Search

Objective: Tonsillectomy is an effective treatment for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome. Tonsillotomy has a milder operative risk profile and postoperative morbidity in children than tonsillectomy. We aimed to compare the efficacy of tonsillotomy to observation‐only in children with PFAPA syndrome at a 3‐month follow‐up. Methods: This was a randomized multicenter trial with sequential design. Participants were randomized into a tonsillotomy group and a control group that was only observed. The trial started in 1/2017 and was accomplished in 12/2021 with 16 patients (10 boys, six girls, the mean age 4.2 years). The symptoms were monitored with daily symptom diaries. Results: After the 3‐month follow‐up, 7/8 patients (87.5%) in the tonsillotomy group and 2/8 (25%) patients in the control group were free from PFAPA symptoms (95% CI 13% to 87%; p = 0.0021). The mean number of days with fever was 2.6 (SD 3.7) in the tonsillotomy group and 8.0 (SD 6.5) days in the control group (n = 8) (p = 0.06). Mean number of fever days compatible with PFAPA syndrome was 0.8 (SD 1.4) in the tonsillotomy group and 6.5 (SD 6.0) in the control group (95%CI −10% to −1%; p = 0.007). Rescue tonsillectomy was needed for all patients in the control group and none of the patients in the tonsillotomy group. Conclusions: Tonsillotomy might be an effective treatment option for children with PFAPA syndrome. Further studies are needed to clarify the long‐term efficacy of tonsillotomy for treating PFAPA. Level of Evidence: 2 Laryngoscope, 134:968–972, 2024 [ABSTRACT FROM AUTHOR]

Children who are overweight and have high LDL cholesterol levels and high blood pressure are more likely than other children to develop atherosclerosis as adults, according to a study of 2,229 people who were examined during childhood and again as adults. Ultrasound scans of their neck were done to measure atherosclerosis in the carotid arteries. This is considered an early sign of generalized cardiovascular disease.

Xylitol gum or syrup may be effective in preventing otitis media in children. Otitis media is an ear inflammation often caused by bacteria. Researchers randomly assigned 857 children in day care to receive one of five treatments: xylitol gum, xylitol syrup, xylitol lozenges or a placebo in gum or syrup. The incidence of otitis media was reduced from 20% to 40% in the children who took xylitol in one form or another. These children also were less likely to require antibiotic treatment. Chewing gum seemed to be the most effective. Xylitol is a sugar substitute., Background. Xylitol, a commonly used sweetener, is effective in preventing dental caries. As it inhibits the growth of pneumococci, we evaluated whether xylitol could be effective in preventing acute otitis media (AOM). Design. Altogether, 857 healthy children recruited from day care centers were randomized to one of five treatment groups to receive control syrup (n = 165), xylitol syrup (n = 159), control chewing gum (n = 178), xylitol gum (n = 179), or xylitol lozenge (n = 176). The daily dose of xylitol varied from 8.4 g (chewing gum) to 10 g (syrup). The design was a 3-month randomized, controlled trial, blinded within the chewing gum and syrup groups. The occurrence of AOM each time the child showed any symptoms of respiratory infection was the main outcome. Results. Although at least one event of AOM was experienced by 68 (41%) of the 165 children who received control syrup, only 46 (29%) of the 159 children receiving xylitol syrup were affected, for a 30% decrease (95% confidence interval [CI]: 4.6%-55.4%). Likewise, the occurrence of otitis decreased by 40% compared with control subjects in the children who received xylitol chewing gum (CI: 10.0%-71.1%) and by 20% in the lozenge group (CI: -12.9%-51.4%). Thus, the occurrence of AOM during the follow-up period was significantly lower in those who received xylitol syrup or gum, and these children required antimicrobials less often than did controls. Xylitol was well tolerated. Conclusions. Xylitol sugar, when given in a syrup or chewing gum, was effective in preventing AOM and decreasing the need for antimicrobials. Pediatrics 1998; 102:879-884; xylitol, otitis media, prevention, syrup, chewing gum., ABBREVIATIONS. AOM, acute otitis media; CI, confidence interval; PYR, person years at risk; URT, upper respiratory tract. During 1990, an estimated 24.5 million visits were made to office-based physicians in [...]