ; Lincomycin ; Otitis Media ; Penicillins ; Pharyngitis ; Physicians, Family ; Prescriptions* ; Respiratory System* ; Respiratory Tract Infections* ; Ribostamycin ; Sinusitis ; Surveys and Questionnaires

Pharyngitis is a prevalent disease of the upper respiratory tract that requires treatment with an antibiotic. Group A streptococci (GAS) are the most frequent etiologic agents of bacterial pharyngitis. Because GAS are susceptible to penicillin, routine antibiotic susceptibility testing is not needed. Generally, patients with bacterial pharyngitis have high fever, cervical lymphadenopathy and tenderness, and tonsillar exudative discharge without symptoms of the common cold (e.g., cough, rhinorrhea, and sneezing). However, differentiating bacterial pharyngitis from viral pharyngitis based only on their clinical manifestations is problematic. Therefore, a bacterial culture or a rapid antigen detection test (RADT) is required for the diagnosis of bacterial pharyngitis. Although bacterial culture is the gold standard for diagnosis of bacterial pharyngitis, its accuracy is affected by the technical expertise of the technician, and there is a delay of 1–2 days before the results become available. In contrast, the sensitivity of RADT has increased to over 90%, making them suitable for screening purposes. The result of a RADT is available within 5–10 minutes, obviating the need for a second visit to obtain the results of culture. Use of a RADT would enable the optimal antibiotic to be administered earlier, reducing the overuse of antibiotics.
Anti-Bacterial Agents ; Common Cold ; Cough ; Diagnosis ; Drug Resistance ; Fever ; Humans ; Immunologic Tests ; Lymphatic Diseases ; Mass Screening ; Penicillins ; Pharyngitis ; Professional Competence ; Respiratory System

Child ; Common Cold ; diagnosis ; therapy ; Communicable Disease Control ; methods ; organization & administration ; standards ; Communicable Diseases ; diagnosis ; therapy ; Humans ; Patient Education as Topic ; Respiratory Tract Infections ; therapy ; Risk Factors ; Severe Acute Respiratory Syndrome ; diagnosis ; therapy ; Virus Diseases ; diagnosis ; therapy

OBJECTIVETo examine the characteristics of cases excluded from severe acute respiratory syndrome (SARS) and the reasons for exclusion.

METHODS2071 probable or suspected cases excluded from SARS between March and June, 2003 were analyzed.

RESULTSTwo-thirds of the excluded cases were males. Construction workers, students and retired people ranked top three in all the occupation categories. Three peaks appeared in the dates of exclusion, and the most obvious one was from June 7 to June 13. There were two peaks in the distribution of time period from onset to exclusion, one was six to ten days and the other was forty-eight to fifty-two days after onset. Patients with history of close contact were more likely to be excluded within fifty days after onset than those without close history of contact. Pneumonia, common cold and lung infection were the leading causes for correction in the 1211 excluded cases.

CONCLUSIONStudy on the diagnosis and differential diagnosis should be emphasized.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Common Cold ; diagnosis ; Contact Tracing ; statistics & numerical data ; Diagnosis, Differential ; Disease Outbreaks ; prevention & control ; Female ; Humans ; Infant ; Male ; Middle Aged ; Pneumonia ; diagnosis ; Severe Acute Respiratory Syndrome ; diagnosis ; epidemiology