Epistemic_Statements  

CORD-19:c6b75757f2a356c2bbc3ec1d986d17a3d0048701 JSONTXT 11 Projects

Annnotations TAB TSV DIC JSON TextAE Lectin_function

Id Subject Object Predicate Lexical cue
T1 248-453 Epistemic_statement denotes The aim of the present study was to investigate the presence of a wide range of bacteria and viruses, including Fusobacterium necrophorum, in patients with pharyngotonsillitis and in asymptomatic controls.
T2 1962-2124 Epistemic_statement denotes The condition can be caused by a wide variety of infectious agents [2] , where the most common is Streptococcus pyogenes (Group A streptococci, GAS) [3] [4] [5] .
T3 2125-2323 Epistemic_statement denotes Also, large colony variants of Streptococcus group C and G [6] , Mycoplasma pneumoniae [3] , Arcanobacterium haemolyticum [7] , and several viruses [3, 5, 8] have been associated with a sore throat.
T4 2324-2565 Epistemic_statement denotes The aetiology has mainly been studied in children [9, 10] , and most studies have been performed with a focus on the presence of a limited number of pathogens [3, 5] , and studies covering both viral and bacterial aetiology are lacking [5] .
T5 2792-2991 Epistemic_statement denotes In recent years, the anaerobic Gram-negative bacterium Fusobacterium necrophorum has been suggested as an important cause of acute pharyngotonsillitis in adolescents and young adults [12] [13] [14] .
T6 3125-3241 Epistemic_statement denotes This conclusion is not, however, generally accepted [17] , as the increase may be due to publication bias [18, 19] .
T7 3436-3731 Epistemic_statement denotes The aim of the present study was to investigate the presence of F. necrophorum together with β-hemolytic streptococci, Mycoplasma pneumoniae, Chlamydophila pneumoniae, and 14 respiratory viruses in adults attending PHC with the symptoms of pharyngotonsillitis, compared to asymptomatic controls.
T8 3732-3900 Epistemic_statement denotes The second aim was to investigate the association of these pathogens to the patient's history and symptoms and signs, and in relation to the Centor score in particular.
T9 4679-4922 Epistemic_statement denotes absence of cough, fever >38.5°C, tender lymphadenitis, and tonsillar coating, as well as potential confounders such as smoking habits, recent antibiotic treatment, history of sore throat, and the duration of symptoms prior to the consultation.
T10 5246-5414 Epistemic_statement denotes A questionnaire including questions about potential confounders such as recurrent sore throat, smoking habits, and antibiotic treatment in the last month was completed.
T11 9368-9497 Epistemic_statement denotes Multiple logistic regressions were used to model the relationship between the outcome variable and several independent variables.
T12 9975-10078 Epistemic_statement denotes The patients had the opportunity to ask questions about the study before informed consent was obtained.
T13 13255-13338 Epistemic_statement denotes The association of bacteria and viruses significantly associated with disease (i.e.
T14 14072-14246 Epistemic_statement denotes The multiple regression analysis revealed "being a smoker" and the presence of tonsillar coatings to be of importance for the likelihood of finding F. necrophorum (Table 5 ).
T15 14247-14559 Epistemic_statement denotes This prospective case control study, analysing 20 potential causative agents of sore throat (6 bacteria and 14 viruses), could detect at least one of these in 70.5% of patients 15-45 years of age attending PHC with the suspicion of pharyngotonsillitis, compared to 20.3% in asymptomatic controls of the same age.
T16 14906-15149 Epistemic_statement denotes As far as we know, this is the first prospective study with a broad diagnostic approach, including both bacteria and viruses that relate to the reported signs and symptoms in patients aged 15-45 years with the suspicion of pharyngotonsillitis.
T17 15150-15303 Epistemic_statement denotes The high quality of clinical data allowed us to perform analyses on the relationship between specific pathogens and patient history, symptoms, and signs.
T18 15304-15555 Epistemic_statement denotes The summer was considered a low season of pharyngotonsillitis and therefore not included, the overall Centor score was relatively low, and the clinical assessment of the patients was not guided, all of which can be considered limitations of the study.
T19 15556-15664 Epistemic_statement denotes This, however, reflects the patient group and practice in Swedish PHCs and is therefore considered relevant.
T20 15829-15973 Epistemic_statement denotes Since the power was not calculated on the associations between bacteria and viruses and signs or symptoms, we may have missed some associations.
T21 15974-16012 Epistemic_statement denotes This should encourage further studies.
T22 16013-16079 Epistemic_statement denotes We could not identify a potential pathogen in 30% of the patients.
T23 16080-16152 Epistemic_statement denotes This could be due to sampling, or the detection methods used [2, 3, 7] .
T24 16153-16297 Epistemic_statement denotes However, the methods for sampling and analyses of the samples used here are the same that may be used in the clinical setting and thus relevant.
T25 16420-16692 Epistemic_statement denotes Interestingly, the median Centor score in the group of patients with no bacterium or virus found (Centor score 2) were similar to the group with viruses found, indicating that there may be more infections due to viruses rather than bacteria being undetected in this group.
T26 16746-16916 Epistemic_statement denotes The Centor score for these patients was higher than for patients with non-GAS infections, supporting the continuous use of this score to predict the presence of GAS [5] .
T27 17195-17300 Epistemic_statement denotes This might be seen as over-reporting of the presence of these viruses due to the high sensitivity of PCR.
T28 17301-17408 Epistemic_statement denotes However, we would argue, rather, that it reflects asymptomatic infections or prolonged shedding of viruses.
T29 17409-17584 Epistemic_statement denotes Despite the unbiased inclusion, as many as 15% of the patients were culturepositive for F. necrophorum, while only 3% of the healthy controls were positive for this bacterium.
T30 18229-18422 Epistemic_statement denotes The use of samples from routine microbiology and "nonstreptococcal" samples will tend, contrary to the prospective open inclusion used in the present study, to over-report the pathogen studied.
T31 18645-18936 Epistemic_statement denotes Although the power of the study was not calculated to rule out associations between signs and symptoms, this study could not find any association between age [14] , recent primary EBV infection [25] , or recurrent sore throat [26] and the detection of F. necrophorum, as suggested by others.
T32 18937-19034 Epistemic_statement denotes However, smoking and coating of the tonsils increased the likelihood of detecting F. necrophorum.
T33 19035-19184 Epistemic_statement denotes Importantly, some of the controls were positive for F. necrophorum, and the presence of this bacterium is thus not strictly associated with symptoms.
T34 19311-19439 Epistemic_statement denotes The growth, and possibly also the pathogenic potential of F. necrophorum, may thus be facilitated by an underlying inflammation.
T35 19751-19868 Epistemic_statement denotes have suggested that a broad antibiotic treatment of tonsillitis could prevent the few cases of severe infection (i.e.
T36 19899-20162 Epistemic_statement denotes We consider this suggestion premature, as the finding of F. necrophorum in a predisposing tonsillitis has not been shown to be of importance for the development of Lemièrre syndrome, and as the best treatment option of F. necrophorum has not yet been established.
T37 20163-20403 Epistemic_statement denotes More studies are warranted to further define the importance of F. necrophorum in tonsillitis, establish a standard for how to handle the finding of F. necrophorum in pharyngotonsillitis, and determine whether antibiotic treatment is needed.