tonsillitis

When symptoms are mild, surgery may not be beneficial.

* THE QUESTION For children who have frequent throat infections, removing the tonsils often remedies the problem. But is the surgery useful for youngsters with milder symptoms?

* THIS STUDY randomly assigned 300 children who had been recommended for a tonsillectomy either to have the surgery or to simply be monitored. The children, 2 to 8 years old, all had recurrent upper respiratory infections or swollen tonsils and adenoids, but symptoms were considered mild. During the first six months, the children who had had their tonsils removed had fewer related problems, such as instances of fever and sore throat. But all differences between the two groups, including variations in sleeping and eating patterns, had disappeared after two years. Among children whose tonsils were removed, benefits were more pronounced for those who originally had the most frequent symptoms.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Children between 5 and 15 years old, who are most likely to have problems with their tonsils. Nearly all children have at least one episode of tonsillitis.

* CAVEATS Children with severe symptoms, including more than seven throat infections a year or obstructive sleep apnea, were excluded from the study; the findings apply only to children with milder symptoms.

* BOTTOM LINE Parents of a child with recurring symptoms of tonsillitis may want to talk with a pediatrician about treatment options. Symptoms often can be treated successfully with antibiotics, negating the need for surgery.

* FIND THIS STUDY Sept. 10 online edition of the British Medical Journal; abstract available online at www.bmj.com (click "Online first").

* LEARN MORE ABOUT tonsils and tonsillectomies at www.mayoclinic.com and kidshealth.org.

fractures

Blood-pressure drugs seem to make bones breaks less likely.

* THE QUESTION Studies on animals have shown that beta blockers, which slow the heart rate and lower blood pressure, also help maintain bone density. Might these drugs have a similar effect on people, making their bones less fragile?

* THIS STUDY analyzed the medical records of about 31,000 adults, 30 to 79 years old, who had broken a bone and compared them with the records of 121,000 similar people with no fractures. Those who had taken beta blockers had 23 percent fewer fractures than participants who had not taken the drugs. People who took beta blockers along with a thiazide diuretic, another type of blood-pressure drug that also is thought to help bones by restricting the excretion of calcium, had 29 percent fewer fractures. Taking thiazide diuretics alone showed a 20 percent reduction in broken bones. Among long-term users of beta blockers, the effect was stronger in men than women.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Older adults. As people age, bones become thinner and weaker and more likely to fracture.

* CAVEATS The study did not evaluate factors such as physical activity and diet that could have affected the risk of fracture.

* BOTTOM LINE Older people in particular may want to ask their doctor about how taking beta blockers to control their blood pressure might also reduce their risk of osteoporosis.

* FIND THIS STUDY Sept. 15 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.

* LEARN MORE ABOUT bone health at www.osteo.org (search for "what is bone") and at http://orthoinfo.aaos.org (search for "bone").

-- Linda Searing