Does Hydrogen Peroxide Mouthwash Improve the Outcome of Secondary Post-Tonsillectomy Bleed? A 10-year Review

2005 ◽  
Vol 133 (2) ◽  
pp. 202-205 ◽  
Author(s):  
Irumee Pai ◽  
Stephen Lo ◽  
Satsuki Brown ◽  
Abbad G. Toma

Objective: To determine whether hydrogen peroxide (H2O2) mouthwash influences the outcome of secondary post-tonsillectomy hemorrhage in children. Study Design: Ten-year retrospective study of all children with secondary post-tonsillectomy hemorrhage. Setting: Tertiary otolaryngology center. Results: Of the 156 patients, 59 received H2O2 and 97 did not. All patients received broad-spectrum intravenous antibiotics. The average rehospitalization duration due to hemorrhage was 1.7 days (H2O2 group) and 1.6 days (control group). In the H2O2 group, 8.5% required surgery, compared with 10.3% in the control group. Further hemorrhage episodes requiring readmission occurred in 3.4% of the H2O2 group and 3.1% of controls. There was no difference between the 2 groups in rehospitalization duration ( P = 0.49), rate of surgical intervention ( P = 0.85), and rate of readmission with further hemorrhage ( P = 0.92). Conclusion: Hydrogen peroxide mouthwash does not improve the outcome of secondary post-tonsillectomy hemorrhage in pediatric patients. Significance: This study does not support the common practice of treating post-tonsillectomy hemorrhage with H2O2.

2002 ◽  
Vol 116 (6) ◽  
pp. 440-442 ◽  
Author(s):  
S. De ◽  
Z. G. G. Makura ◽  
R. W. Clarke

Acute mastoiditis was a common condition in the pre-antibiotic era, but has become rare now with the widespread use of antibiotics.A retrospective study was carried out of patients with acute mastoiditis who were seen at Alder Hey Children’s Hospital, Liverpool over a five-year period. Their case records were identified and details of gender, age at presentation, symptoms, signs and clinical management were noted and analysed.Twenty-one patients who presented with acute mastoiditis were identified. The patients’ age at presentation ranged from three months to 14 years. Five cases out of 21 (23.8 per cent) were under one year of age.Eighteen cases (85.7 per cent) presented with post-aural swelling while 12 (57.1 per cent) had aural discharge.All patients were treated with intravenous antibiotics and only five patients (23.8 per cent) required surgical intervention in the form of a cortical mastoidectomy with, or without, myringotomy.A significant number of cases can be treated conservatively with intravenous antibiotics. Surgery in the form of cortical mastoidectomy can be reserved for complicated cases and in those in whom conservative treatment has failed.


2021 ◽  
Author(s):  
F Von Matthey ◽  
Johannes Weber ◽  
Michael Müller ◽  
Peter Biberthaler ◽  
Helen Abel

Abstract Background: Although distal radius fractures (DRF) are the most common fractures of the human body there is still no consensus concerning the best treatment option, especially for type A fractures. Moreover, studies concerning other anatomic regions could prove that patient age is of high impact on therapy and outcome. Therefore, we have quantified wrist function within a retrospective study design using PROM and we have analysed the influence of age between control and patient collective and young versus old, respectively.Patients and Methods: The retrospective study included all patients with a surgically treated DRF type A and a control group of healthy patients, age and gender matched. The function of the wrist was examined with a self-assessment questionnaire the Munich Wrist Questionnaire (MWQ) according to the patient related outcome measurements (PROM). Results: PROM was answered by 110 patients with DRF type A. The average follow-up was 66 months. 110 healthy wrists were the control group and subgroup matching induced similar age group distribution. Hence, 7 individuals < 30 years, 67 between 31 and 64 years, 29 control individuals between 65 and 79 years and 7 control individuals > 80 years, respectively. Women were significantly older than the men (59±15 vs. 47±17).In overall analysis, there was no significant difference between control and patient group (96±6 vs. 95±7). Function was significantly different between control and patient group < 30 years (100±1 vs. 98±2). In the control group the function was significantly decreasing with advanced aging whereas in the patient group this influence was absent. The difference between age group <30 and 65-79 and >80 and between 30-64 and 65-79 and >80 was significantly different with increasing age. Conclusion: PROM is a suitable tool for a retrospective study design as numerous patients can be analysed. The influence of age is critical for wrist function. Hence, we therefore strongly suggest that this information should be taken into consideration for future study plans.


2019 ◽  
Author(s):  
Alessandra Di Palma ◽  
Federica Maldarelli ◽  
Antonietta Cimino ◽  
Mario Zama ◽  
Sergio Giuseppe Picardo

Abstract Background Dexmedetomidine is widely used in the treatment of emergency delirium (ED) in pediatric patients. However, further evidence on its use in pediatric anesthesia on potential differences in the reduction of ED according to patient’s age and type of anesthesia is required. Moreover, whether dexmedetomidine influences time of discharge from the surgical area remains unclear. We evaluated whether intranasal dexmedetomidine is effective in decreasing the incidence of ED in 106 children who had anesthesia for plastic surgery undergoing general or combined anesthesia at different ages. We also assessed if this drug has an impact on time to discharge from the surgical area. Methods In total, 106 children, aged 2–10 years, were enrolled in this retrospective study. Among them, 50 have been premedicated with dexmedetomidine (dexmedetomidine group); the remaining 56 patients served as controls (control group). The incidence of ED was evaluated according to the use of dexmedetomidine premedication, age and type of anesthesia (general vs combined). The length of anesthesia and duration of staying in the surgical area were also analyzed. Results Three patients who received dexmedetomidine premedication showed ED (6%), compared with 43 patients in the control group (77%; p<0.05). This lower incidence of ED was also present when stratifying patients according to the type of anesthesia or age. No difference between the dexmedetomidine group and control group were reported in timing of discharge from surgical area.Conclusions Premedication with dexmedetomidine is associated with decreased incidence of ED without increasing timing of discharge after surgery, regardless of patients’ age or type of anesthesia. In particular, patients subjected to combined anesthesia report benefit from the use of this molecule.


Author(s):  
Hala Atta Youssef ◽  
Aishah Mohammad Alkhaldi ◽  
Manar Mohammed Alshahrani ◽  
Abdullah Tariq Almalki ◽  
Amjad Ali Alahmari ◽  
...  

Reports showed that children usually complained of acute abdominal pain, which indicated the presence of severe underlying conditions and can have significant clinical importance. Serious challenges have been reported in healthcare settings where an urgent evaluation of the cases was necessary to adequately manage the patient before developing serious complications that might even end up with death. Some of these conditions included intussusception, appendicitis, volvulus and adhesions. Although estimates indicated that only around 1% of pediatric patients with acute abdominal pain usually required surgical intervention, concerns regarding the overlooking and misdiagnosis of significant conditions that might have severe prognostic outcomes were aroused among the different emergency departments. This study reviewed the common causes of acute abdominal pain among children admitted to the emergency department. Our results indicated that various etiologies can develop acute abdominal pain and therefore, establishing an adequate diagnosis by differentiating between the different etiologies should be done by the attending physicians to enhance the outcomes and adequately manage the admitted patients. Gastrointestinal causes of acute abdominal pain were the commonest to cause admissions to the emergency department. However, care should also be provided to the less common conditions, which might include genitourinary and pulmonary disorders and therefore, a thorough examination of children should be provided not to conduct a misdiagnosis of the underlying condition.


2018 ◽  
Vol 5 (6) ◽  
pp. 2283
Author(s):  
Balaji Dhanaram ◽  
Sakthivel Chandrasekar ◽  
Baskar Muthukumaraswamy

Background: Abdominal pain is a very prevalent problem in children and one of the common causes for visit to the hospital. They may be of acute or chronic presentation and depending on severity may also require admission to hospital.Methods: This is a retrospective study conducted in our hospital over a period of 3 years. About 200 children who came to the hospital with abdominal pain and received treatment in surgical outpatient or referred to surgery department from emergency were included in this study and all relevant data were collected.Results: The pain was found to be more in boys and in the age group of 9 to 12years. The most common cause was found to be mesenteric adenitis followed by acute appendicitis. About 38% of children required surgical intervention on that admission due to various surgical causes.Conclusions: The database of our retrospective study regarding age and sex incidence, clinicopathological features and therapeutic outcome was comparable to other studies in various literatures.


2017 ◽  
Vol 05 (11) ◽  
pp. E1116-E1118 ◽  
Author(s):  
Edmar Tafner ◽  
Philipe Tafner ◽  
Cornelius Mittledorf ◽  
Jose Pinhata ◽  
Ana Silva ◽  
...  

Abstract Background and study aims Invagination, which can occur in any part of the intestine, usually affects children and is the second most common cause of intestinal obstruction after pyloric stenosis. The cause of these intussusceptions in children is usually unknown and they typically occur within the ileocolic region. Management of pediatric patients with the condition often consists of surgical intervention. However, this retrospective study from the University Hospital of the University of São Paulo, Brazil, reports a series of cases of intussusception in children in whom a colonoscopy was used to reverse the intussusception. Patients and methods From April 2010 to January 2015, 30 pediatric patients underwent a colonoscopy as an noninvasive method for treatment of children’s intestinal intussusception. Results Overall, treatment with colonoscopy was successful in reversing invagination in 66.7 % of the patients. However, 33.3 % of patients required surgery to resolve the intussusception. Conclusion Noninvasive colonoscopy is a potential treatment for intussusception in children.


2008 ◽  
Vol 139 (4) ◽  
pp. 546-550 ◽  
Author(s):  
Greg R. Licameli ◽  
Dwight T. Jones ◽  
Jodi Santosuosso ◽  
Catherine Lapp ◽  
Carlo Brugnara ◽  
...  

Objective To determine the efficacy of a preoperative bleeding questionnaire (POBQ) and coagulation screening in predicting hemorrhage associated with adenotonsillectomy. Study Design Retrospective study. Subjects and Methods Between January 1998 and December 2003, 7730 tonsillectomy and adenotonsillectomy patients were administered the POBQ preoperatively. Further coagulation screening was based on POBQ responses. Results A total of 232 (3.0%) of 7730 had postoperative bleeding; 184 (3.2%) of 5782 patients who had negative questionnaires bled postoperatively compared with 48 (2.5%) of 1948 patients with positive questionnaires ( P = 0.126). Of 1948 patients with positive questionnaires, 141 (7.2%) had abnormal preoperative coagulation screens and 9 (6.4%) of 141 bled; of the 1807 (92.8%) with negative coagulation screens, 39 (2.2%) bled ( P = 0.005). Conclusion The POBQ is an effective tool for identifying patients who are at potential risk for post-tonsillectomy bleeding. Patients with both a positive POBQ and coagulation screen had a statistically higher likelihood of postoperative bleeding than other patients. The POBQ allowed the identification of individuals with bleeding disorders to be treated before surgery, likely decreasing the risk of bleeding in these patients.


2020 ◽  
Vol 9 (5) ◽  
pp. 1592
Author(s):  
Giorgia Carlone ◽  
Lucio Torelli ◽  
Alessandra Maestro ◽  
Davide Zanon ◽  
Egidio Barbi ◽  
...  

The 12-month mortality rate in patients undergoing hematopoietic stem cell transplantation (HSCT) remains high, especially with respect to transplant-related mortality (TRM), which includes mortality due to infection complications through the aplasia phase. The aim of this study was to determine whether the administration of Pentaglobin® could decrease TRM by lowering sepsis onset or weakening sepsis through the aplasia phase. One hundred and ninety-nine pediatric patients who had undergone HSCT were enrolled in our retrospective study. The patients were divided into two groups: the Pentaglobin group, which had received Pentaglobin® in addition to the standard antibiotic treatment protocol established for the aplasia phase, and the Control group, which received only the standard treatment. As compared to the control group outcome, Pentaglobin® led to a significant decrease in the days of temperature increase (p < 0.001) and a reduced infection-related mortality rate (p = 0.04). In addition, the number of antibiotics used to control infections, and the number of antibiotic therapy changes needed following first-line drug failure, were significantly lowered in the Pentaglobin group as compared to the control group (p < 0.0001). With respect to the onset of new infections following the primary infection detected, the Pentaglobin group showed a significant reduction for bacterial events, as compared to the control group (p < 0.03). Pentaglobin® use in patients undergoing HSCT seems to produce a significant decrease in infection-associated TRM rate.


2021 ◽  
Vol 11 (17) ◽  
pp. 7869
Author(s):  
Daniela Di Venere ◽  
Alessandra Laforgia ◽  
Paola Lorusso ◽  
Saverio Capodiferro ◽  
Massimo Corsalini

Ectopic eruption of the first permanent molar in the maxilla, generally characterized by the wrong axial positioning during eruption, is reported to occur in about 2–6% of children. Its incidence is surely under-estimated as it frequently remains undiagnosed and, additionally, becomes irreversible, resulting in posterior crowding in such cases. This retrospective study aims to investigate the cephalometric features of patients affected by ectopic eruption of the maxillary first molar in comparison to a control group of patients. From a total of 1935 subjects, 13 patients were enrolled in the study group, while 26 patients were randomly selected as a control group. Lateral cephalometric teleradiographs obtained at the time of diagnosis were used to measure cephalometric values between study patients and controls. The prevalence of ectopic eruption of the first maxillary permanent molar in our patients was 1.14%. The mandibular angle (SN-GoMe) was found to be significantly greater in the study group than in control. The same statistical trend was observed for the inter-maxillary angle (SnaSnp-GoMe); also, the distance Sna-Me was greater in the study group. Differences between groups were statistically significant for the following distances: Snp-Sna, Ba-S and SOR-Sna, which were found to be, overall, greater in the study group. Ectopic eruption of the first permanent molar in the maxilla seems to be associated with morphogenetic characteristics of patients, mainly with a dolichocephalic pattern.


2019 ◽  
Author(s):  
Alessandra Di Palma ◽  
Federica Maldarelli ◽  
Antonietta Cimino ◽  
Mario Zama ◽  
Sergio Giuseppe Picardo

Abstract Background Dexmedetomidine is increasingly used in the treatment of emergency delirium (ED) in pediatric patients. However, further evidence on its use in pediatric anesthesia and on potential differences in the reduction of ED according to patient’s age and type of anesthesia is required. Moreover, whether dexmedetomidine influences time of discharge from the surgical area remains unclear. We evaluated whether intranasal dexmedetomidine is effective in decreasing the incidence of ED in 106 children who had anesthesia for plastic surgery undergoing general or combined anesthesia at different ages. We also assessed if this drug has an impact on time to discharge from the surgical area. Methods In total, 106 children, aged 2–10 years, were enrolled in this retrospective study. Among them, 50 have been premedicated with dexmedetomidine (dexmedetomidine group); the remaining 56 patients served as controls (control group). The incidence of ED was evaluated according to the use of dexmedetomidine premedication, age and type of anesthesia (general vs combined). The length of anesthesia and duration of staying in the surgical area were also analyzed. Results Three patients who received dexmedetomidine premedication showed ED (6%), compared with 43 patients in the control group (77%; p<0.05). This lower incidence of ED was also present when stratifying patients according to the type of anesthesia or age. We observed no significant difference between the dexmedetomidine group and control group in terms of discharge from surgical area. Conclusions Premedication with dexmedetomidine is associated with decreased incidence of ED, regardless of patients’ age or type of anesthesia and without seemingly increasing the timing of discharge after surgery.


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