High rate of early recurrence of peritonsillar abscess among adolescents and young adults.

BACKGROUND: Peritonsillar abscess (PTA) can be treated with aspiration or incision for drainage, but a subsequent PTA can occur if tonsillectomy is not performed. Better understanding is needed of when tonsillectomy should be performed to avoid PTA recurrence. OBJECTIVE: This study investigated the recurrence rate of PTA following aspiration or incision for drainage and evaluated the risk factors for recurrence. METHODS: The medical records of 292 patients treated for PTA were reviewed. Recurrence of PTA and elective or quinsy tonsillectomy were the primary endpoints. A Cox proportional hazards regression model for PTA recurrence was constructed with sex, age, and PTA history as predictors. RESULTS: Young age was the only significant predictor of PTA recurrence. Patients aged 15 to 24 years had a 30-day recurrence rate of 15.5% and a total recurrence rate of 26.6%. The total recurrence rate among patients over 30 years of age was significantly less at 4.0% (Fisher's exact test, p < .05). CONCLUSION AND SIGNIFICANCE: Based on our results, tonsillectomy should be considered for PTA patients between 15 and 25 years of age and, to effectively avoid future recurrence of PTA, should be performed urgently.

Molecular Mobility in Keratin-Rich Materials Monitored by Nuclear Magnetic Resonance: A Tool for the Evaluation of Structure-Giving Properties.

Keratins are structural proteins that are abundant in human skin, nails, and hair, where they provide mechanical strength. In the present study, we investigate the molecular mobilities and structures of three keratin-rich materials with clearly different mechanical properties: nails, stratum corneum (upper layer of epidermis), and keratinocytes (from lower layer of epidermis). We use solid-state NMR on natural-abundance 13C to characterize small changes in molecular dynamics in these biological materials with close to atomistic resolution. One strong advantage of this method is that it detects small fractions of mobile components in a molecularly complex material while it simultaneously gives information on the rigid components in the very same sample. The molecular mobility can be linked to mechanical material properties in different conditions, including hydration or exposure to osmolytes or organic solvents. Importantly, the study revealed that the response to both hydration and addition of urea is clearly different for the nail keratin compared to the stratum corneum keratin. The comparative examination of these materials may provide a better understanding of skin diseases originating from keratin malfunction and contributes to the design and development of new materials.