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Xu Y, Bei Z, Li M, Qiu K, Ren J, Chu B, Zhao Y, Qian Z. Biomaterials for non-invasive trans-tympanic drug delivery: requirements, recent advances and perspectives. J Mater Chem B 2024; 12:7787-7813. [PMID: 39044544 DOI: 10.1039/d4tb00676c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Various non-invasive delivery systems have recently been developed as an alternative to conventional injections. Local transdermal administration represents the most attractive method due to the low systemic side effects, excellent ease of administration, and persistent drug release. The tympanic membrane (TM), a major barrier between the outer and middle ear, has a similar structure of the stratum corneum compared to the surface of the skin. After several attempts, non-invasive trans-tympanic drug delivery has been regarded as a promising option in the treatment of middle and inner ear diseases. The round window membrane (RWM) was a possible non-invasive delivery approach from the middle to inner ear. The improved permeability of nanocarriers crossing the RWM is a current hotspot in therapeutics for inner ear diseases. In this review, we include the latest studies exploring non-invasive trans-tympanic delivery to treat middle and inner ear diseases. Both passive and active delivery systems are described. A summary of the benefits and disadvantages of various delivery systems in clinical practice and production procedures is introduced. Finally, future possible approaches for its effective application as a non-invasive middle and inner ear drug delivery system are characterised.
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Affiliation(s)
- Yang Xu
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Zhongwu Bei
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Mei Li
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ke Qiu
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jianjun Ren
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bingyang Chu
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Yu Zhao
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhiyong Qian
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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Alnifaee NS, Althubaiti RF, Almatrafi MK, Alotaibi TA, Almjnouni GG, Sadakah GK, Khojah AM. Parental Knowledge, Attitudes, and Practices Towards Pediatric Ear Infections in the Makkah Region of Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e61990. [PMID: 38989347 PMCID: PMC11233199 DOI: 10.7759/cureus.61990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Pediatric ear infections constitute a significant public health concern worldwide, adversely impacting children's health and well-being. Parents play a crucial role in prevention, ensuring timely healthcare access, and therefore minimizing potential complications. This study aims to assess parental knowledge, attitudes, and practices towards pediatric ear infections in Makkah region. METHODOLOGY A descriptive cross-sectional study was conducted among Saudi parents who were ≥18 years old and lived in Makkah region. Convenience sampling was used to recruit 319 participants through social media platforms; data were collected from June to September 2023 via an online self-administered questionnaire. The questionnaire assessed sociodemographic characteristics, along with knowledge, attitudes, and practices related to pediatric ear infections. RESULTS A total of 319 parents were included in the study. The majority of the participants were female 228 (71.5%), and 208 (65.2%) had a university education level. The most common age groups were 18-30 years and 31-40 years. More than half of the participants (167, 52.4%) demonstrated adequate knowledge regarding pediatric ear infections. Positive attitudes and practices were reported by 183 (57.4%) and 285 (89.3%) of participants, respectively. Adequate knowledge was significantly higher among participants with younger ages (p<0.05). It was found that having a younger age (18-30 years) was an independent predictor of good knowledge (OR: 1.26 (1.96-3.65), p=0.009) and positive practice (OR: 1.53 (1.01-2.33), p=0.045). CONCLUSION We found that the majority of parents in Makkah region had a good level of knowledge regarding childhood ear infections, with an overall positive attitude and practice. The study revealed that younger parents had superior knowledge and younger age was an independent predictor for good knowledge and positive attitude.
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Affiliation(s)
| | | | - Maha K Almatrafi
- College of Medicine and Surgery, Umm Al-Qura University, Makkah, SAU
| | - Turki A Alotaibi
- College of Medicine and Surgery, Umm Al-Qura University, Makkah, SAU
| | | | - Ghadir K Sadakah
- College of Medicine and Surgery, Umm Al-Qura University, Makkah, SAU
| | - Amer M Khojah
- Department of Pediatrics, College of Medicine and Surgery, Umm Al-Qura University, Makkah, SAU
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Lyutenski S, Wendt S, Lieder A, James P, Bloching M. [Standardized risk-based antibiotic prophylaxis and adhesive film dressing for the prevention of wound infection following cochlear implantation]. HNO 2024; 72:405-411. [PMID: 38280932 DOI: 10.1007/s00106-024-01423-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND There is no consensus in the pertinent literature regarding the optimal antibiotic prophylaxis (AP) for cochlear implantation (CI). This study evaluates the implementation of standardized risk-based AP combined with application of an adhesive film dressing. MATERIALS AND METHODS All CI cases since September 2019 were retrospectively reviewed for postoperative wound complications. While all patients received preoperative AP with ceftriaxone, postoperative AP after CI in patients older than 7 years was no longer routinely performed in our clinic. Exceptions were made according to predefined criteria for an increased risk of infection. The wound was covered with a transparent adhesive polyurethane film. RESULTS In 72% of the 219 cases, we did not perform postoperative AP. The overall wound complication rate was 2.7% (in the groups with and without postoperative AP, 4.9% and 1.9%, respectively). Wound infection did not occur in any of the patients without postoperative AP older than 70 years (n = 32), with controlled diabetes mellitus (n = 19), or with reimplantation due to technical defect (n = 19). The film did not need to be changed until the suture material was removed. CONCLUSION Standardized risk-based AP can avoid prolonged administration of antibiotics in selected patients. The film dressing permits continual examination and sufficient wound protection.
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Affiliation(s)
- Stefan Lyutenski
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland.
| | - Susanne Wendt
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland
| | - Anja Lieder
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland
| | - Paul James
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland
| | - Marc Bloching
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Helios Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland
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Ricci Conesa H, Skröder H, Norton N, Bencina G, Tsoumani E. Clinical and economic burden of acute otitis media caused by Streptococcus pneumoniae in European children, after widespread use of PCVs-A systematic literature review of published evidence. PLoS One 2024; 19:e0297098. [PMID: 38564583 PMCID: PMC10986968 DOI: 10.1371/journal.pone.0297098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/21/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Acute otitis media (AOM) is a common childhood disease frequently caused by Streptococcus pneumoniae. Pneumococcal conjugate vaccines (PCV7, PCV10, PCV13) can reduce the risk of AOM but may also shift AOM etiology and serotype distribution. The aim of this study was to review estimates from published literature of the burden of AOM in Europe after widespread use of PCVs over the past 10 years, focusing on incidence, etiology, serotype distribution and antibiotic resistance of Streptococcus pneumoniae, and economic burden. METHODS This systematic review included published literature from 31 European countries, for children aged ≤5 years, published after 2011. Searches were conducted using PubMed, Embase, Google, and three disease conference websites. Risk of bias was assessed with ISPOR-AMCP-NPC, ECOBIAS or ROBIS, depending on the type of study. RESULTS In total, 107 relevant records were identified, which revealed wide variation in study methodology and reporting, thus limiting comparisons across outcomes. No homogenous trends were identified in incidence rates across countries, or in detection of S. pneumoniae as a cause of AOM over time. There were indications of a reduction in hospitalization rates (decreases between 24.5-38.8% points, depending on country, PCV type and time since PCV introduction) and antibiotic resistance (decreases between 14-24%, depending on country), following the widespread use of PCVs over time. The last two trends imply a potential decrease in economic burden, though this was not possible to confirm with the identified cost data. There was also evidence of an increase in serotype distributions towards non-vaccine serotypes in all of the countries where non-PCV serotype data were available, as well as limited data of increased antibiotic resistance within non-vaccine serotypes. CONCLUSIONS Though some factors point to a reduction in AOM burden in Europe, the burden still remains high, residual burden from uncovered serotypes is present and it is difficult to provide comprehensive, accurate and up-to-date estimates of said burden from the published literature. This could be improved by standardised methodology, reporting and wider use of surveillance systems.
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Affiliation(s)
| | | | | | - Goran Bencina
- Center for Observational and Real-World Evidence, MSD, Madrid, Spain
| | - Eleana Tsoumani
- Center for Observational and Real-World Evidence, MSD, Athens, Greece
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Assiri K, Hudise J, Obeid A. Risk Factors for Chronic and Recurrent Otitis Media in Children: A Review Article. Indian J Otolaryngol Head Neck Surg 2024; 76:1464-1469. [PMID: 38440639 PMCID: PMC10908946 DOI: 10.1007/s12070-023-04256-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/28/2023] [Indexed: 03/06/2024] Open
Abstract
Otitis media is an inflammation of the mucous membrane of the middle ear, which includes mastoid air cells, the middle ear cavity, the Eustachian tube, and the mastoid antrum. Otitis media can be either acute, less than six weeks, or chronic, which lasts for more than six weeks. Recurrent otitis media refers to three episodes of the disease occurring within six months or four episodes within one year. There are many risk factors for otitis media among children; however, some of such factors may vary based on the type of otitis media. To highlight the risk factors of chronic and recurrent otitis media in pediatrics. Scientific databases were used to search for articles related to our objective. Various terms were used for the search process. The types of articles included in our review were original articles, review articles, meta-analyses, and systematic reviews written in the English language and concerned with our subject. The topic was discussed under four main titles; the first overviewed the prevalence and risk factors of otitis media, the second title discussed chronic otitis media and its risk factors, the third title discussed recurrent otitis media and its risk factors, and the last title discussed the risk factors of both chronic and recurrent otitis media. There are various risk factors for chronic and recurrent otitis media, and they include allergy, passive smoking, male gender, and snoring. Also, genetics may have a common role, but this needs further investigation.
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Affiliation(s)
- Kholood Assiri
- Otorhinolaryngology - Rhinology and Skull Base Surgery consultant, King Faisal Medical City for Southern Regions, Abha, Saudi Arabia
| | - Jibril Hudise
- Otorhinolaryngology - Facial Plastic and Reconstructive Surgery Consultant, King Faisal Medical City for Southern Regions, Abha, Saudi Arabia
| | - Ali Obeid
- Otorhinolaryngology Senior Registrar, Ministry of Health , Abha, Saudi Arabia
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Delaney DS, Liew LJ, Lye J, Atlas MD, Wong EYM. Overcoming barriers: a review on innovations in drug delivery to the middle and inner ear. Front Pharmacol 2023; 14:1207141. [PMID: 37927600 PMCID: PMC10620978 DOI: 10.3389/fphar.2023.1207141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Despite significant advances in the development of therapeutics for hearing loss, drug delivery to the middle and inner ear remains a challenge. As conventional oral or intravascular administration are ineffective due to poor bioavailability and impermeability of the blood-labyrinth-barrier, localized delivery is becoming a preferable approach for certain drugs. Even then, localized delivery to the ear precludes continual drug delivery due to the invasive and potentially traumatic procedures required to access the middle and inner ear. To address this, the preclinical development of controlled release therapeutics and drug delivery devices have greatly advanced, with some now showing promise clinically. This review will discuss the existing challenges in drug development for treating the most prevalent and damaging hearing disorders, in particular otitis media, perforation of the tympanic membrane, cholesteatoma and sensorineural hearing loss. We will then address novel developments in drug delivery that address these including novel controlled release therapeutics such as hydrogel and nanotechnology and finally, novel device delivery approaches such as microfluidic systems and cochlear prosthesis-mediated delivery. The aim of this review is to investigate how drugs can reach the middle and inner ear more efficiently and how recent innovations could be applied in aiding drug delivery in certain pathologic contexts.
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Affiliation(s)
- Derek S. Delaney
- Hearing Therapeutics, Ear Science Institute Australia, Nedlands, WA, Australia
- Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia
| | - Lawrence J. Liew
- Hearing Therapeutics, Ear Science Institute Australia, Nedlands, WA, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Nedlands, WA, Australia
| | - Joey Lye
- Hearing Therapeutics, Ear Science Institute Australia, Nedlands, WA, Australia
| | - Marcus D. Atlas
- Hearing Therapeutics, Ear Science Institute Australia, Nedlands, WA, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Nedlands, WA, Australia
- Faculty of Health Sciences, Curtin Medical School, Curtin University, Bentley, WA, Australia
| | - Elaine Y. M. Wong
- Hearing Therapeutics, Ear Science Institute Australia, Nedlands, WA, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Nedlands, WA, Australia
- Faculty of Health Sciences, Curtin Medical School, Curtin University, Bentley, WA, Australia
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AlHefdhi HA, Al Qout MM, Alqahtani AY, Alqahtani MM, Asiri RM, Alshahrani OM, Almoghamer HD, Youssef N, Ghazy RM. Parents' Knowledge of and Attitude toward Acute Otitis Media and Its Treatment in Children: A Survey at Primary Healthcare Centers in the Aseer Region. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1573. [PMID: 37761534 PMCID: PMC10528457 DOI: 10.3390/children10091573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Acute otitis media (AOM) in children aged 5 years old and younger poses a critical health concern, affecting both the general health of children and the emotional well-being of parents. The objective of this study was to evaluate parental understanding, attitudes, and experiences related to AOM and its management, including the use of antibiotics without physician prescription. METHOD A cross-sectional study was carried out during the months of May and June of 2023. To collect data for this study, a validated questionnaire was converted into a Google form and given to parents of children aged 5 years and younger who sought healthcare for their children in primary healthcare centers in Abha city, Aseer region, Saudi Arabia. RESULTS A total of 406 parents participated in this study, 64.8% of them were women and 45.3% of them were in the age range of 25 to 34 years. The majority (90.1%) resided in urban areas and a significant proportion (72.2%) had a university education. Among the respondents, 22.7% agreed that bacteria are the cause of AOM, while 21.7% agreed that it is caused by viruses. A total of 51.0% acknowledged the need for antibiotics in the management of AOM. In terms of treatment, 84.5% and 83.5% believed that analgesics and antibiotics, respectively, were the most effective for otalgia. A substantial portion, 43.1%, 34.7%, and 37.7%, respectively, believed that antibiotics could reduce pain, relieve fever, and prevent recurrence. Almost three-quarters sought medical advice primarily from paediatricians and 37.7% obtained information about AOM from the Internet. Furthermore, almost a third (28.8%) chose not to wait for the physician's appointment and immediately administered antibiotics without the physician's prescription due to concerns about disease progression. Approximately two fifths (38.4%) requested physicians to prescribe antibiotics, a pattern that was in agreement with the actual rate of antibiotic prescriptions (38.4%). CONCLUSIONS A notable deficiency in knowledge and unsafe practices about AOM and its management is evident among parents in the Aseer region. This underscores the pressing need for an educational program aimed at improving parental health literacy regarding otitis media causes and treatments, as well as its preventive measures.
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Affiliation(s)
- Hayfa Abdulkhaleq AlHefdhi
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | - Maraam Mohammed Al Qout
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Alhanouf Yahya Alqahtani
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Meshal Mohammed Alqahtani
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Roaa Mohammed Asiri
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Omair Mohammed Alshahrani
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Hanan Delem Almoghamer
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia; (M.M.A.Q.); (A.Y.A.); (M.M.A.); (R.M.A.); (O.M.A.); (H.D.A.)
| | - Naglaa Youssef
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrah-Man University, Riyadh 11671, Saudi Arabia;
| | - Ramy Mohamed Ghazy
- Tropical Health Department, Alexandria University, Alexandria 21561, Egypt
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Song D, Kim T, Lee Y, Kim J. Image-Based Artificial Intelligence Technology for Diagnosing Middle Ear Diseases: A Systematic Review. J Clin Med 2023; 12:5831. [PMID: 37762772 PMCID: PMC10531728 DOI: 10.3390/jcm12185831] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Otolaryngological diagnoses, such as otitis media, are traditionally performed using endoscopy, wherein diagnostic accuracy can be subjective and vary among clinicians. The integration of objective tools, like artificial intelligence (AI), could potentially improve the diagnostic process by minimizing the influence of subjective biases and variability. We systematically reviewed the AI techniques using medical imaging in otolaryngology. Relevant studies related to AI-assisted otitis media diagnosis were extracted from five databases: Google Scholar, PubMed, Medline, Embase, and IEEE Xplore, without date restrictions. Publications that did not relate to AI and otitis media diagnosis or did not utilize medical imaging were excluded. Of the 32identified studies, 26 used tympanic membrane images for classification, achieving an average diagnosis accuracy of 86% (range: 48.7-99.16%). Another three studies employed both segmentation and classification techniques, reporting an average diagnosis accuracy of 90.8% (range: 88.06-93.9%). These findings suggest that AI technologies hold promise for improving otitis media diagnosis, offering benefits for telemedicine and primary care settings due to their high diagnostic accuracy. However, to ensure patient safety and optimal outcomes, further improvements in diagnostic performance are necessary.
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Affiliation(s)
- Dahye Song
- Major in Bio Artificial Intelligence, Department of Applied Artificial Intelligence, Hanyang University, Ansan 15588, Republic of Korea; (D.S.); (T.K.)
| | - Taewan Kim
- Major in Bio Artificial Intelligence, Department of Applied Artificial Intelligence, Hanyang University, Ansan 15588, Republic of Korea; (D.S.); (T.K.)
| | - Yeonjoon Lee
- Major in Bio Artificial Intelligence, Department of Applied Artificial Intelligence, Hanyang University, Ansan 15588, Republic of Korea; (D.S.); (T.K.)
| | - Jaeyoung Kim
- Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, BC V6T 1Z1, Canada;
- Core Research & Development Center, Korea University Ansan Hospital, Ansan 15355, Republic of Korea
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Moradi A, Soltani R, Shamsi M, Moradzadeh R. Effects of online social media on improving mothers' behaviors towards preventing their children's otitis media based on the PRECED model: a randomized educational intervention trial. BMC Pediatr 2023; 23:216. [PMID: 37147633 PMCID: PMC10161150 DOI: 10.1186/s12887-023-04016-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/16/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Otitis media is one of the most common diseases in children, especially those under 2 years of age. This study aimed to investigate the effect of educational intervention based on the PRECEDE model on mothers' preventive behaviors of middle ear infections in infants. METHODS This study was conducted as an educational randomized controlled trial on 88 mothers with infants referred to health centers in Arak, Iran. Sampling from September 2021 to February 2022 selected trough stratified random sampling who were assigned to two groups of experimental = 44 and control = 44. The data collection tool was a reliable and valid questionnaire that included demographic information, constructs of PRECEDE model regarding otitis media, and preventive behaviors. The experimental group received 4 training sessions (each session 60 min) through WhatsApp social network. Information was collected through an online questionnaire before and 3 months after the educational intervention from both groups. Data analysis was also performed with SPSS version 23. RESULTS Before the educational intervention there was no significant difference between the experimental and control groups in the otitis media preventive behaviors and structures of PRECEDE model (p > 0.05). After the educational intervention, in the experimental group the average score of knowledge from 0.49 to 0.81, attitude from 4.01 to 4.58, enabling factors from 0.72 to 0.85, reinforcing factors from 3.31 to 3.91 and behavior from 3.25 to 3.66 increased significantly (p < 0.001). CONCLUSIONS PRECEDE-based education with controlling, monitoring and follow-up during the program was effective in promoting the preventive behaviors of otitis media. Therefore, due to the side effects of otitis media, especially in vulnerable periods such as childhood, it is recommended that trainings based on this model be carried out in other health care centers and clinics in order to maintain children health. TRIAL REGISTRATION This trial has been registered at the Iranian Registry of Clinical Trials, IRCT20210202050228N1. Prospectively registered at 2021-May-21, (2021/05/21) available at: URL: https://en.irct.ir/trial/54073 .
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Affiliation(s)
- Atefeh Moradi
- Student Research Committee, Department of Health Education, Faculty of Health, Arak University of Medical Sciences, Arak, Iran
| | - Raheleh Soltani
- Department of Health Education, Faculty of Health, Arak University of Medical Sciences, Arak, Iran.
| | - Mohsen Shamsi
- Department of Health Education, Faculty of Health, Arak University of Medical Sciences, Arak, Iran
| | - Rahmatallah Moradzadeh
- Department of Epidemiology, Faculty of Health, Arak University of Medical Sciences, Arak, Iran
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El Feghaly RE, Nedved A, Katz SE, Frost HM. New insights into the treatment of acute otitis media. Expert Rev Anti Infect Ther 2023; 21:523-534. [PMID: 37097281 PMCID: PMC10231305 DOI: 10.1080/14787210.2023.2206565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION Acute otitis media (AOM) affects most (80%) children by 5 years of age and is the most common reason children are prescribed antibiotics. The epidemiology of AOM has changed considerably since the widespread use of pneumococcal conjugate vaccines, which has broad-reaching implications for management. AREAS COVERED In this narrative review, we cover the epidemiology of AOM, best practices for diagnosis and management, new diagnostic technology, effective stewardship interventions, and future directions of the field. Literature review was performed using PubMed and ClinicalTrials.gov. EXPERT OPINION Inaccurate diagnoses, unnecessary antibiotic use, and increasing antimicrobial resistance remain major challenges in AOM management. Fortunately, effective tools and interventions to improve diagnostic accuracy, de-implement unnecessary antibiotic use, and individualize care are on the horizon. Successful scaling of these tools and interventions will be critical to improving overall care for children.
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Affiliation(s)
- Rana E. El Feghaly
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Amanda Nedved
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Sophie E. Katz
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Holly M. Frost
- Department of Pediatrics, Denver Health and Hospital Authority, Denver, CO, USA
- Center for Health Systems Research, Denver Health and Hospital Authority, Denver, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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Bhatia R, Singh M, Chauhan A, Kaur K, Sachdeva M, Rana M, Pradhan P. Otitis Media Prevalence in Children Below 18 Years of Age of India and the Associated Risk Factors: A Systematic Review and Meta-Analysis. Indian J Otolaryngol Head Neck Surg 2023; 75:133-139. [PMID: 37206774 PMCID: PMC10188773 DOI: 10.1007/s12070-022-03285-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 11/17/2022] [Indexed: 12/07/2022] Open
Abstract
Ear ailments in children are a major public health problem in India. This systematic review and meta-analysis aim to quantitatively pool the epidemiologic evidence on the prevalence of all forms of otitis media in children of India. In this review PRISMA guidelines (preferred reporting items for systematic reviews and meta-analysis) were followed. We did extensive literature search in PubMed, Embase, Cinahl and Web of Science to identify relevant community based cross sectional studies that investigated the prevalence of otitis media in children of India. We used STATA version 16.0 software to perform meta-analysis. Six studies reporting the prevalence of otitis media in children were included in the final analysis. Based on the results of the random-effects sub-group meta-analysis model, the pooled estimated prevalence of Chronic suppurative otitis media in children of India was 3.78% (95% CI 2.72-4.84), Otitis media with effusion was found to be 2.68% (95% CI 1.80, 3.55) and Acute suppurative otitis media to be 0.55 (95% CI 0.32, 0.78). This review suggests substantial otitis media related disease burden in children of India. But due to lack of epidemiological studies, the actual disease burden remains concealed. It is imperative to promote more epidemiological studies that will aid policy makers in recommendation of preventive, diagnostic and treatment strategies for this disease.
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Affiliation(s)
- Ragini Bhatia
- Department of Pediatrics, Evidence Based Medicine, ICMR, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Meenu Singh
- Department of Pediatrics, Evidence Based Medicine, ICMR, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Anil Chauhan
- Department of Telemedicine, Consultant, Regional Resource Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kulbir Kaur
- Department of Pediatrics, Evidence Based Medicine, ICMR, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Meenakshi Sachdeva
- Department of Pediatrics, Evidence Based Medicine, ICMR, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Monika Rana
- Department of Pediatrics, Evidence Based Medicine, ICMR, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
| | - Pranita Pradhan
- Department of Pediatrics, Evidence Based Medicine, ICMR, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012 India
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Mucha S, Bugnait G, Suri GS, Vibhuti V, Prakash S, Akash A, Tiwari V. Comparative Study on Temporalis Fascia Graft Versus Tragal Cartilage in Type-1 Tympanoplasty in Paediatric Patients. Indian J Otolaryngol Head Neck Surg 2023; 75:396-402. [PMID: 37206827 PMCID: PMC10188822 DOI: 10.1007/s12070-023-03490-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
The aim of the study was to compare anatomical and functional outcomes of temporalis fascia graft versus tragal cartilage graft in type 1 tympanoplasty in paediatric patients. A prospective, comparative and randomised study. A detailed history was taken from all the patients visiting the ENT OP dept after fulfilling the inclusion and exclusion criterion patients were enrolled for the study. Written and informed consent was taken for all the patients from legally acceptable guardians. Preoperative assessment was done and the patients were subjected to type1 tympanoplasty with Temporalis fascia graft or tragal cartilage graft. All the patients were followed up on the third, sixth postoperative months to assess hearing improvement. All the patients were followed up on the first and third,sixth postoperative months for graft status with otoscopic examination. In the present study out of 80 patients, 40 patients underwent type 1 tympanoplasty with temporalis fascia and the remaining 40 patients with tragal cartilage. Both groups were assessed postoperatively for anatomical and functional success with maximum follow up of six months. There was no statistical significance between the outcome and the age or site and size of tympanic membrane perforation. Both groups had comparable graft success rate and hearing improvement. The cartilage group had a higher anatomical success rate. The functional outcome was similar. However, there was no statistically significant difference found in the outcome of two groups. Tympanoplasty can be performed in a paediatric age group with a good success rate in suitable patients. It can be done at an early age,safely with good anatomical and functional outcomes. The age group, site or size of perforation, the type of graft used for tympanoplasty does not alter the anatomical or functional outcome significantly. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03490-1.
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13
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Aladeyelu OS, Olojede SO, Lawal SK, Mbatha WBE, Sibiya AL, Rennie CO. Influence of pneumatization on morphology of temporal bone-related vasculatures and their morphometric relationship with ear regions: a computed tomography study. Sci Rep 2023; 13:1996. [PMID: 36737493 PMCID: PMC9898243 DOI: 10.1038/s41598-023-29295-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
Anatomical variations in the location and position of temporal bone-related vasculature are routinely encountered in clinical practice, contributing to clinical syndromes and complexities in ear-related and neurological surgeries. Pneumatization of the temporal bone (TB) is one of several factors that have been hypothesized to influence the variabilities and variations of these vessels. This study aimed to investigate the association between the degree of pneumatization and the morphologies of some TB-related vessels, as well as their morphometrical relationship with ear regions. Observational retrospective chart review of 496 TBs computed tomographic scans were examined. Different degrees of pneumatization were observed, with hyper-pneumatization being the most common and hypo-pneumatization being the least. Various anatomical variants of the sigmoid sinus (SS), jugular bulb (JB), and internal carotid artery (ICA) were observed. Distances of SS and JB to ear regions were observed to have significant differences (p < 0.05) in laterality. These distances increased relative to increased air cells, showing a significant association (p < 0.05). A significant association (p < 0.001) was also observed between the degree of pneumatization and variants of JB and ICA. High JB, JB dehiscence, and ICA dehiscence were significantly associated with increased pneumatization, while flat JB was significantly associated with decreasing pneumatization. However, no significant association (p = 0.070, p = 0.645) was observed between the degree of pneumatization and morphologies of SS. This study concludes that the degree of pneumatization influences only the jugular bulb variants and ICA dehiscence, as well as the distances of SS and JB to ear regions.
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Affiliation(s)
- Okikioluwa Stephen Aladeyelu
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa.
| | - Samuel Oluwaseun Olojede
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
| | - Sodiq Kolawole Lawal
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
| | - Wonder-Boy Eumane Mbatha
- Radiology Department, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
- Lake, Smit & Partners Inc, Durban, South Africa
| | - Andile Lindokuhle Sibiya
- Discipline of Otorhinolaryngology- Head and Neck Surgery, School of Clinical Medicine, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
- ENT Department, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Carmen Olivia Rennie
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
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Yu H, Gu D, Yu F, Li Q. Social distancing cut down the prevalence of acute otitis media in children. Front Public Health 2023; 11:1079263. [PMID: 36778556 PMCID: PMC9911446 DOI: 10.3389/fpubh.2023.1079263] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/04/2023] [Indexed: 01/28/2023] Open
Abstract
Objectives To evaluate the additional, unintended benefits of social distancing in cutting down the prevalence of acute otitis media (AOM) in children, especially during coronavirus disease 2019 (COVID-19) periods. Methods The daily outpatient attendance of AOM for childhood (from 6 months to 12 years) was compared in the tertiary hospital in Shanghai during pre-COVID-19 and COVID-19 year. Results A total of 24,543 AOM cases were included from 2015 to 2020. When age was taken into account, children in kindergarten (aged 4-6) constitute 66.2% (16,236/24,543) of all case, followed by primary school students (6,441/24,543, 26.2%) and preschoolers <3 years old (1,866/24,543, 7.6%). There was an estimated 63.6% (54.32-70.36%) reduction in the daily outpatient attendance of AOM associated with the introduction of social distancing in 2020 (COVID-19 year). The epidemic trend of AOM in 2015-2019 was characterized by seasonal fluctuations, with highest incidence in December (18.8 ± 0.5%) and lower in February (4.5 ± 0.2%), June (3.7 ± 0.7%) and August (3.5 ± 0.5%). And distribution characteristics of different ages in COVID-19 period broadly in line with that in non-pandemic period. Conclusion Seasonal fluctuation in the prevalence of AOM was observed in pre-COVID-19 period (2015-2019), with a peak in winter and a nadir in summer. The >50% drop of outpatient attendance of AOM in 2020 (COVID-19 year) suggest that social distancing, mask effects and good hand hygiene can significantly reduce the incidence of AOM, which provides a preventive and therapeutic point of view for AOM.
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Xu W, Ceylan Koydemir H. Non-invasive biomedical sensors for early detection and monitoring of bacterial biofilm growth at the point of care. LAB ON A CHIP 2022; 22:4758-4773. [PMID: 36398687 DOI: 10.1039/d2lc00776b] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Bacterial infections have long been a serious global health issue. Biofilm formation complicates matters even more. The biofilm's extracellular polymeric substances (EPSs) matrix protects bacteria from the host's immune responses, yielding strong adhesion and drug resistance as the biofilm matures. Early bacterial biofilm detection and bacterial biofilm growth monitoring are crucial to treating biofilm-associated infections. Current detection methods are highly sensitive but not portable, are time-consuming, and require expensive equipment and complex operating procedures, limiting their use at the point of care. Therefore, there is an urgent need to develop affordable, on-body, and non-invasive biomedical sensors to continuously monitor and detect early biofilm growth at the point of care through personalized telemedicine. Herein, recent advances in developing non-invasive biomedical sensors for early detection and monitoring bacterial biofilm growth are comprehensively reviewed. First, biofilm's life cycle and its impact on the human body, such as biofilm-associated disease and infected medical devices, are introduced together with the challenges of biofilm treatment. Then, the current methods used in clinical and laboratory settings for biofilm detection and their challenges are discussed. Next, the current state of non-invasive sensors for direct and indirect detection of bacterial biofilms are summarized and highlighted with the detection parameters and their design details. Finally, commercially available products, challenges of current devices, and the further trend in biofilm detection sensors are discussed.
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Affiliation(s)
- Weiming Xu
- Department of Biomedical Engineering, Texas A&M University, College Station, 77843, Texas, USA.
- Center for Remote Health Technologies and Systems, Texas A&M Engineering Experiment Station, College Station, 77843, TX, USA
| | - Hatice Ceylan Koydemir
- Department of Biomedical Engineering, Texas A&M University, College Station, 77843, Texas, USA.
- Center for Remote Health Technologies and Systems, Texas A&M Engineering Experiment Station, College Station, 77843, TX, USA
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16
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Taha A, Adeline F, Taha MK, Deghmane AE. Haemophilus influenzae drug resistance in France from 2017 to 2021: consideration for treatment of otitis media. J Glob Antimicrob Resist 2022; 31:222-227. [PMID: 36195280 DOI: 10.1016/j.jgar.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Haemophilus influenzae is a prevalent agent of respiratory infections, including acute otitis media (AOM), that lead to high antibiotic prescription and may contribute to the development of bacterial resistance to antibiotics. The objective of this work was to describe and analyse antibiotic resistance of H. influenzae from 2017 to 2021 in France. METHODS We characterized H. influenzae isolates transmitted to the French national reference centre for H. influenzae between 2017 and 2021. We included all the 608 non-invasive respiratory isolates. Resistance rates to the main antibiotics were described. The relationship between resistance rate, age, and sex of patients and germ serotype was investigated. RESULTS Isolates were mainly from alveolar lavage (29.3%), expectoration (22.9%), or sputum (15%). Resistance to amoxicillin (61.4%), amoxicillin/clavulanic acid (47.4%), and cefotaxime (39.3%) was high and correlated with the presence of β-lactamase and/or modifications of the ftsI gene encoding penicillin-binding protein 3. Resistance to sulfamethoxazole/trimethoprim (33.2%) was more moderate. There were no significant differences according to serotype, age, or gender. CONCLUSIONS The benefit/risk balance of first choice use of amoxicillin and even of amoxicillin/clavulanic acid in AOM is questionable in view of the significant resistance to H. influenzae. The use of sulfamethoxazole/trimethoprim could be an alternative but may still need further evaluation.
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Affiliation(s)
- Anas Taha
- Université Paris-Est Créteil, Department of General Practice, Créteil, Frace; Maison de Santé Universitaire de Sucy-en-Brie, Sucy-en-Brie, France.
| | - Florence Adeline
- Université Paris-Est Créteil, Department of General Practice, Créteil, Frace
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Acute Otitis Media in Children—Challenges of Antibiotic Resistance in the Post-Vaccination Era. Microorganisms 2022; 10:microorganisms10081598. [PMID: 36014016 PMCID: PMC9413688 DOI: 10.3390/microorganisms10081598] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
Abstract
Acute otitis media (AOM) is a leading cause of antibiotic prescriptions in children worldwide, even in the era of pneumococcal conjugate vaccines. We aimed to assess the bacterial spectrum of AOM in children and to investigate the antimicrobial resistance profile in culture-positive cases. We performed a retrospective, tympanocentesis-based analysis of antimicrobial resistance patterns in children with AOM hospitalized in “St Mary” Emergency Hospital for Children Iasi, Romania, between January 2013 and December 2021. A total of 147 samples have been assessed, 97 (65.98%) of which had positive cultures, with Streptococcus pneumoniae and Haemophilus influenzae as the most common microorganisms. A worrying proportion, 82.85% (58/70), of the Streptococcus pneumoniae strains were multidrug-resistant. The World Health Organization included Streptococcus pneumoniae and Haemophilus influenzae on the medium priority group due to penicillin non-susceptibility and ampicillin-resistant strains, respectively. Consequently, strategies to address the threats of antimicrobial resistance are needed to reduce the potential negative effects on hospitalization costs.
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18
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Jamal A, Alsabea A, Tarakmeh M. Effect of Ear Infections on Hearing Ability: A Narrative Review on the Complications of Otitis Media. Cureus 2022; 14:e27400. [PMID: 36046317 PMCID: PMC9419542 DOI: 10.7759/cureus.27400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 11/05/2022] Open
Abstract
Otitis media (OM) is an infection that occurs in the middle ear and can affect the structures around the ear, as well as the auditory system. It is one of the most frequent diseases affecting young children each year, especially those aged around six years, due to the anatomical structure and developing immune system. Although some cases of OM resolve spontaneously, children often need medical care since difficulties persist with such infections. The incidence of OM is higher among children than adults, and therefore, their speaking, hearing, and learning capabilities and general development are impaired by recurring middle ear infections. The literature over the last 40 years has documented the impact of early auditory deprivation produced by early OM with effusion (OME) on central auditory processing (CAP). This study aimed to review the impact of acute ear infections on hearing capacity, assess the complications of OM, and document the scientific evidence around the implications of early OME-induced hearing loss in children. Studies have reported the association between hearing loss owing to early OME and alterations in CAP in both children and adolescents. The auditory foundation enables hearing capacity, but this is continually depleted. Therefore, the use of strong antibiotics, sound amplification, hearing rehabilitation, and ear surgery in children must be improved.
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Affiliation(s)
| | - Abdulla Alsabea
- Cardiology, Mohammed Bin Khalifa Bin Salman Al Khalifa Specialist Cardiac Centre, Awali, BHR
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19
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Pagano AS, Márquez S. The nasopharynx as a window to half a billion years of evolutionary change to the upper respiratory tract. Anat Rec (Hoboken) 2022; 305:1829-1841. [PMID: 35761765 DOI: 10.1002/ar.25020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/20/2022]
Abstract
The nasopharynx is a region at the nexus of several vital physiological systems, including the nasal cavity, oral cavity, braincase, middle ear, and cervical vertebrae. It has undergone pronounced morphological change over the course of tetrapod, mammalian, and human evolution. However, despite its place in evolutionary history, the nasopharynx has received relatively little attention. This special issue focuses on "the evolution, development, and functional morphology of the nasopharynx and its boundaries." Topics covered here include evolutionary developmental biology (or evo-devo), nasopharyngeal adaptions in bats, the importance of the nasopharynx and adjacent structures over the course of human evolution, normal development, middle ear morphology, clinical importance, and the study of the nasopharynx throughout history. Contributions to this special issue range among reviews and syntheses, descriptive analyses, phylogenetic analysis, traditional morphometrics, three-dimensional geometric morphometrics, and computational fluid dynamics. Here, we discuss the central importance of the nasopharynx as can be seen through vertebrate paleontology and comparative morphology. It is via the composite evolutionary history of the nasopharyngeal boundaries that our origins may be better understood, starting with the derivation of the choanae from the median olfactory pit of jawless fish nearly half a billion years ago to the basicranial flexion and facial reduction that distinguish Homo sapiens from all other living mammals. Indeed, the nasopharynx must be acknowledged for its importance in the processes of encephalization and acquisition of speech that have become the hallmark of our species.
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Affiliation(s)
- Anthony S Pagano
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Samuel Márquez
- Department of Cell Biology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
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20
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Dayie NT, Bannah V, Dwomoh FP, Kotey FC, Donkor ES. Distribution and Antimicrobial Resistance Profiles of Bacterial Aetiologies of Childhood Otitis Media in Accra, Ghana. Microbiol Insights 2022; 15:11786361221104446. [PMID: 35734305 PMCID: PMC9208041 DOI: 10.1177/11786361221104446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Otitis media (OM), also known as middle ear infection, is a clinically significant childhood disease. In sub-Saharan Africa, there is a paucity of contemporary reports on it is bacterial aetiologies and antimicrobial resistance among them. Aim: To investigate the OM bacterial aetiologies and their antimicrobial resistance patterns among children visiting the Ear, Nose, and Throat clinics of 3 healthcare facilities in Accra, Ghana – Princess Marie Louise Children’s Hospital, 37 Military Hospital, and Mamprobi Hospital. Methods: This cross-sectional study involved 100 children below 13 years old with suppurative otitis media. Following standard bacteriological methods, sterile ear swabs were used to take middle ear discharges from the study participants for culture and antimicrobial susceptibility testing. A standard questionnaire was also used to collect data on socio-demographic and clinical characteristics. Results: The major OM bacterial aetiologies were Pseudomonas aeruginosa (38.5%), Klebsiella pneumoniae (19.8%), Proteus mirabilis (11.5%), and Staphylococcus aureus (10.4%). The majority of the bacteria demonstrated low to moderate resistance (0%-33.3%) to most of the antibiotics. Eight of the bacteria (4 each of Klebsiella pneumoniae and Escherichia coli) were extended-spectrum beta-lactamase (ESBL) producers; 6 ampicillinase (Amp C)-producing organisms (4 Citrobacter spp. and one each of Morganella morganii and Serratia marcescens) were also identified, and they showed high antibiotic resistance. Conclusions: The predominant OM aetiologies were Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, and Staphylococcus aureus, and they were generally susceptible to most of the antibiotics tested. Amikacin, cefepime, ciprofloxacin, and meropenem could be valuable in the empirical management of childhood OM.
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Affiliation(s)
- Nicholas Tkd Dayie
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Vida Bannah
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
| | - Felicia P Dwomoh
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.,Department of Medical Laboratory, University of Ghana Medical Centre, Legon, Accra, Ghana
| | - Fleischer Cn Kotey
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.,FleRhoLife Research Consult, Teshie, Accra, Ghana
| | - Eric S Donkor
- Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana
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21
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Aladeyelu OS, Olaniyi KS, Olojede SO, Mbatha WBE, Sibiya AL, Rennie CO. Temporal bone pneumatization: A scoping review on the growth and size of mastoid air cell system with age. PLoS One 2022; 17:e0269360. [PMID: 35657972 PMCID: PMC9165849 DOI: 10.1371/journal.pone.0269360] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 05/20/2022] [Indexed: 11/21/2022] Open
Abstract
The interest in the mastoid air cell system arose from the association between temporal bone aeration and otitis media. Its size and growth have been considered when planning chronic and middle ear surgeries. The objective of this review was to explore the literature on the size of mastoid air cells with age, highlighting various growth rates reported and mapping out areas yet to be fully understood for further research. A three-step systematic search was conducted for available literature on the subject matter viz; Google Scholar, Medline, Cochrane Library, and PubMed. Eligibility criteria guided the study selection, and eligible studies were subjected to appraisal using screening and quantitative criteria of mixed-method appraisal tool. A data extraction form was developed to extract information from eligible studies. Nine studies met the eligibility criteria. 55.6% of the included studies were conducted among the east and south Asian population, 33.3% were conducted among Scandinavians, and 11.1% in South America. Age groupings varied among studies; 33.3% utilized 1-year age grouping, 33.3% utilized 5-year age grouping, 11.1% utilized 10-year age grouping. In reporting the size of mastoid air cells across age groupings, 66.7% utilized area, 22.2% utilized volume, while 11.1% utilized both area and volume. Findings from this review showed that the mastoid air cells’ size with respect to age differs among populations of different origins. The most common measurements were the area of air cells. The highest growth rate was reported up to 30 years. Findings also show the influence of sex on the size of mastoid air cells and growth rate with age, as females were reported to have larger air cells with rapid growth until puberty. However, the male mastoid air cell system continues a steady growth after puberty and becomes larger. Information still lacks in the volume of air cells in pediatric pneumatization.
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Affiliation(s)
- Okikioluwa Stephen Aladeyelu
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
- * E-mail:
| | - Kehinde Samuel Olaniyi
- Nelson R Mandela School of Medicine, School of Laboratory Medicine and Medical Sciences, University of Kwazulu-Natal, Durban, South Africa
| | - Samuel Oluwaseun Olojede
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
| | - Wonder-Boy Eumane Mbatha
- Lake, Smit & Partners Inc., Durban, South Africa
- Department of Radiology, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Andile Lindokuhle Sibiya
- Discipline of Otorhinolaryngology-Head and Neck Surgery, School of Clinical Medicine, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
- Department of ENT, Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - Carmen Olivia Rennie
- Discipline of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, Nelson R. Mandela School of Medicine Campus, University of Kwazulu-Natal, Durban, South Africa
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22
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Grønseth T, Ovchinnikov KV, Carlsen H, Benth JŠ, Diep DB, von Unge M, Silvola JT. Lugol's solution and Gentian violet eradicate methicillin-resistant Staphylococcus aureus biofilm in skin wound infections. Int Wound J 2022; 20:120-130. [PMID: 35633295 PMCID: PMC9797939 DOI: 10.1111/iwj.13846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 05/06/2022] [Accepted: 05/07/2022] [Indexed: 01/07/2023] Open
Abstract
The study aimed to evaluate the antibacterial efficacy of Lugol's solution 5% and Gentian violet 1% against methicillin-resistant Staphylococcus aureus (MRSA) biofilm in vivo. The bactericidal efficacy for treatment of MRSA-biofilm skin wound infection was tested in a murine model. Luciferase-tagged S. aureus Xen31, a MRSA-strain derived from S. aureus ATCC-3359130, was used for infection. Wounds were made in the skin of mice and infected with MRSA. The mice were treated with Lugol's solution and Gentian violet. Application of the antimicrobial agents started 24 hours post infection and was repeated daily for five-days. The antimicrobial effect on the biofilm bacteria was evaluated by measuring bioluminescence from MRSA daily for seven-days. Lugol's solution and Gentian violet showed a significant reduction in luminescent signals from the first assessment day to all subsequent days (P < .001). Lugol's solution and Gentian violet effectively eradicated MRSA in biofilm in vivo and could be alternatives or in addition to topical antibiotics when MRSA-biofilm wound infection is suspected.
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Affiliation(s)
- Torstein Grønseth
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Department of Otolaryngology, Head and Neck SurgeryOslo University HospitalOsloNorway
| | - Kirill V. Ovchinnikov
- Faculty of Chemistry, Biotechnology and Food ScienceNorwegian University of Life SciencesÅsNorway
| | - Harald Carlsen
- Faculty of Chemistry, Biotechnology and Food ScienceNorwegian University of Life SciencesÅsNorway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, Campus AhusUniversity of OsloOsloNorway,Health Services Research UnitAkershus University HospitalNordbyhagenNorway
| | - Dzung B. Diep
- Faculty of Chemistry, Biotechnology and Food ScienceNorwegian University of Life SciencesÅsNorway
| | - Magnus von Unge
- Department of Otolaryngology, Head and Neck SurgeryAkershus University HospitalNordbyhagenNorway,Center for Clinical Research, VästeråsUppsala UniversityUppsalaSweden
| | - Juha T. Silvola
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway,Department of Otolaryngology, Head and Neck SurgeryAkershus University HospitalNordbyhagenNorway
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Cheung MMY, Tsang TW, Watkins R, Birman C, Popova S, Elliott EJ. Ear Abnormalities Among Children with Fetal Alcohol Spectrum Disorder: A Systematic Review and Meta-Analysis. J Pediatr 2022; 242:113-120.e16. [PMID: 34780779 DOI: 10.1016/j.jpeds.2021.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/14/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To systematically review and conduct meta-analysis on studies that report the type and prevalence of functional and structural ear abnormalities among children with prenatal alcohol exposure and/or fetal alcohol spectrum disorder (FASD). STUDY DESIGN MEDLINE, PubMed, Embase, Web of Science, PsycINFO, ERIC, CINAHL, and Maternity and Infant Care were searched from 1806 through March 2021. Reference lists of relevant articles were manually searched. Studies reporting on functional and/or structural ear abnormalities among children (<18 years) with prenatal alcohol exposure and/or FASD were eligible. Data extraction and quality assessment were performed by one reviewer and independently checked by another. A random effects meta-analysis was conducted. RESULTS A total of 31 studies met the inclusion criteria and 25 were included in the meta-analyses, representing a total of 843 children with prenatal alcohol exposure and 1653 children with FASD. Functional ear abnormalities with the highest pooled prevalence were chronic serous otitis media (88.5%; 95% CI, 70.4%-99.3%), abnormal auditory filtering (80.1%; 95% CI, 76.5%-84.3%), and unspecified conductive hearing loss (68.0%; 95% CI, 51.9%-82.2%). Structural ear abnormalities with the highest pooled prevalence were microtia (42.9%; 95% CI, 26.8%-59.7%), railroad track ear (16.8%; 95% CI, 8.1%-27.7%), and misplaced ear (12.3%; 95% CI, 7.6%-17.9%). CONCLUSIONS Our findings highlight the importance of examining the ears during assessment for FASD, and the need for public health messaging regarding the harms of prenatal alcohol exposure.
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Affiliation(s)
- Melissa Mei Yin Cheung
- The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia; Australian Pediatric Surveillance Unit, Kids Research, Sydney Children Hospitals Network, Westmead, Australia.
| | - Tracey W Tsang
- The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Rochelle Watkins
- Telethon Kids Institute, Perth Children's Hospital, Perth, Australia
| | - Catherine Birman
- The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia; Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, Australia
| | - Svetlana Popova
- Center for Addiction and Mental Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Elizabeth J Elliott
- The University of Sydney Children's Hospital Westmead Clinical School, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia; Australian Pediatric Surveillance Unit, Kids Research, Sydney Children Hospitals Network, Westmead, Australia
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Perdrizet J, Farkouh RA, Horn EK, Hayford K, Sings HL, Wasserman MD. The broader impacts of otitis media and sequelae for informing economic evaluations of pneumococcal conjugate vaccines. Expert Rev Vaccines 2022; 21:499-511. [PMID: 35191368 DOI: 10.1080/14760584.2022.2040989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Otitis media (OM) is a common childhood infection. Pneumococcal conjugate vaccines (PCVs) prevent OM episodes, thereby reducing short- and long-term clinical, economic, humanistic, and societal consequences. Most economic evaluations of PCVs focus on direct health gains and cost savings from prevented acute episodes but do not fully account for the broader societal impacts of OM prevention. AREAS COVERED This review explores the broader burden of OM on children, caregivers, and society to better inform future economic evaluations of PCVs. EXPERT OPINION OM causes a substantial burden to society through long-term sequelae, productivity losses, reduced quality of life for children and caregivers, and contribution to antimicrobial resistance from inappropriate antibiotic use. The effect of PCVs on acute OM has been recognized globally, yet the broader impact has not been consistently quantified, studied, or communicated. Economic evaluations of PCVs must evolve to include broader effects for patients, caregivers, and society from OM prevention. Future PCVs with broader coverage may further reduce OM incidence and antimicrobial resistance, but optimal uptake will depend on increasing the recognition and use of novel frameworks that include broader benefits. Communicating the full value of PCVs to decision makers may result in wider access and positive societal returns.
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Affiliation(s)
- Johnna Perdrizet
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Raymond A Farkouh
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Emily K Horn
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Kyla Hayford
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer, Inc., Toronto, Canada
| | - Heather L Sings
- Vaccines Medical Development and Scientific and Clinical Affairs, Pfizer, Inc., Collegeville, PA, USA
| | - Matt D Wasserman
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
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Dewan KK, Sedney C, Caulfield AD, Su Y, Ma L, Blas-Machado U, Harvill ET. Probing Immune-Mediated Clearance of Acute Middle Ear Infection in Mice. Front Cell Infect Microbiol 2022; 11:815627. [PMID: 35141173 PMCID: PMC8818953 DOI: 10.3389/fcimb.2021.815627] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Acute otitis media (AOM) is commonly caused by bacterial pathobionts of the nasopharynx that ascend the Eustachian tube to cause disease in the middle ears. To model and study the various complexities of AOM, common human otopathogens are injected directly into the middle ear bullae of rodents or are delivered with viral co-infections which contribute to the access to the middle ears in complex and partially understood ways. Here, we present the novel observation that Bordetella bronchiseptica, a well-characterized respiratory commensal/pathogen of mice, also efficiently ascends their Eustachian tubes to colonize their middle ears, providing a flexible mouse model to study naturally occurring AOM. Mice lacking T and/or B cells failed to resolve infections, highlighting the cooperative role of both in clearing middle ear infection. Adoptively transferred antibodies provided complete protection to the lungs but only partially protected the middle ears, highlighting the differences between respiratory and otoimmunology. We present this as a novel experimental system that can capitalize on the strengths of the mouse model to dissect the molecular mechanisms involved in the generation and function of immunity within the middle ear.
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Affiliation(s)
- Kalyan K. Dewan
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
- *Correspondence: Kalyan K. Dewan,
| | - Colleen Sedney
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Amanda D. Caulfield
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Yang Su
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Longhuan Ma
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Uriel Blas-Machado
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Eric T. Harvill
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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Ghazizadeh M, Barati B. Microbial flora of mastoid cavity after canal wall down (CWD) mastoidectomy. INDIAN JOURNAL OF OTOLOGY 2022. [DOI: 10.4103/indianjotol.indianjotol_247_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Karn RR, Acharya R, Rajbanshi AK, Singh SK, Thakur SK, Shah SK, Singh AK, Shah R, Upadhya Kafle S, Bhattachan M, Abrahamyan A, Shewade HD, Zachariah R. Antibiotic resistance in patients with chronic ear discharge awaiting surgery in Nepal. Public Health Action 2021; 11:1-5. [PMID: 34778008 PMCID: PMC8575382 DOI: 10.5588/pha.21.0029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022] Open
Abstract
SETTING Biratnagar Eye Hospital, Biratnagar, Nepal, which offers ear surgery for chronic suppurative otitis media (CSOM). OBJECTIVE In patients with CSOM awaiting surgery, to determine the 1) sociodemographic characteristics 2) bacterial isolates and their antibiotic resistance patterns and 3) characteristics of those refused surgery, including antibiotic resistance. DESIGN A cohort study using hospital data, January 2018-January 2020. RESULTS Of 117 patients with CSOM and awaiting surgery, 64% were in the 18-35 years age group, and 79% were cross-border from India. Of 118 bacterial isolates, 80% had Pseudomonas aeruginosa and 16% had Staphylococcus aureus. All isolates showed multidrug resistance to nine of the 12 antibiotics tested. The lowest antibiotic resistance in P. aeruginosa was for vancomycin (29%) and moxifloxacin (36%), and for S. aureus, this was vancomycin (9%) and amikacin (17%). Fourteen (12%) patients underwent surgery: myringoplasty (n = 7, 50%), cortical mastoidectomy with tympanostomy (n = 4, 29%) and modified radical mastoidectomy (n = 3, 21%). Those infected with P. aeruginosa and with resistance to over six antibiotics were significantly more likely to be refused for surgery. CONCLUSION Patients awaiting ear surgery were predominantly infected with multidrug-resistant P. aeruginosa and were consequently refused surgery. This study can help inform efforts for improving surgical uptake and introducing cross-border antimicrobial resistance surveillance.
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Affiliation(s)
- R R Karn
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - R Acharya
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - A K Rajbanshi
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - S K Singh
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - S K Thakur
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - S K Shah
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - A K Singh
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - R Shah
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - S Upadhya Kafle
- Nepal Netra Jyoti Sangh/Eastern Regional Eye Care - Programme/Biratnagar Eye Hospital, Biratnagar, Nepal
| | - M Bhattachan
- World Health Organization, Country Office, Kathmandu, Nepal
| | - A Abrahamyan
- Tuberculosis Research and Prevention Center, Yerevan, Armenia
| | - H D Shewade
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France
- The Union, South East Asia, New Delhi, India
| | - R Zachariah
- United Nations Children's Fund/United Nations Development Programme/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
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Das P, Ghosh S, Nayak B. Phyto-fabricated Nanoparticles and Their Anti-biofilm Activity: Progress and Current Status. FRONTIERS IN NANOTECHNOLOGY 2021. [DOI: 10.3389/fnano.2021.739286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Biofilm is the self-synthesized, mucus-like extracellular polymeric matrix that acts as a key virulence factor in various pathogenic microorganisms, thereby posing a serious threat to human health. It has been estimated that around 80% of hospital-acquired infections are associated with biofilms which are found to be present on both biotic and abiotic surfaces. Antibiotics, the current mainstream treatment strategy for biofilms are often found to be futile in the eradication of these complex structures, and to date, there is no effective therapeutic strategy established against biofilm infections. In this regard, nanotechnology can provide a potential platform for the alleviation of this problem owing to its unique size-dependent properties. Accordingly, various novel strategies are being developed for the synthesis of different types of nanoparticles. Bio-nanotechnology is a division of nanotechnology which is gaining significant attention due to its ability to synthesize nanoparticles of various compositions and sizes using biotic sources. It utilizes the rich biodiversity of various biological components which are biocompatible for the synthesis of nanoparticles. Additionally, the biogenic nanoparticles are eco-friendly, cost-effective, and relatively less toxic when compared to chemically or physically synthesized alternatives. Biogenic synthesis of nanoparticles is a bottom-top methodology in which the nanoparticles are formed due to the presence of biological components (plant extract and microbial enzymes) which act as stabilizing and reducing agents. These biosynthesized nanoparticles exhibit anti-biofilm activity via various mechanisms such as ROS production, inhibiting quorum sensing, inhibiting EPS production, etc. This review will provide an insight into the application of various biogenic sources for nanoparticle synthesis. Furthermore, we have highlighted the potential of phytosynthesized nanoparticles as a promising antibiofilm agent as well as elucidated their antibacterial and antibiofilm mechanism.
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Napolean M, Rosemol V, John M, Varghese AM, Periyasamy J, Balaji V, Naina P. Nasopharyngeal colonization of otopathogens in South Indian children with acute otitis media - A case control pilot study. J Otol 2021; 16:220-224. [PMID: 34548867 PMCID: PMC8438633 DOI: 10.1016/j.joto.2021.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 11/28/2022] Open
Abstract
Background Acute otitis media (AOM) is an inflammatory disease of the middle ear causing significant morbidity in early childhood. A pilot study was undertaken to identify the role of various risk factors South Indian children with AOM, especially the role of nasopharyngeal otopathogens. Methodology A prospective case control pilot study was conducted in children aged below six years, presenting to a single tertiary care from 2018 to 2019. Fifty cases with AOM and 45 age and gender matched controls were recruited. Two nasopharyngeal swabs were collected, one was processed for bacterial culture. The other swab was processed according to the CDC recommended broth enrichment method to identify carriage of S. pneumoniae. Subsequent serotyping was done by Quellung method and conventional sequential multiplex PCR. Result Otalgia was the major presentation seen in 92% of the children with AOM. None of the clinical and demographic characteristics were found to be statistically significant between the cases and controls. The most common otopathogen was S. pneumoniae (55%) followed by H. influenza (29%). The common S. pneumoniae serotypes encountered were 11A and 19F.Nasopharyngeal colonization with S. pneumoniae [OR 6.57, p < 0.003] and H. influenzae [OR14.18, p < 0.003] were significant risk factors for AOM in children. The risk increased with co-colonization (OR 13.89,p < 0.003). Conclusion This study strengthens the significant association between nasopharyngeal colonization of otopathogens and AOM as a risk factor that is enhanced by co-colonization.S. pneumoniae was the main otopathogen in this population, serotypes 11A and 19F being the most common.
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Affiliation(s)
- M Napolean
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| | - V Rosemol
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - M John
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| | - A M Varghese
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
| | - J Periyasamy
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - V Balaji
- Department of Clinical Microbiology, Christian Medical College, Vellore, India
| | - P Naina
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India
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Ameur E, Sarra M, Yosra D, Mariem K, Nabil A, Lynen F, Larbi KM. Chemical composition of essential oils of eight Tunisian Eucalyptus species and their antibacterial activity against strains responsible for otitis. BMC Complement Med Ther 2021; 21:209. [PMID: 34384412 PMCID: PMC8359536 DOI: 10.1186/s12906-021-03379-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 07/15/2021] [Indexed: 01/09/2023] Open
Abstract
Background The chemical composition and biological activity of Eucalyptus essential oils have been studied extensively (EOs). A few of them were tested for antibacterial effectiveness against otitis strains. The chemical composition and antibacterial activity of the EOs of eight Tunisian Eucalyptus species were assessed in the present study. Methods Hydrodistillation was used to extract EOs from the dried leaves of eight Eucalyptus species: Eucalyptus accedens, Eucalyptus punctata, Eucalyptus robusta, Eucalyptus bosistoana, Eucalyptus cladocalyx, Eucalyptus lesouefii, Eucalyptus melliodora and Eucalyptus wandoo. They are assessed by GC/MS and GC/FID and evaluated for antibacterial activity using agar diffusion and broth microdilution techniques against three bacterial isolates (Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae) and three reference bacteria strains (Pseudomonas aeruginosa, ATTC 9027; Staphylococcus aureus, ATCC 6538; and Escherichia coli, ATCC 8739). Furthermore, the selected twenty-one major compounds and all values of the inhibition zone diameters were subjected to further statistical analysis using PCA and HCA. Results The EO yields of the studied Eucalyptus species range from 1.4 ± 0.4% to 5.2 ± 0.3%. Among all the species studied, E. lesouefii had the greatest mean percentage of EOs. The identification of 128 components by GC (RI) and GC/MS allowed for 93.6% – 97.7% of the total oil to be identified. 1,8-cineole was the most abundant component found, followed by α-pinene, p-cymene, and globulol. The chemical components of the eight EOs, extracted from the leaves of Eucalyptus species, were clustered into seven groups using PCA and HCA analyses, with each group forming a chemotype. The PCA and HCA analyses of antibacterial activity, on the other hand, identified five groups. Conclusion The oils of E. melliodora, E. bosistoana, and E. robusta show promise as antibiotic alternatives in the treatment of otitis media. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03379-y.
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Affiliation(s)
- Elaissi Ameur
- Chemical, Pharmacological and Gallenic Development Laboratory, University of Monastir, Faculty of Pharmacy, Avenue Avicennne, 5019, Monastir, Tunisia.
| | - Moumni Sarra
- Chemical, Pharmacological and Gallenic Development Laboratory, University of Monastir, Faculty of Pharmacy, Avenue Avicennne, 5019, Monastir, Tunisia
| | - Derbali Yosra
- Chemical, Pharmacological and Gallenic Development Laboratory, University of Monastir, Faculty of Pharmacy, Avenue Avicennne, 5019, Monastir, Tunisia
| | - Kouja Mariem
- University of Carthage, The National Research Institute of Rural Engineering, Water and Forestry, INRGREF, Laboratory of Management and Valorization of Forest Resources, BP 10, 2080, Ariana, Tunisia
| | - Abid Nabil
- Laboratory of Transmissible Diseases and Biological Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia.,High Institute of Biotechnology of Sidi Thabet, University of Manouba, Manouba, Tunisia
| | - Frederic Lynen
- Separation Science Group, Department of Organic and Macromolecular Chemistry, Faculty of Sciences, Ghent University, Krijgslaan 281-S4 Bis, B-9000, Ghent, Belgium
| | - Khouja Mohamed Larbi
- University of Carthage, The National Research Institute of Rural Engineering, Water and Forestry, INRGREF, Laboratory of Management and Valorization of Forest Resources, BP 10, 2080, Ariana, Tunisia
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Sebothoma B, Khoza-Shangase K. Acoustic immittance measures and middle ear assessment: Current practice by South African audiologists. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2021; 68:e1-e7. [PMID: 34212745 PMCID: PMC8252165 DOI: 10.4102/sajcd.v68i1.818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/02/2021] [Accepted: 04/18/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Limited research exists regarding South African audiologists' practice with acoustic immittance. This study was part of a bigger study titled 'Wideband acoustic immittance in adults living with human immunodeficiency virus'. OBJECTIVES The purpose of the study was to explore current practice of South African audiologists regarding acoustic immittance measures, and to explore their perceived knowledge and views on acoustic immittance advancements. METHOD A quantitative survey with a cross sectional design was employed. An electronic questionnaire was distributed to participants via professional associations of audiologists. Data was analysed through descriptive and inferential statistics. RESULTS Most audiologists worked in private practice and conducted tympanometry with 226Hz probe tone and ipsilateral acoustic reflexes. There was no association between clinical setting, levels of qualification, and the use of tympanometry. None of the participants included multifrequency and multicomponent tympanometry (MFT) and/or wideband acoustic immittance (WAI) in their test battery. Most of the participants were not familiar with MFT and WAI. Familiarity with MFT and WAI were only associated with the level of qualification. Limited training and lack of equipment were major barriers to conducting some of the acoustic immittance measures. Most participants believed that they would include MFT and/or WAI in their test battery if they had access to the equipment. CONCLUSION Current findings raise training and clinical implications for the South African audiologists, including training institutions. These findings provide motivation for strategic resource allocation, planning and distribution of audiology clinics in the country if positive preventive audiology outcomes are to be achieved.
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Affiliation(s)
- Ben Sebothoma
- Department of Speech Pathology and Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Efficacy and safety of azithromycin and amoxicillin/clavulanate for otitis media in children: a systematic review and meta-analysis of randomized controlled trials. Ann Clin Microbiol Antimicrob 2021; 20:28. [PMID: 33894769 PMCID: PMC8070272 DOI: 10.1186/s12941-021-00434-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/16/2021] [Indexed: 11/16/2022] Open
Abstract
Background Resistance, prolonged therapy, and more adverse reactions made amoxicillin less preferred for treating otitis media. This study aimed to compare the efficacy and safety of azithromycin and amoxicillin/clavulanate for the treatment of otitis media in children. Methodology This study was a systematic review and meta-analysis. PubMed, Cochrane library, and Google scholar databases were searched. Comparative randomized clinical trial studies between azithromycin and amoxicillin/clavulanate to treat otitis media in children published up to 30 September 2019 were included. The risk of bias was assessed and Data was extracted by the first author and checked by the second author. Meta-analysis was performed by STATA software version 16, and Mantel–Haenszel statistical method with effect measure odds ratio was employed for analysis. Result 751 records were identified and 14 studies were eligible for analysis. In 12 studies azithromycin had equivalent clinical efficacy and 2 had less to amoxicillin/clavulanate. Meta-analysis results showed no statistically significant difference in efficacy in favor of amoxicillin/clavulanate after completion of treatment OR 0.75, 95% CI (0.62–0.91). On subgroup analysis for children less than 2 years (OR 0.96 95% CI (0.49–2.29), and greater than 2 years (OR 1.40 95% CI (0.93–2.11) and also efficacy on follow up (OR 0.97 95% CI (0.83–1.15) there is no statistically significant difference. The clinical adverse events are more in the amoxicillin/clavulanate group than in the azithromycin with a statistical significant difference OR 0.46 95% CI (0.43–0.56). Conclusion Azithromycin is comparable to amoxicillin/clavulanate to treat otitis media in children, and it is safer and more tolerable.
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Pagano AS, Márquez S, Smith CM, Laitman JT. Identification of critical windows in early development of human upper respiratory tract and middle ear disease. Anat Rec (Hoboken) 2021; 304:1953-1973. [PMID: 33586870 DOI: 10.1002/ar.24600] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 12/23/2022]
Abstract
Otitis media (OM) or middle ear disease is a prevalent pediatric condition generally related to early growth of the cartilaginous Eustachian tube (CET). This study used a developmental series of dry crania to reconstruct CET and dilator tubae (DT, the muscle opening the CET) morphology. Timing and directionality of CET and upper respiratory tract (URT) growth were investigated. Traditional and 3D geometric morphometrics (GM) were used to assess bony landmarks on the crania. The series was divided using dental eruption into seven growth stages ranging from before eruption of deciduous dentition (approximately the first 6 postnatal months) to eruption of the first permanent maxillary molar (after approximately 6 years). Bony endpoints of the CET and DT were used to calculate their morphology. GM analysis showed substantial shape differences between newborns, early infants, and all later developmental stages. Univariate measures showed the largest growth change between birth and 6 months. Subsequently, CET morphology changed little in the latter half of year 1, instead maturing gradually until approximately 3 years whereas DT relative length and orientation finish growth by the end of year 1. Incongruence in slower CET growth and faster DT growth could impact CET function between 6 and 12 months and be a contributing factor of OM. Tubal aeration may improve after this time when both CET and DT morphology mature, coinciding with clinically reported drop-off in ear infections.
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Affiliation(s)
- Anthony S Pagano
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | - Samuel Márquez
- Department of Cell Biology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA.,Department of Otolaryngology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Christopher M Smith
- Department of Anthropology, CUNY Graduate Center, New York, New York, USA.,New York Consortium in Evolutionary Primatology (NYCEP), New York, New York, USA.,Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jeffrey T Laitman
- Department of Anthropology, CUNY Graduate Center, New York, New York, USA.,New York Consortium in Evolutionary Primatology (NYCEP), New York, New York, USA.,Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Effects of allergic rhinitis on the progression and recovery of acute otitis media in a mouse model. Int J Pediatr Otorhinolaryngol 2021; 140:110497. [PMID: 33218690 DOI: 10.1016/j.ijporl.2020.110497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the effects of allergic rhinitis (AR) on the development, progression, and recovery of acute otitis media (OM) in an animal model and investigate the secondary effects of bacterial infection. METHODS BALB/c mice were divided into four groups: AR + OM, AR, OM, and control groups. AR + OM and AR groups were sensitized with ovalbumin (OVA) and alum and then challenged intranasally with OVA. Phosphate-buffered saline (PBS) was administered to the OM and control groups the same number of times. After AR induction, OM was induced by surgical inoculation of non-typeable Haemophilus influenza (NTHi) into the middle ear (ME) cavity of the mice in the AR + OM and OM groups. PBS was injected into the bulla in the AR and control groups. Each group was subdivided into sets of six mice, one for each of the four time points (0, 2, 7, and 10 days post-bacterial inoculation), at which point the mice were euthanized and ME and nasal cavity mucosa were obtained and evaluated. The occurrence of OM and the ME mucosa thickness were evaluated and compared among the four groups. Tissue expression of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) in infected ME mucosa was assessed by immunohistochemical staining. We also investigated IgE, IL-4, and IL-5 in the nasal mucosa. RESULTS Most of the ears showed OM on post-inoculation day 2 in both AR + OM and OM groups. In the AR + OM group, 58.3% of ears still had OM on post-inoculation day 10, while only 16.7% of the OM group had OM. The ME mucosa of all groups increased, and the AR + OM group exhibited the thickest mucosa. The OM group showed peak thickness on post-inoculation day 2 and then decreased, whereas the ME mucosa thickness of the AR + OM group continued to increase to day 7. In the OM group, the expression of IL-1β, IL-6, and TNF-α in the ME also increased significantly, peaking on post-inoculation day 2, and then gradually decreased. In the AR + OM group, the expression of these proteins increased until day 7 and then decreased. The IgE and Th2 response (IL-4 and IL-5) cytokines were expressed at higher levels in the AR + OM and AR groups than in the OM and control groups. CONCLUSION The inflammatory reaction to NTHi was more intense and lasted longer in the allergic group, which indicates that AR affects the progression and subsequent recovery of acute bacterial OM.
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Maharjan M, Phuyal S, Shrestha M, Bajracharya R. Chronic otitis media and subsequent hearing loss in children from the Himalayan region residing in Buddhist Monastic schools of Nepal. J Otol 2020; 15:144-148. [PMID: 33293915 PMCID: PMC7691833 DOI: 10.1016/j.joto.2020.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/28/2020] [Accepted: 09/01/2020] [Indexed: 12/28/2022] Open
Abstract
Objectives The main objective of the study was to ascertain the prevalence of chronic otitis media and determine the corresponding hearing loss in children from Nepal’s Himalayan region now residing in Buddhist Monastic schools of Nepal. Methods The study was conducted among children at Buddhist monastic school in different parts of Nepal. A total of 3174 children aged between 5 and 15 years, who were originally from the Himalayan region of Nepal and were currently residing in monastic schools, were screened for ear problems and hearing loss. They were examined by otoscope to diagnose chronic otitis media. Hearing was evaluated by pure tone audiometer, and 0.5–4 kHz air conduction hearing threshold was measured and documented. Results Of the total of 3174 children who were screened for ear diseases and hearing loss, monks constituted 76.21% (n = 2419) and Nuns 23.78% (n = 755). Chronic otitis media was the most common otoscopic finding during the screening, and it affected a total of 344 (10.83%) children. Out of these 344, hearing loss of varying degrees was observed in 5.42% (n = 172) children. Conclusion There is high prevalence of chronic otitis media in children belonging to the Himalayan region of Nepal, and it is the main cause of avoidable hearing loss. Timely diagnosis and treatment of chronic otitis media could prevent unnecessary hearing loss in these children.
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A study of knowledge, attitude and practices about otitis media in parents in Navi-Mumbai. J Otol 2020; 16:89-94. [PMID: 33777121 PMCID: PMC7985005 DOI: 10.1016/j.joto.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/07/2020] [Accepted: 11/09/2020] [Indexed: 11/23/2022] Open
Abstract
Although otitis media poses a serious health risk in developing countries, being a frequent occurrence in children below five years of age, parental awareness and practices about otitis media have not been adequately researched. Present cross-sectional study was undertaken in Navi Mumbai schools, from October 2019 to December 2019, wherein parents with children ≤5 years of age answered a questionnaire which gathered data on their knowledge, attitude and practices about otitis media in their wards. Chi-square tests, Cramer’s V were used to study association between gender, age-group and education of parents with their knowledge, practice and attitude about otitis media. Out of 425 valid responses, overall most parents displayed adequate knowledge (77%), positive attitude (61%) and good care-seeking practices (70%). There was a positive correlation of knowledge and practice with level of education. This study shows acceptable levels of knowledge, attitude and practices in parents about otitis media. Parents who did not seek treatment from health centre attributed the behaviour to poverty, ignorance and lack of health insurance. The positive correlation of knowledge and practices with level of education highlights the importance of role of education in modifying parental awareness and care seeking behaviour. Our findings call for a need to further strengthen community-based healthcare and improve parental confidence in healthcare services for early detection and adequate treatment of otitis media.
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KÖKSOY VAYISOĞLU S, ERDOĞAN O, ÖNCÜ E, MUTLU M. Prevalence and risk factors of otitis media with effusion in primary school children in Mersin. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.793439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Hardani AK, Moghimi Esfandabadi F, Delphi M, Ali Samir M, Zamiri Abdollahi F. Risk Factors for Otitis Media in Children Referred to Abuzar Hospital in Ahvaz: A Case-Control Study. Cureus 2020; 12:e9766. [PMID: 32944478 PMCID: PMC7489764 DOI: 10.7759/cureus.9766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction Otitis media is one of the most common causes of infection in preschool children. The most damaging complication of otitis media is temporary or permanent hearing loss. This study aimed to determine the important risk factors for otitis media. Methods In this case-control study, 625 children aged six months to seven years were examined from winter to spring 2020, and 53 children with otitis media were allocated to the case group and the same number to the control group. The chi-square test was used to identify the risk factors affecting otitis media, and the risk factors were compared between the case and control groups. Logistic regression was used to investigate the relationship between the incidence of otitis media and risk factors. Results Bivariate analysis revealed the following primary risk factors for otitis media: using pacifiers or bottle feeding, working mother, seasonal rhinitis, allergic rhinitis, tonsillopharyngitis, rhinorrhea, and adenoid hypertrophy (P<0.05). In logistic regression analysis, using pacifiers or bottle feeding (odds ratio [OR]=0.156, P=0.000), working mother (OR=0.226, P=0.000), seasonal rhinitis (OR=0.175, P=0.000), allergic rhinitis (OR=5.20, P=0.000) and adenoid hypertrophy (OR=1.57, P=0.000) were identified as the most important risk factors. Conclusion Adenoid hypertrophy and allergic rhinitis increased the risk of otitis media more than the other risk factors. Therefore, pediatricians should increase their awareness of the existence of these risk factors in a patient, and take the appropriate diagnostic steps and implement therapeutic care to prevent language and speech complications.
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Affiliation(s)
- Amir Kamal Hardani
- Department of Pediatrics, Faculty of Medicine, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IRN
| | - Fatemeh Moghimi Esfandabadi
- Department of Pediatrics, Faculty of Medicine, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IRN
| | - Maryam Delphi
- Department of Audiology, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IRN
| | - Mohsen Ali Samir
- Department of Pediatrics, Faculty of Medicine, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IRN
| | - Farzaneh Zamiri Abdollahi
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, IRN
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Grønseth T, Vestby LK, Nesse LL, von Unge M, Silvola JT. Bioactive glass S53P4 eradicates Staphylococcus aureus in biofilm/planktonic states in vitro. Ups J Med Sci 2020; 125:217-225. [PMID: 32552165 PMCID: PMC7720983 DOI: 10.1080/03009734.2020.1765908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: Increasing antimicrobial resistance to antibiotics is a substantial health threat. Bioactive glass S53P4 (BAG) has an antimicrobial effect that can reduce the use of antibiotics. The aim of this study was to evaluate the antimicrobial efficacy of BAG in vitro on staphylococci in biofilm and in planktonic form. Secondary aims were to investigate whether supernatant fluid primed from BAG retains the antibacterial capacity and if ciprofloxacin enhances the effect.Methods: BAG-S53P4 granules, <45 µm, primed in tryptic soy broth (TSB) were investigated with granules present in TSB (100 mg/mL) and after removal of granules (100, 200, and 400 mg/mL). The efficacy of BAG to eradicate Staphylococcus aureus biofilm in vitro was tested using 10 different clinical strains and 1 reference strain in three test systems: the biofilm-oriented antiseptic test based on metabolic activity, the biofilm bactericidal test based on culturing surviving bacteria, and confocal laser scanning microscopy (CLSM) combined with LIVE/DEAD staining.Results: Exposure to 48 h primed BAG granules (100 mg/mL) produced bactericidal effects in 11/11 strains (p = 0.001), and CLSM showed reduction of viable bacteria in biofilm (p = 0.001). Supernatant primed 14 days, 400 mg/mL, reduced metabolic activity (p < 0.001), showed bactericidal effects for 11/11 strains (p = 0.001), and CLSM showed fewer viable bacteria (p = 0.001). The supernatant primed for 48 h, or in concentrations lower than 400 mg/mL at 14 days, did not completely eradicate biofilm.Conclusion: Direct exposure to BAG granules, or primed supernatant fluid, effectively eradicated S. aureus in biofilm. The anti-biofilm effect is time- and concentration-dependent. When BAG had reached its full antimicrobial effect, ciprofloxacin had no additional effect.
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Affiliation(s)
- Torstein Grønseth
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
- CONTACT Torstein Grønseth Øre- nese og halsavdelingene, Oslo universitetssykehus HF, Postboks 4950 Nydalen, Oslo, 0424, Norway
| | - Lene K. Vestby
- Department of Analysis and Diagnostic, Norwegian Veterinary Institute, Oslo, Norway
| | - Live L. Nesse
- Department of Animal Health and Food Safety, Norwegian Veterinary Institute, Oslo, Norway
| | - Magnus von Unge
- Department of Otolaryngology, Head and Neck Surgery, Akershus University Hospital, Akershus and Oslo, Norway
- Center for Clinical Research, Uppsala University, Västerås, Sweden
| | - Juha T. Silvola
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
- Department of Otolaryngology, Head and Neck Surgery, Akershus University Hospital, Akershus and Oslo, Norway
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Associations between Particulate Matter and Otitis Media in Children: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124604. [PMID: 32604870 PMCID: PMC7345266 DOI: 10.3390/ijerph17124604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/18/2020] [Accepted: 06/23/2020] [Indexed: 12/22/2022]
Abstract
Particulate matter (PM), a primary component of air pollution, is a suspected risk factor for the development of otitis media (OM). However, the results of studies on the potential correlation between an increase in the concentration of PM and risk of developing OM are inconsistent. To better characterize this potential association, a meta-analysis of studies indexed in three global databases (PubMed, EMBASE, and The Cochrane Library) was conducted. These databases were systematically screened for observational studies of PM concentration and the development of OM from the time of their inception to 31 March 2020. Following these searches, 12 articles were analyzed using pooled odds ratios generated from random-effects models to test for an association between an increased concentration of PM and the risk of developing OM. The data were analyzed separately according to the size of particulate matter as PM2.5 and PM10. The pooled odds ratios for each 10 μg/m3 increase in PM2.5 and PM10 concentration were 1.032 (95% confidence interval (CI), 1.005–1.060) and 1.010 (95% CI, 1.008–1.012), respectively. Specifically, the pooled odds ratios were significant within the short-term studies (PM measured within 1 week of the development of OM), as 1.024 (95% CI, 1.008–1.040) for PM2.5 concentration and 1.010 (95% CI, 1.008–1.012) for PM10 concentration. They were significant for children under 2 years of age with pooled odds ratios of 1.426 (95% CI, 1.278–1.519) for an increase in the concentration of PM2.5. The incidence of OM was not correlated with the concentration of PM, but was correlated with an increase in the concentration of PM. In conclusion, an increase in the concentration of PM2.5 is more closely associated with the development of OM compared with an increase in the concentration of PM10; this influence is more substantial in shorter-term studies and for younger children.
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Leach AJ, Homøe P, Chidziva C, Gunasekera H, Kong K, Bhutta MF, Jensen R, Tamir SO, Das SK, Morris P. Panel 6: Otitis media and associated hearing loss among disadvantaged populations and low to middle-income countries. Int J Pediatr Otorhinolaryngol 2020; 130 Suppl 1:109857. [PMID: 32057518 PMCID: PMC7259423 DOI: 10.1016/j.ijporl.2019.109857] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE: Summarise the published evidence on otitis media and associated hearing loss in low to middle-income countries (LMIC) and disadvantaged populations. DATA SOURCES: PubMed and other databases. REVIEW METHODS: Firstly, sensitive search strategy using ‘otitis media’, combined with specific key words for each topic of the review, from January 2015 to June 2019. Then, restriction to LMIC and disadvantaged populations. Topics covered included prevention, epidemiology, risk factors, microbiology, prognosis, diagnosis, and treatment. CONCLUSIONS: There was a high degree of methodological heterogeneity and high risk of bias. The majority of studies were school-based. In Africa, Asia and Oceania (e.g., Australian Aboriginal populations) the prevalence of OM was respectively 8% (range 3–16%), 14% (range 7–22%) and 50% (4–95%). Prevalence of any hearing loss in these regions was 12% (range 8–17%), 12% (range 3–24%), and 26% (range 25–28%) respectively. Risk factors in LMIC and disadvantaged populations included age, gender, exposure to smoke and pollution. Microbiology was reported for otitis media with effusion at time of surgery or ear discharge (acute otitis media with perforation or chronic suppurative otitis media). Specimen handling and processing in hospital laboratories was associated with low detection of S. pneumoniae and H. influenzae. Case series described complicated cases of OM due to M. tuberculosis, multidrug resistance and HIV. QOL studies identified discrimination of persons with OM and hearing loss. Diagnostic methods varied greatly, from naked eye to tympanometry. Treatment interventions were reported from four RCTs. Non-RCTs included evaluations of guidelines, surgery outcomes, access to ENTs. IMPLICATIONS FOR CLINICAL PRACTICE: Chronic suppurative otitis media, otitis media with effusion and conductive hearing loss are common in LMIC and disadvantaged populations. Paucity of research, poor regional representation, non-standardised methods and low-quality reporting preclude accurate assessment of disease burden in LMIC and disadvantaged populations. Awareness and adherence to reporting Guidelines should be promoted.
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Affiliation(s)
- Amanda Jane Leach
- Menzies School of Health Research, John Mathews Building 58, Royal Darwin Hospital Campus, Rocklands Dr, Tiwi, NT, 0810, Australia.
| | - Preben Homøe
- Køge University Hospital, Copenhagen, Lykkebækvej 1, 4600, Køge, Denmark.
| | - Clemence Chidziva
- University of Zimbabwe, Department of Surgery, 630 Churchill Avenue, Harare, Zimbabwe.
| | - Hasantha Gunasekera
- University of Sydney, Australia; The Children's Hospital at Westmead, Cnr Hawkesbury Rd &, Hainsworth St, Westmead, NSW, 2145, Australia.
| | - Kelvin Kong
- John Hunter Children's Hospital, Newcastle, Australia; Hunter ENT, Kookaburra Cct, New Lambton Heights, NSW, 2305, Australia.
| | - Mahmood F Bhutta
- Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK.
| | - Ramon Jensen
- Dept of Oto-rhino-laryngology and Audiology, F 2071 Rigshospitalet, Blegdamsvej 9, DK, 2100, Denmark; Department of Clinical Medicine, Blegdamsvej 3, 2200, København, Denmark.
| | - Sharon Ovnat Tamir
- Dept of OTO-HNS, Samson Assuta Ashdod University Hospital, Ashdod, Israel; Department of Otolaryngology-Head and Neck Surgery, Assuta University Hospital, Israel; Faculty of Health Sciences, Ben Gurion University of the Negev, Ashdod, Israel.
| | - Sumon Kumar Das
- Menzies School of Health Research, John Mathews Building 58, Royal Darwin Hospital Campus, Rocklands Dr, Tiwi, NT, 0810, Australia.
| | - Peter Morris
- Menzies School of Health Research, John Mathews Building 58, Royal Darwin Hospital Campus, Rocklands Dr, Tiwi, NT, 0810, Australia; Royal Darwin Hospital, Rocklands Dr, Tiwi, NT, 0810, Australia.
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Marsh RL, Aho C, Beissbarth J, Bialasiewicz S, Binks M, Cervin A, Kirkham LAS, Lemon KP, Slack MPE, Smith-Vaughan HC. Panel 4: Recent advances in understanding the natural history of the otitis media microbiome and its response to environmental pressures. Int J Pediatr Otorhinolaryngol 2020; 130 Suppl 1:109836. [PMID: 31879084 PMCID: PMC7085411 DOI: 10.1016/j.ijporl.2019.109836] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To perform a comprehensive review of otitis media microbiome literature published between 1st July 2015 and 30th June 2019. DATA SOURCES PubMed database, National Library of Medicine. REVIEW METHODS Key topics were assigned to each panel member for detailed review. Draft reviews were collated and circulated for discussion when the panel met at the 20th International Symposium on Recent Advances in Otitis Media in June 2019. The final draft was prepared with input from all panel members. CONCLUSIONS Much has been learned about the different types of bacteria (including commensals) present in the upper respiratory microbiome, but little is known about the virome and mycobiome. A small number of studies have investigated the middle ear microbiome; however, current data are often limited by small sample sizes and methodological heterogeneity between studies. Furthermore, limited reporting of sample collection methods mean that it is often difficult to determine whether bacteria detected in middle ear fluid specimens originated from the middle ear or the external auditory canal. Recent in vitro studies suggest that bacterial interactions in the nasal/nasopharyngeal microbiome may affect otitis media pathogenesis by modifying otopathogen behaviours. Impacts of environmental pressures (e.g. smoke, nutrition) and clinical interventions (e.g. vaccination, antibiotics) on the upper respiratory and middle ear microbiomes remain poorly understood as there are few data. IMPLICATIONS FOR PRACTICE Advances in understanding bacterial dynamics in the upper airway microbiome are driving development of microbiota-modifying therapies to prevent or treat disease (e.g. probiotics). Further advances in otitis media microbiomics will likely require technological improvements that overcome the current limitations of OMICs technologies when applied to low volume and low biomass specimens that potentially contain high numbers of host cells. Improved laboratory models are needed to elucidate mechanistic interactions among the upper respiratory and middle ear microbiomes. Minimum reporting standards are critically needed to improve inter-study comparisons and enable future meta-analyses.
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Affiliation(s)
- Robyn L Marsh
- Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia.
| | - Celestine Aho
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Jemima Beissbarth
- Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Seweryn Bialasiewicz
- The University of Queensland, Australian Centre for Ecogenomics, Queensland, Australia; Children's Health Queensland, Centre for Children's Health Research, Queensland, Australia
| | - Michael Binks
- Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Anders Cervin
- The University of Queensland Centre for Clinical Research, Royal Brisbane & Women's Hospital, Queensland, Australia
| | - Lea-Ann S Kirkham
- Centre for Child Health Research, University of Western Australia, Western Australia, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Western Australia, Australia
| | - Katherine P Lemon
- Forsyth Institute (Microbiology), USA and Division of Infectious Diseases, Boston Children's Hospital, Harvard Medical School, Massachusetts, USA; Alkek Center for Metagenomics & Microbiome Research, Department of Molecular Virology & Microbiology and Pediatrics, Infectious Diseases Section, Texas Children's Hospital, Baylor College of Medicine, Texas, USA
| | - Mary P E Slack
- School of Medicine, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Heidi C Smith-Vaughan
- Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia; School of Medicine, Griffith University, Gold Coast Campus, Queensland, Australia
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Vestby LK, Grønseth T, Simm R, Nesse LL. Bacterial Biofilm and its Role in the Pathogenesis of Disease. Antibiotics (Basel) 2020; 9:E59. [PMID: 32028684 PMCID: PMC7167820 DOI: 10.3390/antibiotics9020059] [Citation(s) in RCA: 417] [Impact Index Per Article: 104.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 12/31/2022] Open
Abstract
Recognition of the fact that bacterial biofilm may play a role in the pathogenesis of disease has led to an increased focus on identifying diseases that may be biofilm-related. Biofilm infections are typically chronic in nature, as biofilm-residing bacteria can be resilient to both the immune system, antibiotics, and other treatments. This is a comprehensive review describing biofilm diseases in the auditory, the cardiovascular, the digestive, the integumentary, the reproductive, the respiratory, and the urinary system. In most cases reviewed, the biofilms were identified through various imaging technics, in addition to other study approaches. The current knowledge on how biofilm may contribute to the pathogenesis of disease indicates a number of different mechanisms. This spans from biofilm being a mere reservoir of pathogenic bacteria, to playing a more active role, e.g., by contributing to inflammation. Observations also indicate that biofilm does not exclusively occur extracellularly, but may also be formed inside living cells. Furthermore, the presence of biofilm may contribute to development of cancer. In conclusion, this review shows that biofilm is part of many, probably most chronic infections. This is important knowledge for development of effective treatment strategies for such infections.
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Affiliation(s)
- Lene K. Vestby
- Department of Immunology and Virology, Norwegian Veterinary Institute, P.O. Box 750 Sentrum, N-0106 Oslo, Norway;
| | - Torstein Grønseth
- Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital HF, Postboks 4950 Nydalen, 0424 Oslo, Norway;
| | - Roger Simm
- Institute of Oral Biology, University of Oslo, P.O. Box 1052, Blindern, 0316 Oslo, Norway;
| | - Live L. Nesse
- Department of Food Safety and Animal Health Research, Norwegian Veterinary Institute, P.O. Box 750 Sentrum, N-0106 Oslo, Norway
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Mealings K, Harkus S, Hwang J, Fragoso J, Chung K, Dillon H. Hearing loss and speech understanding in noise in Aboriginal and Torres Strait Islander children from locations varying in remoteness and socio-educational advantage. Int J Pediatr Otorhinolaryngol 2020; 129:109741. [PMID: 31677536 DOI: 10.1016/j.ijporl.2019.109741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Otitis media resulting in conductive hearing loss is a major health issue for Aboriginal and Torres Strait Islander children, which can also lead to the child developing spatial processing disorder (SPD). This study examined the prevalence of hearing loss and deficits in speech understanding in noise, including SPD, in Aboriginal and Torres Strait Islander children from schools varying in remoteness and socio-educational advantage. METHOD 288 Aboriginal and Torres Strait Islander children aged 4-14 years from three schools varying in remoteness and socio-educational advantage completed audiological assessment and the Listening in Spatialized Noise - Sentences test to assess for hearing loss and SPD. Children also completed Sound Scouts, a self-administered tablet-based hearing test which screens for these deficits. The prevalence of hearing issues was compared to what is expected from a typical population. RESULTS The proportion of children with hearing problems was related to the school's socio-educational advantage, with higher proportions in schools with a lower socio-educational advantage. Proportions of children with speech-in-noise deficits (including SPD) was related to the remoteness of the school, with higher proportions in schools that were more remote. CONCLUSIONS The prevalence of hearing loss and SPD is much higher in Aboriginal and Torres Strait Islander children than described for non-Aboriginal populations, and is related to the socio-educational advantage or remoteness of the school. Resources are needed to reduce the incidence of hearing loss and health disparity in Aboriginal communities, especially those in remote areas with lower socio-educational advantages.
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Affiliation(s)
| | | | | | | | - King Chung
- Northern Illinois University, United States
| | - Harvey Dillon
- National Acoustic Laboratories, Sydney, Australia; University of Manchester, Manchester, United Kingdom; Macquarie University, Sydney, Australia
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A comprehensive review of otorhinolaryngological global health concerns. The Journal of Laryngology & Otology 2019; 133:930-935. [DOI: 10.1017/s002221511900197x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackgroundENT disease prevalence, risk factors and treatment vary between developed and developing countries. Health provision, particularly disease prevention strategies and surgery, in developing countries is poor, manifesting as a high frequency of common and preventable diseases. Healthcare systems in developing countries are unsustainable, and the technological advances that provide ENT surgery with novel diagnostic and treatment opportunities are inaccessible.ConclusionA multifaceted approach is essential to improve the care of patients with ENT diseases in developing countries. Public health efforts must focus on educating the local community, reducing high-risk behaviours and decreasing the frequency of preventable diseases. Governments must be pressured to prioritise the funding of long-term, sustainable efforts with effective disease prevention strategies. Providing local healthcare professionals with high-quality ENT training so that self-sustaining and low-cost care can be delivered, mainly in a primary care setting, is key.
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Parental perceptions and management strategies for otitis media in Greenland. Int J Pediatr Otorhinolaryngol 2019; 125:15-22. [PMID: 31238157 DOI: 10.1016/j.ijporl.2019.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/12/2019] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Otitis media (OM) in Greenland is a substantial problem and the country prevalence is among the highest in the world. However, little is known about how Greenlandic Inuit parents perceive and manage everyday life with children suffering from OM. We hypothesize that having a child with OM has consequences for the families that go beyond the advice and treatment offered in primary health care. METHODS We conducted a qualitative study based on semi-structured interviews and focus groups with parents to children suffering from OM. The interviews took place in three different Greenlandic regions; the capital Nuuk and two smaller towns in West and East Greenland. Access to specialized health care differs among the regions, creating an underlying difference on the limitations of referral and thereby level of care. We conducted the data analysis using Systematic Text Condensation. RESULTS In total, 27 parents participated in the study. Although most parents perceived OM as a result of genetic or environmental dispositions, individual perceptions and cultural beliefs of causal associations between behavior and OM co-existed with the general understanding of medical explanation models. This created a sense of guilt among the parents. Some parents felt in control of managing the disease of the child and used medically well-established strategies. Others felt frustrated and considered contact to the health clinics as futile, thereby managing the disease by 'waiting it out'. Emerging themes were shame and stigma related to the symptoms of OM, which led to social isolation as a consequence for several of the families. CONCLUSION Our results indicate that Greenlandic Inuit families are impacted by OM in a complex and severe manner. Guilt, shame and social isolation were predominant themes influencing the everyday life of the affected families. Perceptions and management strategies go beyond the scope of the medical explanation models which poses a potential challenge for the parents' experiences with the present treatment offer. The results underline the need to develop a broader approach to prevention and treatment for OM - both at the clinical level as well as part of public health promotion at the community level.
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Alharbi MM, Almasri MS, Aldayel AY, Alkhonezan SM. Parental Knowledge, Attitudes and Practices Towards Paediatric Ear Infections in Riyadh, Saudi Arabia: A quantitative study. Sultan Qaboos Univ Med J 2019; 19:e114-e121. [PMID: 31538009 PMCID: PMC6736261 DOI: 10.18295/squmj.2019.19.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/10/2019] [Accepted: 02/07/2019] [Indexed: 01/25/2023] Open
Abstract
Objectives This study aimed to assess the knowledge, attitude and care-seeking practices of parents towards childhood ear infections in Riyadh, Saudi Arabia. Methods This quantitative cross-sectional study was conducted in Riyadh, Saudi Arabia, between April and June 2018. An online survey was sent to a random selection of parents who were ≥18 years old with children of ≤10 years old. Associations between parental knowledge, attitude, care-seeking practices, socioeconomic status, level of education and age were assessed using the chi square test and logistic regression analysis. Results A total of 782 subjects participated in this study (response rate: 78.2%). Most respondents were knowledgeable (76.2%), had a positive attitude (78.9%) and had positive care-seeking practices (89.5%). There was a statistically significant difference on both bivariate and multivariate analyses (P <0.05) between parental care seeking practice and knowledge. Parents who sought modern approaches to treatment were found to be almost nine times more likely to have a good attitude towards ear infections than those who did not seek treatment (odds ratio = 8.907, 95% confidence interval = 2.655–34.928; P <0.001). A statistically significant relationship was found between good care-seeking practice and age, as well as socioeconomic status (P <0.05 each). Conclusion This study showed that knowledge, attitude and practice regarding paediatric ear infections were positive in the majority of parents in Riyadh, Saudi Arabia. Future studies should assess other factors that enhance the knowledge, attitude and practices regarding ear infections.
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Affiliation(s)
- Muteb M Alharbi
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mohammed S Almasri
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdulrahman Y Aldayel
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Saleh M Alkhonezan
- College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Pagano AS, Márquez S, Laitman JT. Reconstructing the Neanderthal Eustachian Tube: New Insights on Disease Susceptibility, Fitness Cost, and Extinction. Anat Rec (Hoboken) 2019; 302:2109-2125. [PMID: 31472033 DOI: 10.1002/ar.24248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/17/2019] [Accepted: 08/20/2019] [Indexed: 12/30/2022]
Abstract
Neanderthals are among the best studied and yet most enigmatic fossil human groups with aspects of their anatomy and functional morphology remaining poorly understood. We present the first anatomical reconstruction of the Neanderthal cartilaginous Eustachian tube (CET), a vital component of the upper respiratory tract and nexus for the middle ear and postnasal airway. The Eustachian (auditory, pharyngotympanic) tube, comprised of a bony and cartilaginous (CET) portion, is integral to normal physiological functions such as middle ear aeration and pressure equilibration. Findings indicate that Neanderthal tubal morphology may have predisposed them to high rates of middle ear disease (otitis media [OM]). In living humans, mechanical CET dysfunction underlies OM in infants and young children, with sequelae including hearing loss, meningitis, and pneumonia. Despite proven linkage of CET malfunction with OM, the role of CET morphology in Neanderthal health and disease remains unstudied. We reconstructed Neanderthal CET morphology, comparing their crania to a modern human growth series. Methods included geometric morphometrics and univariate measures among Procrustes-fitted coordinates. Results showed Neanderthal adults exhibiting primitively tall and narrow nasopharynges with infant-like horizontal CET and choanal orientation. As horizontal CET orientation is associated with increased OM incidence in infants and children until around age six, its appearance in Neanderthal adults strongly indicates persistence of high OM susceptibility at this time. This could have compromised fitness and disease load relative to sympatric modern humans, affecting Neanderthals' ability to compete within their ecological niche, and potentially contributing to their rapid extinction. Anat Rec, 302:2109-2125, 2019. © 2019 American Association for Anatomy.
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Affiliation(s)
- Anthony Santino Pagano
- Department of Medical Sciences, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey.,NYCEP Morphometrics Group.,Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Samuel Márquez
- Department of Cell Biology, SUNY Downstate College of Medicine, New York, New York.,Department of Otolaryngology, SUNY Downstate College of Medicine, New York, New York
| | - Jeffrey T Laitman
- Center for Anatomy and Functional Morphology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Otolaryngology, Icahn School of Medicine, New York, New York
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Xu MJ, Stanford-Moore G, Czechowicz JA. Association of Ebola Virus Infection With Hearing Loss in Regions Where Ebola Virus Infection Is Endemic: A Systematic Review. JAMA Otolaryngol Head Neck Surg 2019; 145:669-675. [PMID: 31095264 DOI: 10.1001/jamaoto.2019.0710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Many survivors of Ebola virus infection describe new-onset hearing loss after infection. The prevalence, severity, and pathophysiologic features of hearing loss in this population have not been well characterized. Objective To perform a systematic review of the current literature to characterize hearing loss in survivors of Ebola virus infection. Evidence Review This study adhered to the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Searches through PubMed, Embase, and Google Scholar were performed to include publications written in English from January 1, 1965, to October 1, 2018. Relevant vocabulary terms and key terms related to Ebola and hearing loss were used. Two investigators independently screened the eligible studies, extracted data, and assessed quality and risk of bias. Findings Of 127 publications reviewed, 15 met the criteria for inclusion; 3 were retrospective case-control studies (level of evidence, 3), and 12 were cross-sectional studies or case reports (level of evidence, 4). Studies included 1775 survivors of Ebola virus infection (993 female [55.9%]) and 363 uninfected controls (186 female [51.2%]) from the Democratic Republic of the Congo, Uganda, Guinea, Liberia, and Sierra Leone. The duration of follow-up ranged from 0 to 29 months (median, 5 months). Hearing loss was reported in 147 survivors of Ebola virus infection (8.3%). Among studies that compared survivors with controls, the reported odds ratios for hearing loss in survivors was 7.50 (95% CI, 3.91-14.39; range, 1.4-12.1). Including all studies, the odds ratio of hearing loss in survivors vs controls in countries where Ebola virus infection is endemic was 1.84 (95% CI, 1.10-3.08). Conclusions and Relevance Survivors of Ebola virus infection had higher rates of hearing loss than uninfected controls in regions where the infection is endemic. Further research with consistent objective methods and pure-tone audiometry may be needed to better characterize the hearing loss, understand its pathophysiologic features, and develop treatments.
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Affiliation(s)
- Mary Jue Xu
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco
| | - Gaelen Stanford-Moore
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco
| | - Josephine A Czechowicz
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco
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Etiology of Childhood Otorrhea in Luanda, Angola, and a Review of Otitis Media in African Children. Pediatr Infect Dis J 2019; 38:577-581. [PMID: 30516594 DOI: 10.1097/inf.0000000000002254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In resource-poor settings, otorrhea causes a significant burden of disease in children. Etiologic studies and structured data on otorrhea and chronic otitis media among African children remain scarce. METHODS Here, we reviewed 678 bacteriologically analyzed otorrhea samples from Luanda Children's Hospital from children ≤15 years of age between 2008 and 2015. We then compared these with data from other studies among African children through a literature review of 20 articles published over 2 decades. RESULTS Overall, 32 different bacteria were identified among 542 isolates from 654 children in Luanda. Gram-negative bacteria constituted the majority of all isolates (85%), whereby Pseudomonas spp. was the most common (n = 158; 29%), followed by Proteus spp. (n = 134; 25%). Among Staphylococcus aureus (n = 54; 10%), 69% of tested isolates were Methicillin-resistant S. aureus, and among Enterobacteriaceae, 14% were expanded-spectrum β-lactamase isolates. Resistance to quinolones was rare. Furthermore, in a review of the literature, we found a high occurrence of otorrhea and chronic suppurative otitis media in children as well as possible gaps in existing knowledge. CONCLUSIONS In Angola, Gram-negative rods emerged as common causative agents of otorrhea in children followed by S. aureus. The magnitude of chronic otorrhea in Africa represents a cause for public health concern.
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