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Cao J, Yang Z, Liu W, Chen S, Qu G, Zhong C. Association of iron deficiency with chronic suppurative otitis media in adults. Acta Otolaryngol 2024; 144:19-22. [PMID: 38315117 DOI: 10.1080/00016489.2024.2310013] [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] [Received: 01/09/2024] [Accepted: 01/17/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Chronic suppurative otitis media (CSOM) is a prevalent chronic inflammatory disease globally. Current research suggests a possible association between anaemia and the development of CSOM. OBJECTIVES The objective of this trial was to investigate the relationship between iron metabolism and chronic suppurative otitis media (CSOM) in adults aged 20-60 years. MATERIALS AND METHODS A consecutive sampling case-control study was used. The study participants were divided into a case group (42 children diagnosed with CSOM) and a control group (42 children with normal ears). Haemoglobin (Hb), Hematocrit (Hct), mean corpuscular volume of erythrocytes (MCV), serum iron level (SI), unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), transferrin (TF), ferritin (Fer) were tested in all the participants, and the results were compared with the normal ranges of the World Health Organization (WHO). The comparative analysis of cases and controls was performed using the Fisher extract test, independence t-test, or Mann-Whitney U test. p-value <.05 was considered statistically significant for correlation. RESULTS There were 61 patients with CSOM and 61 controls included in the study. In the case group, 16 out of 61 patients (26.2%) had low ferritin levels and in the control group, 1 out of 61 patients (1.6%) had low ferritin levels (p < .001). In the case group, 6 (9.8%) of 61 patients had IDA, and in the control group, there were no patients with IDA among 61 patients (p = .027). There were significant differences in SI, UIBC, and Fer parameters between the groups. CONCLUSIONS In adult patients, the incidence of iron deficiency was higher in CSOM patients than in controls. Iron deficiency may be considered a potential risk factor for chronic suppurative otitis media, and serum iron parameters should be evaluated in these CSOM patients and further studies should be conducted to better understand the potential link between iron deficiency and CSOM.
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Affiliation(s)
- Jingwen Cao
- Otolaryngology-Head and Neck Surgery, The 940th Hospital Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, Gansu, China
- Ningxia Medical University, Ningxia, China
| | - Zixuan Yang
- Otolaryngology-Head and Neck Surgery, The 940th Hospital Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, Gansu, China
| | - Wei Liu
- Otolaryngology-Head and Neck Surgery, The 940th Hospital Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, Gansu, China
| | - Sijing Chen
- Otolaryngology-Head and Neck Surgery, The 940th Hospital Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, Gansu, China
| | - Gaoya Qu
- Otolaryngology-Head and Neck Surgery, The 940th Hospital Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, Gansu, China
| | - Cuiping Zhong
- Otolaryngology-Head and Neck Surgery, The 940th Hospital Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, Gansu, China
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Wang J, Chen B, Gao Y, Hu J, Chen Z, Zhang Y. ABO blood type correlates with risk and protective factors for chronic suppurative otitis media. Acta Otolaryngol 2023; 143:669-674. [PMID: 37702578 DOI: 10.1080/00016489.2023.2252031] [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] [Received: 07/04/2023] [Accepted: 08/17/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND ABO blood type associated with differentiated onset of infectious diseases. AIMS/OBJECTIVE To investigate whether people with different blood types were vulnerable in developing chronic otitis media (CSOM) and if the risk and protective factors varied among them. MATERIAL AND METHODS The study was a case-control study that included 206 participants in the case group and 210 in the control group. Stratified analysis for blood type was adopted. RESULTS Patients with different blood types were insignificantly different in the incidence of CSOM. Upper respiratory tract infection (URTI, OR = 21.81, 95% CI: 4.80-99.06), socioeconomic status (OR = 3.02, 95% CI: 1.35-6.74), and were risk factors in blood type A. In blood type B, smoking and urban residence were risk factors. The OR (95% CI) were 11.42 (2.77-47.08), and 0.14 (0.03-0.65). Urban residence, BMI and blood calcium increase, male gender were protective factors for different blood types. CONCLUSIONS AND SIGNIFICANCE Our study identified the risk and protective factors for CSOM among different blood types. The findings might provide new insights into taking precautions against CSOM in people of different blood types.
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Affiliation(s)
- Junli Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, China
| | - Bin Chen
- Department of Neurosurgery, Xi'an Fengcheng Hospital, Xi'an, China
| | - Ying Gao
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, China
| | - Juan Hu
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, China
| | - Zichen Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, China
| | - Yan Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, China
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Complementary/Integrative Medicine for Pediatric Otitis Media. Otolaryngol Clin North Am 2022; 55:1055-1075. [PMID: 36088163 DOI: 10.1016/j.otc.2022.06.018] [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: 11/22/2022]
Abstract
Complementary/integrative medicine can be used in treating otitis media, especially during the watchful waiting phase. Elimination of risk factors can be important. Products such as echinacea, xylitol, and probiotics may help in prevention. Herbal eardrop formulations can relieve symptoms in some patients. Other modalities such as homeopathy can lead to faster relief of symptoms in combination with conventional therapy. Chinese, Japanese, and other forms of traditional medicine have varying formulations with unclear safety, but initial results are promising. Most studies are limited by methodological failures and small sample sizes, emphasizing the need for continued research in this area.
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The association of iron deficiency anemia on chronic suppurative otitis media in children: A case-control study. Ann Med Surg (Lond) 2021; 72:103105. [PMID: 34900249 PMCID: PMC8640113 DOI: 10.1016/j.amsu.2021.103105] [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] [Received: 10/07/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 11/22/2022] Open
Abstract
Background Chronic suppurative otitis media (CSOM) is the most common infectious disease in the world and the leading cause of hearing loss in children in developing countries. Iron deficiency anemia (IDA) is often found in children with CSOM. Objective This study was conducted to determine the association between IDA and the incidence of CSOM in children. Method This research is a case-control study using consecutive sampling. Participants were divided into case group which are children diagnosed with CSOM (n = 42) and control group which are children with normal ear (n = 42). All participants were examined for serum iron (FE), hemoglobin (Hb), total iron-binding capacity (TIBC), and ferritin levels. The analysis used in this study includes the chi-square test or fisher extract test and independence t-test or Man Whitney test with p < 0.05. Result The measurement results obtained values of Hb (13.00 ± 1.34 g/dL; p < 0.001), FE (95.13 ± 40.84 g/dL; p < 0.001), TIBC (354.18 ± 62.44 g/dL; p = 0.016), and ferritin levels (17.57 ± 8.55 g/dL; p < 0.001). Participants who experienced IDA were 21.43% which in the case group was 31.0% and control group was 11.9% (OR = 3.32; p = 0.033). Conclusion IDA can increase the incidence of CSOM in children. Iron deficiency anemia is a risk factor for CSOM in Children. Children with iron deficiency anemia have a 3-fold risk of experiencing CSOM. Supplement iron needs to be given as a preventative for CSOM in children.
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Wijayanti SPM, Wahyono DJ, Rejeki DSS, Octaviana D, Mumpuni A, Darmawan AB, Kusdaryanto WD, Nawangtantri G, Safari D. Risk factors for acute otitis media in primary school children: a case-control study in Central Java, Indonesia. J Public Health Res 2021; 10:1909. [PMID: 33489992 PMCID: PMC7816044 DOI: 10.4081/jphr.2021.1909] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/16/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Acute otitis media (AOM) is the most common disease in young children requiring antibiotic treatment. Information on AOM-related determinant risk factors in primary school children is still limited, particularly in Indonesia. This study aims to identify risk factors related to AOM in primary school children in Banyumas Regency, Central Java, Indonesia. Design and Methods: This is an analytical study with a casecontrol design in Banyumas Regency, Indonesia. 3574 children from 6 regions of the Banyumas Regency were recruited for the screening of AOM detection, and confirmation of AOM diagnosis was determined by Otolaryngologist. One hundred and twentyfive cases and 125 control were involved in this study. Data collection was carried out using a structured questionnaire focusing on several variables such as household cooking fuel, house environment, smoking exposure, knowledge of parents, and nutrition status. Univariate, bivariate using chi-square and multivariate with regression logistic was conducted for data analysis. Results: This study highlights the risk of household firewood use (p=0.003), poor nutritional status (p=0.009), and a family history of ear infections (p=0.015) with an increased risk of otitis media. Conclusions: Household firewood use, poor nutritional status and family history of ear infection are factors associated with the occurrence of acute otitis media. It is necessary to provide public health education to prevent exposure to fuel at risk for children and to improve their nutritional status. Significance for public health This study has important public health benefits because it offers valuable information about Acute Otitis Media (AOM) that is still limited in previous studies, particularly in Indonesia. This study confirms that problems related to AOM are still important because cases are still present in the community, particularly among primary school children. The basic advantage of this paper is the information that household firewood use, poor nutritional status and family history of ear infection are factors associated with acute otitis media in primary school children. This critical knowledge should be followed up by related parties to prevent the incidence of AOM cases in the community.
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Affiliation(s)
| | | | - Dwi Sarwani Sri Rejeki
- Department of Public Health, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto
| | - Devi Octaviana
- Department of Public Health, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto
| | - Aris Mumpuni
- Faculty of Biology, Jenderal Soedirman University, Purwokerto
| | - Anton Budhi Darmawan
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Jenderal Soedirman University, Purwokerto
| | - Wahyu Dwi Kusdaryanto
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Jenderal Soedirman University, Purwokerto
| | | | - Dodi Safari
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
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Rodrigo L, Campos-Asensio C, Rodríguez MÁ, Crespo I, Olmedillas H. Role of nutrition in the development and prevention of age-related hearing loss: A scoping review. J Formos Med Assoc 2020; 120:107-120. [PMID: 32473863 DOI: 10.1016/j.jfma.2020.05.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 11/18/2022] Open
Abstract
Age-related hearing loss (ARHL) is a major and increasingly prevalent health problem worldwide, causing disability and social isolation in the people who present it. This impairment is caused by genetic and environmental factors. Nutritional status has been identified as a related risk associated with hearing loss (HL). This scoping review aimed to characterize the links between HL and nutritional status. PubMed, Embase, Cochrane and Scopus databases were searched up to December 2019. Studies examining the relation between nutrition and dietary habits and HL were included. After screening 3510 citations, 22 publications were selected for inclusion in the current review, all of which were published between 2010 and 2019. Diets rich in saturated fats and cholesterol have deleterious effects on hearing that could be prevented by lower consumption. Conversely, greater consumption of fruit and vegetables, and of polyunsaturated fatty acids (omega-3) and anti-oxidants in the form of vitamins A, C, and E, prevent the development of ARHL. The current literature suggests a possible association between nutritional status and hearing loss. More studies are needed to better characterize the clinical consequences of this association.
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Affiliation(s)
- Luis Rodrigo
- Gastroenterology Unit, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
| | | | | | - Irene Crespo
- Department of Functional Biology, University of Oviedo, Oviedo, Spain; Institute of Biomedicine, University of León, León, Spain
| | - Hugo Olmedillas
- Department of Functional Biology, University of Oviedo, Oviedo, Spain; Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain.
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Liu C, Wang A, Huang Y, Zhang Y, Ding H, Wu J, Du L, Yang J, Mai F, Zeng Y, Liu L, Zhao X, Zhang C, Yin A. Development of a community-based hearing loss prevention and control service model in Guangdong, China. BMC Public Health 2019; 19:1601. [PMID: 31783833 PMCID: PMC6884879 DOI: 10.1186/s12889-019-7910-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 11/07/2019] [Indexed: 11/30/2022] Open
Abstract
Background Hearing loss is a prevalent sensorineural disorder and a major public health issue in China. It is suggested that half of all cases of hearing loss can be prevented through public health measures. However, national strategies for hearing healthcare are not implemented well in Guangdong and some other regions in China. Methods To develop a community-based service model for the prevention and control of hearing loss in Guangdong, we integrated the model with multiple maternal and child healthcare models, and set up a series of clinical programs along with an optimum timeline for the preventive measures and intervention treatments to take place. A total of 36,090 families were enrolled in the study, including 358 high-risk families and 35,732 general-risk families. Results The study lasted for 6.5 years, and 30,769 children were born during that period. A total of 42 children were born with congenital deafness; 17 of them were born into families with advanced genetic risks for hearing loss, 9 were born with specific medical conditions, and 16 were born into general-risk families. About one third of them were diagnosed prenatally, others were diagnosed within 3 months of age, and 72% of them received interventions initiated before 6 months of age. 13 children presented with delayed hearing loss; 9 of them were diagnosed with delayed hereditary sensorineural deafness in neonatal period, and 4 were diagnosed within 3 months after onset. Timely interventions were provided to them, with appropriate referrals and follow-ups. Beside these, 80 families were identified with genetic susceptibility to aminoglycoside ototoxicity. Detailed medication guides were provided to prevent aminoglycoside-induced hearing loss. Moreover, through health education and risk reduction strategies, the prevalence of TORCH syndrome decreased from 10.7 to 5.2 per 10,000. Additionaly, the awareness rates of health knowledge about hearing healthcare significantly increased in the cohort. Conclusions Adapting national strategies for local or district projects could be an important step in implementing hearing loss prevention measures, and developing community-based service models could be of importance in carrying them out.
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Affiliation(s)
- Chang Liu
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Anshi Wang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Yanlin Huang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Yan Zhang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Hongke Ding
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Jing Wu
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Li Du
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Jie Yang
- Department of Neonatolog, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Fei Mai
- Department of ENT, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Yukun Zeng
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Ling Liu
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China.,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Xin Zhao
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Changbin Zhang
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China
| | - Aihua Yin
- Medical Genetic Center, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China. .,Maternal and Children Metabolic-Genetic Key Laboratory, Guangdong Women and Children Hospital, Guangzhou, 510010, Guangdong, China.
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Agostoni C, Guz-Mark A, Marderfeld L, Milani GP, Silano M, Shamir R. The Long-Term Effects of Dietary Nutrient Intakes during the First 2 Years of Life in Healthy Infants from Developed Countries: An Umbrella Review. Adv Nutr 2019; 10:489-501. [PMID: 30843039 PMCID: PMC6520039 DOI: 10.1093/advances/nmy106] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 07/23/2018] [Accepted: 10/31/2018] [Indexed: 02/06/2023] Open
Abstract
The role of both qualitative and quantitative early nutrient intakes on later health has been suggested for decades and supported by observational studies on humans, mainly preterm and low-birth-weight infants, and animal models. However, to date, no comprehensive review has been conducted to evaluate the full impact of nutritional variables on healthy full-term infants. This umbrella review considers meta-analyses and systematic reviews on the health effects of different nutritional exposures or interventions in the first 2 y of life of healthy full-term infants in developed countries. The systematic reviews and meta-analyses published by March 2018 in MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews were included. The following outcomes were considered: growth and obesity, cardiovascular disease, neurodevelopment, allergy and autoimmunity, infections, and malignancy. Breastfeeding and complementary feeding were considered separately and analyzed by means of their differences in delivering heterogeneous food-related variables. The resulting data on the long-term effect of early nutritional differences in healthy full-term infants were found to be inconclusive. Only breastfeeding has a beneficial effect, which is nevertheless slight and limited to just a few outcome measures, whereas the type and duration required to be effective are still unclear. As regards the complementary feeding period, no clear effects of different dietary interventions emerge in terms of health outcomes. Available evidence on the health effects of differences in early nutrition in healthy full-term infants still remains largely inconclusive.
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Affiliation(s)
- Carlo Agostoni
- Pediatric Intermediate Care Unit and Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, DISCCO, Università degli Studi di Milano, Milan, Italy,Address correspondence to CA (e-mail: )
| | - Anat Guz-Mark
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Luba Marderfeld
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,Department of Clinical Nutrition and Dietetics, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Gregorio P Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, DISCCO, Università degli Studi di Milano, Milan, Italy
| | - Marco Silano
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Raanan Shamir
- Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Bastos Maia S, Rolland Souza AS, Costa Caminha MDF, Lins da Silva S, Callou Cruz RDSBL, Carvalho Dos Santos C, Batista Filho M. Vitamin A and Pregnancy: A Narrative Review. Nutrients 2019; 11:nu11030681. [PMID: 30909386 PMCID: PMC6470929 DOI: 10.3390/nu11030681] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 12/13/2022] Open
Abstract
Vitamin A is a crucial micronutrient for pregnant women and their fetuses. In addition to being essential for morphological and functional development and for ocular integrity, vitamin A exerts systemic effects on several fetal organs and on the fetal skeleton. Vitamin A requirements during pregnancy are therefore greater. Vitamin A deficiency (VAD) remains the leading cause of preventable blindness in the world. VAD in pregnant women is a public health issue in most developing countries. In contrast, in some developed countries, excessive vitamin A intake during pregnancy can be a concern since, when in excess, this micronutrient may exert teratogenic effects in the first 60 days following conception. Routine prenatal vitamin A supplementation for the prevention of maternal and infant morbidity and mortality is not recommended; however, in regions where VAD is a public health issue, vitamin A supplementation is recommended to prevent night blindness. Given the importance of this topic and the lack of a complete, up-to-date review on vitamin A and pregnancy, an extensive review of the literature was conducted to identify conflicting or incomplete data on the topic as well as any gaps in existing data.
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Affiliation(s)
- Sabina Bastos Maia
- Maternal and Child Healthcare Postgraduate Program, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife 50070-550, Pernambuco, Brazil.
- Department of Obstetrics and Gynecology, Lauro Wanderley University Hospital, Federal University of Paraíba (UFPB), João Pessoa 58059-900, Paraíba, Brazil.
| | - Alex Sandro Rolland Souza
- Maternal and Child Healthcare Postgraduate Program, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife 50070-550, Pernambuco, Brazil.
- Department of Maternal and Child Healthcare, Federal University of Pernambuco (UFPE), Recife 50670-901, Pernambuco, Brazil.
- Biological and Health Sciences Center, Catholic University of Pernambuco (UNICAP), Recife 50050-900, Pernambuco, Brazil.
| | - Maria de Fátima Costa Caminha
- Maternal and Child Healthcare Postgraduate Program, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife 50070-550, Pernambuco, Brazil.
- Coordination of the Nursing Mentoring Program, Faculdade Pernambucana de Saúde (FPS), Recife 51180-001, Pernambuco, Brazil.
| | - Suzana Lins da Silva
- Maternal and Child Healthcare Postgraduate Program, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife 50070-550, Pernambuco, Brazil.
- Coordination of the Nursing Mentoring Program, Faculdade Pernambucana de Saúde (FPS), Recife 51180-001, Pernambuco, Brazil.
| | | | | | - Malaquias Batista Filho
- Maternal and Child Healthcare Postgraduate Program, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife 50070-550, Pernambuco, Brazil.
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Purdy SC, Taylor S, Schluter PJ, Tautolo ES, Iusitini L, Ahmad Z, Sundborn G, Paterson J. Hearing and ear status of Pacific children aged 11 years living in New Zealand: the Pacific Islands families hearing study. Int J Audiol 2018; 58:77-86. [PMID: 30261774 DOI: 10.1080/14992027.2018.1506170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study aimed to determine the prevalence of hearing loss and ear problems in Pacific children, and investigate current and past demographic, health and social factors potentially associated with hearing and ear problems. DESIGN A cross-sectional observational study design nested within a birth cohort was employed. STUDY SAMPLE Nine-hundred-twenty Pacific children aged 11 years were audiologically assessed. Using average hearing thresholds at 500, 1k and 2k Hz, 162 (18%) right and 197 (21%) left ears had ≥20 dB hearing loss. Hearing loss was mild (20-39 dB) in most cases; 2% of ears had moderate to moderate-severe (40-69 dB) hearing loss. However, only 101 (11%) children had normal peripheral hearing defined by passing hearing threshold, tympanogram and distortion product otoacoustic emission assessments. Those with confirmed middle ear disease at age 2 years had significantly increased odds of a non-Type A tympanogram (adjusted odds ratio: 2.00; 95% confidence interval: 1.56, 2.50) when re-assessed at age 11 years. CONCLUSIONS Hearing loss, abnormal tympanograms, and auditory processing difficulties were present in many Pacific children. Interventions are also urgently needed to mitigate the effect of the longstanding ear disease likely to be present for many Pacific children.
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Affiliation(s)
- Suzanne C Purdy
- a School of Psychology , University of Auckland , Auckland , New Zealand
| | - Steve Taylor
- b Department of Biostatistics and Epidemiology , Auckland University of Technology , Auckland , New Zealand
| | - Philip J Schluter
- c School of Health Sciences , University of Canterbury - Te Whare Wānanga o Waitaha , Christchurch , New Zealand.,d School of Clinical Medicine, Primary Care Clinical Unit , The University of Queensland , Brisbane , Australia
| | - El-Shadan Tautolo
- e Centre for Pacific Health and Development Research , Auckland University of Technology , Auckland , New Zealand
| | - Leon Iusitini
- e Centre for Pacific Health and Development Research , Auckland University of Technology , Auckland , New Zealand
| | - Zahoor Ahmad
- f Ear, Nose & Throat (ENT) - Otorhinolaryngology, Manukau SuperClinic , Counties Manukau District Health Board, Ear , Auckland , New Zealand
| | - Gerhard Sundborn
- g School of Population Health , University of Auckland , Auckland , New Zealand
| | - Janis Paterson
- e Centre for Pacific Health and Development Research , Auckland University of Technology , Auckland , New Zealand
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12
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Koçyiğit M, Çakabay T, Örtekin SG, Akçay T, Özkaya G, Üstün Bezgin S, Yıldız M, Adalı MK. Association Between Endocrine Diseases and Serous Otitis Media in Children. J Clin Res Pediatr Endocrinol 2017; 9:48-51. [PMID: 27612192 PMCID: PMC5363164 DOI: 10.4274/jcrpe.3585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Otitis media with effusion (OME) is a condition in which fluid is retained in the middle ear cavity. The association between endocrine disorders and OME has not yet been determined. This study aimed to investigate the presence of OME in children diagnosed with an endocrine disease and the relationship between these two conditions. METHODS The study was conducted on 918 pediatric patients (440 boys, 478 girls; mean age: 8.40, range 3-15 years) and 158 healthy controls (76 boys, 79 girls; mean age: 8.31, range 3-15 years). All children underwent an ear examination and a tympanometry performed by an otorhinolaryngologist. Tympanometry results were used to diagnose OME. RESULTS OME was detected in 205 (22.3%) of 918 patients and in 19 (12.0%) of 158 subjects in the control group. The difference in frequency of OME between the two groups was statistically significant (p=0.003). CONCLUSION The results of the study reveal that there may be a tendency towards the occurrence of OME in pediatric endocrinology patients.
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Affiliation(s)
- Murat Koçyiğit
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Otolaryngology, İstanbul, Turkey
| | - Taliye Çakabay
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Otolaryngology, İstanbul, Turkey
| | - Safiye G. Örtekin
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Otolaryngology, İstanbul, Turkey
| | - Teoman Akçay
- Medical Park Gaziosmanpaşa Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey Phone: +90 212 404 15 00 E-mail:
| | - Güven Özkaya
- Uludağ University Faculty of Medicine, Department of Biostatistics, Bursa, Turkey
| | - Selin Üstün Bezgin
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Otolaryngology, İstanbul, Turkey
| | - Melek Yıldız
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Endocrinology, İstanbul, Turkey
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Wang J, Chen B, Xu M, Wu J, Wang T, Zhao J, Zhang Q, Zhang Y. Etiological factors associated with chronic suppurative otitis media in a population of Han adults in China. Acta Otolaryngol 2016; 136:1024-8. [PMID: 27206699 DOI: 10.1080/00016489.2016.1183818] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Risk factors for chronic suppurative otitis media (CSOM) were not clearly established. The study was to investigate the etiological factors for CSOM from a population of Han adults in China. METHODS A case-control study was conducted at Second Affiliated Hospital of Xi'an Jiaotong University, School of Medicine in China. A total of 416 individuals participated in this study, which included 206 cases and 210 controls. RESULTS Multivariate logistic regression analysis revealed male (OR = 0.42; 95% CI: 0.21-0.83), BMI increasing (OR = 0.85; 95% CI: 0.77-0.93), URTI (OR = 152.85; 95% CI: 34.11-684.93), smoke/passive smoke (OR = 7.11; 95% CI: 3.36-15.07), residential location (urban area) (OR = 0.27; 95% CI: 0.13-0.56), serum calcium increasing (OR = 0.09; 95% CI: 0.01-0.71) were prime risk factors for CSOM. Univariate analysis revealed that low socioeconomic status (OR= 2.33; 95% CI: 1.57-3.45) and hepatitis B (OR = 4.90; 95% CI: 1.82-13.21) were risk factors together with the above variables. CONCLUSION This study has identified several variables as risk factors for CSOM, suggesting better healthcare, living condition, as well as better nutrition might decrease the development of CSOM. Further studies are necessary to assess the outcome of CSOM after interventions in the etiological factors.
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Affiliation(s)
- Junli Wang
- Department of Otorhinolaryngology-HNS, Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, PR China
| | - Bin Chen
- Department of Neurosurgery, the First Affiliated Hospital of Xi’an Medical University, Xi’an, PR China
| | - Min Xu
- Department of Otorhinolaryngology-HNS, Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, PR China
| | - Junbao Wu
- Department of Otorhinolaryngology-HNS, Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, PR China
| | - Ting Wang
- Department of Otorhinolaryngology-HNS, Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, PR China
| | - Jian Zhao
- Department of Otorhinolaryngology-HNS, Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, PR China
| | - Qing Zhang
- Department of Otorhinolaryngology-HNS, Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, PR China
| | - Yan Zhang
- Department of Otorhinolaryngology-HNS, Second Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, PR China
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Li HB, Tai XH, Sang YH, Jia JP, Xu ZM, Cui XF, Dai S. Association between vitamin D and development of otitis media: A PRISMA-compliant meta-analysis and systematic review. Medicine (Baltimore) 2016; 95:e4739. [PMID: 27749530 PMCID: PMC5059032 DOI: 10.1097/md.0000000000004739] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Nutrients related to serum vitamin D level were previously shown to be significantly associated with the risk of many chronic diseases. This study aimed to assess potential relationships between serum vitamin D level and otitis media (OM) risk. METHODS PubMed, EMBASE, and Cochrane Library databases were searched till Aug 18, 2015 for studies of quantitative OM risk estimates in relation to serum vitamin D level. The odds ratio and weighted mean difference, with 95% confidence intervals (CIs), were used to measure the relationship between serum vitamin D level and OM risk. RESULTS Of the 89 articles identified by database search, 5 studies reported data of 16,689 individuals were included in our meta-analysis. We noted participants with OM was associated with lower level of plasma vitamin D when compared with patients without OM (weighted mean difference -5.67; 95% CI -8.08 to -3.26, P < 0.001). Furthermore, as compared with control group, serum vitamin D level was not associated with the risk of OM (odds ratio 0.80, 95% CI 0.47-1.38, P = 0.425). Subgroup analyses suggested that participants with acute OM might associate with lower serum vitamin D level. CONCLUSIONS Plasma vitamin D level might play an important role on the progression of acute OM, whereas no significant impact in patients with chronic OM.
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Affiliation(s)
| | | | | | | | | | | | - Song Dai
- Department of Otolaryngology, Head & Neck Surgery, No. 463 Hospital of Chinese PLA, Shenyang, Liaoning, China
- Correspondence: Song Dai, Department of Otolaryngology, Head & Neck Surgery, No. 463 Hospital of Chinese PLA, Shenyang, Liaoning 110042, China (e-mail: )
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Emmett SD, West KP. Nutrition and hearing loss: a neglected cause and global health burden. Am J Clin Nutr 2015; 102:987-8. [PMID: 26468119 PMCID: PMC4625599 DOI: 10.3945/ajcn.115.122598] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Susan D Emmett
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; and Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Keith P West
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Abstract
OBJECTIVE In Shwachman-Diamond syndrome (SDS), pancreatic insufficiency can lead to malabsorption of fat-soluble vitamins and trace elements. The aim of this study was to assess the serum concentrations of vitamins A and E, zinc, copper, and selenium and their deficiencies. METHODS This retrospective review was performed in 21 children (12 were male; median age, 7.8 years) with genetically confirmed SDS at a tertiary pediatric hospital. Pancreatic enzyme replacement therapy (PERT) and vitamin or trace elements supplements were documented. RESULTS Twenty patients (95%) had pancreatic insufficiency receiving PERT, 10 (47%) had a combined vitamin and trace element deficiency, 6 (29%) had an isolated vitamin deficiency, and 4 (19%) had an isolated trace element deficiency. Vitamins A and E deficiency occurred in 16 (76%) and 4 (19%) of 21, respectively. Low serum selenium was found in 10 (47%), zinc deficiency in 7 (33%), and copper deficiency in 5 (24%). Eleven patients (52%) were on multivitamin supplementation, and 2 (10%) on zinc and selenium supplements. No statistical differences were found between repeated measurements for all micronutrients. CONCLUSIONS More than 50% of the children had vitamin A and selenium deficiencies despite adequate supplementation of PERT and supplements. Micronutrients should be routinely measured in SDS patients to prevent significant complications.
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Iannotti LL, Henretty NM, Delnatus JR, Previl W, Stehl T, Vorkoper S, Bodden J, Maust A, Smidt R, Nash ML, Tamimie CA, Owen BC, Wolff PB. Ready-to-use supplementary food increases fat mass and BMI in Haitian school-aged children. J Nutr 2015; 145:813-22. [PMID: 25833784 DOI: 10.3945/jn.114.203182] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 01/12/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In Haiti and other countries, large-scale investments in school feeding programs have been made with marginal evidence of nutrition outcomes. OBJECTIVE We aimed to examine the effectiveness of a fortified ready-to-use supplementary food (RUSF), Mamba, on reduced anemia and improved body composition in school-aged children compared to an unfortified cereal bar, Tablet Yo, and control groups. METHODS A cluster, randomized trial with children ages 3-13 y (n = 1167) was conducted in the north of Haiti. Six schools were matched and randomized to the control group, Tablet Yo group (42 g, 165 kcal), or Mamba group (50 g, 260 kcal, and >75% of the RDA for critical micronutrients). Children in the supplementation groups received the snack daily for 100 d, and all were followed longitudinally for hemoglobin concentrations, anthropometry, and bioelectrical impedance measures: baseline (December 2012), midline (March 2013), and endline (June 2013). Parent surveys were conducted at baseline and endline to examine secondary outcomes of morbidities and dietary intakes. Longitudinal regression modeling using generalized least squares and logit with random effects tested the main effects. RESULTS At baseline,14.0% of children were stunted, 14.5% underweight, 9.1% thin, and 73% anemic. Fat mass percentage (mean ± SD) was 8.1% ± 4.3% for boys and 12.5% ± 4.4% for girls. In longitudinal modeling, Mamba supplementation increased body mass index z score (regression coefficient ± SEE) 0.25 ± 0.06, fat mass 0.45 ± 0.14 kg, and percentage fat mass 1.28% ± 0.27% compared with control at each time point (P < 0.001). Among boys, Mamba increased fat mass (regression coefficient ± SEE) 0.73 ± 0.19 kg and fat-free mass 0.62 ± 0.34 kg compared with control (P < 0.001). Mamba reduced the odds of developing anemia by 28% compared to control (adjusted OR: 0.72; 95% CI: 0.57, 0.91; P < 0.001). No treatment effect was found for hemoglobin concentration. CONCLUSION To our knowledge, this is the first study to give evidence of body composition effects from an RUSF in school-aged children.
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Affiliation(s)
- Lora L Iannotti
- Institute for Public Health, George Warren Brown School of Social Work, Washington University, St. Louis, MO;
| | | | | | | | - Tom Stehl
- Meds & Food for Kids, St. Louis, MO; and
| | | | - Jaime Bodden
- Institute for Public Health, George Warren Brown School of Social Work, Washington University, St. Louis, MO
| | - Amanda Maust
- Institute for Public Health, George Warren Brown School of Social Work, Washington University, St. Louis, MO
| | - Rachel Smidt
- Institute for Public Health, George Warren Brown School of Social Work, Washington University, St. Louis, MO
| | - Marilyn L Nash
- National Soybean Research Laboratory, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Courtney A Tamimie
- National Soybean Research Laboratory, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Bridget C Owen
- National Soybean Research Laboratory, University of Illinois at Urbana-Champaign, Champaign, IL
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Rettig E, Tunkel DE. Contemporary concepts in management of acute otitis media in children. Otolaryngol Clin North Am 2014; 47:651-72. [PMID: 25213276 DOI: 10.1016/j.otc.2014.06.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Acute otitis media (AOM) is a common disease of childhood. AOM is most appropriately diagnosed by careful otoscopy with an understanding of clinical signs and symptoms. The distinction between AOM and chronic otitis media with effusion should be emphasized. Treatment should include pain management, and initial antibiotic treatment should be given to those most likely to benefit, including young children, children with severe symptoms, and those with otorrhea and/or bilateral AOM. Tympanostomy tube placement may be helpful for those who experience frequent episodes of AOM or fail medical therapy. Recent practice guidelines may assist the clinician with such decisions.
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Affiliation(s)
- Eleni Rettig
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - David E Tunkel
- Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Room 6161B, Baltimore, MD 21287-0910, USA.
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Hallbauer UM, Atkins MD, Tiedt NJ, Butler IRT, Pieters M, Elliott E, Joubert G, Seedat RY. Co-morbidities in children presenting with chronic suppurative otitis media--a South African study. J Trop Pediatr 2014; 60:198-202. [PMID: 24401753 DOI: 10.1093/tropej/fmt107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Chronic suppurative otitis media (CSOM) is common among children in southern Africa. Managing associated co-morbidities may result in earlier disease resolution. METHODS Children <13 years of age with otorrhoea lasting >4 weeks were recruited to the study. Each child underwent a full clinical examination, a blood count, an HIV test and CD4 cell count, if found to be infected. RESULTS The study included 86 children, and the median age was 4.6 years. HIV infection was present in 45 of 83 children (54.2%), of which 23 (51.1%) were receiving antiretroviral treatment at the time of presentation. Underweight was present in 22 of 85 (25.9%) children and in 17 of the 45 (37.8%) HIV-infected children. One or more clinical signs (not aural-related) were found in 46 of 86 (53.4%) children. Cholesteatoma was found in 23 of 113 (20.4%) ears, and 9 of 86 (10.5%) children had serious associated aural or intracranial complications. CONCLUSIONS A high percentage of children with CSOM have associated pathology that needs to be diagnosed to optimally manage CSOM.
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Affiliation(s)
- Ute M Hallbauer
- Department of Paediatrics and Child Health, University of the Free State, Bloemfontein 9300, South Africa
| | - Mark D Atkins
- Department of Paediatrics and Child Health, University of the Free State, Bloemfontein 9300, South Africa
| | - Nicholas J Tiedt
- Department of Otorhinolaryngology, University of the Free State, Bloemfontein 9300, South Africa
| | - Iain R T Butler
- Department of Otorhinolaryngology, University of the Free State, Bloemfontein 9300, South Africa
| | - Madeleine Pieters
- Department of Medical Microbiology, NHLS and University of the Free State
| | - Eugene Elliott
- Department of Medical Microbiology, NHLS and University of the Free State
| | - Gina Joubert
- Department of Biostatistics, University of the Free State, Bloemfontein 9300, South Africa
| | - Riaz Y Seedat
- Department of Otorhinolaryngology, University of the Free State, Bloemfontein 9300, South Africa
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Vasconcellos AP, Colello S, Kyle ME, Shin JJ. Societal-level Risk Factors Associated with Pediatric Hearing Loss: A Systematic Review. Otolaryngol Head Neck Surg 2014; 151:29-41. [PMID: 24671458 DOI: 10.1177/0194599814526561] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 02/12/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine if the current body of evidence describes specific threshold values of concern for modifiable societal-level risk factors for pediatric hearing loss, with the overarching goal of providing actionable guidance for the prevention and screening of audiological deficits in children. DATA SOURCES Three related systematic reviews were performed. Computerized PubMed, Embase, and Cochrane Library searches were performed from inception through October 2013 and were supplemented with manual searches. REVIEW METHODS Inclusion/exclusion criteria were designed to determine specific threshold values of societal-level risk factors on hearing loss in the pediatric population. Searches and data extraction were performed by independent reviewers. RESULTS There were 20 criterion-meeting studies with 29,128 participants. Infants less than 2 standard deviations below standardized weight, length, or body mass index were at increased risk. Specific nutritional deficiencies related to iodine and thiamine may also increase risk, although data are limited and threshold values of concern have not been quantified. Blood lead levels above 10 µg/dL were significantly associated with pediatric sensorineural loss, and mixed findings were noted for other heavy metals. Hearing loss was also more prevalent among children of socioeconomically disadvantaged families, as measured by a poverty income ratio less than 0.3 to 1, higher deprivation category status, and head of household employment as a manual laborer. CONCLUSIONS Increasing our understanding of specific thresholds of risk associated with causative factors forms the foundation for preventive and targeted screening programs as well as future research endeavors.
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Is there a relationship between serum levels of vitamin a, vitamin e, copper and zinc and otitis media with effusion in children? Indian J Otolaryngol Head Neck Surg 2014; 65:594-7. [PMID: 24427720 DOI: 10.1007/s12070-012-0564-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 04/13/2012] [Indexed: 10/28/2022] Open
Abstract
The aim of this study is to determine whether the serum levels of vitamin A, vitamin E, copper and zinc have a role in the development of otitis media with effusion (OME) in childhood. This prospective study was conducted between February 2010 and February 2011 at a tertiary Otorhinolaryngoloy Clinic. There were 113 subjects and subdivided into three groups. Group 1 consisted of 44 patients who underwent adenoidectomy with ventilation tube placement due to OME. Group 2 consisted of 43 patients underwent adenoidectomy alone and group 3,called control group, included 26 healthy children. Serum values of vitamin A, vitamin E, copper and zinc were measured preoperatively. Comparison of the patient groups showed that group 1 patients had significantly lower serum zinc levels than group 2 patients (p = 0.002), although differences between both patients groups and controls were not significant. We found that the differences among the three groups in terms of serum levels of vitamin A, vitamin E and copper were not statistically significant (p > 0.05). The results of this study showed that serum levels of vitamin A, vitamin E and copper may not play a role on development of OME. We postulated that high serum zinc status may have the preventive effect in the predisposition to OME which may related to adenoid hyperplasia.
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Emmett SD, West KP. Gestational vitamin A deficiency: a novel cause of sensorineural hearing loss in the developing world? Med Hypotheses 2014; 82:6-10. [PMID: 24120698 PMCID: PMC4391953 DOI: 10.1016/j.mehy.2013.09.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 09/11/2013] [Accepted: 09/17/2013] [Indexed: 10/26/2022]
Abstract
Hearing loss is a substantial public health problem with profound social and economic consequences in the developing world. The World Health Organization (WHO) estimates that there are 360 million people living with disabling hearing loss globally, and 80% of these individuals are from low- and middle-income countries. The epidemiology of hearing impairment remains poorly defined in most impoverished societies. Middle ear infections in childhood are a key determinant; however, congenital anomalies may also comprise an important etiology and may arise from gestational malnutrition. While evidence exists that preventable vitamin A deficiency exacerbates the severity of ear infections and, consequently, hearing loss, antenatal vitamin A deficiency during sensitive periods of fetal development may represent an etiologically distinct and virtually unexplored causal pathway. Evidence from multiple animal systems clearly shows that fetal inner ear development requires adequate vitamin A nutriture to proceed normally. Inner ear malformations occur in experimentally imposed maternal vitamin A deficiency in multiple species in a dose-response manner. These anomalies are likely due to the loss of retinoic acid-dependent regulation of both hindbrain development and otic morphogenic processes. Based on in vivo evidence in experimental animals, we hypothesize that preventable gestational vitamin A deficiency, especially during early stages of fetal development, may predispose offspring to inner ear malformations and sensorineural hearing loss. As vitamin A deficiency affects an estimated 20 million pregnant women globally, we hypothesize that, in undernourished settings, routine provision of supplemental vitamin A at the recommended allowance throughout pregnancy may promote normal inner ear development and reduce risk of an as yet unknown fraction of sensorineural hearing loss. If our hypothesis proves correct, gestational vitamin A deficiency would represent a potentially preventable etiology of sensorineural hearing loss of substantial public health significance.
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Affiliation(s)
- Susan D Emmett
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N Caroline Street, Baltimore, MD 21287, USA; Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, W2041, Baltimore, MD 21205, USA.
| | - Keith P West
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, W2041, Baltimore, MD 21205, USA
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Aduda DSO, Macharia IM, Mugwe P, Oburra H, Farragher B, Brabin B, Mackenzie I. Bacteriology of chronic suppurative otitis media (CSOM) in children in Garissa district, Kenya: a point prevalence study. Int J Pediatr Otorhinolaryngol 2013; 77:1107-11. [PMID: 23711391 DOI: 10.1016/j.ijporl.2013.04.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/12/2013] [Accepted: 04/15/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To identify by type and sensitivity to drugs the bacteria found in ears of school-going children with chronic otitis media in Garissa district. STUDY DESIGN This was a descriptive prevalence study of CSOM bacterial flora in eligible ears conducted among a cohort of children attending public and private primary as well as Islamic religious schools, screened for chronic ear discharge in Garissa district, Kenya. Procedure and bacteriological techniques: We used sterile swab-sticks to collect a specimen of the discharge from eligible ears of consenting pupils at the induction stage of the zinc supplementation trial for treatment of chronic suppurative otitis media conducted between January and July 2010. All pupils below 18 years present on day of visit were eligible. Both aerobic and anaerobic bacterial cultures were done to identify clinically and epidemiologically important bacteria. Sensitivity tests were based on disc diffusion methods. Results are presented as frequencies and proportions. RESULTS Of the pupils seen, 61% were still in pre- or lower primary school. Majority were aged 13 and 14 years. Of the 261 ear swab samples processed, 336 isolates - either in mixed or pure flora - were identified, being almost exclusively aerobes. Proteus spp., Enterococcus, Staphylococcus aureus and Pseudomonas spp. were isolated in 32.7%, 28.6%, 12.8% and 11.3% respectively. Proteus was susceptible to majority of the antibiotics tested for, while Enterococcus was poorly susceptible. CONCLUSIONS Aerobic bacteria were most prevalent in this study. Several of the bacteria identified are known to require iron for their growth. This may be important for CSOM treatment if biofilm formation is involved in pathogenesis. Majority of the isolates were susceptible to basic antibiotics compared to Enterococcus bacteria. This portends an important consideration for clinical management and therapeutic decision-making. Additionally, given the prevalence of Enterococcus bacteria, which is an indicator of faecal contamination of the environment, there is need to consider relevant public health components in managing childhood CSOM besides the clinical ones alone.
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Affiliation(s)
- Dickens S O Aduda
- University of Nairobi, School of Health Sciences, Department of Surgery, ENT/Head & Neck Surgery, Kenya.
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Levi JR, Brody RM, McKee-Cole K, Pribitkin E, O'Reilly R. Complementary and alternative medicine for pediatric otitis media. Int J Pediatr Otorhinolaryngol 2013; 77:926-31. [PMID: 23562352 DOI: 10.1016/j.ijporl.2013.03.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 03/04/2013] [Accepted: 03/07/2013] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To review the literature involving complementary and alternative medicine (CAM) for pediatric otitis media. Multiple modalities are discussed, including prevention involving breastfeeding, nutrition, and vaccination; symptomatic treatment involving homeopathy, natural health products, and probiotics; manual manipulations involving osteopathy and chiropractics; and traditional Chinese and Japanese medicine. The information presented will assist physicians in advising patients on their decision-making during the early stages of otitis media when antibiotics and surgery are not yet indicated. METHODS A systematic literature search was conducted through January 2012 in PubMed using MESH term "otitis media" in conjunction with "complementary therapies," "homeopathy," "manipulation, osteopathic," "manipulation, chiropractic," "acupuncture therapy," "probiotics," "naturopathy," and "xylitol." Theses searches yielded 163 unique results. Abstracts and titles were evaluated for relevance. Case reports, case series, randomized controlled trials, and basic science research were included. Publications not relevant to the discussion of alternative medicine in otitis media were excluded. Bibliographies were checked for further publications. Thirty-six unique publications were reviewed. RESULTS Of all therapies in complementary and alternative medicine, only xylitol has been studied in well-designed, randomized, blinded trials; it is likely effective, but compliance limits its applicability. CONCLUSIONS Management of acute otitis media begins with watchful waiting. Herbal eardrops may help relieve symptoms. Homeopathic treatments may help decrease pain and lead to faster resolution. Prevention should be emphasized with elimination of risk factors, such as second hand smoke and bottle-feeding, as well as maintaining nutrition and vaccinations. Vitamin supplementation may be helpful. Probiotics and xylitol may be beneficial as well. Traditional Chinese/Japanese therapies show promising results but remain speculative until further research is conducted. Severe cases of otitis media with complications or those that fail to improve with observation or CAM (after 48-72h) should be treated with antibiotics and, in some cases, surgical intervention. It is best to consult a physician when making treatment decisions for full guidance on the risks and benefits of any treatment option.
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Affiliation(s)
- Jessica R Levi
- Boston University, Department of Otolaryngology, 830 Harrison Ave, 4th floor, FGH building, Boston, MA 02118, United States
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Ulbricht C, Basch E, Chao W, Conquer J, Costa D, Culwell S, Flanagan K, Guilford J, Hammerness P, Hashmi S, Isaac R, Rusie E, Serrano JMG, Ulbricht C, Vora M, Windsor RC, Woloszyn M, Zhou S. An evidence-based systematic review of vitamin A by the natural standard research collaboration. J Diet Suppl 2013; 9:299-416. [PMID: 23157584 DOI: 10.3109/19390211.2012.736721] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
An evidence-based systematic review of vitamin A by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated and reproducible grading rationale. This paper includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
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Esposito S, Baggi E, Bianchini S, Marchisio P, Principi N. Role of Vitamin D in Children with Respiratory Tract Infection. Int J Immunopathol Pharmacol 2013; 26:1-13. [DOI: 10.1177/039463201302600101] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
It has recently been shown that vitamin D (VitD) plays an important role in host defences, inflammation and immunity. We reviewed PubMed and selected all of the studies published over the last 15 years concerning VitD deficiency and VitD supplementation in children with respiratory tract infections. Our analysis showed that VitD seems to be very important because of its part in the complexity of the immune system. However, there are few pediatric studies and most have various limitations. First of all, the literature mainly refers to studies concerning the prevalence of VitD insufficiency and deficiency in specific pathologies. Secondly, it is extremely difficult to identify a common specific range of normal, insufficient and deficient VitD levels. Thirdly, the available studies of VitD supplementation often combined VitD with the use of other micronutrients, thus obscuring the role of VitD itself. Finally, different doses have been used for VitD supplementation. These observations clearly highlight the fact that further studies are needed to evaluate the impact of VitD deficiency and insufficiency in terms of the epidemiology and outcomes of pediatric respiratory tract infection, and whether VitD supplementation favours a positive outcome.
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Affiliation(s)
- S. Esposito
- Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - E. Baggi
- Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S. Bianchini
- Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P. Marchisio
- Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - N. Principi
- Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Schmitz J, West KP, Khatry SK, Wu L, Leclerq SC, Karna SL, Katz J, Sommer A, Pillion J. Vitamin A supplementation in preschool children and risk of hearing loss as adolescents and young adults in rural Nepal: randomised trial cohort follow-up study. BMJ 2012; 344:d7962. [PMID: 22234907 PMCID: PMC3254201 DOI: 10.1136/bmj.d7962] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine whether vitamin A supplementation administered in the preschool years can lower the risk of hearing loss in adolescence and adulthood. DESIGN Follow-up study of adolescents and young adults who, as preschool aged children in 1989, were enrolled into a cluster randomised, double blinded, placebo controlled trial of vitamin A supplementation. SETTING South central, rural Nepal. PARTICIPANTS 2378 adolescents and young adults aged 14 to 23, representing 51% of those who finished the original trial and 71% of those living in the study area in 2006. INTERVENTIONS Every four months for 16 months preschool children were visited at home, given an oral 200,000 IU dose of vitamin A (half dose at age 1-11 months, quarter dose at <1 month) or placebo and the parents were queried about any childhood illnesses in the previous week, including purulent discharge from the ears. MAIN OUTCOME MEASURES Prevalence of mild or worse hearing loss (≥ 30 dB) in the most affected ear and tympanometric measures of middle ear function (peak height, ear canal volume, and gradient). RESULTS During the original trial, the prevalence of middle ear infection during the preschool years did not differ between the supplement groups. By adolescence and early adulthood, a non-significant 17% reduction in hearing loss occurred among those who had periodically received vitamin A compared with placebo as preschool aged children (odds ratio 0.83, 95% confidence interval 0.62 to 1.12). Among participants with any ear discharge in early childhood, vitamin A supplementation was associated with a reduced risk of hearing loss, by 42% (0.58, 0.37 to 0.92) compared with controls, after adjusting the confidence interval for the design effect of the original trial. Abnormal tympanometric peak height of the middle ear system was less likely among participants supplemented with vitamin A in childhood. CONCLUSION In undernourished settings, periodic, high dose vitamin A supplementation may reduce the risk of hearing loss associated with purulent ear infections in early childhood.
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Affiliation(s)
- Jane Schmitz
- Institute for Global Health and Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
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Elemraid MA, Mackenzie IJ, Fraser WD, Harper G, Faragher B, Atef Z, Al-Aghbari N, Brabin BJ. A case-control study of nutritional factors associated with chronic suppurative otitis media in Yemeni children. Eur J Clin Nutr 2011; 65:895-902. [PMID: 21540875 DOI: 10.1038/ejcn.2011.58] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND/OBJECTIVES Undernutrition and chronic suppurative otitis media (CSOM) in children are common in low resource settings, but there are few studies of their interactions. The aim is to evaluate nutritional factors associated with CSOM in Yemeni children. SUBJECTS/METHODS A case-control study of 75 children with CSOM and 74 healthy controls. Assessment included dietary history, anthropometry, haemoglobin (Hb) and serum analytes zinc (Zn), copper (Cu), selenium (Se), iron, calcium, phosphate (PO(4)) and total 25-hydroxy vitamin D (25(OH)D). RESULTS Cases had lower mean Z-scores for weight-for-age, weight-for-height, body mass index and mid-upper arm circumference (MUAC) (all P<0.05), and lower mean concentrations of serum Zn (P=0.032), Se (P<0.001) and calcium adjusted for albumin (P=0.026). Age-adjusted Hb and iron biomarkers did not differ between cases and controls. There was high prevalence of low serum Zn concentration (≥ 90%) and vitamin D deficiency in both cases (80%) and controls (96%). Duration of ear discharge was negatively correlated with total 25(OH)D (P=0.028), calcium adjusted for albumin (P<0.001), PO(4) (P=0.002), transferrin receptor/log ferritin ratio (P<0.001) and Cu (P<0.001), and positively correlated with child age and MUAC (both P<0.001). CONCLUSIONS Children with CSOM were more undernourished than controls with lower mean serum Zn, Se and calcium concentrations. Vitamin D-deficient and iron-replete children had longer duration of infection, although this association was lost with age adjustment. Trials evaluating specific micronutrients are required in order to investigate specific nutrient-infection interactions in CSOM.
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Affiliation(s)
- M A Elemraid
- WHO Collaborating Centre for Prevention of Hearing Impairment, Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool, UK
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Olusanya BO. Predictors of early-onset permanent hearing loss in malnourished infants in Sub-Saharan Africa. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:124-132. [PMID: 20952158 DOI: 10.1016/j.ridd.2010.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 08/16/2010] [Accepted: 09/09/2010] [Indexed: 05/30/2023]
Abstract
The objective of this study was to determine the predictors of early-onset permanent hearing loss (EPHL) among undernourished infants in a low-income country where routine screening for developmental disabilities in early childhood is currently unattainable. All infants attending four community-based clinics for routine immunization who met the criteria for undernutrition by the Growth Standards of the World Health Organization (WHO) based on weight-for-age, weight-for-length and body-mass-index-for-age were enlisted. EPHL was determined after two-stage screening with transient-evoked otoacoustic emissions, automated auditory brainstem response and diagnostic evaluation. Factors predictive of EPHL were explored with multivariable logistic regression analysis. Some 39 (1.7%) infants from 2254 undernourished infants were confirmed with hearing loss (>30 dB HL). Bilateral EPHL was mild in 7 (17.9%) and moderate-to-profound in 26 (66.7%). EPHL was unilateral in 6 (15.4%). Multiparity, chronological age of more than 30 days, the absence of skilled attendant at birth and severe neonatal jaundice were associated with an increased risk of EPHL while having a Christian mother and exclusive breast feeding had protective effect against EPHL. EPHL is highly prevalent among undernourished infants and associated with modifiable risk factors that can be addressed at the community-level and used as a basis for targeted intervention in resource-poor countries.
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Affiliation(s)
- Bolajoko O Olusanya
- Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-araba, Surulere, Lagos, Nigeria.
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Mackenzie I, Smith A. Deafness--the neglected and hidden disability. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2010; 103:565-71. [PMID: 19825278 DOI: 10.1179/000349809x12459740922372] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The problem of deafness or hearing loss is increasing world-wide. In countries rich and poor, people are living longer, and presbyacusis, the deafness of old age, is becoming more frequent. Hearing loss is a chronic and often life-long disability that, depending on the severity and the frequencies affected, can cause profound damage to the development of speech, language, and cognitive skills in children, especially if commencing prelingually. That damage, in turn, affects the child's progress in school and, later, his or her ability to obtain, keep, and perform an occupation. For all ages and for both sexes, hearing loss causes difficulties with interpersonal communication and leads to significant individual social problems, especially isolation and stigmatization. All of these difficulties are much magnified in developing countries, where there are generally limited services for the hard of hearing, few people trained to help those with hearing loss, and little awareness about how to deal with the difficulties associated with such loss. Although deafness and hearing impairment are likely to have huge economic effects in such countries, in most areas these effects remain to be quantified.
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Affiliation(s)
- I Mackenzie
- World Health Organization Collaborating Centre for Prevention of Deafness, Child and Reproductive Health, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
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Abstract
The present cross-sectional study set out to determine the nutritional status of infants aged 0–3 months with the WHO Multicentre Growth Reference (WHO-MGR) and examine the relationship between undernutrition and congenital or early-onset sensorineural hearing loss (CESHL) rarely reported for developing countries. The nutritional status of all infants attending community-based clinics for routine Bacille de Calmette-Guérin (BCG) immunisation from July 2005 to December 2006 was determined by weight-for-age, weight-for-length and BMI-for-age based on the WHO-MGR. Hearing loss status was determined by tympanometry, auditory brainstem response (ABR) and visual response audiometry after a two-stage screening with transient evoked otoacoustic emissions and automated ABR. The relationship between nutritional status and CESHL were explored after adjusting for potentially confounding maternal and infant characteristics using multivariable logistic regression analyses. Of the 3386 infants who completed the hearing evaluation protocol, seventy-one were confirmed with hearing loss (>30 dB hearing level). More than one-third (37·9 %) of all infants and over half (54·9 %) of those with CESHL were undernourished by at least one measure of growth. Stunting (35·3 %) was the most prevalent nutritional deficit in infants with CESHL. In the final logistic model, infants with any undernourished physical state were significantly likely to have CESHL (OR 1·67; 95 % CI 1·03, 2·77) and of a severe-to-profound degree (OR 3·92; 95 % CI 1·38, 11·17) compared with infants without any undernourishment. Prospective studies to establish the full spectrum of the relationship between undernutrition and CESHL, particularly in resource-poor countries, are therefore warranted.
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