Strep Throat

This research aims to evaluate whether chewing gum and cold water gargling can ease common throat discomforts, such as sore throat and difficulty swallowing, experienced after bronchoscopy. The study compares these simple interventions against standard care to see if they improve patient comfort and satisfaction following the procedure. Participants will be randomly assigned to one of three groups: chewing sugar-free xylitol gum for 15 minutes before bronchoscopy, gargling cold water (8-12°C) twice for 30 seconds each before the procedure, or receiving the usual care without additional treatments. The chewing gum and cold water gargle are supervised by researchers who provide instructions and ensure proper procedure. Participants' symptoms and satisfaction will be assessed before bronchoscopy, then at 2 hours and 24 hours after the procedure. The 24-hour follow-up will be done by phone. Researchers will measure the severity of sore throat and swallowing difficulty along with patient satisfaction, aiming to understand if these interventions affect recovery and comfort. The study starts with standard fasting and includes routine education about bronchoscopy.

This research aims to compare whether using different sizes of tracheal catheters causes less sore throat in women after thyroid surgery. It involves female patients aged 18 to 65 years with physical health status ranging from ASA I to III, all scheduled for thyroid surgery under general anesthesia. The study focuses on evaluating sore throat incidence and severity following the procedure. Participants are randomly assigned to one of three groups, each receiving a tracheal catheter with a different inner diameter: 6.0 mm, 6.5 mm, or the traditional 7.0 mm size. The study monitors how each catheter size affects postoperative sore throat at multiple time points after surgery, specifically at 1 hour, 6 hours, 24 hours, and 48 hours. During the study, researchers record the presence and severity of sore throat at these times to assess differences among the groups. The trial includes women undergoing elective thyroid surgery under general anesthesia who meet the eligibility criteria. The study is expected to run until October 2026, with participant involvement mainly around the surgery and follow-up sore throat assessments.

Researchers are evaluating whether skipping tracheal suctioning right before removing a breathing tube is as safe as routine suctioning for adult patients aged 18 to 90 who undergo planned surgery under general anesthesia with endotracheal intubation. The study aims to see if avoiding suctioning affects early oxygen levels after the tube is removed and whether it impacts cough severity, sore throat, and other related side effects. Participants are randomly divided into two groups: one receiving routine suctioning inside the trachea and throat just before extubation, and the other receiving suctioning only in the throat without inserting the suction catheter into the trachea. All patients receive standard anesthesia care and are monitored in the post-anesthesia care unit (PACU) for 60 minutes after extubation. Airway symptoms and satisfaction are checked again 24 hours after surgery. During the study, participants will have their oxygen levels monitored closely for the first hour after extubation, along with assessments of coughing, sore throat severity, nausea, vomiting, and any extubation-related problems. Researchers will also record oxygen therapy needs and patient satisfaction at 24 hours. Safety monitoring continues up to 6 hours post-PACU arrival. Overall participation involves the surgery day and a follow-up at 24 hours post-surgery.

Researchers are studying periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome and other tonsil disorders, which are common causes of periodic fever in children. The study aims to understand how PFAPA develops by collecting genetic, immunologic, cellular, molecular, and microbial data from affected individuals. This observational study seeks to identify risk factors and immune responses related to these conditions. Participants with PFAPA or other tonsil disorders will provide various specimens, including blood, saliva, mucus, stool, and cells from the nose or mouth. Tissue samples may also be collected if participants undergo tonsil or adenoid removal surgery. Specimens can be collected either in person at study sites or remotely through local health providers. Some participants may have optional follow-up visits over a period of up to 10 years. During the study, medical records will be reviewed and family history of PFAPA will be collected. Researchers will analyze genetic variations, immune cell populations, gene and protein expression, and microbiota in tissues and samples. Outcomes include understanding immune responses, molecular pathways, and clinical effects after tonsillectomy or other treatments. The study involves specimen collection, clinical evaluations, and long-term monitoring.

Researchers are evaluating the use of gabapentin to reduce pain after tonsillectomy and adenoidectomy in children aged 3 to 18 years. This pilot study aims to see if a single preoperative dose of gabapentin decreases the amount of narcotic pain medicine needed in the first 48 hours after surgery. It also compares the timing of the first pain medicine dose and pain scores at 12, 24, and 48 hours after surgery using pain scales like Wong Baker and a numeric distress scale. In this double-blind randomized controlled trial, 50 children undergoing tonsillectomy and adenoidectomy will be randomly assigned to receive either one dose of gabapentin (15 mg/kg up to 600 mg) or a placebo before surgery. Both groups will receive the usual narcotic pain treatment during surgery. After surgery, younger children will be guided to take Tylenol and Motrin, while teenagers will get a narcotic prescription. The study will measure the amount of each pain medicine used and the time to first pain medicine. Participants will be monitored through phone calls with a research nurse for three days after surgery to collect pain scores at specified times. Researchers will track the total narcotic consumption during the first 48 hours after surgery as the main outcome. The study also looks at the timing of the first pain medicine and pain levels at 12, 24, and 48 hours. This detailed follow-up helps evaluate how gabapentin affects pain control in children after these common surgeries.

This research aims to understand why some children become carriers of Group A streptococcus (GAS) and whether those carriers need antibiotic treatment. The study focuses on differences in GAS bacteria between children with acute infection and those who carry the bacteria without symptoms. Researchers will examine genetic and transcriptional changes in the bacteria to learn how it behaves in these two states. Children aged 5 to 15 years with acute pharyngitis caused by GAS are eligible. Participants will be tested using a rapid antigen detection test and throat cultures at study entry, after 14 days, and again after 14 to 21 days if initial follow-up tests are positive. The study involves collecting samples to analyze the bacteria's gene expression and genome. Participants will undergo throat swabs and sample collections at specified times to identify who are carriers of GAS. Researchers will measure the presence of GAS bacteria and study their genetic profiles over time. The study's main outcome is identifying children who carry GAS bacteria in their throat after initial infection. The total participation time is around two weeks for primary outcome measurement.

Researchers are evaluating whether adding lateral pharyngoplasty to tonsillectomy provides better outcomes for children aged 3 to 17 years undergoing tonsillectomy with or without adenoidectomy. The study aims to find out if this combined procedure leads to less pain, improved eating and drinking after surgery, and a lower risk of bleeding complications compared to tonsillectomy alone. This randomized controlled trial seeks to establish lateral pharyngoplasty with tonsillectomy as a standard care option if benefits are confirmed. Participants will be randomly assigned to one of two groups: one group will have extracapsular tonsillectomy with or without adenoidectomy, while the other group will receive the same surgery plus lateral pharyngoplasty. The lateral pharyngoplasty involves placing two figure-of-8 sutures using 3-0 vicryl to bring together the anterior and posterior tonsillar pillars, reconstructing the mucosal covering of the lateral pharyngeal walls. The surgery and procedures will be performed under medical supervision as part of the trial. During the study, parents will help track their child's pain levels, use of pain medications, daily oral intake amounts, and any complications after surgery. Researchers will monitor participants from immediately after surgery through six weeks post-operation, focusing on pain levels, bleeding incidents that require or do not require surgical intervention, and the time it takes for the child to resume normal eating and drinking. This monitoring helps assess the safety and recovery experience between the two surgical approaches.

Researchers are conducting an observational study to assess the performance and safety of OROSEDAL, an oral spray medical device, in children and adults with sore throat or minor oral lesions such as minor aphthous ulcers and oral lichen planus. This study takes place in real-life general practice settings and includes patients aged 8 years and older who have had symptoms for less than 15 days and significant pain levels. The goal is to gather real-world information on how OROSEDAL is used and its effects on pain and discomfort. Participants are those who have been prescribed OROSEDAL independently of the study. They will use the product as directed, and data will be collected at the start, daily through self-assessment diaries, and at Day 6 7 days or upon early study exit. The study focuses on pain relief, swallowing discomfort, treatment use, safety, device performance, and patient compliance in typical care settings. During the study, participants will record their pain, swallowing discomfort, symptoms, and any adverse events daily. Researchers will evaluate pain reduction at Day 1 evening as the primary outcome and assess additional measures such as pain at Day 6, immediate pain relief after use, and overall patient-rated effectiveness. Safety and any device issues will be monitored from inclusion through Day 6. The study duration per participant is approximately 6 days.

Researchers are evaluating the use of short-acting opioids (fentanyl/hydromorphone) compared to long-acting opioid methadone for managing pain after tonsillectomy surgery in children and adolescents aged 3 to 17 years. This randomized, double-blind, parallel-group study aims to find the most effective pain control method while monitoring the need for additional opioid rescue and the occurrence of side effects. The trial is sponsored by Duke University and includes multiple age cohorts to tailor dosing appropriately. Participants will be randomly assigned in a 2:1 ratio to receive either methadone or short-acting opioids during surgery. Methadone dosing starts at 0.15 mg/kg for children aged 3 to under 12 years and 0.2 mg/kg for adolescents aged 12 to 17 years, with possible dose increases based on interim safety and effectiveness reviews. Standard surgical and anesthesia care is maintained aside from the study drug administration. Two study periods cover recruitment and dose escalation phases within the age groups. During the study, researchers will collect data in the hospital and after discharge, including daily surveys for seven days and follow-up phone calls at 30 days, 3 months, and 6 months after surgery. Outcomes measured include the number of participants needing rescue opioids within six hours post-surgery and pain levels up to seven days. Safety is monitored by tracking adverse events in the recovery unit and ongoing opioid use, with the total participation period lasting up to six months.

Researchers are evaluating families' perspectives and decision-making about how long children aged 4 to 17 should take oral antibiotics for uncomplicated bacterial infections. This study focuses on children treated at the Royal Children's Hospital Emergency Department, either discharged with oral antibiotics or transferred to Hospital-in-the-Home for IV antibiotics before switching to oral therapy. The study also assesses how practical and acceptable it is to use a Garmin Smartwatch and the WeGuide platform to track children's symptoms during treatment. The study involves all eligible participants completing daily symptom questionnaires throughout their antibiotic course, a one-time survey about views on antibiotic duration, and two short follow-up questionnaires on days 14 and 28 to record if antibiotics were restarted and to gather feedback on study procedures. A small group of about 60 participants will wear a Garmin Smartwatch during their antibiotic treatment to collect data on heart rate, skin temperature, sleep, and activity, which will be compared with parent-reported symptoms. Participants and their parents will be involved in completing surveys and, if selected, wearing the smartwatch while antibiotics are taken. Data collection occurs through the WeGuide platform, which manages enrollment, consent, and survey responses. Researchers will measure how often the smartwatch is worn, any issues reported with the device or questionnaires, and the agreement between smartwatch data and parent reports. The study will also track antibiotic use and symptom resolution up to 28 days after starting antibiotics. The total participation duration varies based on antibiotic course length and follow-up timing.