Optimizing the management of the main acute infections in pediatric ORL: tonsillitis, sinusitis, otitis media

As sinusites, otites médias agudas e tonsilites são muito freqüentes em crianças. A maioria dessas infecções é causada por vírus, mas em geral, elas são tratadas com antibióticos. O uso inapropriado de antibióticos favorece a seleção, crescimento e disseminação de bactérias resistentes que colonizam as vias respiratórias, atingindo toda a comunidade. A emergência de bactérias resistentes dificulta os tratamentos das infecções respiratórias, sendo essencial desenvolver estratégias efetivas para restringir o uso de antibióticos sem prejudicar as crianças que realmente precisam desses medicamentos. OBJETIVO: Analisar os resultados de estudos randomizados e controlados sobre critérios clínicos e laboratoriais utilizados para diagnóstico e tratamento das tonsilites, sinusites e otites. MÉTODOS: Levantamento dos estudos randomizados e controlados sobre o tema, publicados no MEDLINE e SCIELO, de 2000 a 2006. CONCLUSÕES: Como a maioria dessas infecções evolui bem sem antibióticos, deve-se evitar o uso desses medicamentos a menos que a criança pertença aos grupos de alto risco para complicações ou apresente persistência ou piora dos sintomas com tratamento sintomático. É necessário que os médicos e leigos conheçam melhor a evolução natural das infecções respiratórias agudas e que seja garantido o acesso das crianças a serviços médicos de boa qualidade para orientação e reavaliação, quando necessária.Sinusitis, acute otitis media and tonsillitis are very frequent in children. Most of these infections are caused by viruses, but are generally treated with antibiotics. Inappropriate use of antibiotics favors the selection, growth and spread of resistant bacteria; these bacteria colonize the airways and affect the entire community. With the emergence of antibiotic-resistant bacteria, respiratory infections have become more difficult to treat. Effective strategies are needed to restrict the use of antibiotics without harming children that truly need these drugs. AIM: to present a critical analysis of the results of randomized and controlled studies on clinical and laboratory criteria used in diagnosing and treating tonsillitis, sinusitis and otitis. METHODS: a review of randomized and controlled studies about these conditions published in MEDLINE and SCIELO from 2000 to 2006. CONCLUSIONS: Given that most of these infections progress favorably without antibiotics, the use of these drugs should be avoided unless the child belongs to a high risk group for complications, or symptoms persist or worsen with despite symptomatic treatment. Physicians and laypersons should have better knowledge about the natural evolution of acute respiratory infections

Cystic Fibrosis: Brazilian ENT Experience

Most published studies about Cystic Fibrosis (CF) are European or North American. There are still few publications about the characteristics of fibrocystic populations in developing countries. The incidence of cystic fibrosis (CF) in Brazil varies among different regions (1 : 10,000 in Minas Gerais, 1 : 9,500 in Paraná, 1 : 8,700 in Santa Catarina, and 1 : 1600 in Rio Grande do Sul). The prevalence of the DF508 mutation also varies according to population: 33% in Sao Paulo, 49% in Rio Grande do Sul, 27% in Santa Catarina, and 52% in Minas Gerais. Cough and nasal obstruction are the most common symptoms. The variation in nasal polyposis prevalence may be explained by population genotypic characteristics in a country that spans a continent. Findings on nasal endoscopy and computed tomography (CT) have better correlation than do this information compared with surgical and clinical history. Microbiologic studies suggest a high level of early contamination of the airways. Sensorineural hearing loss (SNHL) occurs in these patients as a result of ototoxic antibiotics. The data compiled in this paper is useful, but also lead to the general agreement that more research would be welcome due to the unique characteristics of this country

ANALISIS KEBUTUHAN AIR IRIGASI DAN OPTIMASI POLA TANAM PADA DAERAH IRIGASI CISADANE

ABSTRAKDaerah irigasi Cisadane Barat Laut dengan luas ±11.052 Ha termasuk ke dalam administratif kota Tangerang. Daerah irigasi ini menerapkan pola tanam tidak serentak pada kondisi eksistingnya. Tujuan penelitian ini adalah membandingkan kebutuhan air irigasi menggunakan pola tanam tidak serentak terhadap pola tanam serentak, serta menentukan optimasi pola tanam menggunakan solver pada Microsoft Excel untuk mendapatkan keuntungan maksimum. Dari hasil perhitungan, kebutuhan air irigasi pola tanam tidak serentak sebesar 1,95 lt/det/ha, sedangkan pola tanam serentak sebesar 2,36 lt/det/ha. Hasil optimasi pola tanam yang dipilih adalah skenario ke-3 (Padi MT1-Padi MT2-Kangkung), skenario ini dipilih karena hasil keuntungan yang didapatkan paling maksimum yaitu Rp.1,169,195,030,802.72/tahun.

Pediatric nasal and sinus disorders

The first and only source to offer a detailed and authoritative review of every aspect of nasal and sinus disorders in children, this reference provides an impressive collection of reviews on topics ranging from disease mechanisms and immunodefense to diagnosis, medical management, and surgical strategy.SCOPUS: bk.binfo:eu-repo/semantics/publishe