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1.
Article in Spanish | LILACS, COLNAL | ID: biblio-1253869

ABSTRACT

La tuberculosis es la primera causa de mortalidad infectocontagiosa a nivel mundial. La tuberculosis pulmonar corresponde a la presentación más frecuente, sin embargo, el 15 % de los casos cursan con infección extrapulmonar, siendo raro el compromiso amigdalino. Este reporte de caso describe a un paciente de 39 años con odinofagia recurrente secundaria a amigdalitis por Mycobacterium tuberculosis, un raro caso de tuberculosis extrapulmonar. La amigdalitis es una infección leve y frecuente de la vía aérea superior, que responde adecuadamente al manejo antibiótico; sin embargo, cuadros recurrentes y prolongados, manifestaciones atípicas o pobre respuesta a la antibioticoterapia son características que obligan a la búsqueda de diagnósticos diferenciales, lo que lleva a considerar la presencia de Mycobacterium tuberculosis como agente etiológico, especialmente en países con alto índice de tuberculosis como Colombia


Tuberculosis is the leading cause of infectious mortality worldwide. The pulmonary one corresponds to the most frequent presentation, however up to 15% of tuberculosis cases present extrapulmonary involvement, tonsillar tuberculosis being rare. The following is a case report of a 39-year-old patient with recurrent odynophagia secondary to Mycobacterium tuberculosis tonsillitis, a rare form of extrapulmonary tuberculosis. Tonsillitis is a benign and extremely common infection of the upper airway. Such patients benefit from systemic antibiotics, although, recurrent episodes, prolonged odynophagia, atypical manifestations, or poor response to antimicrobial therapy forces consideration of diagnostic possibilities other than the obvious, including Mycobacterium tuberculosis as the etiological agent, especially in countries with the highest rates of tuberculosis.


Subject(s)
Humans , Male , Adult , Tuberculosis, Pulmonary/complications , Tonsillitis/microbiology , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/diagnostic imaging , Tonsillitis/drug therapy , Tonsillitis/diagnostic imaging , Anti-Bacterial Agents/therapeutic use
2.
Article in Chinese | WPRIM | ID: wpr-878951

ABSTRACT

Based on the network pharmacology and molecular docking method to explore the molecular mechanism of Shengjiang Powder in treating chronic tonsillitis in children. This research first based on the Traditional Chinese Medicine System Pharmacology(TCMSP) and the Bioinformatics Analysis Tools for Molecular Mechanism of Traditional Chinese Medicine(BATMAN-TCM), the effective active ingredients of the drugs contained in Shengjiang Powder were screened out by the pharmacokinetic(ADME) parameters, the targets were predicted, and then chronic tonsillitis disease in children targets were obtained by GeneCards database. Afterwards, the target protein names were standardized by the Uniprot database. The drug targets were matched with the disease targets to obtain the potential therapeutic targets of Shengjiang Powder. Cytoscape 3.8.0 software was used to screen out and construct the network diagram of "drug-components-core targets-disease". DAVID database and R language were used to conduct the enrichment analysis of core action targets. Finally, AutoDock software was used to conduct molecular docking between drug components with a high network medium value and core action targets. According to the findings, after standardized treatment, a total of 79 active ingredients of Shengjiang Powder were obtained; it was predicted to get 1 261 potential targets, 268 potential targets for treatment of chronic tonsillitis in children, and 29 core targets; and 81 entries of GO enrichment were determined(P<0.05), including 63 biological processes, 7 cell components, 11 molecular function items, 24 KEGG pathway enrichment items(P<0.05), mainly including cell cycle, inflammatory factors, viral infection, immune regulation and other signaling pathways. The results of molecular docking showed that main active components in Shengjiang Powder had a stable binding activity with the core targets. This study revealed the mechanism of Shengjiang Powder in the treatment of chronic tonsillitis in children, mainly by resisting virus, inhibiting inflammation, regulating immunity and other means to play a synergistic effect, so as to provide a theoretical basis for rational clinical application.


Subject(s)
Child , Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Molecular Docking Simulation , Powders , Tonsillitis/drug therapy
3.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(2): 221-228, jun. 2019. tab
Article in Spanish | LILACS | ID: biblio-1014441

ABSTRACT

RESUMEN Durante el embarazo ocurren una serie de cambios, como edema y disminución de la actividad ciliar en la mucosa respiratoria alta, que pueden favorecer la aparición de síntomas y patologías del área otorrinolaringológica. La eficacia de los tratamientos farmacológicos en la rinitis del embarazo es pobre. El tratamiento de primera línea de la rinitis alérgica son los corticoides intranasales. Existe evidencia sobre la seguridad en el embarazo para furoato de fluticasona, mometasona y budesonida intranasal. El tratamiento del resfrio común está enfocado en el manejo sintomático, los antinflamatorios no esteroidales están contraindicados. En rinosinusitis aguda bacteriana la amoxicilina es de primera línea. En rinosinusitis crónica el manejo quirúrgico está reservado sólo para las complicaciones. Tanto la otitis media aguda como la amigdalitis aguda deben ser tratadas con antibióticos sólo si se sospecha origen bacteriano, el esquema de primera linea es amoxicilina y en caso de alergias se debe usar cefpodoxime o azitromicina. En caso de otorrea no existe evidencia sobre la seguridad de las gotas de antibióticos ótico durante el embarazo. Múltiples medicamentos utilizados habitualmente en otorrinolaringologia no pueden ser usados durante el embarazo. Se debe privilegiar la seguridad materno fetal, utilizando aquellos medicamentos con seguridad demostrada.


ABSTRACT During pregnancy a series of changes occur, such as edema and decreased ciliary activity in the upper respiratory mucosa, which may favor the appearance of symptoms and pathologies of the otorhinolaryngological area. The efficacy of pharmacological treatments in rhinitis of pregnancy is poor. The first-line treatment of allergic rhinitis is intranasal corticosteroids. There is evidence on safety in pregnancy for fluticasone furoate, mometasone and intranasal budesonide. The treatment of the common cold is focused on symptomatic management, nonsteroidal anti-inflammatory drugs are contraindicated. In acute bacterial rhinosinusitis, amoxicillin is first-line. In chronic rhino-sinusitis in surgical management is reserved only for complications. Both acute otitis media and acute tonsillitis should be treated with antibiotics only if bacterial origin is suspected, the first-line treatment is amoxicillin, in the case of allergies, cefpodoxime or azithromycin should be used. In case of otorrhea there is no evidence on the safety of otic antibiotic drops during pregnancy. Conclusion: multiple medications commonly used in otorhinolaryngology cannot be used during pregnancy. Maternal and fetal safety should be privileged, using those medications with proven safety.


Subject(s)
Humans , Female , Pregnancy , Otorhinolaryngologic Diseases/drug therapy , Pregnancy Complications/drug therapy , Otitis Media/drug therapy , Sinusitis/drug therapy , Tonsillitis/drug therapy , Rhinitis/drug therapy
4.
Braz. j. otorhinolaryngol. (Impr.) ; 84(3): 265-279, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-951826

ABSTRACT

Abstract Introduction: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. Objectives: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. Methods: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Results: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Conclusions: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.


Resumo Introdução: A resistência bacteriana a antibióticos nos processos infecciosos é um fato crescente nos últimos anos, especialmente devido ao seu uso inapropriado. Ao longo dos anos vem se tornando um grave problema de saúde pública devido ao prolongamento do tempo de internação, elevação dos custos de tratamento e aumento da mortalidade relacionada às doenças infecciosas. Quase a metade das prescrições de antibióticos em unidades de pronto atendimento é destinada ao tratamento de alguma infecção de vias aéreas superiores, especialmente rinossinusites, otite média aguda supurada e faringotonsilites agudas, sendo que uma significativa parcela dessas prescrições é inapropriada. Nesse contexto, os otorrinolaringologistas têm um papel fundamental na orientação de pacientes e colegas não especialistas, para o uso adequado e racional de antibióticos frente a essas situações clínicas. Objetivos: Realizar uma revisão das atuais recomendações de utilização de antibióticos nas otites médias, rinossinusites e faringotonsilites agudas adaptadas à realidade nacional. Método: Revisão na base PubMed das principais recomendações internacionais de tratamentos das infecções de vias aéreas superiores, seguido de discussão com um painel de especialistas. Resultados: Os antibióticos devem ser utilizados de maneira criteriosa nas infecções agudas de vias aéreas superiores não complicadas, a depender da gravidade da apresentação clínica e dos potenciais riscos associados de complicações supurativas e não supurativas. Conclusões: Constantes revisões a respeito do tratamento das principais infecções agudas são necessárias para que sejam tomadas medidas coletivas no uso racional e apropriado de antibióticos. Somente com orientação e transformações no comportamento de médicos e pacientes é que haverá mudanças do paradigma de que toda infecção de vias aéreas superiores deva ser tratada com antibióticos, minimizando por consequência os efeitos de seu uso inadequado.


Subject(s)
Humans , Respiratory Tract Infections/drug therapy , Practice Patterns, Physicians'/statistics & numerical data , Inappropriate Prescribing/statistics & numerical data , Anti-Bacterial Agents/administration & dosage , Otitis Media/drug therapy , Sinusitis/drug therapy , Pharyngitis/drug therapy , Tonsillitis/drug therapy , Rhinitis/drug therapy , Acute Disease
6.
Rev. bras. cir. plást ; 29(3): 442-445, jul.-sep. 2014. ilus
Article in English, Portuguese | LILACS | ID: biblio-743

ABSTRACT

A face representa uma estrutura importante nos seres humanos, devido a ser a parte mais visível do corpo e conter elementos delicados e complexos, que são essenciais em termos de beleza e funcionalidade. As reconstruções faciais, em áreas de grandes perdas de substâncias, permanecem como um desafio para os cirurgiões. Apresentam várias opções de reparo, todas com suas vantagens e desvantagens. Mostramos o caso de um paciente apresentando perda de substância de espessura total em região de bochecha, que foi submetido à associação de retalho mucoso e retalho cutâneo local, apresentando bom resultado e preservação funcional.


The face is an important structure, because it is the most visible part of the body and contains delicate and complex elements that are essential for aesthetics and functionality. Facial reconstruction of areas with substantial substance loss remains a surgical challenge. There are several repair options, with corresponding advantages and disadvantages. We present a case of a patient with substance loss of the total thickness of the cheek region who received mucosal and local skin flap surgery, with good results and functional preservation.


Subject(s)
Humans , Male , Adult , History, 21st Century , Penicillins , Atrophy , Surgical Flaps , Case Reports , Tonsillitis , Cheek , Acquired Immunodeficiency Syndrome , HIV , Reconstructive Surgical Procedures , Diffusion of Innovation , Face , Facial Bones , Anti-Bacterial Agents , Penicillins/therapeutic use , Atrophy/surgery , Surgical Flaps/surgery , Surgical Flaps/transplantation , Tonsillitis/pathology , Tonsillitis/drug therapy , Cheek/surgery , Cheek/pathology , Acquired Immunodeficiency Syndrome/pathology , Reconstructive Surgical Procedures/methods , Face/abnormalities , Face/surgery , Facial Bones/surgery , Anti-Bacterial Agents/therapeutic use
8.
Rev. paul. pediatr ; 31(1): 4-9, mar. 2013. tab
Article in Portuguese | LILACS | ID: lil-671651

ABSTRACT

OBJETIVO: Avaliar o impacto da realização rotineira da prova rápida para pesquisa de estreptococo do grupo A no diagnóstico e tratamento da faringotonsilite aguda em crianças. MÉTODOS: Estudo prospectivo e observacional que contou com a utilização de protocolo de pesquisa estabelecido na Unidade de Emergência do Hospital Universitário da Universidade de São Paulo para o atendimento de crianças e adolescentes com faringotonsilite aguda. RESULTADOS: Com base na avaliação clínica, dos 650 pacientes estudados, antimicrobianos seriam prescritos para 389 indivíduos (59,8%) e, com o uso da pesquisa de estreptococo do grupo A, foram prescritos em 286 pacientes (44,0%). Das 261 crianças que não receberiam antibiótico pelo quadro clínico, 111 (42,5%) tiveram pesquisa de estreptococo do grupo A positiva. O diagnóstico baseado no quadro clínico apresentou sensibilidade de 61,1%, especificidade de 47,7%, valor preditivo positivo de 44,9% e valor preditivo negativo de 57,5%. CONCLUSÕES: O diagnóstico clínico da faringotonsilite estreptocócica mostrou baixa sensibilidade e especificidade. O uso rotineiro da prova rápida para pesquisa de estreptococo permitiu a redução do uso de antibióticos e a identificação de um grupo de risco para as complicações da infecção estreptocócica, pois 42,5% dos pacientes com prova rápida positiva não receberiam antibióticos, se levado em consideração apenas o diagnóstico clínico.


OBJECTIVE: To evaluate the impact of the routine use of rapid antigen detection test in the diagnosis and treatment of acute pharyngotonsillitis in children. METHODS: This is a prospective and observational study, with a protocol compliance design established at the Emergency Unit of the University Hospital of Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: 650 children and adolescents were enrolled. Based on clinical findings, antibiotics would be prescribed for 389 patients (59.8%); using the rapid antigen detection test, they were prescribed for 286 patients (44.0%). Among the 261 children who would not have received antibiotics based on the clinical evaluation, 111 (42.5%) had positive rapid antigen detection test. The diagnosis based only on clinical evaluation showed 61.1% sensitivity, 47.7% specificity, 44.9% positive predictive value, and 57.5% negative predictive value. CONCLUSIONS: The clinical diagnosis of streptococcal pharyngotonsillitis had low sensitivity and specificity. The routine use of rapid antigen detection test led to the reduction of antibiotic use and the identification of a risk group for complications of streptococcal infection, since 42.5% positive rapid antigen detection test patients would not have received antibiotics based only on clinical diagnosis.


OBJETIVO: Evaluar el impacto de la realización de rutina de la prueba rápida para investigación de estreptococos del grupo A en el diagnóstico y tratamiento de la faringotonsilitis aguda en niños. MÉTODOS: Estudio prospectivo y observacional que contó con el uso de protocolo de investigación establecido en la Unidad de Emergencia del Hospital Universitario de la USP para la atención a niños y adolescentes con faringotonsilitis aguda. RESULTADOS: Con base en la evaluación crítica, de los 650 pacientes estudiados, antimicrobianos serían prescritos a 389 individuos (59,8%) y, con el uso de la investigación de estreptococos del grupo A se los prescribieron a 286 pacientes (44,0%). De los 261 niños que no recibirían antibióticos por el cuadro clínico, 111 (42,5%) tuvieron investigación de estreptococos del grupo A positiva. El diagnóstico basado en el cuadro clínico presentó sensibilidad del 61,1%, especificidad del 47,7%, valor predictivo positivo del 44,9% y valor predictivo negativo del 57,5%, CONCLUSIONES: En este estudio, el diagnóstico clínico de la faringotonsilitis estreptocócica mostró baja sensibilidad y especificidad. El uso de rutina de la prueba rápida para investigación de estreptococos permitió la reducción del uso de antibióticos y la identificación de un grupo de riesgo para las complicaciones de la infección estreptocócica, pues el 42,5% de los pacientes con prueba rápida positiva no recibirían antibióticos si se llevara en consideración solamente el diagnóstico clínico.


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Anti-Bacterial Agents/therapeutic use , Antigens, Bacterial/analysis , Pharyngitis/diagnosis , Pharyngitis/drug therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/therapy , Streptococcus pyogenes/immunology , Tonsillitis/diagnosis , Tonsillitis/drug therapy , Acute Disease , Emergency Service, Hospital , Prospective Studies , Pharyngitis/complications , Respiratory Tract Infections , Time Factors , Tonsillitis/complications
9.
Arch. argent. pediatr ; 110(3): 207-213, mayo-jun. 2012. graf, tab
Article in Spanish | LILACS | ID: lil-639610

ABSTRACT

Introducción. Las faringoamigdalitis agudas suponen un importante porcentaje de las consultas pediátricas y una de las principales causas de prescripción antibiótica. Nuestro objetivo fue analizar los hábitos de prescripción antimicrobiana en niños diagnosticados con faringoamigdalitis aguda en servicios de urgencias hospitalarios y consultas pediátricas de atención primaria en Asturias (España). Métodos. Estudio descriptivo multicéntrico que evalúa pacientes pediátricos diagnosticados con faringoamigdalitis aguda en los servicios de urgencias de 5 hospitales y en 80 consultas pediátricas de atención primaria. La idoneidad de las prescripciones se estableció por comparación con estándares de referencia. Resultados. Se incluyeron 563 niños con faringoamigdalitis agudas, 49,7% en atención primaria (IC 95% 45,6-53,8%), a los largo de 30 días no consecutivos (6,8% de las consultas pediátricas). Se prescribieron antibióticos en el 75,5% de las faringoamigdalitis (IC 95% 71,9-79,0%) [(78,3% en los menores de 3 años (IC 95% 71,8-84,8%)]. El antibiótico más indicado fue la amoxicilina [39,1% de los casos que recibieron antibioterapia (IC 95% 34,4-43,7%)]. Se encontraron diferencias signifcativas en el porcentaje de prescripción antibiótica entre atención primaria y urgencias hospitalarias (70,0% contra 80,9%, p= 0,003). El tratamiento prescrito se consideró de primera elección en el 43,3% de los tratados (IC 95% 38,6-48,0%) e inadecuado en el 56,0% (IC 95% 51,3-60,7%). Conclusiones. Pese a que la mayoría de las faringomigdalitis agudas pediátricas son de probable etiología vírica, tres cuartas partes de ellas reciben tratamiento antibiótico en nuestro medio, siendo la elección inapropiada en más de la mitad de los casos.


Introduction. Acute pharyngotonsillitis accounts for a large portion of antibiotic prescriptions in pediatric offces. Our aim was to analyze the antimicrobial prescription habits for acute pharyngotonsillitis in children from hospital emergency departments and primary care pediatric clinics in Asturias (Spain). Methods. Multicenter descriptive study evaluating pediatric patients with a diagnosis of acute pharyngotonsillitis in 5 hospital emergency departments and 80 pediatric primary care clinics. Appropriateness of prescription was established by comparing with reference standards. Results. Five hundred sixty-three children with acute pharyngotonsillitis [49.7% in primary care CI 95% 45.6-53.8%)] were included along 30 nonconsecutive days. Antibiotics were prescribed in 75.5% of cases (95% CI 71.9-79.0%) [78.3% in children under 3 years of age (95% CI 71.8-84.8%)]. Amoxicillin was the antibiotic most frequently prescribed [39.1% (95% CI 34.4-43.7%)]. Signifcant differences in the frequency or antibiotic prescription were found between primary care and hospital emergency departments (70% vs. 80.9%, p= 0.003). The treatment prescribed was considered frst choice in 43.3% (95% CI 38.6-48.0%) and inappropriate in 56.0% (95% CI 51.3-60.7%). Conclusions. Although in most cases pediatric acute pharyngotonsillitis is viral in origin, three out of four are treated with antibiotics. Treatment was inappropriate in more than half of the cases in our study.


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Anti-Bacterial Agents/therapeutic use , Pediatrics , Practice Patterns, Physicians' , Pharyngitis/drug therapy , Tonsillitis/drug therapy , Acute Disease , Cross-Sectional Studies , Drug Utilization/statistics & numerical data , Pharyngitis/complications , Spain , Tonsillitis/complications
10.
Medical Forum Monthly. 2012; 23 (5): 55-60
in English | IMEMR | ID: emr-144622

ABSTRACT

To observe and study the cause of penicillin-failure and to see the therapeutic effects of other drugs and find out more effective and better remedy. A Retrospective study. This study was conducted in Microbiology Department, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, National institute of Child Health from April 2004 - June 2005. A total of 300 children attending OPD's and admitted [250 suspected and 50 Normal as control cases] of age group 5 - 15 years were included in this study. Drug sensitivity pattern of streptococcus pyogenes isolated in infected and control children was observed. Antibiotic discs used were Penicillin [10] units and Erythromycin [15 micrograms]. The organism isolated GABHS shows 100% sensitivity to penicillin, while in case of erythromycin, it was sensitive in 24[85.7%] infected cases and resistant to 4[14.3%] cases. Pharyngotonsillitis is a disease of poor community, the therapy with penicillin is economical compared with Cephalosporin group. Penicillin therapy is helpful in preventing the supporative and n supporative complications caused by GABHs


Subject(s)
Humans , Tonsillitis/drug therapy , Pharyngitis/drug therapy , Treatment Outcome , Retrospective Studies , Microbial Sensitivity Tests , Disk Diffusion Antimicrobial Tests , Streptococcus pyogenes/drug effects , Erythromycin , beta-Lactamases , Penicillin Resistance
11.
West Indian med. j ; 59(6): 722-725, Dec. 2010. ilus, tab
Article in English | LILACS | ID: lil-672704

ABSTRACT

DRESS syndrome (drug reaction with eosinophilia and systemic symptoms), previously named "drug hypersensitivity syndrome", is a severe adverse drug reaction characterized by skin rash, fever, lymph node enlargement and internal organ involvement. We report on a 7-year old girl who developed DRESS syndrome caused by penicillin V treatment.


El síndrome DRESS (así llamado por las indíciales del inglés "drug reaction with eosinophilia y systemic symptoms ") es una reacción a medicamentos, acompañada por eosinofilia y síntomas sistémicos. Conocida anteriormente como "síndrome de hipersensibilidad a los medicamentos, se trata de una reacción adversa severa a los medicamentos, caracterizada por erupción cutánea, fiebre, agrandamiento de los ganglios y compromiso de órganos internos. El presente trabajo reporta el caso de una niña de 7 años de edad, que desarrolló el síndrome DRESS a partir de un tratamiento con penicilina V.


Subject(s)
Child , Female , Humans , Anti-Bacterial Agents/adverse effects , Drug Eruptions/etiology , Eosinophilia/chemically induced , Fever/chemically induced , Lymphatic Diseases/chemically induced , Penicillin V/adverse effects , Diagnosis, Differential , Drug Hypersensitivity , Drug Eruptions/diagnosis , Eosinophilia/diagnosis , Fever/diagnosis , Lymphatic Diseases/diagnosis , Pharyngitis/drug therapy , Syndrome , Tonsillitis/drug therapy
12.
Rev. otorrinolaringol. cir. cabeza cuello ; 68(1): 7-15, abr. 2008. graf, tab
Article in Spanish | LILACS | ID: lil-499244

ABSTRACT

Introducción: La faringoamigdalitis aguda (FAA) es un cuadro infeccioso producido por numerosos agentes etiológicos, siendo Streptococcus pyogenes (SP) el más frecuentemente involucrado y el principal responsable de potenciales complicaciones. Objetivo: El objetivo del estudio fue determinar la prevalencia de éste y otros microorganismos en una muestra de población pediátrica y adulta. Material y método: Se diseñó un estudio prospectivo de casos y controles en pacientes que consultaron en forma consecutiva por odinofagia con signos de inflamación faringoamigdalina. Resultados: Se obtuvo un examen completo incluyendo un cultivo faríngeo en 159 pacientes entre 3 y 55 años. Entre los síntomas relevantes destacaron: cefalea, fiebre, adenopatíasy exudado. En adultos, 29 por ciento de las FAA fueron causadas por SP, mientras que en niños sólo 17 por ciento. En ningún paciente control se objetivó la presencia de SP. Conclusión: No existió correlación entre las características clínicas y la presencia de SP. De acuerdo a estos resultados se sugiere la realización rutinaria de un estudio etiológico al enfrentarse a una FAA.


Acute pharyngotonsillitis (APT) is an infectious disease that can be caused by numerous etiologic agents, with Streptococcus pyogenes (SP) being the most frequently involved and the main cause of potential complications. This study was aimed to determine the prevalence of this and other microorganisms in a sample of a pediatric and adult population. A prospective study of cases and controls was designed in patients that presented consecutively with odynophagia and pharyngotonsilar inflammation. A complete exam was performed, including pharyngeal culture in 159 patients between 3 and 55 years of age. Among relevant symptoms we found: headache, fever, lymphadenopathy and tonsilar exúdate. 29 percentofAPTs were caused by SP in adults, and only 17 percent In children. Conclusions: There was no correlation between clinical characteristics and SP presence. According to these results, a routine etiologic study is suggested when facing an APT.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Pharyngitis/microbiology , Streptococcal Infections/epidemiology , Streptococcus pyogenes/isolation & purification , Tonsillitis/microbiology , Deglutition Disorders/microbiology , Acute Disease , Age Distribution , Anti-Bacterial Agents/pharmacology , Case-Control Studies , Chile/epidemiology , Pharyngitis/drug therapy , Microbial Sensitivity Tests , Prevalence , Prospective Studies , Streptococcus pyogenes , Tonsillitis/drug therapy
13.
Rev. bras. otorrinolaringol ; 74(1): 61-67, jan.-fev. 2008. ilus, tab
Article in Portuguese | LILACS | ID: lil-479829

ABSTRACT

Os cáseos amigdalianos afetam uma significativa porcentagem da população. As cirurgias, conservadoras ou não, têm sido as únicas alternativas viáveis de tratamento. Entretanto, ainda hoje não há um método econômico e não-invasivo de tratamento que apresente resultados satisfatórios. OBJETIVOS: Os objetivos deste estudo são avaliar a eficiência de um enxaguatório, cujos ingredientes ativos associam substâncias oxigenantes e antimicrobianas, na diminuição da formação dos cáseos amigdalianos e da saburra lingual, cuja etiologia é semelhante à dos cáseos, e avaliar a redução da concentração dos compostos sulfurados voláteis (CSVs). FORMA DE ESTUDO: Estudo clínico e experimental, randomizado, duplo-cego, placebo-controlado. MATERIAL E MÉTODO: Foi utilizada uma amostra de 50 voluntários, com queixa de tonsilite crônica caseosa há mais de um ano. A pesquisa foi realizada em 2005, nas cidades de São Paulo e Campinas. RESULTADOS: Para o grupo que utilizou a solução placebo, não houve correlação entre as variáveis nem significância estatística nos resultados. Para o grupo que utilizou o enxaguatório, os resultados foram significativos em todos os quesitos analisados. CONCLUSÕES: O novo enxaguatório demonstrou ser uma alternativa conservadora viável para o tratamento da tonsilite crônica caseosa, sendo eficiente também na redução da formação de saburra lingual e concentração dos CSVs.


Tonsil caseous affects a significant percentage of the population. Surgeries, conservative or not, have been the only viable alternatives of treatment. However, today there is still not, up to now, an economical and non-invasive treatment that presents satisfactory results. AIMS: The objectives of this study are to evaluate the efficiency of a mouthwash, with active ingredients that associate oxygenating and antimicrobial substances, in the reduction of caseous and tongue coating formation, whose etiology is similar to caseous, and to evaluate the reduction of the volatile sulfur compounds (VSCs) concentration. STUDY DESIGN: Double blind, placebo-controlled, randomized, clinical and experimental study. MATERIAL E METHODS: A sample of 50 volunteers with more than one year of chronic caseous tonsillitis complaint used it. The research was carried out in 2005, in the cities of São Paulo and Campinas. RESULTS: For the group that used the placebo solution, there was no correlation between the variables or statistical significance in the results. For the group that used the mouthwash, the results were significant in all analyzed questions. CONCLUSIONS: This new mouthwash proved to be a viable conservative alternative for the treatment of tonsil caseous, being also efficient in the reduction of tongue coating formation and VSCs concentration.


Subject(s)
Adult , Female , Humans , Male , Halitosis/drug therapy , Mouthwashes/therapeutic use , Tongue Diseases/drug therapy , Chronic Disease , Cohort Studies , Double-Blind Method , Halitosis/etiology , Longitudinal Studies , Placebos , Sulfur Compounds/analysis , Treatment Outcome , Tongue Diseases/complications , Tonsillitis/complications , Tonsillitis/drug therapy
14.
Indian J Pediatr ; 2007 Dec; 74(12): 1105-8
Article in English | IMSEAR | ID: sea-80918

ABSTRACT

Tonsillopharyngitis is very common in children, with Group A Streptococci being the most common bacterial etiology. Effective antibacterial treatment is imperative due to risk of rheumatic fever. Cephalosporins have been used successfully for the treatment of Group A beta-hemolytic Streptococcal (GABHS) tonsillopharyngitis. Cefprozil is a novel broad-spectrum oral cephalosporin. Cefprozil is rapidly absorbed from the gastrointestinal tract with high bioavailability. The excellent penetration of cefprozil into tonsillar and adenoidal tissue corresponds well with the clinical outcome. The drug provides excellent coverage against both gram-negative and -positive bacteria that may cause pharyngitis/tonsillitis. The beta-lactamase stability of cefprozil appears to exceed that of other oral cephalosporins for important gram negative pathogens. In clinical trials, cefprozil appears to be at least as effective as commonly used comparison agents such as cefaclor and cefixime. Additionally, cefprozil is better tolerated than the latter, especially with regard to gastrointestinal adverse effects. Thus cefprozil can be considered a safe and reliable drug for the treatment of Streptococcal tonsillopharyngitis in children.


Subject(s)
Acute Disease , Anti-Bacterial Agents/administration & dosage , Cephalosporins/administration & dosage , Child , Child, Preschool , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Infant , Male , Pharyngitis/drug therapy , Randomized Controlled Trials as Topic , Sensitivity and Specificity , Tonsillitis/drug therapy , Treatment Outcome
15.
J. pediatr. (Rio J.) ; 82(5,supl): S146-S152, Nov. 2006.
Article in English | LILACS | ID: lil-441734

ABSTRACT

OBJETIVOS: Apresentar as recomendações baseadas em evidência para uso de antibióticos no tratamento das infecções respiratórias agudas (IRA) mais freqüentes e as informações disponíveis sobre a importância desse tipo de conduta. FONTES DOS DADOS: Bases de dados MEDLINE, LILACS, publicações técnicas de organizações internacionais, diretrizes nacionais e internacionais. Foram utilizados os unitermos acute respiratory infection, otitis, sinusitis, tonsillitis, pneumonia, antibiotic, guidelines, bacterial resistance. Artigos citados pelos artigos incluídos foram analisados quanto à apresentação de informação de interesse. SíNTESE DOS DADOS: A resistência bacteriana tem crescido, sendo atualmente reconhecida como problema mundial de saúde pública. As IRA são a causa mais freqüente para uso de antibiótico na comunidade; grande parte desses casos, tanto nas vias aéreas superiores (otite, sinusite, faringoamidalite) como nas inferiores (pneumonia), são decorrente de infecção viral. As recomendações para racionalizar o uso de antibióticos nos pacientes com IRA têm como objetivo comum minimizar o uso desnecessário de antibióticos, visto que a "pressão antibiótica" é um dos fatores desencadeantes da resistência bacteriana. CONCLUSÕES: É de grande importância a distinção, entre os pacientes com IRA, daqueles que podem se beneficiar do uso de antibióticos. O uso das recomendações para a prescrição de antibióticos é uma estratégia para minimizar a freqüência de resistência bacteriana.


OBJECTIVES: To present evidence-based recommendations for the use of antibiotics for the treatment of the most common acute respiratory infections (ARI) and the available information on the importance of this type of management. SOURCES: MEDLINE and LILACS databases, technical publications by international organizations, national and international directives. The search terms acute respiratory infection, otitis, sinusitis, tonsillitis, pneumonia, antibiotic, guidelines and bacterial resistance were used. Articles cited by the articles selected were analyzed for information of interest. SUMMARY OF THE FINDINGS: Bacterial resistance has grown, to the extent that today it is recognized as a global public health problem. ARI are the most common cause of antibiotic usage within the community; yet a large proportion of these cases, compromising the upper (otitis, sinusitis, tonsillitis) or the lower airways (pneumonia), are the result of viral infections. Recommendations to rationalize the use of antibiotics in patients with ARI have the common objective of minimizing unnecessary antibiotic use, since "antibiotic pressure" is one of the factors triggering bacterial resistance. CONCLUSIONS: It is of great importance to differentiate among ARI patients those who will benefit from the use of antibiotics. The establishment of recommendations for the prescription of antibiotics is one strategy for minimizing the frequency of bacterial resistance.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Drug Resistance, Bacterial/drug effects , Outpatients , Otitis Media/drug therapy , Pneumonia/drug therapy , Sinusitis/drug therapy , Acute Disease , Algorithms , Drug Prescriptions , Haemophilus influenzae/drug effects , Moraxella catarrhalis/drug effects , Otitis Media/diagnosis , Otitis Media/microbiology , Practice Patterns, Physicians'/standards , Pneumonia/diagnosis , Pneumonia/microbiology , Sensitivity and Specificity , Sinusitis/diagnosis , Sinusitis/microbiology , Streptococcus pneumoniae/drug effects , Streptococcus pyogenes/drug effects , Tonsillitis/diagnosis , Tonsillitis/drug therapy , Tonsillitis/microbiology , Unnecessary Procedures
16.
Indian J Pediatr ; 2004 Jul; 71(7): 601-5
Article in English | IMSEAR | ID: sea-82246

ABSTRACT

OBJECTIVE: The emergence of penicillin resistant strains and the presence of co-pathogens have made the treatment of bacterial infections in children a challenge. Streptococcal tonsillopharyngitis, which is a common infection has been well treated with cefprozil, a novel third generation cephalosporin. The aim of the present study was to evaluate cefprozil in pediatric tonsillopharyngitis. An assessment of the clinical cure and bacteriological eradication rates and an overall tolerability was made. METHODS: It was a prospective, open, non-comparative multicentric study. 316 children (mean age 6.61 years) with tonsillopharyngitis were included. Patients were given cefprozil susp 15 mg/kg/day in two divided doses a day for 10 days. RESULTS: A clinical cure of 96.6% and bacteriological eradication of 94.29% was achieved with cefprozil. Overall tolerability of cefprozil was assessed by physicians and 46% rated tolerability of cefprozil as excellent, 38% as very good, 10% as good, 6% as fair and none as poor. CONCLUSION: Cefprozil has been found to be an excellent drug of superior microbiological and clinical activity in the treatment of pediatric patients with tonsillopharyngitis. The drug also has an expanded spectrum.


Subject(s)
Anti-Bacterial Agents/adverse effects , Cephalosporins/adverse effects , Child , Child, Preschool , Humans , Infant , Pharyngitis/drug therapy , Prospective Studies , Safety , Tonsillitis/drug therapy
18.
Indian J Med Sci ; 2001 Jul; 55(7): 371-5
Article in English | IMSEAR | ID: sea-67744

ABSTRACT

Of 175 throat swabs processed, anaerobes were isolated from 16 (9.14%) patients. Isolation of anaerobes from healthy controls was 2 out of 25 (8%). Peptostreptococci and Bacteroides species were the commonest isolates followed by Peptococci and Propioni-bacterium. All of these isolates were sensitive to Metronidazole. Clindamycin, Erythromycin and Tetracycline also showed good response.


Subject(s)
Anti-Bacterial Agents/administration & dosage , Bacteria, Anaerobic/drug effects , Bacterial Infections/drug therapy , Case-Control Studies , Chronic Disease , Female , Humans , Incidence , India/epidemiology , Male , Microbial Sensitivity Tests , Tonsillitis/drug therapy
19.
Salud pública Méx ; 42(3): 226-9, mayo-jun. 2000. tab
Article in Spanish | LILACS | ID: lil-280462

ABSTRACT

Objetivo. Determinar la susceptibilidad antimicrobiana de Streptococcus pyogenes con el fin de estimar la prevalencia de los fenotipos de resistencia a los macrólidos. Material y métodos. Se realizó un estudio de tipo transversal, en 1999, en el que se evaluaron 100 cepas de S. pyogenes, aislados en el Hospital Infantil de México Federico Gómez, en el lapso comprendido entre 1992 y 1998, procedentes de niños con faringoamigdalitis, conservadas en congelación en el laboratorio de bacteriología hasta su procesamiento. Se determinó la susceptibilidad antimicrobiana a algunos blactámicos, macrólidos y clindamicina. La resistencia a eritromicina se probó por medio de la prueba de difusión de doble disco. Se calcularon medidas de tendencia central. Resultados. Todas las cepas fueron sensibles a los blactámicos y clindamicina; 16 por ciento fueron resistentes a los macrólidos, y todas correspondieron al fenotipo M. Conclusiones. Es conveniente realizar periódicamente pruebas de escrutinio para conocer los posibles cambios en los patrones de sensibilidad estreptocócica.


Subject(s)
Drug Resistance, Microbial , In Vitro Techniques , Streptococcus pyogenes/drug effects , Tonsillitis/drug therapy , Anti-Bacterial Agents/pharmacokinetics , Clindamycin/pharmacokinetics , Lactams/pharmacokinetics
20.
Rev. chil. infectol ; 17(supl.1): 95-7, 2000.
Article in Spanish | LILACS | ID: lil-269449

ABSTRACT

Podemos concluir que esquemas abreviados de amoxicilina durante 6 días, cefalosporinas orales (cefadroxilo, cefuroxima, cefixima y cefpodoxima) durante 4 ó 5 días y azitromicina o superiores que el tratamiento clásico de la faringoamigdalitis estreptocóccica con fenoximetil penicilina durante 10 días, en términos de eficacia clínica y erradicación bacteriológica


Subject(s)
Humans , Streptococcal Infections/drug therapy , Pharyngitis/drug therapy , Pharyngitis/etiology , Tonsillitis/drug therapy , Tonsillitis/etiology , Amoxicillin/administration & dosage , Amoxicillin/therapeutic use , Azithromycin/administration & dosage , Azithromycin/therapeutic use , Cephalosporins/administration & dosage , Cephalosporins/therapeutic use , Penicillin V/administration & dosage , Penicillin V/therapeutic use , Streptococcus pyogenes/drug effects , Streptococcus pyogenes/pathogenicity
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