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At least 793 records · Page 44Linked to original sources
PubMed1995

The economic cost of a streptococcal tonsillitis episode.

OBJECTIVE: To estimate the cost of a streptococcal tonsillitis episode from the data of a questionnaire. SETTING: Five primary health centres in the west of Sweden. PARTICIPANTS: 101 consecutive patients treated for streptococcal tonsillitis. MAIN OUTCOME MEASURE: The cost estimation included costs for physician visit and drug, travel costs to and from the primary health centre, cost of lost production resulting from the patient's or the guardian's absence from work for physician visit or sick-leave, and cost of telephone consultation with a physician or nurse. RESULTS: The period of illness was on average seven days, time to recovery after treatment five days, and the mean period of sick-leave 2.5 days. The total cost of a tonsillitis episode was about SEK 3,300 (385 USD). Of this sum, the cost for the antibiotic accounted for only 3% and loss of production for 75%. CONCLUSION: Differences in the cost of drugs only have a minor influence on the total cost, while factors causing loss of production, such as efficacy and side effects of the drug, have a greater influence. Economic evaluation of pharmaceuticals will be more relevant in the future, and in the search for the most effective treatment, cost effective studies will be integrated with clinical trials.

Adolescent↗
PubMed1985

Treatment failure in acute streptococcal tonsillitis in children over the age of 10 and in adults.

13/169 outpatients (8%) with streptococcal tonsillitis developed a new tonsillitis with the same strain within 2 weeks of completion of therapy (clinical treatment failures) and 24 (14%) remained carriers (bacterial treatment failures) after treatment with phenoxymethylpenicillin (penicillin V) 12.5 mg/kg body weight twice daily for 10 days. The mean serum concentration 60 min after penicillin V administration was 7.84 micrograms/ml. Very large individual differences in serum concentration were found but these differences could not be correlated to treatment failure. About 60% of the patients showed salivary concentrations around 0.03 micrograms/ml. Three strains of streptococci (groups C and G) from patients with bacterial treatment failure had MIC values of 0.06 and 0.12 micrograms/ml. A majority of the patients with clinical treatment failures had contact with individuals with high carrier rates of beta-hemolytic streptococci. It therefore seems likely that some so-called treatment failures in reality are new infections. In clinical treatment failures group A streptococci were twice as common as groups C + G. In bacteriological treatment failures the ratio between A and C + G was 1:1. Patients with nonstreptococcal tonsillitis as well as carriers of groups C and G may appear among bacterial treatment failures.

Acute Disease↗
PubMed1999

[Analysis of serum antibodies to alpha-streptococci in patients with tonsil-related pustulosis palmaris et plantaris].

To determine the systemic immune response to alpha-streptococci (Str. sanguis, Str. salivarius and Str. mitis) and beta streptococcus (Str. pyogenes T12) in patients with tonsil related pustulosis palmaris et plantaris (PPP), we measured serum antibody levels to whole cell body antigens of Streptococcus (Str.) sanguis, Str. salivarius, Str. mitis or Str. pyogenes by enzyme-linked immunosorbent assay (ELISA). The serum IgG antibody levels to alpha-streptococci, Str. sanguis and Str. salivarius were significantly higher in patients with PPP (n = 44) than in patients with recurrent tonsillitis (RT: n = 25) and in healthy adults (n = 17). Serum antibody IgG level to Str. pyogenes was not different among the 3 groups. The IgA antibody levels against any Streptococcus strain were not different among the 3 groups. The IgM antibody levels to Str. pyogenes were significantly higher in patients with RT than in patients with PPP. In western blot analysis, the serum IgG antibodies against 25-27 kDa protein from whole cell body of Str. sanguis, Str. salivarius and Str. mitis were found more frequently in patients with PPP than in healthy adults. However, the western blot profile in Str. pyogenes was not different between PPP and healthy adults. No significant difference was seen in the western blot profile of IgM or IgM antibodies to any streptococcal whole cell bodies. These data suggest that systemic hyper immune response to alpha-streptococci may be present in patients with tonsil-related PPP and the 25-27 kDa protein of the organism may be the target for this immunologic abnormality.

Adult↗
PubMed1992

[Incidence of alpha-streptococcus having inhibitory activity against beta-streptococcus in patients with tonsillitis].

Inhibitory activity against the proliferation of group A beta-streptococci by alpha-streptococci, part of the normal flora of the oral cavity and throat, plays a role in host defense against infection. We speculated that there might be some relationship between alteration of oral flora and the presence of recurring tonsillitis. Accordingly, 141 cases of tonsillitis have been investigated for the detection of inhibitory alpha-streptococci. In patients scheduled for tonsillectomy, the mean number of inhibitory alpha-streptococci was preoperatively decreased and postoperatively increased. In patients in whom beta-streptococcus had been detected (including patients scheduled for tonsillectomy), the mean number of inhibitory alpha-streptococci was markedly decreased, indicating a high incidence of beta-streptococci in patients with tonsillitis. As inhibitory strains of alpha-streptococcus are sensitive to almost all antibiotics, it is suggested that chemotherapy may disrupt the normal flora of the throat. In summary, investigation of the oral cavity and the throat for the detection of inhibitory alpha-streptococcus appear to be useful in the management of group A beta-streptococcal infection.

Adolescent↗
PubMed1994

[Superoxide production by neutrophils in patients with recurrent tonsillitis].

Superoxide anion (O2-) production by peripheral blood polymorphonuclear leukocytes (PMNs) stimulated with phorbol myristate acetate (PMA) was measured by the cytochrome C method in 57 patients with recurrent tonsillitis. There was no significant correlation between superoxide production and episodes of acute tonsillitis, serum C-reactive protein levels, or peripheral white blood cell count. However, the superoxide production by PMNs was inversely correlated with serum anti-streptolysin-O titers (r = -.38, p = .008). Furthermore, the mean +/- SD superoxide levels produced by PMNs from patients with high serum ASO titers (> 71 U/ml), 69.58 +/- 30.56 nM/10(6) cells, was significantly lower than that of patients with low serum ASO titers (< 71 U/ml), 89.83 +/- 38.90 nM/10(6) cells (p = 0.037), and that of healthy adult controls, 102.27 +/- 44.67 nM/10(6) cells (p = 0.012). In addition, the effect of Streptococcus pyogenes on superoxide production by PMNs was studied in vitro. Superoxide production by PMNs preincubated with 600 micrograms/ml culture supernatant of Streptococcus pyogenes T4 (not detected) and T12 (34.82 +/- 31.40 nM/10(6) cells) was significantly lower than that of PMNs preincubated with culture medium (136.09 +/- 70.41 nM/10(6) cells; p < 0.05, each). Inhibition of superoxide production by PMNs by preincubation with culture supernatant of Streptococcus was increased by the protein in the culture supernatant in a concentration-dependent manner. These findings suggest that frequent and/or persistent streptococcal infections may reduce the superoxide production by PMNs, leading to recurrent episodes of tonsillitis.

Adolescent↗
PubMedDate not supplied

Comparison of solid and liquid forms of homeopathic remedies for tonsillitis.

The efficacy of three plants used in homeopathy to treat acute tonsillitis was evaluated. A fixed combination of three plant substances (Phytolacca americana, Guajacum officinale, Capsicum annuum) was used in either solid (tablet) or liquid (drop) formulation: 107 patients were treated and no antibiotics were used. The objective and subjective symptoms of acute tonsillitis were noted. A significant decrease in symptoms was observed as early as 2.5 days after treatment startup; no serious adverse effects were reported. It was concluded that acute tonsillitis can be treated with a homeopathic remedy characterized by its immunomodulatory, analgesic, and anti-inflammatory properties.

Acute Disease↗
PubMedDate not supplied

Localization of T and B lymphocytes in human adenoid, tonsil, appendix and Peyer's patches.

T and B lymphocytes were detected in human adenoid, tonsil, appendix and Peyer's patches by adherence to sheep erythrocytes (E) and human erythrocytes sensitized with antibody and complement (HEAC). The percentages of T lymphocytes in adenoid and tonsil cell suspensions averaged 30.9 +/- 3.4 (S.D.) and 35.8 +/- 6.4 (S.D.). The percentages of B lymphocytes in the same tissues were 42.5 +/- 11.3 (S.D.) and 40.1 +/- 34 (S.D.) respectively. In adenoid and tonsil tissue sections, B lymphocytes were found in the follicles and T lymphocytes were detected around the follicular areas. The predominant cell population in Peyer's patches and appendix sections was constituted by B lymphocytes.

Adenoids↗
PubMedDate not supplied

[The development of a treatment method for streptococcal tonsillitis in children].

Kept under continuous medical surveillance were 77 children with streptococcal tonsillitis. In all patients, a pathogenic streptococcus (GABHS) was invariably found in culture. Among other common features of the above disease were decline in the tonsil colony resistance state and lowering of those parameters characterizing immunity. A highly efficient means of treating tonsillitis of streptococcal etiology has been elaborated, relying on the use of macrolides and L. acidophilus according to our methods, which can, we believe, come to be widely used in health care practice.

Adenoids↗
PubMed1975

A method for the separation of lymphocytes and plasma cells from the human palatine tonsil using sedimentation in an isokinetic gradient of Ficoll in tissue culture medium.

Several methods for the dissociation of human tonsils into cell suspensions were compared. Dissociation of tonsils using 0-25 per cent trypsin gave both the largest number of total cells and the largest number of plasma cells per gram of tonsil. Lymphocytes and plasma cells were separated in a previously described isokinetic gradient of Ficoll in tissue culture medium. In the purest gradient fractions, lymphocytes were 97-2 plus or minus 1-9 per cent of nucleated cells. The purest gradient fractions contained 43-1 plus or minus 5-9 per cent plasma cells. More than 95 per cent of purified lymphocytes and plasma cells excluded Trypan Blue.

Cell Separation↗
PubMed2000

Adenoids and tonsils, indications for surgery and immunological consequences of surgery.

Tonsillectomy and adenoidectomy procedures are among the oldest surgical procedures still performed today. Tonsils and adenoids are part of Waldeyer's ring, the basic function of which is antibody formation. Because of their location at the portal of entry of many airborne and alimentary antigens, the tonsils and adenoids often have been considered as the first line of defense against respiratory infections. Indications for adenoidectomy or tonsillectomy are to date still controversial. The two main indications for tonsillectomy are upper airway obstruction due to tonsillar hypertrophy and recurrent acute or chronic tonsillitis. Adenoid hypertrophy with upper airway or eustachian tube obstruction and recurrent acute or chronic adenoiditis or otitis media are main indications to perform an adenoidectomy. The possible immunological effects of tonsillectomy and adenoidectomy are still controversial. Some authors have found changes in immunoglobulin levels after tonsillectomy, while others failed to find significant changes. In a review of long-term follow-up studies, the authors showed that while tonsillectomy may lead to certain changes in the cellular and humoral immune system, these alterations are clinically insignificant and no increased frequency of immunomodulated diseases should be expected.

Acute Disease↗
PubMed1975

Antibiotics in the treatment of tonsillitis.

Tonsillitis was studied in 317 patients over two years. A short course of antibiotics was found to be highly effective in clearing streptococci from the throat, but it was questionable whether the clearance shown represented eradication. It is suggested that the duration of treatment should be on a selective basis, using a ten-day, or short antibiotic course, according to circumstances. Withholding antibiotics altogether is not considered advisable. I could not differentiate between streptococcal and presumed viral tonsillitis on clinical grounds. The resulting possible policies of treatment are discussed. I suggest giving all cases of tonsillitis antibiotics at the time of presentation.

Adolescent↗
PubMed2002

[A preliminary study on the immune suppressive protein of stress in human tonsil].

Our previous work demonstrated that under the conditions of restraint stress and under the control of central nervous system (CNS), an immune suppressive protein of stress (ISPS) was generated in peripheral lymph tissue and released into the blood stream, acting as an immune suppressor. In the present work, a protein similar to ISPS was found in human tonsil (a peripheral lymph tissue). Human tonsil was homogenized and the extract was prepared. It was found that lymphocyte proliferation was significantly suppressed by the extract. The suppression induced by the extract was partially reversed by the monoclonal antibody against ISPS (2C4). In ELISA test, the extract was able to bind to the monoclonal antibody. By immunohistochemistry, many ISPS positive cells were found in human tonsil. The ISPS positive cells were also found in human lymph nodes. Taken together, all the results demonstrate that a protein similar to ISPS may exist in human peripheral lymphoid tissue.

Animals↗
PubMed2001

[A report of twice outbreak epidemic of acute tonsillitis and acute pharyngitis].

OBJECTIVE: To discuss the pathogenic factors, prevention and treatment of fulminant epidemic of acute tonsillitis and acute pharyngitis. METHOD: We investigated and analysed the cases of twice fulminant epidemic of acute tonsillitis and acute pharyngitis. RESULT: In the first time, 91 patients among 518 persons were attacted, the sick rate was 17.6%. In the second time, 39 among 295 persons were attacted, the sick rate was 13.2%. The main symptoms were pharyngodynia and fever. Bacterial culture of throat swab of 20 cases of the first time and 17 cases of the second time were carried out. The positive rate of beta-hemolytic streptococcus was 82.5% and 85.3% respectively. CONCLUSION: Environment and individual health condition are important factors in the fulminant epidemic of acute tonsillitis and acute pharyngitis.

Acute Disease↗
PubMed2003

[Connection between changing the vitamin and immune status and the character of the throat microflora in patients with chronic tonsillitis].

The author investigated 28 patients with chronic tonsillitis. The fungi sort Candida on the tonsils was discovered at 10 (35.72) patients, the bacterial flora was discovered at the other patients. There were more considerable decrease content of vitamins B2, C, methylnicotinamide and methylmalonic acid in the urine, vitamins B2 and methylnicotinamide in the saliva, vitamins A and B1 in the serum of the blood in the group of the patients with the fungus flora on the tonsils. It was discovered the decrease of numbers of lymphocytes CD8 and level of immunoglobulins G and M, disimmunoglobulinemia in this group. This decrease of the vitamins, cell and humoral immunity level leads to disbacteriosis, decompensation of the disease and development of the complications.

Adolescent↗
PubMed2003

The role and expression of CD27 and CD70 lymphocytes in the human tonsil.

In this study, we investigated the expression and function of CD27 and CD70 in the human tonsil. We found that IgG production was significantly reduced after the administration of anti-CD27 and anti-CD70 antibodies in the T cell dependent B cell activation system, suggesting the involvement of CD27/CD70 in the production of IgG. In addition, the amounts of peripheral and tonsililar CD4+ CD27+ cells were almost identical, whereas the expression of CD4+ CD27- cells was higher (4.9%) in tonsil than in peripheral blood (2.4%). Furthermore, anti-CD27 antibody and anti-CD4 antibody-positive cells were found mainly in the interfollicular region, and a small number of this cell population was observed in both germinal center (GC) and mantle. Double-staining showed that the germinal center was almost completely composed of CD4+ CD27+ cells. In contrast to CD27 cells, only a small number of CD70+ cells were present in the follicles. Moreover, anti-CD19 antibody, a B cell marker, was stained in the GC and mantle zone, and CD19+ CD27+ cells were observed in the GC close to the mantle. The above findings favor the involvement and role of CD27/CD70 in the T-B cell interaction by inducing IgG production and increasing memory cell (CD4+ CD27-) number in the tonsil.

Antigens, CD↗
PubMedDate not supplied

Therapy for pharyngitis and tonsillitis caused by group A beta-hemolytic streptococci: a meta-analysis comparing the efficacy and safety of cefadroxil monohydrate versus oral penicillin V.

A meta-analysis was conducted to compare the efficacy and safety of oral cefadroxil monohydrate (30 mg/kg QD or 15 mg/kg BID) with that of oral penicillin V (8, 10, or 15 mg/kg BID, TID, or QID) in the treatment of group A beta-hemolytic streptococcal (GABHS) pharyngitis and tonsillitis treated for 10 days. A simple random effects model was used for combining the efficacy and safety results of nine comparative trials performed in the United States. A total of 1646 patients aged < or = 19 years were considered evaluable; 1406 patients were evaluable using revised bacteriologic criteria, and 1499 patients were considered fully evaluable for safety. The results demonstrate significantly better response rates (P < 0.05) with cefadroxil monohydrate than with penicillin V for overall cure (91.8% versus 81.3%), bacteriologic cure (92.6% versus 81.4%), and bacteriologic recurrence (4.2% versus 10.5%); clinical cure rates were statistically similar (90.5% versus 90.2%). Revised bacteriologic criteria analysis revealed bacteriologic cure rates of 95.8% versus 88.7% (P < 0.05) and bacteriologic recurrence rates of 4.9% versus 7.1% (P = NS) for cefadroxil monohydrate and penicillin V, respectively. Adverse events related to drug administration occurred infrequently and did not differ significantly between treatment groups (P > 0.05). Compliance with cefadroxil monohydrate was at least as good as with penicillin V. Penicillin is currently the drug of choice in the treatment of GABHS pharyngitis and tonsillitis. Based on the information described in this large meta-analysis, cefadroxil monohydrate is an excellent alternative to oral penicillin V in the treatment of GABHS pharyngitis and tonsillitis.

Administration, Oral↗
PubMed2002

[The curative effect observation of shuanghuanglian and penicillin on acute tonsillitis].

OBJECTIVE: To investigate the curative effect of shuanghuanglian on acute tonsillitis. METHOD: 95 cases of acute tonsillitis were randomly divided into shuanghuanglian group (treatment group) and penicillin group (control group). RESULT: The total effective rate in treatment group was 87.5%, hardly less than that (83.0%) in control group (P > 0.05). CONCLUSION: Shuanghuanglian was an effective medicine in the treatment of acute tonsillitis, in addition, it was effective for virus infection.

Acute Disease↗
PubMed2005

Spontaneous resolution of acquired tonsillar herniation caused by isolated cerebellar tonsil inflammation: case report.

OBJECTIVE AND IMPORTANCE: Chiari I malformation is a well-known disease involving caudal descent of the cerebellar tonsils and is generally considered to be a congenital condition. Acquired Chiari I malformations as a result of various causes are well described. An unusual case is reported in which regression of an acquired Chiari I malformation caused by isolated cerebellar tonsil inflammation in a patient with infectious mononucleosis was observed after conservative treatment. This supports the view that the cause of tonsillar herniation should be considered as an important factor in patient selection for surgical decompression. CLINICAL PRESENTATION: A 6-year-old boy presented with a 1-week history of progressive occipital headache, neck pain, and dysequilibrium. A neurological examination revealed hyperreflexia in all extremities; he also had a fever, pharyngitis, and cervical adenopathy. A magnetic resonance imaging study demonstrated isolated right cerebellar tonsil enhancement and herniation into the foramen magnum. Further laboratory findings disclosed Epstein-Barr virus infection. INTERVENTION: The patient underwent conservative treatment for systemic illness, and he was asymptomatic after 3 weeks. A follow-up magnetic resonance imaging study obtained 2 months after discharge demonstrated resolution of the tonsillar herniation. CONCLUSION: Because the patient presented with infectious mononucleosis and cerebellar tonsillar herniation, direct treatment of decompression was considered unnecessary. Thus, caution in patient selection for surgical treatment is suggested in such unique cases.

Antiviral Agents↗