International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Investigation of pepsin in tears of children with laryngopharyngeal reflux disease.
Numerous investigations postulated that laryngopharyngeal reflux (LPR) is implicated in the pathogenesis of various upper airway inflammatory diseases as sinusitis or dacryostenosis. The presence of pepsin in tears might be confirmed the presuntive hypothesis of the arrival in the nasolacrimal ducts and precorneal tears film through the laryngopharyngeal reflux of either gastric acid or stomach secretions (pepsin) with inflammatory potentialities. The aim of this preliminary study was to identify the presence or absence of pepsin in the tears collected from children with a high suspicion of LPR who underwent 24-h pH (MII-pH) monitoring to confirm the disease. ⋯ 20% of the children with diagnosed LPR showed pepsin in the tears. Our specific investigation might provide information regarding sinusitis or dacryostenosis.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Metabolic alterations in adolescents with obstructive sleep apnea.
Obesity is one of the leading health concerns in developed and in developing countries. The risk of obstructive sleep apnea (OSA) is greatly increased by obesity. Obesity is known to be associated with the Metabolic Syndrome and cardiovascular disease in adults. This same association in children is not well defined. Understanding the relationship of obesity, OSA, and metabolic alterations in children would improve understanding of the risks of cardiovascular disease into adulthood. ⋯ OSA severity is associated with increased fasting insulin, blood glucose and HOMA-IR even after controlling for the age, and BMI z score in adolescents.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Case ReportsThe "multiport airway adapter" in flexible bronchoscopy for peripheral bronchial foreign bodies in children.
Many children require emergency foreign body removal by bronchoscopy. Although a flexible bronchoscope is frequently used for removal of a bronchial foreign body in children, this procedure is difficult in children with a narrow tracheal lumen, even using a thin flexible bronchoscope. ⋯ The thicker forceps etc. were passed alongside the flexible bronchoscope through the adaptor. These findings suggest that this multiport airway adaptor will be useful as an advanced tool for foreign body removal in pediatric patients.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Oral morphine for pain management in paediatric patients after tonsillectomy and adenotonsillectomy.
The withdrawal of codeine for use in children following tonsillectomy enforced a change in our practice of providing regular paracetamol and ibuprofen, with codeine for breakthrough pain relief. Our objectives were to; examine the effectiveness of paracetamol and ibuprofen; examine the effectiveness of the addition of rescue (PRN) morphine to regular paracetamol and ibuprofen. ⋯ This service evaluation found that postoperative morphine on an as-required basis, in addition to regular paracetamol and ibuprofen, did not significantly alter initial pain profile, worst pain scores or rate of health service contact when compared to regular paracetamol and ibuprofen alone. The majority of children in this study felt additional analgesia required. Children in the morphine groups experienced significantly less pharmacological intervention when contacting the GP after surgery.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Reliable acoustic measurements in children between 5;0 and 9;11 years: Gender, age, height and weight effects on fundamental frequency, jitter and shimmer in phonations without and with controlled voice SPL.
Current pediatric voice assessment guidelines include instrumental measurements of fundamental frequency (F0) and the perturbation indices jitter and shimmer. In children below 10 years, gender, age, height and weight effects on these parameters have been inconsistently characterized. Recent research in healthy children showed, that differences in habitual speaking voice intensity (voice SPL) under the usual assessment procedure significantly affect jitter and shimmer. These effects were reduced in phonations with controlled voice SPL >80dBA. Reliable measurement methods and description of physiologic influencing factors are essential to identify pathologic voices. ⋯ Neither without nor with controlled voice SPL there were systematic gender, age, height or weight effects on voice F0, jitter and shimmer. Gender related F0 discrepancies were equalized in phonations with >80dBA. In children below 10 years gender related acoustic voice differences may be mainly linked to behavior, which should be considered in future works regarding physiologic voice development.