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[PMID]:28452705
[Au] Autor:Lin L; Chen Z; Cao Y; Sun G
[Ad] Endereço:Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai, China.
[Ti] Título:Normal saline solution nasal-pharyngeal irrigation improves chronic cough associated with allergic rhinitis.
[So] Source:Am J Rhinol Allergy;31(2):96-104, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Upper airway inflammation is one of the most commonly identified causes of chronic cough, although the underlying mechanism is not clear. This study compared normal saline solution nasal-pharyngeal irrigation (NSNPI) and fluticasone propionate nasal spray (FPNS) treatment for chronic cough associated with allergic rhinitis (AR). METHODS: Patients with suspected AR to house-dust mite were enrolled, and the symptom of cough was assessed by a cough symptom score and the Leicester Cough Questionnaire, and cough response to capsaicin was evaluated. AR was assessed by using the visual analog scale (VAS) and the Mini Juniper Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ). Mediators, including histamine, leukotriene C4, and prostaglandin D2, and the major basic protein from nasal lavage fluid (NLF) were examined. The patients were treated with NSNPI (the NSNPI group) or FPNS (the FPNS group) for 30 days, after which they were reassessed. RESULTS: Forty-five of 50 patients completed this study. The scores of the cough symptom and the Leicester Cough Questionnaire, and the capsaicin cough threshold all improved statistically after NSNPI but did not change after FPNS. There were statistically significant changes in the evaluations of the MiniRQLQ and the mediators, including histamine and leukotriene C4, in the NLF in the NSNPI group. However, significant changes were found in the assessments of VAS, MiniRQLQ, and all above mediators including histamine, leukotriene C4, and prostaglandin D2, and the major basic protein in the NLF of the FPNS group. Furthermore, the assessments of VAS and all the mediators were reduced more in the FPNS group compared with those in the NSNPI group. CONCLUSION: The patients with suspected AR to house-dust mite reported a better relief of the cough symptom after 30 days of treatment with NSNPI compared with that after nasal corticosteroid.
[Mh] Termos MeSH primário: Tonsila Faríngea/patologia
Tosse/prevenção & controle
Fluticasona/uso terapêutico
Seios Paranasais/patologia
Rinite Alérgica/terapia
Cloreto de Sódio/uso terapêutico
Irrigação Terapêutica
[Mh] Termos MeSH secundário: Tonsila Faríngea/efeitos dos fármacos
Adolescente
Adulto
Idoso
Animais
Antígenos de Dermatophagoides/imunologia
Doença Crônica
Tosse/etiologia
Seres Humanos
Meia-Idade
Sprays Nasais
Seios Paranasais/efeitos dos fármacos
Pyroglyphidae/imunologia
Rinite Alérgica/complicações
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antigens, Dermatophagoides); 0 (Nasal Sprays); 451W47IQ8X (Sodium Chloride); CUT2W21N7U (Fluticasone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4418


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[PMID]:28459055
[Au] Autor:Kuo CY; Lin YY; Chen HC; Shih CP; Wang CH
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
[Ti] Título:Video Nasoendoscopic-Assisted Transoral Adenoidectomy with the PEAK PlasmaBlade: A Preliminary Report of a Case Series.
[So] Source:Biomed Res Int;2017:1536357, 2017.
[Is] ISSN:2314-6141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:. The primary objective for this study is to evaluate the advantages, disadvantages, surgical applicability, and outcome of the pulsed electron avalanche knife (PEAK) PlasmaBlade in transoral adenoidectomy under direct visualization using video nasoendoscopy. . In this series, six cases of adenoid hypertrophy showing varying clinical presentations in relation to its clinical course were surgically treated using a PEAK PlasmaBlade. Before and after surgery, all patients underwent nasal endoscopy to define the grading of hypertrophic adenoids and postoperative outcome. Pure tone audiometry and tympanometry tests were carried out to investigate the change in middle and inner ear functions. . The mean follow-up period was 23.8 months. Postoperatively, symptoms of otitis media with effusion were all relieved with closure of the air-bone gap (6/6). Other relevant ear complaints like tinnitus were resolved (1/1) and aural fullness disappeared in 87.5% of ears (7/8). Nasal obstruction (2/2) and postnasal drip (2/2) were improved after surgery. . Based on this preliminary report of a case series in a limited sample size, we suggest that using the transoral PEAK PlasmaBlade for adenoidectomy guided by video nasoendoscopy is a safe and feasible surgical technique, allowing remarkable outcomes by providing precise tissue removal, effective hemostasis, and painless postoperative recovery.
[Mh] Termos MeSH primário: Adenoidectomia/métodos
Tonsila Faríngea/diagnóstico por imagem
Tonsila Faríngea/cirurgia
Endoscopia/métodos
Cirurgia Vídeoassistida/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Feminino
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1155/2017/1536357


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[PMID]:29369187
[Au] Autor:Zeng G; Teng Y; Zhu J; Zhu D; Yang B; Hu L; Chen M; Fu X
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery.
[Ti] Título:Clinical application of MRI-respiratory gating technology in the evaluation of children with obstructive sleep apnea hypopnea syndrome.
[So] Source:Medicine (Baltimore);97(4):e9680, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objective of the present study was to investigate the clinical application of magnetic resonance imaging (MRI)-respiratory gating technology for assessing illness severity in children with obstructive sleep apnea hypopnea syndrome (OSAHS).MRI-respiratory gating technology was used to scan the nasopharyngeal cavities of 51 children diagnosed with OSAHS during 6 respiratory phases. Correlations between the ratio of the area of the adenoid to the area of the nasopalatine pharyngeal cavity (Sa/Snp), with the main indexes of polysomnography (PSG), were analyzed. Receiver operator characteristic (ROC) curve and Kappa analysis were used to determine the diagnostic accuracy of Sa/Snp in pediatric OSAHS.The Sa/Snp was positively correlated with the apnea hypopnea index (AHI) (P < .001) and negatively correlated with the lowest oxygen saturation of blood during sleep (LaSO2) (P < .001). ROC analysis in the 6 respiratory phases showed that the area under the curve (AUC) of the Sa/Snp in the end-expiratory phase was the largest (0.992, P < .001), providing a threshold of 69.5% for the diagnosis of severe versus slight-moderate OSAHS in children. Consistency analysis with the AHI showed a diagnosis accordance rate of 96.0% in severe pediatric OSAHS and 96.2% in slight-moderate pediatric OSAHS (Kappa = 0.922, P < .001).Stenosis of the nasopalatine pharyngeal cavity in children with adenoidal hypertrophy was greatest at the end-expiration phase during sleep. The end-expiratory Sa/Snp obtained by a combination of MRI and respiratory gating technology has potential as an important imaging index for diagnosing and evaluating severity in pediatric OSAHS.
[Mh] Termos MeSH primário: Imagem por Ressonância Magnética/métodos
Técnicas de Imagem de Sincronização Respiratória/métodos
Apneia Obstrutiva do Sono/diagnóstico por imagem
[Mh] Termos MeSH secundário: Tonsila Faríngea/diagnóstico por imagem
Tonsila Faríngea/fisiopatologia
Adolescente
Área Sob a Curva
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Nasofaringe/diagnóstico por imagem
Nasofaringe/fisiopatologia
Polissonografia
Curva ROC
Respiração
Índice de Gravidade de Doença
Sono
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009680


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[PMID]:28468136
[Au] Autor:Ant A; Kemaloglu YK; Yilmaz M; Dilci A
[Ad] Endereço:*Department of Otorhinolaryngology, Faculty of Medicine, Gazi University †Department of Otorhinolaryngology, Ankara Oncology Education and Research Hospital, Ankara ‡Department of Otorhinolaryngology, Eskisehir Yunus Emre State Hospital, Eskisehir, Turkey.
[Ti] Título:Craniofacial Deviations in the Children With Nasal Obstruction.
[So] Source:J Craniofac Surg;28(3):625-628, 2017 May.
[Is] ISSN:1536-3732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Nasal obstruction mainly caused by adenoid hypertrophy in children affects the craniofacial growth and development process, and the craniofacial deviations and/or differences reported in the children are very similar to those in the adults with obstructive sleep apnea syndrome (OSAS). The authors aimed to look for relationships of the linear craniofacial dimensions in the children suffering from nasal obstruction with age, degree of clinical nasal obstruction score (CNOS), and relative size of the adenoid mass within the nasopharynx in their study.Fifty-five children suffering from nasal obstruction were retrospectively enrolled, and clinical data was used to calculate CNOS. On the lateral cephalometric radiographies, 9 linear variables were measured and adenoidal-nasopharyngeal ratio (ANR) was calculated.The data presented that, not CNOS, but ANR shown decrease by age, while many skeletal variables with exception of the nasopharyngeal and adenoidal postero-anterior dimensions were increased by age. Further, it was found that while CNOS were negatively correlated with the anterior cranial base length, anterior-superior facial height, and maxillary depth, ANR disclosed significant correlation only with the anteriorsuperior facial height. The authors' results support that nasal obstruction in the children was related not only to the adenoidal hypertrophy. Although relative size of the adenoidal mass in relation to the nasopharynx decreased by age, nasal obstruction was still present. Further, these results support that craniofacial deviations and/or differences in the children with nasal obstruction is similar to the adult OSAS patients. Smaller dimensions related to the naso-maxillary complex in the children with more severe nasal obstruction appear to be continuous by age. Hence, it could be said that narrow naso-maxillary complex could contribute to proceed nasal obstruction by age, which may contribute to OSAS in the adults.
[Mh] Termos MeSH primário: Tonsila Faríngea/patologia
Obstrução Nasal/etiologia
Crânio/patologia
[Mh] Termos MeSH secundário: Tonsila Faríngea/diagnóstico por imagem
Fatores Etários
Cefalometria
Criança
Pré-Escolar
Feminino
Seguimentos
Seres Humanos
Hipertrofia/complicações
Hipertrofia/diagnóstico por imagem
Masculino
Obstrução Nasal/diagnóstico por imagem
Obstrução Nasal/patologia
Radiografia
Estudos Retrospectivos
Crânio/diagnóstico por imagem
Crânio/crescimento & desenvolvimento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003409


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[PMID]:29287875
[Au] Autor:Mularczyk C; Walner DL; Hamming KK
[Ad] Endereço:University of Illinois, College of Medicine, Urbana-Champaign, IL, USA.
[Ti] Título:Coblation versus microdebrider in pediatric adenoidectomy.
[So] Source:Int J Pediatr Otorhinolaryngol;104:29-31, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare and contrast coblation and microdebrider with touch-up electrocautery (ME) for adenoidectomy in children. METHODS: Patients <18 years old undergoing adenoidectomy without tonsillectomy were selected for this prospective, single-blinded, randomized controlled trial. Participants were enrolled into one of two groups based on birth date: coblation or ME. The surgeons completed a standard survey about intraoperative factors for each method. Recovery nurses filled out a standardized survey postoperatively. A third standardized survey was completed via a phone interview with the parent or patient caregiver on postoperative day 3 to assess procedure outcomes. The survey results were then compared using ANOVA statistical analysis. RESULTS: 50 patients were enrolled in the coblation group and 51 were enrolled in the ME group. There was no significant difference in mean age between the coblation (4.96 years) and ME groups (4.58 years) (p = 0.525). The mean time (in minutes) for coblation (5.50) was significantly lower than ME (9.47) when controlling for the confounder: surgical site exposure (p < 0.001). The surgical time was significantly influenced by the quality of exposure/visualization (p = 0.037). The coblator method had significantly less intraoperative blood loss compared to ME (p < 0.001). There was a statistically significant difference between coblation (1.53) and ME (2.05) for days of pain (p = 0.045) when controlling for the confounder adenoid size. CONCLUSION: In our study we found that coblation demonstrated significantly less intraoperative time and less blood loss, as well as a shorter duration of postoperative pain, when compared to ME for adenoidectomy.
[Mh] Termos MeSH primário: Técnicas de Ablação/métodos
Adenoidectomia/métodos
Eletrocoagulação/métodos
[Mh] Termos MeSH secundário: Técnicas de Ablação/efeitos adversos
Tonsila Faríngea/cirurgia
Criança
Pré-Escolar
Eletrocoagulação/efeitos adversos
Feminino
Seres Humanos
Masculino
Duração da Cirurgia
Complicações Pós-Operatórias/epidemiologia
Período Pós-Operatório
Estudos Prospectivos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE


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[PMID]:29224752
[Au] Autor:Johnston J; Mahadevan M; Douglas RG
[Ad] Endereço:University of Auckland, Department of Surgery, PO Box 99743, Newmarket, Auckland 1149, New Zealand. Electronic address: jj.johnston@auckland.ac.nz.
[Ti] Título:Incidence and factors associated with revision adenoidectomy: A retrospective study.
[So] Source:Int J Pediatr Otorhinolaryngol;103:125-128, 2017 Dec.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Adenoidectomy is one of the most commonly performed pediatric operations worldwide. There are a proportion of children who require revision adenoidectomy. Yet there is little in the literature about the incidence, associated factors and etiology of adenoidal regrowth. The aim of this retrospective cohort study was to determine incidence and factors associated with revision adenoidectomy. METHODS: An extraction of all hospital morbidity records belonging to patients under the age of 18 years who underwent one or more adenoidectomy procedures (with or without tonsillectomy) between January 1, 2000 and June 2016 at a tertiary care children's hospital was performed. Demographic, diagnostic, and procedural data were included in the analysis. Community prescribing information was examined for the number of courses of antibiotics prescribed to each patient prior to initial adenoidectomy. RESULTS: There were 8260 patients under the age of 18 years who underwent primary adenoidectomy from 2000 to 2016 at a tertiary pediatric hospital. 2.5% (n = 212) of patients underwent revision adenoidectomy in our cohort during the same time period. A higher proportion of females underwent revision adenoidectomy when compared to male counterparts (p = 0.007). Patients who were prescribed more than five courses of antibiotics prior to initial adenoidectomy were more likely to undergo revision adenoidectomy (p = 0.003). Patients with a diagnosis of otitis media with effusion were more likely to undergo revision adenoidectomy (p=<0.001). A diagnosis of asthma (p=<0.001), gastroesophageal reflux disease (GERD) (p=<0.001), and allergic rhinitis (p=<0.001) was associated with revision adenoidectomy. An age of over 4 years at the time of initial adenoidectomy was associated with revision adenoidectomy (p=<0.001). Adenoids that obstructed over 75% of the nasal choanae were associated with revision adenoidectomy in this cohort (p=<0.001). CONCLUSION: This study has identified several factors associated with revision adenoidectomy.
[Mh] Termos MeSH primário: Adenoidectomia/estatística & dados numéricos
Tonsila Faríngea/cirurgia
Reoperação/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adenoidectomia/métodos
Adolescente
Criança
Pré-Escolar
Estudos de Coortes
Feminino
Hospitais Pediátricos
Seres Humanos
Incidência
Masculino
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:29224765
[Au] Autor:Lai D; Qin G; Pu J; Liu L; Yang Y
[Ad] Endereço:Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China. Electronic address: lz_ld@126.com.
[Ti] Título:Pre- and post-operative application of acoustic rhinometry in children with otitis media with effusion and with or without adenoid hypertrophy-a retrospective analysis.
[So] Source:Int J Pediatr Otorhinolaryngol;103:51-54, 2017 Dec.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There is no standardized scheme for preoperative evaluation of adenoid hypertrophy or a consensus on surgical indications for adenoidectomy in children with otitis media with effusion (OME), especially for young children intolerant to nasal endoscopic assessment. The aim of this study was to evaluate the efficacy and reliability of acoustic rhinometry (AR) in evaluating benefits from adenoidectomy in children with OME. METHOD: Children with OME who were scheduled for surgical intervention were reviewed and AR tests performed preoperatively and postoperatively. The patients were divided into two groups based on the surgical strategy (Group I: tympanostomy tube placement alone; Group II: tympanostomy tube placement plus adenoidectomy). Correlation and regression analyses were performed to assess the relationship between findings of AR and nasal endoscopy. AR parameters including minimal nasal cross-sectional area (MCA), and nasopharyngeal volume (NPV), as well as scores of subjective symptoms were obtained to evaluate the utility of AR pre- and post-surgery. RESULTS: Sixty-five children aged 4-10 years who met the inclusion criteria were included. No significant differences in gender or age distribution were observed between Group I and Group II. MCA, as well as NPV significantly decreased in Group II when compared with Group I (p = 0.000). A significant inverse correlation was observed between NPV and choanal obstruction ratio in both groups I (r = -0.625, p < 0.001) and II (r = -0.570, p < 0.001). A significant difference between preoperative and postoperative NPV and subjective symptom scores was observed in group II after adenoidectomy (p = 0.000). CONCLUSION: AR parameters showed a good clinical correlation with findings of nasal endoscopy and thus may be useful for evaluating candidacy for surgical adenoidectomy among children with OME, especially in whom preoperative nasal endoscopic examination is not feasible. Additionally, AR can reveal the changes occurring within the nasopharyngeal passage before and after adenoidectomy.
[Mh] Termos MeSH primário: Adenoidectomia/métodos
Tonsila Faríngea/patologia
Ventilação da Orelha Média/métodos
Otite Média com Derrame/fisiopatologia
Rinometria Acústica/métodos
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Endoscopia
Feminino
Seres Humanos
Hipertrofia/cirurgia
Masculino
Cavidade Nasal/fisiopatologia
Otite Média com Derrame/cirurgia
Reprodutibilidade dos Testes
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:29049225
[Au] Autor:Wu J; Gu M; Chen S; Chen W; Ni K; Xu H; Li X
[Ad] Endereço:Department of Otolaryngology and Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
[Ti] Título:Factors related to pediatric obstructive sleep apnea-hypopnea syndrome in children with attention deficit hyperactivity disorder in different age groups.
[So] Source:Medicine (Baltimore);96(42):e8281, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to retrospectively investigate the factors related to pediatric obstructive sleep apnea-hypopnea syndrome (OSAHS) with attention deficit hyperactivity disorder (ADHD) in children younger than 6 years and those older than 6 years.A total of 437 children who were hospitalized due to OSAHS between January 2014 and December 2014 were retrospectively reviewed. The children were further divided into OSAHS group and OSAHS + ADHD group. The general characteristics, OSA-18 quality of life, intention-hyperactivity score, and polysomnographic parameters (apnea-hypopnea index and the lowest oxygen saturation) were collected and compared between groups.There were 298 boys and 139 girls with the male to female ratio of 2.14:1. ADHD was found in 146 children including 105 boys and 41 girls with the male to female ratio of 2.56:1. Of these children, 31.62% and 35.46% had concomitant ADHD in children aged 4 to 5 years and those aged 6 to 11 years, respectively. In children aged 4 to 5 years, the incidence of allergic rhinitis was significantly higher (P = .016) and the adenoid hypertrophy was more severe (P = .001) in those with concomitant ADHD. In children aged 6 to 11 years, the tonsil hypertrophy was more severe in those with concomitant ADHD (P = .019). In children with concomitant ADHD, OSA-18 score was higher than in those with OSAHS alone (P < .001). Higher frequency of respiratory events (P < .001) and more severe hypoxia (P < .001) were found in children with concomitant ADHD than in those with OSAHS alone.As high as 30% of OSAHS children have concomitant ADHD, and the incidence of ADHD in OSAHS children is increasing over age. Boys are more likely to develop OSAHS and incidence of ADHD in OSAHS boys is higher than in OSAHS girls. In addition, risk factors of ADHD also vary between age groups. The ADHD is related to the severity of allergic rhinitis and adenoid hypertrophy in children aged 4 to 5 years, and to the severity of tonsil hypertrophy in children aged 6 to 11 years. Hypoxia may be an important factor causing ADHD. OSAHS should be treated as early as possible to reduce the incidence of ADHD in children.
[Mh] Termos MeSH primário: Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia
Apneia Obstrutiva do Sono/epidemiologia
[Mh] Termos MeSH secundário: Tonsila Faríngea/patologia
Fatores Etários
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Tonsila Palatina/patologia
Doenças Faríngeas/epidemiologia
Doenças Faríngeas/patologia
Polissonografia
Qualidade de Vida
Estudos Retrospectivos
Rinite Alérgica/epidemiologia
Índice de Gravidade de Doença
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008281


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[PMID]:28964308
[Au] Autor:Çetin M; Bozan N
[Ad] Endereço:Department of Pediatric Cardiology, Yuzuncu Yil University, Van, Turkey. Electronic address: drmecnun@hotmail.com.
[Ti] Título:The effects of adenotonsillar hypertrophy corrective surgery on left ventricular functions and pulmonary artery pressure in children.
[So] Source:Int J Pediatr Otorhinolaryngol;101:41-46, 2017 Oct.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Comparison of left ventricular functions in preoperative and postoperative periods of children with adenotonsillar hypertrophy (ATH) who have findings of upper airway obstruction (UAO), using echocardiographic parameters. METHODS: Thirty children who were diagnosed with UAO due to ATH, and who have undergone adenoidectomy/adenotonsillectomy and 30 healthy children, between 2 and 11 years of age, were included in the study. Patient group was evaluated by the pulsed wave tissue Doppler echocardiography, as well as with conventional echocardiography, before and 6 months after the operation. RESULTS: Of 30 children in study group, 18 (60%) had adenotonsillectomy and 12 (40%) had adenoidectomy. The differences between groups regarding myocardial performance index (MPI) was not statistically significant (p = 0.847). There was not any statistically significant difference between groups in terms of mitral isovolemic acceleration (MIVA) (2.28 ± 0.67, 2.24 ± 0.55, 2.23 ± 0.49; p = 0.943, respectively). Interventricular septum diameter (IVSD) was significantly higher in preoperative group than postoperative and control groups (3.68 ± 0.52, 3.50 ± 0.40, 3.38 ± 0.60; p = 0.028, respectively). Pulmonary acceleration time (PAcT) was found to be significantly lower in preoperative group compared to postoperative and control groups (107.64 ± 16.60, 119.52 ± 15.95, 120.47 ± 16.19; p = 0.004, respectively). Mean pulmonary arterial pressure (mPAP) was significantly higher in preoperative group than postoperative and control groups (30.58 ± 8.11, 25.23 ± 9.07, 25.00 ± 6.52; p = 0.002, respectively). In postoperative group mPAP was found to be similar to the control group. CONCLUSIONS: Clinical or subclinical left ventricle (LV) dysfunction in children with ATH who have findings of UAO was not determined while mean pulmonary arterial pressure was significantly higher compared with the control cases. Besides early adenotonsillectomy is a beneficial treatment option for these patients.
[Mh] Termos MeSH primário: Adenoidectomia/efeitos adversos
Tonsila Faríngea/cirurgia
Obstrução das Vias Respiratórias/cirurgia
Tonsila Palatina/cirurgia
Artéria Pulmonar/fisiopatologia
Tonsilectomia/efeitos adversos
Função Ventricular Esquerda/fisiologia
[Mh] Termos MeSH secundário: Obstrução das Vias Respiratórias/etiologia
Criança
Pré-Escolar
Ecocardiografia
Feminino
Seres Humanos
Hipertrofia/cirurgia
Masculino
Período Pós-Operatório
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171002
[St] Status:MEDLINE


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[PMID]:28802366
[Au] Autor:Kljajic Z; Roje Z; Becic K; Capkun V; Vilovic K; Ivanisevic P; Marusic E
[Ad] Endereço:University Department of ENT, University Hospital Center Split, Spinciceva 1, Split, Croatia.
[Ti] Título:Formula for the prediction of apnea / hypopnea index in children with obstructive sleep apnea without polysomnography according to the clinical parameters: Is it reliable?
[So] Source:Int J Pediatr Otorhinolaryngol;100:168-173, 2017 Sep.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF THE STUDY: The aim of the study was to propose "the risk formula" for obstructive sleep apnea in children according to the general and local clinical parameters and findings relevant for obstructive sleep apnea (OSA) severity. The unmet need for this formula arises from the economic burden of polysomnography (device, staff, training, special sleep centers, etc) as the golden standard for the diagnostics. MATERIALS AND METHODS USED: The study was performed from January 2013 until January 2016 in the Sleep Center, Department for Neuroscience, School of Medicine of the University of Split, Department of Pediatrics, University Hospital Split, Croatia and ENT Dept. University Hospital in Split, Croatia. Inclusion criteria were: age > two years, AHI >1 diagnosed by polysomnography. Exclusion criteria were: chronic lung disease, active tonsillitis/pharyngitis at the time of the physical exam and syndromes that affect breathing. All polysomnograms were scored by a qualified sleep technologist and interpreted by two board certified sleep physicians independently. Age, sex, BMI, Mallampati score, tonsillar size and adenoids size were recorded. All statistical calculations were performed using SPSS 20. RESULTS: In total 60 children were included in the study. The median of age was 5 years (range 2-9). There were 19 (32%) girls and 41 (68%) boys. Of all evaluated predictors, there were statistically significant differences in the values of AHI among children with different modified Mallampati score (χ2 = 28.2; p < 0.001), different size of tonsils (χ2 = 25.3; p < 0.001) and different size of adenoids (z = 2.7; p = 0,006) in univariate regression analysis. Strong positive association of AHI with modified Mallampati score (standardized B = 0.51; partial correlation = 0.542, r = 0.631) was found, as well as positive correlation of AHI with tonsillar size (standardized B = 0.246; partial correlation = 0.295,R = 0.489) in the multivariate forward stepwise regression analysis. CONCLUSION: Even though we are aware that PSG is the gold standard for diagnostics of SDB there is a significant financial burden for this diagnostic procedure. That is why there is a necessity for establishing good clinical standards and possible formula for OSA severity evaluation. We propose formula which includes Mallampati score and tonsillar size for OSA -risk calculation in order to perform early therapeutic intervention thereby reducing the risk of long-term negative consequences. We recommend this formula as the screening formula in circumstances where PSG is not available, in cases when the "waiting list" is too long or when a child can not cooperate to perform it. In developing countries like Croatia on time intervention with reduced procedure-associated costs is of the utmost importance.
[Mh] Termos MeSH primário: Tonsila Faríngea/fisiopatologia
Tonsila Palatina/fisiopatologia
Polissonografia/métodos
Apneia Obstrutiva do Sono/diagnóstico
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Croácia
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170814
[St] Status:MEDLINE



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