Nutritional evaluation in surgical treatment of children with hypertrophic tonsils and or adenoids

Eighty seven children, between 2 and 10 years of age were studied. Twenty four had adenotonsillar hypertrophy and underwent surgery (Group I). Fifteen had adenoidal hypertrophy and underwent surgery (Group II). Thirty three had adenotonsillar hypertrophy and not undergo surgery (Group III), and 15 had adenoidal hypertrophy and did not have surgery (Group IV). ENT examination and fiberoptic examination of the adenoids were performed. Height and weight were measured at 2 points, 4 months apart. the heights and weights were marked on the National Center for Health Statistics Percentiles (NCHS) percentiles and the children were classified by Jelliffe's criterions. the results showed children were generally not underweight before surgery (8.8% of the adenotonsillar hypertrophy and 10% of the adenoidal hypertrophy were underweight). in Group I there was a significant increase in growth 4 months after surgery. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.Universidade Federal de São Paulo, Div Pediat Otorhinolaryngol, BR-04025001 São Paulo, BrazilHosp Professor Edmundo Vasconcello, Div Pediat Otorhinolaryngol, São Paulo, BrazilUniversidade Federal de São Paulo, Div Pediat Otorhinolaryngol, BR-04025001 São Paulo, BrazilWeb of Scienc

Study of the hearing loss in children and adolescents comparing the periods of 1990-1994 and 1994-2000

Introduction: in 1994, a study was performed with 200 children and adolescents suffering from hearing toss. It concluded that the diagnostic confirmation of hearing toss within 2 years of age occurred in just 13% of the cases, although 56% were suspected in that phase. the loss of time of over 2 years between suspicion and confirmation of hearing loss occurred in 42% of the cases.Objectives: the comparison of the main hearing loss etiologies-genetic cause, consanguinity, congenital rubella, meningitis, perinatal. events and unknown causes-in children and adolescents in the periods of 1990-1994 and 1994-2000; comparison of incidence, in mates and females, for each etiology and among the others; comparison of age at the first consultation, for each and among them; and the investigation as to whether the time between suspicion and diagnosis of hearing Loss was different for each etiology and among the others.Methods: During the period of 1990-2000, of the 519 children and adolescents with hearing toss, 442 individuals were selected, in the two moments of the study: 1990-1994 and 1994-2000. the variables used were: sex, age at first consultation, suspected etiotogy and time between suspicion and confirmation of hearing loss.Results: Congenital. rubella, genetic and perinatal. causes, meningitis, consanguinity and unknown causes were responsible for over 80% of all etiologies, in both periods. There were no differences between the sexes in the periods studied. There was no relation among age, sex and etiology. Among the etiologies studied, there were no differences in the lengths of times between suspicion and confirmation of hearing loss, in each period separately. the comparative study showed that congenital rubella, genetic and unknown causes took longer times between suspicion and confirmation of hearing loss, for the period of 1990-1994, as compared with 1994-2000.Conclusions: Congenital rubella remains as an important etiology, as welt post-meningitis deafness. Age at first consultation did not show relationship to the hearing loss etiology nor to sex. Independently of whether the etiology being pre-natal, perinatal or post-natal, congenital or acquired, the length of time between suspicion and confirmation of hearing loss did not differ between the periods studied, separately. (c) 2005 Elsevier Ireland Ltd. All rights reserved.Universidade Federal de São Paulo UNIFESP, EPM, Disciplina Otorrinolaringol Pediat, BR-04025001 São Paulo, BrazilUniv Santo Amaro, Dept Saude Publ, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, EPM, Disciplina Otorrinolaringol Pediat, BR-04025001 São Paulo, BrazilWeb of Scienc

Serum levels of immunoglobulins in children with recurrent otitis media

Seventy-seven children with recurrent otitis media took part in the study at the Department of Otorhinolaryngology and Pediatrics of the University of Sao Paulo from February 1992 to March 1995. They were administered serum immunoglobulins and the relationship between recurrent otitis media and immunodeficiency was evaluated. No total IgG and IgM values were detected below the normal level: however, seven children with low levels of subclasses of IgG were detected and a below normal IgA value was detected in a child.Univ Fed Sao Paulo, Escola Paulista Med, Dept Pediat & Otorhinolaryngol, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Dept Pediat & Otorhinolaryngol, Sao Paulo, BrazilWeb of Scienc

Caries prevalence, levels of mutans streptococci, and gingival and plaque indices in 3.0-to 5.0-year-old mouth breathing children

Universidade Federal de São Paulo, Disciplina Otorrinolaringol Pediat, BR-04025002 São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Doencas Infecciosas, BR-04025002 São Paulo, BrazilUniv São Paulo, Inst Ciencias Biomed, Dept Microbiol, BR-05508 São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Otorrinolaringol Pediat, BR-04025002 São Paulo, BrazilUniversidade Federal de São Paulo, Disciplina Doencas Infecciosas, BR-04025002 São Paulo, BrazilWeb of Scienc

The Th1/Th2 immune-type response of the recurrent aphthous ulceration analyzed by cDNA microarray

BACKGROUND: the reduced ability to activate oral tolerance plays a role in the pathogenesis of some gastrointestinal inflammatory diseases. This activation may reflect a preferential reduction of a T-helper (Th)2- or Th3-type response. in recurrent aphthous ulceration (RAU), genetic and environmental factors may contribute to low tolerance, permitting a cytotoxic reaction against the oral epithelium. the cytokine profile has not permitted the definition of RAU as resulting from enhanced Th1 or Th2 responses. A cDNA microarray study would allow the identification of differentially expressed genes and provide a basis for classification of the immune response.METHODS: the cDNA from 29 samples of aphthae and from 11 samples of normal mucosa from aphthae-free volunteers were hybridized on microarray membranes with 1176 genes.RESULTS: Forty-one differentially expressed genes were identified, and a higher expression level of the Th1 gene cluster in RAU was found.CONCLUSIONS: Microarrays permitted us definition of the gene expression profile of the lesion and identify an increased Th1 activity in RAU lesions.Universidade Federal de São Paulo, Dept Pathol, São Paulo, BrazilUniversidade Federal de São Paulo, Mol Gynecol Lab, São Paulo, BrazilUniversidade Federal de São Paulo, Clin Immunol Lab, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Otolaryngol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pathol, São Paulo, BrazilUniversidade Federal de São Paulo, Mol Gynecol Lab, São Paulo, BrazilUniversidade Federal de São Paulo, Clin Immunol Lab, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Otolaryngol, São Paulo, BrazilWeb of Scienc

OSAS in children: Correlation between endoscopic and polysomnographic findings

OBJECTIVES., To correlate polysomnographic findings with clinical history of apnea, the degree of obstruction caused by tonsillar hypertrophy, and to age group.STUDY DESIGN and SETTING: 267 children with a clinical diagnosis of obstructive sleep apnea (OSAS) were evaluated. Patients were divided into preschool- and school-age categories, and subdivided in 3 additional groups, according to tonsillar hypertrophy. Polysomnographic findings were compared within groups.RESULTS. 34% of children had history of OSAS and normal polysomnographic findings. Tonsillar hypertrophy was correlated to more severe apnea among preschool-age children, but not among school-age children. Among children with tonsillar hypertrophy, more severe apnea was observed in preschool-age children than in school-age children.CONCLUSIONS. There is little correlation between polysomnographic and clinical findings in children with OSAS.SIGNIFICANCE. Adenotonsillar hypertrophy leads to more severe polysomnographic patterns in preschool-age children. More severe apnea is observed in younger children with adenotonsillar hypertrophy than in older ones.Universidade Federal de São Paulo, Div Otorrinolaringol Pediat, São Paulo, BrazilUniv São Paulo, Sch Med Ribeirao Preto, Div Otorhinolaryngol, São Paulo, BrazilUniv São Paulo, Div Polysonmog, São Paulo, BrazilUniversidade Federal de São Paulo, Div Otorrinolaringol Pediat, São Paulo, BrazilWeb of Scienc

Efficacy of celecoxib in treating symptoms of viral pharyngitis: A double-blind, randomized study of celecoxib versus diclofenac

This study compared the efficacy and safety of the cyclooxygenase-2 specific inhibitor celecoxib with the conventional nonsteroidal anti-inflammatory drug diclofenac in the symptomatic treatment of viral pharyngitis. Adult patients from 27 study centers in Latin America were treated with oral doses of celecoxib 200 mg once daily or 200 mg twice daily, or diclofenac 75 mg twice daily for 5 days in a double-blind, randomized study. The primary efficacy assessment was 'Throat Pain on Swallowing' on day 3. In addition, secondary quality-of-life assessments were performed on days 3 and S. All adverse events and treatment-emergent signs and symptoms were recorded. Data from 313 patients were evaluable for efficacy (105 celecoxib 200 mg once daily, 107 celecoxib 200 mg twice daily, 101 diclofenac 75 mg twice daily). The upper 95% confidence limits for the visual analog scale of 'Throat Pain on Swallowing' on day 3 for celecoxib 200 mg once daily relative to diclofenac 75 mg twice daily, and celecoxib 200 mg twice daily relative to diclofenac 75 mg twice daily were 9.26 and 7.83, respectively. All secondary efficacy and quality-of-life measures were clinically similar for the three treatment groups, and no statistically significant differences were detected. The incidences of treatment-emergent adverse events and withdrawals due to adverse events were similar for all groups, but numerically higher among patients taking diclofenac than celecoxib. More patients in the diclofenac group reported gastrointestinal complaints (7.3%) compared with those in the celecoxib groups (4.3% in the celecoxib 200 mg once-daily group and 3.4% in the celecoxib 200 mg twice-daily group). In conclusion, 5 days of treatment with celecoxib 200 mg once daily is as effective as diclofenac 75 mg twice daily in the symptomatic treatment of viral pharyngitis. Celecoxib 200 mg once daily is also as effective as celecoxib 200 mg twice daily in this condition.Univ Fed Sao Paulo, Disciplina Otorrinolaringol Pediat, Dept Peidat Otolaryngol, BR-04025001 Sao Paulo, BrazilHosp Familia, SADEC, FEMAP, Chihuahua, MexicoGPPG, Hosp Clin Porto Alegre, Porto Alegre, RS, BrazilComplexo Hosp Santa Casa Porto Alegre, Ambulatorio Otorrino, Porto Alegre, RS, BrazilHosp CEMA, Sao Paulo, BrazilUniv Fed Sao Paulo, Disciplina Otorrinolaringol Pediat, Dept Peidat Otolaryngol, BR-04025001 Sao Paulo, BrazilWeb of Scienc

Otorrinolaringologia pediátrica no Sistema Público de Saúde de Belo Horizonte Pediatric (Otolaryngology) at the Public Health System of a city in Southeastern Brazil

OBJETIVO: Analisar a adequação dos encaminhamentos da atenção primária para a secundária em otorrinolaringologia pediátrica. MÉTODOS: Estudo realizado em Belo Horizonte, estado de Minas Gerais, de março de 2004 a maio de 2005. Foram avaliadas 408 crianças pré-escolares encaminhadas da atenção primária para a secundária do setor de otorrinolaringologia com otite, faringoamigdalite, rinossinusite, rinite alérgica e hipertrofia de amígdala/adenóide. As variáveis analisadas foram: concordância dos diagnósticos na atenção primária e secundária, tempo de espera pela consulta, acompanhamento e especialista (médico de família ou pediatra) que examinou a criança na atenção primária. A concordância dos diagnósticos foi avaliada pela análise estatística de kappa. RESULTADOS: Os pacientes tinham em média cinco anos de idade, dos quais 214 (52,5%) eram meninos, o tempo médio de espera pela consulta foi de 3,7 meses. Os diagnósticos na atenção primária e secundária foram, respectivamente: otite (44%, 49%), hipertrofia de amígdala/adenóide (22%, 33%), faringoamigdalite (18%, 23%), rinossunusite (13%, 21%), rinite alérgica (3%, 33%). Análise de concordância kappa foi 0,15 para otite com efusão, 0,35 para otite recorrente, 0,04 para hipertrofia de amígdala/adenóide, 0,43 para faringoamigdalite, 0,05 para rinite alérgica; 0,2 para rinossinusite. Os diagnósticos na atenção primária para encaminhamento à secundária, definidos pelo médico de família ou pelo pediatra que avaliou a criança foram concordantes. CONCLUSÕES: A inadequação dos encaminhamentos da atenção primária para a secundária em otorrinolaringologia foi expressa pelo longo tempo de espera pela consulta e pela baixa concordância de diagnósticos firmados entre os níveis de atenção para os mesmos pacientes avaliados. A atenção primária poderia se tornar mais eficiente se os profissionais fossem mais bem capacitados em otorrinolaringologia.<br>OBJECTIVE: To assess the suitability of referral from primary to secondary care in pediatric Otolaryngology. METHODS: The study was performed in the city of Belo Horizonte, in the state of Minas Gerais, from March 2004 to May 2005. A total of 408 pre-school children referred from primary care to secondary care in the department of Otolaryngology presenting with otitis, tonsillitis, sinusitis, allergic rhinitis, and tonsillar/adenoidal hypertrophy was assessed. The studied variables were: agreement between diagnoses in primary and secondary care; waiting time for doctor's appointment; follow-up, and professional (pediatrician or family physician) that examined children in primary care. Agreement of diagnoses was assessed using kappa statistics. RESULTS: Patients were five years old on average, 214 (52.5%) were boys, mean waiting time for appointment was 3.7 months. Diagnoses in primary and secondary care were respectively: otitis (44%, 49%), tonsillar/adenoidal hypertrophy (22%, 33%), tonsillitis (18%, 23%), sinusitis (13%, 21%), allergic rhinitis (3%, 33%). Agreement analysis of kappa was 0.15 for otitis with effusion, 0.35 for recurrent otitis, 0.04 for tonsillar/adenoidal hypertrophy, 0.43 for tonsillitis, 0.05 for allergic rhinitis, and 0.2 for sinusitis. Diagnoses in primary care referred to secondary care were in agreement when given either by pediatrician or family physician. CONCLUSIONS: Unsuitability of referrals from primary to secondary care in otolaryngology was expressed by the long time waiting for appointments and by the low agreement between diagnoses in different level of care for the same patients. Primary health care could be more efficient if professionals were better qualified in Otolaryngology