July 31, 2007
article
Bijan Khademi, MD;
Nika Niknejad, MD;
Behrooz Gandomi, MD;
Firoozeh Yeganeh, MD
Abstract
We conducted a prospective study to determine the correlation between the presence or absence of Helicobacter pylori on the tonsillar surface and in the tonsillar core as determined by the Campylobacter-like organism (CLO) rapid urease enzyme test. Our study population was made up of 55 patients who underwent adenoidectomy, tonsillectomy, or both from December 2002 through April 2003 at Khalili Hospital in Shiraz, Iran. Of these 55 patients, 45 (82%) were positive and 10 (18%) were negative for H pylori colonization as determined by CLO testing. Analysis of samples obtained from individual patients revealed differences in H pylori colonization between tonsillar surface samples and the core tissue samples. Of 106 tonsils obtained from 53 patients who underwent adenotonsillectomy or tonsillectomy, H pylori was found on 56 tonsillar surface samples (53%) and 24 tonsillar core samples (23%); only 13 tonsils (12%) contained H pylori both on the surface and in the core. We conclude that a surface swab is neither specific nor sensitive as an indicator of the presence or absence of H pylori colonization in tonsillar core tissue.
July 31, 2007 Gabriel Caponetti, MD; Liron Pantanowitz, MD
article
Cat-scratch disease is an infectious disease caused primarily by the bacillus Bartonella henselae. Its manifestations can include self-limited regional lymphadenopathy, fever of unknown origin, and visceral organ, neurologic, and ocular involvement. In immunocompromised patients, cat-scratch disease can cause life-threatening systemic disease. This infection generally occurs in young immunocompetent individuals who have been scratched or bitten by a cat; it can also be caused by a flea bite.
March 31, 2007 Dewey A. Christmas Jr., MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
March 1, 2007 Eric P. Wilkinson, MD; Robert A. Robinson, MD, PhD; Douglas K. Trask, MD, PhD
March 1, 2007 Jagan Gupta, MD; Troy Hutchins, MD; Enrique Palacios, MD
February 1, 2007 Kristin L. Fredrickson, DO; Anthony J. D'Angelo, Jr., DO, FOCOO
January 1, 2007 Frederick S. Rosen, MD; Matthew W. Ryan, MD
September 30, 2006 Roland H. Lamkin, MD, FACS; James Portt, PAC, MMS
article
Abstract
Several surgical methods are used to treat peritonsillar abscess, but no protocol for outpatient medical treatment has yet been published. Between February 2002 and February 2005, we treated 98 peritonsillar abscess patients with an outpatient medical regimen that involved hydration, antibiotics, steroids, and good pain control. All patients were Native Americans, who are known to have a particularly high incidence of peritonsillar abscess. The medical regimen was generally successful, as only 4 patients (4.1%) subsequently required post-treatment needle aspiration or incision and drainage. We conclude that the medical protocol described herein provides practitioners with a viable noninvasive alternative for treating peritonsillar abscess.
September 30, 2006 Enrique Palacios, MD, FACR; Rafael Rojas, MD
July 31, 2006 Jack B. Anon, MD; Berrylin Ferguson, MD; Monique Twynholm, MSc; Brian Wynne, MD; Elchonon Berkowitz, PhD; Michael D. Poole, MD, PhD
article
Abstract
We evaluated the efficacy of a new pharmacokinetically enhanced formulation of amoxicillin/clavulanate (2,000/125 mg) twice daily for the treatment of acute bacterial rhinosinusitis (ABRS) caused by Streptococcus pneumoniae, particularly penicillin-resistant S pneumoniae (PRSP; penicillin minimum inhibitory concentrations [MICs]: ≥2 µg/ml. A total of 2,482 patients received study medication (safety population). Of these, 2,324 were clinically evaluable (efficacy population), and 1,156 of them had at least one pathogen isolated at screening (bacteriology population). S pneumoniae was isolated from 371 patients in the bacteriology population, including 37 with PRSP. Follow-up in the bacteriology population on days 17 through 28 revealed that amoxicillin/clavulanate therapy was successful in 345 of 371 patients with S pneumoniae infection (93.0%) and in 36 of 37 patients with PRSP infection (97.3%), including 7 of 8 patients (87.5%) whose amoxicillin/clavulanic acid MICs were 4/2 µg/ml or higher. Pharmacokinetically enhanced amoxicillin/clavulanate was generally well tolerated, as only 2.2% of patients withdrew because of adverse events. This agent represents a valuable new therapeutic option for the empiric treatment of ABRS, particularly in areas where antimicrobial-resistant pathogens (including β-lactamase'positive organisms) are prevalent, and for the treatment of patients who are at increased risk of infection with PRSP.
July 31, 2006 Ryan F. Osborne, MD, FACS; Jason S. Hamilton, MD
April 30, 2006 Lester D.R. Thompson, MD, FASCP
