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Objective: Thiol-disulphide homeostasis (TDH) has a critical role in various clinical disorders. We aimed to assess the association of TDH with acute tonsillopharyngitis (AT) in children. Methods: This study included 94 (73 viral and 21 bacterial) tonsillopharyngitis patients and 88 control children. Their native thiol, total thiol, and disulphide levels were measured. Results: Viral and bacterial tonsillopharyngitis patients had lower native thiol levels compared with healthy children (P < 0.001 andP = 0.008, respectively). Both groups had lower total thiol levels compared with control children (P = 0.002 for viral,P = 0.011 for bacterial). The disulphide levels were lower in bacterial than in viral tonsillopharyngitis patients (P = 0.04), and there was a significant difference between viral tonsillopharyngitis patients and the control group (P < 0.001). The native/total thiol ratio in each patient group was lower than in the control group (P < 0.001 for viral,P = 0.017 for bacterial). The disulphide/native thiol and disulphide/total thiol ratios were significantly higher in viral (P < 0.001 for both) and bacterial tonsillopharyngitis patients (P = 0.017 for both) than in healthy children. In all patients, a correlation was found between the levels of C-reactive protein (CRP) and native thiol (r = −0.211,P = 0.04), CRP and total thiol (r = −0.217,P = 0.036), white blood cell (WBC) and native thiol (r = −0.228,P = 0.002), WBC and total thiol (r = −0.191,P = 0.01), and WBC and disulphide (r = 0.160,P = 0.03). Discussion: TDH is altered in AT in children. The alteration is more prominent in viral than in bacterial tonsillopharyngitis. [ABSTRACT FROM AUTHOR]

Objectives. Modified adult disease severity scoring systems are being used for childhood FMF. We aim to test the clinical consistency of two common severity scoring systems and to evaluate the correlation of scores with the type of FMF mutations in paediatric FMF patients since certain mutations are prone to severe disease.Methods. Two hundred and fifty-eight children with FMF were cross-sectionally studied. Assessment of the disease severity was performed by using the modified scoring systems of Mor et al. and Pras et al. Genetic analysis was performed using PCR and restriction endonuclease digestion methods for the presence of 15 FMF gene mutations. FMF mutations were grouped into three based on well-known genotypic–phenotypic associations. Correlation between the mutation groups and the severity scoring systems was assessed. The consistency of the severity scoring systems was evaluated.Results. The results of two scoring systems were not statistically consistent with each other (κ = 0.171). This inconsistency persisted even in a more homogeneous subgroup of patients with only homozygote mutations of M694V, M680I and M694I (κ = 0.125). There was no correlation between the mutation groups and either of the scoring systems (P = 0.002, r = 0,196 for scoring systems of Mor et al.; P = 0.009, r = 0.162 for Pras et al.).Conclusions. The inconsistency of the two scoring systems and lack of correlation between the scoring systems and mutation groups raises concerns about the reliability of these scoring systems in children. There is a need to develop a scoring system in children based on a prospective registry. [ABSTRACT FROM PUBLISHER]

Vocal cord paralysis (VCP) is a well-known complication after thyroidectomy operation which may occur due to direct or indirect injury to the recurrent laryngeal nerve (RLN). Indirect damage to the RLN may be due to compression or stretch of the nerve and usually results in transient VCP. Here, we report a case of bilateral VCP developed after total prophylactic thyroidectomy due to RET proto-oncogene mutation. The patient was successfully extubated after 3 days of waiting with anti-edema treatment. Despite protective measures, thyroidectomy may result in injury to LRN leading to VCP. A trial of waiting period with anti-edema treatment seems to be a reasonable approach in patients with temporary VCP. [ABSTRACT FROM AUTHOR]