Lymphocyte-white blood cell count ratio: a quickly available screening tool to differentiate acute purulent tonsillitis from glandular fever.

OBJECTIVE: To find a quickly available screening tool for the differentiation of patients with glandular fever from those with acute purulent tonsillitis. The null hypothesis was that there was no difference between the lymphocyte-white blood cell count (L/WCC) ratio between the 2 patient groups. DESIGN: Retrospective pilot study based on laboratory tests for lymphocyte counts, white blood cell counts, and the mononucleosis spot test. SETTING: Ear, Nose, and Throat Department, St George's Hospital, London, England. PATIENTS: One hundred twenty patients with glandular fever and 100 patients with bacterial tonsillitis. MAIN OUTCOME MEASURES: Results from the mononucleosis spot test in conjunction with the clinical picture and the L/WCC ratio were analyzed. Significant differences were evaluated using the Mann-Whitney test and Fisher exact test. RESULTS: The L/WCC ratio was significantly different in the 2 groups (P<.001). The mean L/WCC ratio in the glandular fever group was 0.54 and the mean L/WCC ratio in the bacterial tonsillitis group was 0.10. A ratio higher than 0.35 had a specificity of 100% and a sensitivity of 90% for the detection of glandular fever. CONCLUSIONS: We recommend that the L/WCC ratio should be used as an indicator to decide whether mononucleosis spot tests should be requested. A ratio higher than 0.35 had a high specificity in our study group.

Does hydrogen peroxide mouthwash improve the outcome of secondary post-tonsillectomy bleed? A 10-year review.

OBJECTIVE: To determine whether hydrogen peroxide (H(2)O(2)) 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 H(2)O(2) and 97 did not. All patients received broad-spectrum intravenous antibiotics. The average rehospitalization duration due to hemorrhage was 1.7 days (H(2)O(2) group) and 1.6 days (control group). In the H(2)O(2) group, 8.5% required surgery, compared with 10.3% in the control group. Further hemorrhage episodes requiring readmission occurred in 3.4% of the H(2)O(2) 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 H(2)O(2).

Changes in dental caries prevalence of school children in Araraquara, SP, Brazil.

The aim of this study was to compare the prevalence of caries in 1989 and 1992 in 7-12 year old school children in Araraquara, SP, Brazil. Systematic random samples were drawn from school children enrolled in the urban public schools and the surveys were carried out by trained examiners using the DMFT index. The results showed that in all ages there was an increase in the percentage of children free of caries for the permanent dentition (from 29.0 per cent in 1989 to 40.6 per cent in 1992). A decrease in the percentage of children classified in the 1-3 DMFT index category (from 40.0 per cent in 1989 to 33.7 per cent in 1992) and a decrease in the percentage of those classified in the 4-6 DMFT index category (from 26.6 per cent to 22.5 per cent) was observed. A slight decrease in the prevalence of children classified in the 7 or more DMFT index category was also observed (from 4.4 per cent to 3.1 per cent). The results obtained suggest that continuing efforts should be made to reduce the percentage of children with experience of caries in order to achieve the WHO/FDI goals for the year 2000.