Expert consensus-based clinical recommendation for an integrative anthroposophic treatment approach to acute tonsillitis in childhood.

BACKGROUND: Medical guidelines are an important basis for qualitative and cost-effective patient care. However, there is a lack of clinical recommendations in anthroposophic medicine (AM), an integrative medicine approach frequently practised in Europe. Acute tonsillitis, which includes tonsillopharyngitis, is a common childhood disease. that is mostly caused by a viral infection. Symptomatic treatment is therefore of high importance, and AM can offer several therapy options. METHODS: 53 physicians from Germany, Spain, Netherlands, Switzerland, Austria, and Hungary with at least one year of experience in anthroposophic paediatric medicine were invited to participate in an online Delphi process. The process comprises five survey rounds starting with open-ended questions and ending with final statements, which need 75% agreement of experts to reach consensus. Expert answers were evaluated by two independent reviewers using MAXQDA and Excel. RESULTS: Response rate was between 28% and 45%. The developed recommendation included 15 subtopics. These covered clinical, diagnostic, therapeutic and psychosocial aspects of acute tonsillitis. Six subtopics achieved a high consensus (>90%) and nine subtopics achieved consensus (75-90%). CONCLUSION: The clinical recommendation for acute tonsillitis in children aims to simplify everyday patient care and provide decision-making support when considering and prescribing anthroposophic therapies. Moreover, the recommendation makes AM more transparent for physicians, parents, and maybe political stakeholders as well.

Cost analysis of face-to-face visits, virtual visits, and a digital care pathway in the treatment of tonsillitis patients.

PURPOSE: The aim of this study was to compare the costs of two different telemedicine-assisted tonsillitis care pathways with traditional face-to-face visits at the Department of Otorhinolaryngology - Head and Neck Surgery (ORL-HNS) at Helsinki University Hospital. METHODS: We characterized and analyzed the patient flows and their individual episodes of all tonsillitis patients at the Department of ORL-HNS between September 2020 and August 2022. Records were collected by doctors at the clinic. We investigated costs and allocated resources in four categories: invoice from the Department of ORL-HNS to the public payer, expenses to the Department, patient fees, and doctor's resource. RESULTS: At least a third of the tonsillitis patients were eligible for telemedicine. The digital care pathway was 12.6 % less expensive for the public payer compared to the previous virtual visit model. For the Department, the expense of the digital care pathway was 58.8 % less per patient than the virtual visit model. Patient fees decreased 79.5 %. The digital care pathway reduced the doctor's resource from 30.28 min to 19.78 min, which accounts for a 34.7 % reduction. Patients finished the digital care pathway in a median of 62 min (SD = 60) compared to the 2-4 h which they would spend on an outpatient clinic visit. CONCLUSION: Our study demonstrates that tonsillitis patients are eligible for preoperative telemedicine. With at least a third of the tonsillitis patients being eligible for telemedicine, major cost savings can be achieved with efficient e-health-assisted solutions.

Tratamento homeopático da amigdalite de repetição

O objetivo do presente trabalho foi relatar um caso clínico de paciente com amigdalite de repetição, que, após tentativas de tratamento alopático (antibioticoterapia) sem sucesso, buscou a homeopatia médica. A amigdalite é a infecção das vias respiratórias superiores mais comuns na demanda de cuidados pediátricos. Neste relato de caso, optou-se pelo tratamento homeopático, pois seus sintomas se apresentavam persistentes. Durante o tratamento homeopático, este se mostrou resolutivo, pois houve melhora significativa no quadro geral da criança. (AU)

The aim of the present study was to report a clinical case of a patient with recurrent tonsillitis who, after unsuccessfully attempted allopathic treatment (antibiotic therapy), sought medical homeopathy. Tonsillitis is the most common upper respiratory tract infection in demand for pediatric care. In this case report, homeopathic treatment was chosen because its symptoms were persistent. During homeopathic treatment, this proved to be resolute, as there was a significant improvement in the child's general condition. (AU)

Difensil Immuno Reduces Recurrence and Severity of Tonsillitis in Children: A Randomized Controlled Trial.

Oral supplements (OS) support the immune system in fighting upper airways infection. This study aimed to analyze the effect of Difensil Immuno (DI) on the recurrence of tonsillitis and fever in children. A multicentric randomized clinical trial was conducted. One-hundred and twenty children with chronic tonsillitis were randomly assigned to group A, B or control. Patients in group A were treated with 10 mL of DI for 90 consecutive days, patients in group B underwent treatment with 15 mL of DI for 45 consecutive days. The following data were collected at baseline (T0), T1 and T2: tonsillitis and fever episodes, tonsillar volume, blood test results. One-way ANOVA was used to analyze within and between variances. Patients in group A and B statistically improved their clinical parameters (episode of tonsillitis and fever, tonsillar volume) when compared to control group both at T1 and T2. However, T1 variances were more consistent in group A than in group B. All patients in the study groups improved their clinical outcomes. No statistically significant variances were observed in blood parameters both at T1 and T2. Our results suggest that children treated with DI had fewer episodes of tonsillitis and fever and a reduction in their tonsillar volume.

Use of probiotics in medical devices applied to some common pathologies.

Probiotics, defined as "living microorganisms that, whether ingested in useful amount, may have beneficial effects on human body", are widely used in various products for human use, such as dietary supplements, medical devices and pharmaceutical products. The European Directive on medical devices (MDs) (DDM 93/42), also includes those MDs containing live microorganisms, particularly probiotics, that may have various destinations of use, including that of assisting the therapy of several human pathologies. In this brief note we analyzed the use of probiotics in MDs and how probiotics administration could represent one of the new frontiers of scientific research on the prevention and treatment of various diseases. We'll analyze the literature on probiotics based MDs, to review their major targets in the therapy of some of the most common human pathologies: bacterial vaginosis and vaginitis, atopic dermatitis, infantile colic, obesity, type 2 diabetes, and pharyngotonsillitis.

Mucosal bacterial immunotherapy with MV130 highly reduces the need of tonsillectomy in adults with recurrent tonsillitis.

Recurrent tonsillitis in adults is a common ENT disease. The current standard treatment is tonsillectomy. However, continuous prophylaxis with antibiotics has been prescribed in order to avoid tonsillectomy. The objective was to evaluate if the bacterial immunotherapy (Bactek MV130) together with the prophylactic antibiotic therapy can produce clinical improvement and to avoid the tonsillectomy. Material and methods: The medical records of 88 patients with recurrent tonsillitis were reviewed. Sixty-six were treated during 3 months with a course of antibiotics and 22 received, in addition to the antibiotics, immunotherapy with Bactek MV130 during this Globally, 53 (60%) patients had clinical improvement and 35 were tonsillectomized. In the The group of patients who received only antibiotic, 35 (53%) avoided tonsillectomy and 31 (47%) did not. In the group that, in addition to antibiotics, were treated with Bactek MV130, 18 patients (82%) experi- enced clinical improvement avoiding tonsillectomy and 4 (18%) didn't improve and the tonsils were surgically removed. The difference between both groups was significant (P = 0.023).he results obtained in this evaluation support this combined treatment as an effective strategy to reduce the need of tonsillectomy.

Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a oral spray for children with recurrent streptococcal pharyngotonsillitis: a randomized placebo-controlled clinical study.

PURPOSE: Group A beta-hemolytic Streptococcus (GABHS) causes a recurrent acute pharyngotonsillitis (RAPT) in children. Moreover, the repeated use of antibiotics contributes to its resistance. However, S. Salivarius 24SMB and S. oralis 89a were effective probiotics in other infections. Thus, we decided to evaluate this combination efficacy compared to placebo in RAPT. METHODS: Patients with microbiologically confirmed GABHS were enrolled in this randomized, placebo-controlled trial. They received the aforementioned combination or placebo as an oral spray. We investigated episodes of frequency and duration, need for antibiotics, school days lost, the treatment impact on life quality, treatment compliance and side effects during a 90-day treatment and a 6-month follow-up. RESULTS: We included 41 patients in each group. The mean number of GABHS infection was significantly lower during both study periods for the two groups. However, our treatment group showed a lower rate. Moreover, the probiotic group had a lower mean number and a shorter median duration of GABHS episodes during both study periods than controls. Furthermore, the mean duration of antibiotic treatment was lower in the probiotic group during the 90-day and 6-month follow-up periods. Similarly, patients in the probiotic group showed a significantly lower mean number of absence days from school but higher EQ-VAS score. Indeed, all patients included were compliant to treatment. CONCLUSIONS: We identified potential probiotics, possessing desirable features against GABHS pharyngotonsillitis. Our findings represent the first evidence which throws the light on using these probiotics that can reduce antibiotics use which did not have efficient results regarding recurrence.

[Advantages and evidence of Chinese medicine in prevention and treatment of adult acute tonsillitis].

Though evaluation and analysis on the relevant literatures at home and abroad in recent years, the total number of retrieved literature was 2 664. According to the inclusion criteria and exclusion criteria,the literatures were screened out, and the results were as follows：374 literatures. To analyse the advantages and evidence of Chinese medicine in the prevention and treatment of adult acute tonsillitis. It is found to be effective, convenient and practical for the treatment of acute tonsillitis by traditional Chinese medicine (TCM) like treatment according to syndrome differentiation, Chinese patent drug, self Chinese medicine prescription and external treatment. TCM has obvious advantages in the prevention and treatment of acute tonsillitis, has the function of supplementing or substituting antibiotics, and has the function of regulating the defense function of organism.

Bacteriology and antibiotic sensitivity of tonsillar diseases in Chinese children.

Although many bacteriology studies on tonsillar diseases have been completed, only a few studies investigated bacteriology of tonsillar diseases in recent years, especially in Asian children population. The aim of our study is to elucidate the bacterial flora and antibiotic sensitivity of tonsillar diseases in Chinese children. A three-center study was performed on 2994 children with or without tonsillar diseases. We compared and analyzed differences of bacterial pathogens among recurrent tonsillitis, tonsillar hypertrophy and controls. We found that on the surface of tonsil, Staphylococcus aureus, Haemophilus influenzae and Streptococcus pneumoniae were noted in the order given in the recurrent tonsillitis (RT) group. In the tonsillar hypertrophy (TH) and control group, H. influenzae, S. aureus and S. pneumoniae were noted in the order given. For the core of tonsil, H. influenzae, S. aureus and ß-hemolytic streptococcus were noted in the order given in both RT and TH group. S. aureus and H. influenzae were the most prevalent types of bacteria present in cultures containing two strains in the RT and TH group, respectively. We also observed some differences in the types of bacteria in the surface and core between the recurrent tonsillitis and tonsillar hypertrophy groups. Our study provides recent bacteria distribution and antibiotic sensitivity for tonsillar diseases in Chinese children and will be helpful in the treatment of these diseases.

Randomized, double-blind trial on the efficacy of homeopathic treatment in children with recurrent tonsillitis

OBJECTIVE: The efficacy and safety of homeopathic treatment was investigated onchildren with recurrent tonsillitis justifying surgery. METHODS: Prospective, randomized, double-blind clinical trial that included 40 children between ages of 3 to 7 years old;20 children were treated with homeopathic medication and 20 children with placebo. Follow up was 4 months per child. Assessment of results was clinical by means of astandard questionnaire and clinical examination on the first and last day of treatment. Recurrent tonsillitis was defined as 5 to 7 episodes of bacterial acute tonsillitis per year. RESULTS: From the group of 18 children who completed homeopathic treatment, 14 did not present any episode of acute bacterial tonsillitis; from the group of 15 children who received placebo 5 patients did not present tonsillitis; this difference was statistically significant (p= 0,015). None of the patient exhibited side effects. CONCLUSIONS: Homeopathic treatment was effective in children with recurrent tonsillitis compared toplacebo, 14 children (78%) were no longer indicated surgery. Homeopathic treatment was not associated with adverse events.

Estudo clínico, duplo-cego, randomizado, em crianças com amigdalites recorrentes submetidas a tratamento homeopático / A double-blind, randomized clinical study in children with recurrent tonsillitis undergoing homeopathic treatment

Objetivo: Avaliar a eficácia e a segurança do tratamento homeopático em crianças com amigdalite recorrente, com indicação cirúrgica. Métodos: Estudo prospectivo, duplo-cego, randomizado, em que foram incluídas 40 crianças com idade variando de 3 a 7 anos; 20 crianças foram tratadas com medicação homeopática individualizada e 20 crianças receberam placebo. A duração do estudo de cada paciente foi de 4 meses. A avaliação dos resultados foi clínica, por meio de questionário padrão, de exame otorrinolaringológico, no primeiro e no último dia do tratamento. Utilizou-se como critério de amigdalites de repetição a ocorrência de 5 a 7 episódios de amigdalites agudas ao ano. Resultados: Das 18 crianças que completaram o tratamento homeopático, 14 não apresentaram nenhum episódio de amigdalite aguda bacteriana; das 15 crianças que receberam placebo por 4 meses, 5 pacientes não apresentaram amigdalite, com diferenças estatisticamente significantes (p= 0,015). Nenhum dos pacientes apresentou efeitos colaterais aos medicamentos prescritos. Conclusões: O tratamento homeopático foi eficaz nas crianças com amigdalites recorrentes, quandocomparado ao placebo, excluindo 14 crianças (78%) da indicação cirúrgica. O medicamento homeopático não provocou eventos adversos nas crianças. (AU)

Objective: The efficacy and security of homeopathic treatment was investigated on children with recurrent tonsillitis justifying surgery. Methods: Prospective, randomized, double-blind clinical trial that included 40 children between ages of 3 to 7 years old, 20 children were treated with homeopathic medication and 20 children with placebo. The duration of the study of each child was 4 months. The evaluation of the results was clinical, by means of a standard questionnaire and clinical examination on the first and last day of treatment. Recurrent tonsillitis was defined as 5 to 7 episodes of bacterial acute tonsillitis per year. Results: From the group of 18 children who completed homeopathic treatment, 14 did not present any episode of acute bacterial tonsillitis; from the group of 15 children who received placebo 5 patients did not present tonsillitis; this difference was statistically significant (p= 0,015). None of the patient exhibited side effects. Conclusions: homeopathic treatment was effective in the children with recurrent tonsillitis compared to placebo, 14 children (78%) were no longer indicated surgery. Homeopathic treatment was not associated with adverse events. (AU)

Randomized, double-blind trial on the efficacy of homeopathic treatment inchildren with recurrent tonsillitis

Objective: The efficacy and safety of homeopathic treatment was investigated onchildren with recurrent tonsillitis justifying surgery. Methods: Prospective, randomized,double-blind clinical trial that included 40 children between ages of 3 to 7 years old;20 children were treated with homeopathic medication and 20 children with placebo.Follow up was 4 months per child. Assessment of results was clinical by means of astandard questionnaire and clinical examination on the first and last day of treatment.Recurrent tonsillitis was defined as 5 to 7 episodes of bacterial acute tonsillitis per year.Results: From the group of 18 children who completed homeopathic treatment, 14 didnot present any episode of acute bacterial tonsillitis; from the group of 15 children whoreceived placebo 5 patients did not present tonsillitis; this difference was statisticallysignificant (p= 0,015). None of the patient exhibited side effects. Conclusions:Homeopathic treatment was effective in children with recurrent tonsillitis compared toplacebo, 14 children (78%) were no longer indicated surgery. Homeopathic treatmentwas not associated with adverse events. (AU)

Estudo clínico, duplo-cego, randomizado, em crianças com amigdalites recorrentes submetidas a tratamento homeopático / Randomized, double-blind trial on the efficacy of homeopathic treatment in children with recurrent tonsillitis

Objetivo: Avaliar a eficácia e a segurança do tratamento homeopático em crianças com amigdalite recorrente, com indicação cirúrgica. Métodos: Estudo prospectivo, duplo-cego, randomizado, em que foram incluídas 40 crianças com idade variando de 3 a 7 anos; 20 crianças foram tratadas com medicação homeopática individualizada e 20 crianças receberam placebo. A duração do estudo de cada paciente foi de 4 meses. A avaliação dos resultados foi clínica, por meio de questionário padrão, de exame otorrinolaringológico, no primeiro e no último dia do tratamento. Utilizou-se como critério de amigdalites de repetição a ocorrência de 5 a 7 episódios de amigdalites agudas ao ano. Resultados: Das 18 crianças que completaram o tratamento homeopático, 14 não apresentaram nenhum episódio de amigdalite aguda bacteriana; das 15 crianças que receberam placebo por 4 meses, 5 pacientes não apresentaram amigdalite, com diferenças estatisticamente significantes (p= 0,015). Nenhum dos pacientes apresentou efeitos colaterais aos medicamentos prescritos. Conclusões: O tratamento homeopático foi eficaz nas crianças com amigdalites recorrentes, quandocomparado ao placebo, excluindo 14 crianças (78%) da indicação cirúrgica. O medicamento homeopático não provocou eventos adversos nas crianças. (AU)

[The rationale for the conservative treatment of chronic tonsillitis in the patients of the older age groups by the «soft¼ therapy methods]. / Obosnovanie konservativnogo lecheniya khronicheskogo tonzillita u lits starshikh vozrastnykh grupp metodami «myagkoi¼ terapii.

The objective of the present study was to develop an efficient system for the treatment of chronic tonsillitis in the patients of advanced and middle age based on the application of polyvalent bacteriophages in the combination with the physical factors and herbal medicines. The study involved 65 patients (39 women and 276 men) at the age from 65 to 73 years presenting with chronic tonsillitis. The treatment included washing the tonsillar lacunae with herbal infusion consisting of a tetterwort (Choledoniummajus) extract. This procedure was followed by phonophoresiswith the use of the combined polyvalent bacteriophage preparation in the non-liquid formulation during 7-10 days. The effectiveness of such treatment was evaluated based on the results of clinical examination and the analysis of the subjective feelings reported by the patients. In addition, the rosette-forming function of lymphocytes was estimated and palatine tonsil microbiotas in different patients were compared. The effectiveness of therapy was estimated at 89.2%. The positive outcome of the proposed treatment was documented in 78.6% of the cases within 6 months after the onset of therapy. It is concluded that the treatment of chronic tonsillitis with bacteriophagal preparations and herbal infusions in combination with thetraditionallow-frequency ultrasound treatment is highly efficacious (favourable outcome in 78.6% of the patients of middle and advanced age) without the use of antibiotic medications.

Integrative management of pediatric tonsillopharyngitis: An international survey.

This survey investigated the management of pediatric tonsillopharyngitis, with a focus on natural remedies. 138 pediatricians, general practitioners and ear-nose-throat (ENT) specialists in 7 countries were surveyed by a dedicated questionnaire. A rapid strept test (RST) to diagnose acute tonsillopharyngitis was routinely used by 56/138 participants (41%). The use of RST allowed 200 diagnosis/year compared with 125 diagnosis/year for clinicians who did not use this tool. Homeopathy remedies were prescribed as a supportive therapy by 62% of participants (85/138). Among different homeopathic remedies, SilAtro-5-90 was the most frequently prescribed (53/138, 38%). In the chronic setting, homeopathy was suggested as a supportive therapy by 82/138 participants (59%), phytotherapy by 39 (28%) and vitamins/nutritional supplementation by 51 (37%). The management of tonsillopharyngitis in pediatric patients still remains empiric. Natural remedies, and homeopathy in particular, are used in the management of URTIs. An integrative approach to these infections may help reduce excessive antibiotic prescription.

Complementary and integrative treatments: adenotonsillar disease.

The purpose of this article is to familiarize the otolaryngologist with complementary and integrative treatment options for the management of sore throat and tonsillitis. A review of the available literature will provide insight into available treatment options with these therapies. Current medical and surgical approaches to therapy for adenotonsillar disease will be reviewed.

[The experience with the application of selective polarized chromotherapy in the clinical practice].

A series of investigations have demonstrated the anti-inflammatory, bactericidal, analgesic, and vegetocorrective effects of extraocular selective polarized chromotherapy using blue and red light and the possibility to optimize autonomous regulation with the help of this technique. The results of the study confirmed the high clinical effectiveness and safety of the method being considered for the treatment of acute respiratory diseases, chronic tonsillitis, cervical dorsopathies, and vegetative dysfunction.

[Efficacy observation of acupuncture bloodletting and penicillin on treatment of children acute tonsillitis].

OBJECTIVE: To observe differences of therapeutic effects among acupuncture bloodletting, penicillin and acupuncture bloodletting combined with penicillin for children acute tonsillitis and providea better treatment method in cli nic. METHODS: Seventy-five mild cases were selected into section of mild symptoms while seventy-five severe cases were selected into section of severe symptoms. Cases in the two sections then were divided into, an acupuncture bloodletting group, a penicillin group and a comprehensive group by random digital table method separately, 25 cases in each one. Qu-chi (LI 11), Hegu (LI 4), Dazhui (GV 14), Shaoshang (LU 11) and Erjian (EX 11) were selected in the acupuncture bloodletting group, intravenous injection of penicillin sodium was applied in the penicillin group and acupuncture bloodletting combined with penicillin was applied in the comprehensive group. Efficacy assessment was conducted after 3 days in the section of mild symptoms and after 5 days in the section of severe symptoms. RESULTS: For the section of mild symptoms, the total effective rate was 96.0% (24/25) in the comprehensive group and 92.0% (23/25) in the acupuncture bloodletting group, which were both superior to 68. 0% (17/25) in the penicillin group (P<0.05), but no statistical significance was seen between the comprehensive group and acupuncture bloodletting group (P>0.05). For the section of severe symptoms, the total effective rate was 96.0% (24/25) in the comprehensive group, which was obviously superior to 60.0% (15/25) in the acupuncture bloodletting group (P<0.01) and 68.0% (17/25) in the penicillin group (P<0. 05), and no statistical significance was seen between the acupuncture bloodletting group and penicillin group (P>0.05). CONCLUSION: The efficacy of acupuncture bloodletting combined with penicillin is little different from that of acupuncture bloodletting for treatment of children acute tonsillitis with mild accompanied symptoms, which were both superior to intravenous injection of penicillin sodium. For severe accompanied symptoms, the efficacy of acupuncture bloodletting combined with penicillin is obviously superior to acupuncture bloodletting and penicillin.