International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2011
Comparative StudyA pilot study to identify pre- and peri-operative risk factors for airway complications following adenotonsillectomy for treatment of severe pediatric OSA.
A pilot study to identify risk factors predicting post-operative complications in children with severe OSA undergoing adenotonsillectomy. ⋯ This pilot study identified pre- and peri-operative risk factors that collectively can be investigated as predictors of post-operative airway complications in a prospective study. By identifying preliminary results comparing the complication rates between those children with and without these risk factors, we will be able to calculate the sample size for a future prospective validation study. Such a study is necessary to understand the safety and potential significant cost savings of observing children without risk factors on the pediatric floor and not in an ICU setting. A best practice algorithm can be created for children with severe OSA only after completing this prospective study.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2011
Comparative StudyActivity of soluble aminopeptidase A and dipeptidyl peptidase IV and membrane-bound aminopeptidase B and pyroglutamyl peptidase I in adenoid hyperplasia, tonsillar hyperplasia and chronic tonsillitis.
To analyze soluble and membrane-bound peptidase activities in the tonsils and adenoids removed from patients with adenoid hyperplasia, tonsillar hyperplasia and chronic tonsillitis. ⋯ Our results suggest a potential role of soluble aminopeptidase A, soluble dipeptidyl peptidase IV, membrane-bound aminopeptidase B and membrane-bound pyroglutamyl peptidase I in the pathobiology of adenoid hyperplasia, tonsillar hyperplasia and chronic tonsillitis that is differently regulated as a function of gender. These finfings may modify in the future the clinical approach to these diseases.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2011
ReviewAnesthesia management in pediatric patients with laryngeal papillomatosis undergoing suspension laryngoscopic surgery and a review of the literature.
The excision of laryngeal papillomas poses a great challenge for both the anesthesiologist and the surgeon. The narrowness of the airways and the great variability of the pathological lesions necessitate close collaboration between the surgical and anesthesia teams to provide optimal operating conditions and ensure adequate ventilation and oxygenation. Our aim was to explore perioperative anesthesia management in pediatric patients during the excision of laryngeal papillomas with a suspension laryngoscope. ⋯ The most important consideration for anesthesia during suspension laryngoscopy is (1) the maintenance of adequate ventilation, (2) to permit surgical exposure, and (3) to maintain suitable depth of anesthesia which relaxes the vocal band, avoids laryngeal spasms (reflex closure), reduces cardiovascular reaction and wakes up quickly after operation. Any factors that aggravate laryngeal obstruction and dyspnea should be avoided.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2011
Changes in sleep apnea after supraglottoplasty in infants with laryngomalacia.
To determine the clinical and polysomnography outcomes in infants with laryngomalacia undergoing supraglottoplasty. ⋯ Supraglottoplasty may be an effective and safe option to improve moderate to severe obstructive sleep apnea in infants with laryngomalacia. In addition, polysomnography may be useful in infants with laryngomalacia to identify obstructive sleep apnea and/or to objectively measure outcomes after supraglottoplasty. This pilot study warrants a larger, prospective, and controlled study to validate these findings.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2011
Acoustic estimates of respiration in the pain cries of newborns.
The purpose of the present study was to examine the temporal features of pain-elicited crying demonstrated by healthy full term infants to estimate (1) the respiratory rate during cry and (2) the inspiratory and expiratory phase composition of the cry respiratory cycle. ⋯ The respiratory patterns associated with pain cries is highly variable and may be associated with variations in stress-arousal, strength of emotional expression, and overall fitness. This study supports the notion that the respiratory activity surrounding newborn infant crying is unique to the type of cry sampled.