Abstract:
OBJECTIVE:Risk of childhood asthma is increased in children with recurrent otitis media. This may be associated with recurrent respiratory tract infections in these children, but the role of adenoidectomy, a frequent operation during childhood, is unknown. Therefore, the role of adenoidectomy in the development of atopy and respiratory function changes characteristic of asthma was evaluated. DESIGN:Randomised controlled study. SETTING:Tertiary care centre. PATIENTS:166 children aged 12-48 months who had recurrent or persistent otitis media and who were followed-up for 3 years after randomisation. INTERVENTION:Randomisation to undergo insertion of tympanostomy tubes with or without adenoidectomy. MAIN OUTCOME MEASURES:The primary outcome measure was exercise-induced bronchoconstriction as evaluated by impulse oscillometry. The secondary outcome measures were bronchial inflammation as evaluated by exhaled nitric oxide and atopy as evaluated by skin prick tests. During the 3-year follow-up period otitis media episodes were documented in patient diaries. RESULTS:Adenoidectomy did not significantly influence baseline lung function, exercise-induced bronchoconstriction, exhaled nitric oxide concentration, the development of positive skin prick tests, or doctor-diagnosed asthma. Adenoidectomy did not significantly prevent otitis media. Recurrent otitis media (>or=4 episodes) during the first follow-up year was associated with an abnormal exercise-induced bronchoconstriction (OR 6.62, 95% CI 1.27 to 34) and an elevated exhaled nitric oxide concentration (OR 3.26, 95% CI 0.98 to 10.8) regardless of adenoidectomy. CONCLUSIONS:Adenoidectomy did not promote asthma or allergy. Recurrent respiratory tract infections during early childhood are associated with the risk of bronchial hyper-reactivity.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Mattila PS,Hammarén-Malmi S,Pelkonen AS,Malmberg LP,Mäkelä MJ,Saxen H,Tarkkanen Jdoi
10.1136/adc.2008.145664subject
Has Abstractpub_date
2009-05-01 00:00:00pages
366-70issue
5eissn
0003-9888issn
1468-2044pii
adc.2008.145664journal_volume
94pub_type
杂志文章,随机对照试验abstract::Doppler ultrasound measurements of pulmonary blood flow in 20 babies with severe respiratory distress syndrome treated in a randomised controlled trial of surfactant replacement showed that the immediate improvement of oxygenation was not associated with a significant increase in pulmonary blood flow. Reduction in ven...
journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Archives of disease in childhood
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章,评审
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journal_title:Archives of disease in childhood
pub_type: 临床试验,杂志文章
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journal_title:Archives of disease in childhood
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journal_title:Archives of disease in childhood
pub_type: 杂志文章
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pub_type: 杂志文章
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