The Relationship between Colonization by Moraxella catarrhalis and Tonsillar Hypertrophy.

We sought to investigate the prevalence of potentially pathogenic bacteria in secretions and tonsillar tissues of children with chronic adenotonsillitis hypertrophy compared to controls. Prospective case-control study comparing patients between 2 and 12 years old who underwent adenotonsillectomy due to chronic adenotonsillar hypertrophy to children without disease. We compared detection of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, and Moraxella catarrhalis by real-time PCR in palatine tonsils, adenoids, and nasopharyngeal washes obtained from 37 children with and 14 without adenotonsillar hypertrophy. We found high frequency (>50%) of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Pseudomonas aeruginosa in both groups of patients. Although different sampling sites can be infected with more than one bacterium and some bacteria can be detected in different tissues in the same patient, adenoids, palatine tonsils, and nasopharyngeal washes were not uniformly infected by the same bacteria. Adenoids and palatine tonsils of patients with severe adenotonsillar hypertrophy had higher rates of bacterial coinfection. There was good correlation of detection of Moraxella catarrhalis in different sampling sites in patients with more severe tonsillar hypertrophy, suggesting that Moraxella catarrhalis may be associated with the development of more severe hypertrophy, that inflammatory conditions favor colonization by this agent. Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Moraxella catarrhalis are frequently detected in palatine tonsils, adenoids, and nasopharyngeal washes in children. Simultaneous detection of Moraxella catarrhalis in adenoids, palatine tonsils, and nasopharyngeal washes was correlated with more severe tonsillar hypertrophy.

The seasonality of respiratory viruses in patients with chronic rhinosinusitis.

BACKGROUND: Chronic rhinosinusitis (CRS) is a common illness, yet little is known about its pathogenesis, including the role played by respiratory viruses. METHODS: A transversal prospective study was conducted to analyze the seasonality of CRS using real-time polymerase chain reaction to detect respiratory virus genomes in secretions and tissue samples from patients with CRS with and without nasal polyps. RESULTS: The frequency of viral detection was 41% (31/75). The respiratory virus most frequently detected was human rhinovirus, found in 18 patients (24%), followed by human metapneumovirus, human enterovirus, human respiratory sincicial virus, human adenovirus, human bocavirus, human coronavirus, and human influenza virus, detected in 12 (16%), five (6.6%), four (5.3%), four (5.3%), two (2.6%), two (2.6%), and one (1.3%) patient(s), respectively. Although none of the patients presented symptoms when the samples were collected, there was a peak in detection of the most prevalent virus in the autumn and winter seasons of both years, similar to the pattern that occurs in acute conditions. CONCLUSIONS: The pattern of respiratory virus seasonality found in nasal mucosa, polyps, and paranasal sinus samples in patients with CRS reinforces the possibility of asymptomatic respiratory viral infections.

Invasive fungal rhinosinusitis in immunocompromised patients.

INTRODUCTION: Invasive fungal rhinosinusitis (IFR) is one of the most important causes of morbidity and mortality in immunocompromised patients, principally those with cellular immunodeficiency, with mortality ranging from 50 to 80%. Prophylaxis and early diagnosis increase the chances of successful treatment. STUDY DESIGN: Clinical prospective randomized study. AIM: To present cases of IFR and to compare them with data reported in the literature. MATERIAL AND METHODS: Analysis of eleven cases of IFR confirmed by pathologist examination. RESULTS: Aspergillus was found to be the most prevalent pathogen. Symptoms ranged from high fever in most cases to nasal discharge, ulceration of the nasal mucosa, headache and periorbital edema. CONCLUSION: The combination of amphotericin B and endoscopic surgery, associated or not with Caldwell-Luc surgery, showed good results. The use of liposomal amphotericin B also presented a satisfactory outcome.

Angiogenic non-Hodgkin T/natural killer (NK)-cell lymphoma: report of three cases.

Angiogenic T/natural killer (NK)-cell lymphoma is a non-Hodgkin lymphoma characterized by necrosis and vascular destruction that is strongly associated with Epstein-Barr virus and AIDS. Early diagnosis is essential to improve the chances of patient survival, but severe local inflammatory infiltrate impairs histologic diagnosis by obscuring neoplastic cells. The most common markers are CD2, CD56, cytoplasmic CD3, and CD43 EBV. We describe 3 cases of angiogenic T/NK-cell lymphoma that show the diverse presentation of the same disease. Patient 1 was HIV positive and had nasal obstruction, facial edema, and ulceration of the nasal mucosa. Patient 2 had fever, a sore throat, and weight loss. Patient 3 had facial edema, fever, proptosis, and rapid development of neurologic alterations. Several biopsies were needed for histologic confirmation in these patients, despite positivity for the CD3 and CD56 markers.

Study of nasal cycles in children by acoustic rhinometry.

BACKGROUND: Studies concerning nasal cycle physiology in children are still rare, and controversies exist about its existence. This study was ascertained to evaluate the dynamic behavior of inferior turbinates in children by acoustic rhinometry. METHODS: Sixteen volunteer patients, aged 2-11 years old (mean, 6.25 years), were evaluated between April and July 2003. The patients submitted to periodic acoustic rhinometry, with triplicate measurements (each 30 minutes) for 3 hours. RESULTS: All evaluated children presented nasal cycles, with five children presenting a classic pattern (31.25%), three children presenting a concert pattern (18.75%), and eight children presenting an irregular pattern (50%). CONCLUSION: This study suggests that children present nasal cycles, as well as adults. Nevertheless, the most prevalent pattern in children was the irregular pattern, whereas in adults the most frequently detected is the classic pattern.

Síndrome da Apnéia e da Hipopnéia Obstrutivas do Sono (SAHOS) em crianças / Obstructive Sleep Apnea Syndrome (OSAS) in children

A Síndrome da Apnéia e da Hipopnéia Obstrutivas do Sono (SAHOS) na infância tem se tornado cada vez mais freqüente, adquirindo importância crescente nos últimos anos. Este aumento na incidência se deve em grande parte à melhoria de seu diagnóstico, seja pelo melhor reconhecimento dos sintomas associados a esta Síndrome em crianças, ou pelo aprimoramento dos exames complementares para confirmação diagnóstica. Nesta revisão, serão abordados as principais características e os sintomas envolvidos na SAHOS durante a infância. Além disso, os autores discutem as causas e as conseqüências da SAHOS no desenvolvimento da criança, assim como as possíveis formas de tratamento atualmente empregadas e o seu prognóstico.

Hair cell loss and regeneration in the chick cochlea after treatment with gentamicin

Hair cells can be damaged by countless agents, among them aminoglycoside antibiotics. In the cheek cochlea, the hair cell loss can be recovered by regeneration. The objectives of the present investigation were to estudy the time progression of injury caused by gentamicin and the regeneration process in chick hair cells. Gentamicin was administered in a single subcutaneous dose of 125 or 250 mg/kg to two groups of 3-day old chicks. The cochleae were processed for analysis by scanning electron microscopy on the 1st, 3rd, 5th and 20th day after injection The cellular sequence of degeneration and regeneration was studied. On the 20th day, most it he damaged cochlear area showed regenerated hair and suport cells. Stereocilia and microvilli were observed on the apical surface of the regenerated hair cells.

Regeneraçäo de Células após Ototoxicidade com Aminoglicosídeo na Cóclea de Aves / Hair Cell Regeneration in the Avian Cochlea after Ototoxicity with Aminoglycoside

Introduçäo: As células ciliadas podem ser lesada por inúmeros agentes, incluindo os antibióticos aminoglicosídeos. Na cóclea das aves, a perda das células ciliadas pode ser reposta por regeneraçäo. Objetivos: Os objetivos da pesquisa foram estudar o processo de regeneraçäo em aves e a progressäo temporal das lesöes provocadas pela gentamicina. Material e método: No estudo, foi administrada gentamicina em dose única subcutânea de 125 e 250 mg/kg respectivamente, em um e outro grupos de pintos de três dias. As cócleas foram processadas, para anáIise em microscopia eletrônica de varredura, no 1§, 3§, 5§ e 20§ dias após a injeçäo. A sequência celular de degeneraçäo e regeneraçäo foi estudada. No 20§ dia, a maior parte da área cóclear lesada havia sido reposta por células ciliadas e de suporte regeneradas. Estereocílios e microvilos foram observados na superfície apical das células ciliadas regeneradas