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Olzowy B, Müller S, Cidlinsky NA, Guderian D. [Antiseptics in otorhinolaryngology-a substance overview]. HNO 2024:10.1007/s00106-024-01456-5. [PMID: 38592477 DOI: 10.1007/s00106-024-01456-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/10/2024]
Abstract
For preoperative skin antisepsis, alcohol-containing iodine solutions and octenidine are suitable. For wound antisepsis, polyhexanide and hypochlorous acid (HOCL) are also available, but only PVP-iodine and HOCL can be applied to cartilage. Chlorhexidine should only be used as mouth- and bodywash for Staphylococcus aureus (MRSA) decolonization. For the many other throat antiseptics, evidence of clinical efficacy is lacking. For decolonization of the nares, polyhexanide and octenidine are available as nasal gels, but these are inferior to mupirocin for MRSA decolonization. PVP-iodine and HOCL are safe to use for nasal irrigation, but only HOCL has proven effective to improve symptoms of chronic rhinosinusitis. All antiseptics exhibit a certain ototoxicity. With an intact eardrum, acetic acid-containing eardrops can be used to prevent and treat external otitis and myringitis. When the eardrum is perforated, only alcohol-free PVP-iodine and HOCL may be used.
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Affiliation(s)
- Bernhard Olzowy
- HNO-Zentrum Landsberg, Ahornallee 2a, 86899, Landsberg, Deutschland.
| | - Sarina Müller
- Hals-Nasen-Ohrenklinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | | | - Daniela Guderian
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Frankfurt a.M., Goethe-Universität, Frankfurt am Main, Deutschland
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Massimi L, Cinalli G, Frassanito P, Arcangeli V, Auer C, Baro V, Bartoli A, Bianchi F, Dietvorst S, Di Rocco F, Gallo P, Giordano F, Hinojosa J, Iglesias S, Jecko V, Kahilogullari G, Knerlich-Lukoschus F, Laera R, Locatelli D, Luglietto D, Luzi M, Messing-Jünger M, Mura R, Ragazzi P, Riffaud L, Roth J, Sagarribay A, Pinheiro MS, Spazzapan P, Spennato P, Syrmos N, Talamonti G, Valentini L, Van Veelen ML, Zucchelli M, Tamburrini G. Intracranial complications of sinogenic and otogenic infections in children: an ESPN survey on their occurrence in the pre-COVID and post-COVID era. Childs Nerv Syst 2024; 40:1221-1237. [PMID: 38456922 DOI: 10.1007/s00381-024-06332-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND COVID-19 pandemic is thought to have changed the epidemiology of some pediatric neurosurgical disease: among them are the intracranial complications of sinusitis and otitis (ICSO). According to some studies on a limited number of cases, both streptococci-related sinusitis and ICSO would have increased immediately after the pandemic, although the reason is not clear yet (seasonal changes versus pandemic-related effects). The goal of the present survey of the European Society for Pediatric Neurosurgery (ESPN) was to collect a large number of cases from different European countries encompassing the pre-COVID (2017-2019), COVID (2020-2021), and post-COVID period (2022-June 2023) looking for possible epidemiological and/or clinical changes. MATERIAL AND METHODS An English language questionnaire was sent to ESPN members about year of the event, patient's age and gender, presence of immune-deficit or other favoring risk factors, COVID infection, signs and symptoms at onset, site of primary infection, type of intracranial complication, identified germ, type and number of surgical operations, type and duration of medical treatment, clinical and radiological outcome, duration of the follow-up. RESULTS Two hundred fifty-four cases were collected by 30 centers coming from 14 different European countries. There was a statistically significant difference between the post-COVID period (129 children, 86 cases/year, 50.7% of the whole series) and the COVID (40 children, 20 cases/year, 15.7%) or the pre-COVID period (85 children, 28.3 cases/year, 33.5%). Other significant differences concerned the presence of predisposing factors/concurrent diseases (higher in the pre-COVID period) and previous COVID infection (higher in the post-COVID period). No relevant differences occurred as far as demographic, microbiological, clinical, radiological, outcome, morbidity, and mortality data were concerned. Paranasal sinuses and middle ear/mastoid were the most involved primary site of infection (71% and 27%, respectively), while extradural or subdural empyema and brain abscess were the most common ICSO (73% and 17%, respectively). Surgery was required in 95% of cases (neurosurgical and ENT procedure in 71% and 62% of cases, respectively) while antibiotics in 99% of cases. After a 12.4-month follow-up, a full clinical and radiological recovery was obtained in 85% and 84% of cases, respectively. The mortality rate was 2.7%. CONCLUSIONS These results suggest that the occurrence of ICSO was significantly increased after the pandemic. Such an increase seems to be related to the indirect effects of the pandemic (e.g., immunity debt) rather than to a direct effect of COVID infection or to seasonal fluctuations. ICSO remain challenging diseases but the pandemic did not affect the management strategies nor their prognosis. The epidemiological change of sinusitis/otitis and ICSO should alert about the appropriate follow-up of children with sinusitis/otitis.
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Affiliation(s)
- L Massimi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
| | - G Cinalli
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - P Frassanito
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - V Arcangeli
- Clinical Psychology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C Auer
- Department of Neurosurgery, Johannes Kepler University Linz, Kepler University Hospital GmbH, Linz, Austria
| | - V Baro
- Pediatric and Functional Neurosurgery, Department of Neurosciences, University of Padova, Padua, Italy
| | - A Bartoli
- Department of Neurosurgery, Geneva University Hospitals, Geneva, Switzerland
| | - F Bianchi
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - S Dietvorst
- University Hospitals Leuven, Leuven, Belgium
| | - F Di Rocco
- Hôpital Femme-Mère-Enfant, Université de Lyon, Lyon, France
| | - P Gallo
- Birmingham Children's Hospital, Birmingham, UK
| | - F Giordano
- University of Florence, Florence, Italy
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - J Hinojosa
- Hospital Sant Joan de Déu, Barcelona, Spain
| | - S Iglesias
- Hospital Regional Universitario de Malaga, Malaga, Spain
| | - V Jecko
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - G Kahilogullari
- Department of Neurosurgery, Ankara University, Ankara, Turkey
| | - F Knerlich-Lukoschus
- Division Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
| | - R Laera
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - D Locatelli
- Neurosurgery Department, Università Dell'Insubria, Ospedale di Circolo e Macchi Foundation, Varese, Italy
| | - D Luglietto
- Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - M Luzi
- Azienda Ospedaliero Universitaria Delle Marche, Ancona, Italy
| | | | - R Mura
- Meyer Children's Hospital IRCCS, Florence, Italy
| | - P Ragazzi
- Department of Pediatric Neurosurgery, Ospedale Infantile Regina Margherita, Città della Salute e della Scienza, Turin, Italy
| | - L Riffaud
- Rennes University Hospital, Rennes, France
| | - J Roth
- Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - A Sagarribay
- Hospital Dona Estefânia-Centro Hospitalar Universitário, Lisboa, Portugal
- Hospital CUF Descobertas, Lisboa, Portugal
| | - M Santos Pinheiro
- Centro Hospitalar Lisboa Norte-Hospital Santa Maria, Lisboa, Portugal
| | - P Spazzapan
- University Medical Center-Ljubljana, Ljubljana, Slovenia
| | - P Spennato
- Santobono-Pausilipon Children's Hospital, AORN, Naples, Italy
| | - N Syrmos
- Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - L Valentini
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M L Van Veelen
- Erasmus MC Sophia Children's Hospital, Rotterdam, Netherlands
| | - M Zucchelli
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto Scienze Neurologiche Di Bologna, Boulogne, Italy
| | - G Tamburrini
- Pediatric Neurosurgery, Neuroscience-Sense Organs-Chest Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University Medical School, Rome, Italy
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González-Moreno P, Araujo-Sánchez M, Fernández-Suárez J, Fernández-Dominguez J, Llorente JL, Zapico-González MS. Auritidibacter ignavus in ear discharge of paediatric patients: Two cases reports and literature review. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:202-204. [PMID: 38262875 DOI: 10.1016/j.eimce.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/16/2023] [Accepted: 10/30/2023] [Indexed: 01/25/2024]
Abstract
INTRODUCTION The development and research of new technologies for identifying microorganisms, has allowed the identification of hitherto unknown bacteria. Auritidibacter ignavus is a newly described Gram-positive rod possibly associated with otitis, although its role as an etiologic agent in otitis is currently controversial. METHODS We report two cases of recurrent otitis in paediatric patients in which A. ignavus was isolated and review the previous cases reported in the literature. RESULTS All the isolates were identified as A. ignavus by proteomic and genomic methods. Both patients recovered from their symptoms. CONCLUSION A. ignavus was recovered from ear discharges of paedriatic patients with chronic ear problems. All the cases previously reported in the literature were adults. More evidence is needed for the association between A. ignavus and otitis, since data regarding this species are still scarce.
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Affiliation(s)
- Pablo González-Moreno
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Martina Araujo-Sánchez
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Jonathan Fernández-Suárez
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
| | - Javier Fernández-Dominguez
- Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
| | - Jose Luis Llorente
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Mahdavi A. Diagnostic and Imaging Findings in Inflammatory Opacifications of the Middle Ear: A Review of the Literature. Int Tinnitus J 2024; 27:146-153. [PMID: 38507628 DOI: 10.5935/0946-5448.20230023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Opacification in the middle ear and mastoid region can stem from a wide range of factors. In terms of diagnostic imaging, CT is the primary tool due to its exceptional spatial resolution, particularly for examining the temporal bone and ossicles. MRI complements this by offering detailed soft tissue lesion characterization and assessing involvement in the inner ear and cranial nerves. This study focuses on inflammatory causes of opacification in the middle ear and mastoid, with an emphasis on the utility of CT and MRI. This comprehensive review aimed to provide a practical framework for considering potential differential diagnoses.
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Affiliation(s)
- Ali Mahdavi
- Department of Radiology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lechien JR, Maniaci A, Gengler IM, Al Barajraji M, Mayo-Yanez M. Laryngopharyngeal reflux in otitis media with effusion. Am J Otolaryngol 2024; 45:104152. [PMID: 38134846 DOI: 10.1016/j.amjoto.2023.104152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/29/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Jerome R Lechien
- Research Committee of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (World Ear, Nose, and Throat Federation), Paris, France; Department of Laryngology and Bronchoesophagology, EpiCURA Hospital, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
| | - Antonino Maniaci
- Research Committee of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (World Ear, Nose, and Throat Federation), Paris, France; Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, ENT Section, University of Catania, Catania 95123, Italy
| | - Isabelle M Gengler
- Research Committee of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (World Ear, Nose, and Throat Federation), Paris, France; Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Mejdeddine Al Barajraji
- Research Committee of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (World Ear, Nose, and Throat Federation), Paris, France
| | - Miguel Mayo-Yanez
- Research Committee of Young Otolaryngologists of International Federation of Otorhinolaryngological Societies (World Ear, Nose, and Throat Federation), Paris, France; Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
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Folino F, Di Pasquale D, Marchisio P, Pignataro L, Capaccio P, Gaini L, Battilocchi L, Bosis S, Torretta S. Topical administration of S. salivarius 24SMB-S. oralis 89a in children with adenoidal disease: a double-blind controlled trial. Eur J Pediatr 2024; 183:289-294. [PMID: 37874401 PMCID: PMC10857951 DOI: 10.1007/s00431-023-05192-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 10/25/2023]
Abstract
Chronic adenoiditis (CA) is generally sustained by some infectious foci mainly located within the nasopharynx or in the deep adenoidal pads and it is characterized by a complex interplay between bacterial species. The aim of this study was to assess the efficacy and safety of the topical nasal administration of a probiotic compound based on S. salivarius 24SMB and S. oralis 89a in children with CA in terms of reduction in: the number of acute adenoidal infections (primary outcome), and in the blockage of the nasopharynx space by hypertrophic adenoids (secondary outcome). A prospective, double-blind, 1:1 randomized controlled study was performed to test the effectiveness of a 90-day treatment with Rinogermina spray (DMD ITALIA s.r.l, Rome), 1 puff each nostril twice a day for 90 days, to nasal spray placebo in children with CA (in terms of number of acute exacerbations and blockage of nasopharynx space assessed after 90 days of treatment- T1, and 90 days later- T2). The final analysis was based on 152 children (males = 48.0%; mean age = 49.2 ± 14.1 months). Compared to the baseline, no significant differences in terms of number of acute exacerbations at T1 and T2 follow-up visits were detected in both groups. After treatment, a significant reduction in the blockage of nasopharynx space by hypertrophic adenoids (0.002 < p-value < 0.007) compared to the baseline was attested in the study group at T1 and T2, but not in the control group. CONCLUSIONS Our findings document a positive effect of Rinogermina spray in achieving reduction in the blockage of nasopharynx space by hypertrophic adenoids, thus suggesting that its use into the integrated therapeutic management of children with CA could be of a certain utility. WHAT IS KNOWN • Chronic adenoiditis in children results from an imablance in baterial homeostasis at the nasophaynx, with impairment in respiratory microbiota. • The modulatory effect of target transnasal bacteriotheray by means of S. salivarius has been considered in children with chronic adenoiditis in children with recurrent acute otitis media with preliminary positive results. WHAT IS NEW • This randomized controlled study, specifically designed on a cohrt of children with chronic adenoiditis, documents a certain effectiveness of the probiotic treatment in achieving a reduction in the grade of adenoidal hypertropy, compared to placebo.
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Affiliation(s)
- Francesco Folino
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Daniele Di Pasquale
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lorenzo Pignataro
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
| | - Pasquale Capaccio
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
- Department of Biomedical Surgical Dental Science, University of Milan, Milan, Italy
| | - Lorenzo Gaini
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Ludovica Battilocchi
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Samantha Bosis
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Sara Torretta
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Università degli Studi di Milano, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
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Storch-De-Gracia P, Antoñanzas-Bernar V, Vergara-Muñoz B, Lamagrande-Casanova N, Di Campli-Zaghlul M, Suárez-Bustamante M, Añón-Hidalgo J, Maiques M. Comparison of amoxicillin administered twice and three times daily in children with acute otitis media. Eur J Pediatr 2023; 182:5599-5605. [PMID: 37816980 DOI: 10.1007/s00431-023-05243-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023]
Abstract
To compare the effectiveness of amoxicillin administered in regimens of two or three daily doses in children with acute otitis media (AOM). As a secondary aim, we measured and compared treatment adherence between the two groups.A prospective observational study was conducted in the emergency department of a children's hospital.We recruited a total of 353 patients having a median age of 1.58 years. Twice-daily dosing was prescribed to 58%, while 42% received three doses per day. The clinical course of AOM was favourable in 92% of the patients who received two doses of amoxicillin and in 95% of those who received three doses (p = 0.25). Four patients (1%) had persistent symptoms beyond day 7. None developed intracranial complications. In the group receiving three doses daily, 31% reported difficulties with the dosing schedule, and 9.6% faced challenges when administering the medication at the specified volume, compared with 5.8% and 25% of those who received the two-dose regimen, respectively. Conclusion: Twice-daily amoxicillin has similar efficacy to a three-dose daily regimen and can offer advantages for caregivers in terms of administration schedule. What is Known: • Amoxicillin given in two daily doses is as effective as a three doses regimen in the treatment of acute otitis media in children. • The lower the number of daily doses, the higher the adherence to a drug treatment. What is New: • Administration of amoxicillin in twice-daily doses may improve adherence, as it is less frequently associated with family-perceived problems with dosing schedules.
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Affiliation(s)
- Pilar Storch-De-Gracia
- Emergency Department, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, Madrid, Spain.
- Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.
| | | | | | | | | | | | | | - Miguel Maiques
- Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Yao J, Shi H, Lu J, Wang X, Xie D, Wang X, Wan G, Li F, Wang T. Prevalence and indoor environment risk factors of otitis among preschool children in Urumqi, China. J Pediatr (Rio J) 2023; 99:362-370. [PMID: 36716790 PMCID: PMC10373138 DOI: 10.1016/j.jped.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/13/2022] [Accepted: 12/21/2022] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To investigate the indoor environmental risk factors to provide measures for the prevention and control of otitis in preschool children. METHOD In this cross-sectional study, a questionnaire survey was administered to preschool children aged 2-7 years from 60 kindergartens in six districts of Urumqi City in August 2019. Multiple regression was run to predict influence factors for otitis media in preschool children. RESULT A total of 8153 valid questionnaires were collected. After adjusting for age, the prevalence of otitis among preschool children in Urumqi was 13.1%. Multivariate logistic regression showed that previous antibiotic treatment, treatment with one to two antibiotics before 1 year of age, presence of walls with aqueous or latex paint, use of carpet floor bedding in rooms, newly decorated homes of mothers before pregnancy, purchase of new furniture for homes of children at 0-1 year of age, and presence of flowering plants in the residence of children at 0-1 years of age were all identified as risk factors for the development of otitis in children. CONCLUSION Parents should also pay attention to indoor living environments, and reduce indoor renovation in the homes of children during their growth and development, which can positively improve children's indoor living environment, thus effectively preventing otitis in preschool children.
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Affiliation(s)
- Jian Yao
- Xinjiang Medical University, School of Public Health, Urumqi, China.
| | - Haonan Shi
- Xinjiang Medical University, School of Public Health, Urumqi, China.
| | - Junwen Lu
- Xinjiang Medical University, School of Public Health, Urumqi, China.
| | - Xiaolan Wang
- Shanghai University of Medicine & Health Sciences, School of Nursing & Health Management, Shanghai, China.
| | - Daming Xie
- Shanghai University of Medicine & Health Sciences, School of Nursing & Health Management, Shanghai, China.
| | - Xiaowei Wang
- Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Department of Operation and Security, Shanghai, China.
| | - Guangsheng Wan
- Shanghai University of Medicine & Health Sciences, School of Nursing & Health Management, Shanghai, China.
| | - Fuye Li
- Xinjiang Medical University, School of Public Health, Urumqi, China.
| | - Tingting Wang
- Shanghai University of Medicine & Health Sciences, School of Nursing & Health Management, Shanghai, China.
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Bardellini E, Amadori F, Garo ML, Majorana A, Conti G. Is there any correlation between otitis media and dental malocclusion in children? A systematic review. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00807-0. [PMID: 37338742 PMCID: PMC10382365 DOI: 10.1007/s40368-023-00807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/15/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE This study aims to evaluate whether there is a correlation between otitis and dental malocclusions. METHODS Electronic databases were searched for observational studies published until July 2021 without language or time restrictions. PROSPERO CRD42021270760. Observational studies on children with and without OM and/or malocclusion were included. After removing duplicates and excluding not-eligible articles, two reviewers screened relevant articles independently. Two reviewers independently extracted data and assessed data quality and validity through the Newcastle-Ottawa Scale (NOS) quality assessment tool for non-randomized studies. RESULTS Five studies met the selection inclusion criteria and were included in the studies for a total of 499 patients. Three studies investigated the relationship between malocclusion and otitis media, while the remaining two studies analyzed the inverse relationship and one of them considered eustachian tube dysfunction as a proxy of OM. An association between malocclusion and otitis media and vice versa emerged, although with relevant limitations. CONCLUSION There is some evidence that there is an association between otitis and malocclusion; however, it is not yet possible to establish a definitive correlation.
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Affiliation(s)
- E Bardellini
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy.
| | - F Amadori
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy
| | - M L Garo
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy
| | - A Majorana
- Department of Medical and Surgery Specialties, Radiological Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Dental Clinic, P.le Spedali Civili N.1, 25133, Brescia, Italy
| | - G Conti
- University of Insubria, Varese, Italy
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Prakash PR, Gupta G, Aggarwal M, Baitha U. Type 2 hyper-IgM syndrome with a rare variant of AICDA gene mutation in a young woman. BMJ Case Rep 2023; 16:16/3/e253878. [PMID: 36931691 PMCID: PMC10030550 DOI: 10.1136/bcr-2022-253878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Abstract
We report the case of a woman in her early 20s with a history of recurrent infection, atopic dermatitis, filariasis and bilateral purulent ear discharge since childhood with tonsillar enlargement on examination. She was started on supportive care and evaluated for primary immunodeficiency disease. Blood investigations revealed increased IgM levels with reduced IgG, IgA and IgE levels. Radiological imaging of the chest revealed bilateral bronchiectasis. Otoscopic examination showed features suggestive of chronic suppurative otitis media. Next-generation sequencing identified homozygous single base pair deletion in exon 2 of the activation-induced cytidine deaminase gene. Thus, a diagnosis of hyper-IgM syndrome type 2 was confirmed. The patient was started on monthly intravenous immunoglobulin replacement therapy and is currently symptomatically better, and she remains under regular follow-up.
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Affiliation(s)
| | - Gaurav Gupta
- Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Mukul Aggarwal
- Hematology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Upendra Baitha
- Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
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Sharma C, Tiwari A, Goel A, Vashist S, Raheja V, Jakhar A. Rare Cause of CSOM: Langerhans Cell Histiocytosis. Indian J Otolaryngol Head Neck Surg 2022; 74:3678-3681. [PMID: 36742476 PMCID: PMC9895658 DOI: 10.1007/s12070-021-02431-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/25/2021] [Indexed: 02/07/2023] Open
Abstract
Langerhans cell histiocytosis (LCH) is a proliferation of dendritic mononuclear cells with infiltration into organs locally or diffusely. Most cases occur in children. LCH can also present as chronic otitis media and otitis externa due to involvement of the mastoid and petrous portions of the temporal bone with partial obstruction of the auditory canal. A 4 year old male child presented with complaints of bilateral ear discharge for 4 months and inability to walk and giddiness for 2 days. On otoscopic examination, in right ear, polypoidal tissue was present in the external auditory canal which bled on touch. CECT head and MRI brain was done which showed large altered intensities in the region of bilateral external and middle ears involving the temporal bone. It also showed a well defined ovoid expansile lesion involving the skull vault in left high parietal region. Biopsy was taken from the polypoidal tissue in the right EAC which on HPE showed features suspicious for LCH. On IHC, the tissue was found out to be immunoreactive for CD 68, CD 1a and S-100 with score of 4+ for all three of the IHC markers. Patient was later put on chemotherapy and steroids which resulted in disease remission.
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Affiliation(s)
- Chandni Sharma
- Department of Otorhinolaryngology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana 124001 India
| | - Abhiraj Tiwari
- Department of Otorhinolaryngology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana 124001 India
| | - Ashiya Goel
- Department of Otorhinolaryngology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana 124001 India
| | - Swati Vashist
- Department of Otorhinolaryngology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana 124001 India
| | - Vinny Raheja
- Department of Otorhinolaryngology, Pt. B.D. Sharma PGIMS, Rohtak, Haryana 124001 India
| | - Aman Jakhar
- Department of Otorhinolaryngology, Maharaja Agrasen Medical College, Agroha, Haryana India
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Machado CS, Seeger MG, Moreira KS, Burgo TAL, Iglesias BA, Vogel FSF, Cargnelutti JF. In vitro porphyrin-based photodynamic therapy against mono and polyculture of multidrug-resistant bacteria isolated from integumentary infections in animals. Photodiagnosis Photodyn Ther 2022; 40:103179. [PMID: 36334907 DOI: 10.1016/j.pdpdt.2022.103179] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/19/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Abstract
Multidrug-resistant (MDR) organisms have been frequently isolated from integumentary lesions of animals, and these lesions are usually infected by more than one pathogen. This study evaluated an in vitro antimicrobial photodynamic therapy (aPDT) using two water-soluble tetra-cationic porphyrins (3-H2TMeP and 4-H2TMeP) against mono and polyculture of MDR bacteria isolated from dogs, cats, and horses. Ten isolates of MDR bacteria (two of each species: Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Serratia marcescens, and Staphylococcus pseudointermedius) were used to evaluate aPDT against the monoculture using a non-cytotoxic concentration of 3-H2TMeP and 4-H2TMeP porphyrins (40 µM), with 30 min of light irradiation in Gram-positive and 90 min for Gram-negative bacteria. The aPDT using the 4-H2TMeP porphyrin was also tested against five different polycultures (Coagulase positive Staphylococcus (CPS) and Pseudomonas sp.; E. coli and Proteus sp.; Pseudomonas sp. and Proteus sp.; CPS and E. coli; and CPS and Proteus sp.) for 90 min. The efficacy of both treatments was evaluated by plating the solution exposed to light or kept in the dark and counting the colonies forming units after 24 h of incubation at 37 °C. Atomic force microscope analysis was used to map bacteria morphological changes and extract adhesion force parameters from the bacteria membranes. Only the 4-H2TMeP porphyrin had antibacterial activity against MDR bacteria in monoculture, especially S. pseudointermedius and P. aeruginosa. In polyculture, the 4-H2TMeP porphyrin reduced bacterial concentrations (p < 0.05) in the associations of E. coli and S. pseudointermedius, P. aeruginosa and S. pseudointermedius, and P. aeruginosa and P. mirabilis. These results showed that aPDT using 4-H2TMeP is a good option for future associations of aPDT and other therapies or in vivo research.
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Affiliation(s)
- Carolina S Machado
- Programa de Pós-graduação em Medicina Veterinária (PPGMV) - Av. Roraima, Universidade Federal de Santa Maria (UFSM), 1000, prédio 97 - HVU, bairro Camobi, Santa Maria, RS CEP 97105-900, Brazil
| | - Marlane G Seeger
- Programa de Pós-graduação em Medicina Veterinária (PPGMV) - Av. Roraima, Universidade Federal de Santa Maria (UFSM), 1000, prédio 97 - HVU, bairro Camobi, Santa Maria, RS CEP 97105-900, Brazil
| | - Kelly S Moreira
- Coulomb Electrostatic and Mechanochemical Laboratory, Universidade Federal de Santa Maria (UFSM), Av. Roraima, 1000, Campus Camobi, Santa Maria, RS CEP 97105-900, Brazil
| | - Thiago A L Burgo
- Coulomb Electrostatic and Mechanochemical Laboratory, Universidade Federal de Santa Maria (UFSM), Av. Roraima, 1000, Campus Camobi, Santa Maria, RS CEP 97105-900, Brazil; Department of Chemistry and Environmental Sciences, Ibilce, São Paulo state University (Unesp), São José do Rio Preto, São Paulo, Brazil
| | - Bernardo A Iglesias
- Laboratório de Bioinorgânica e Materiais Porfirínicos - Departamento de Química, Universidade Federal de Santa Maria (UFSM), Av. Roraima, 1000, Campus Camobi, Santa Maria, RS CEP 97105-900, Brazil.
| | - Fernanda S F Vogel
- Departamento de Medicina Veterinária Preventiva (DMVP) - Av. Roraima, Universidade Federal de Santa Maria (UFSM), 1000, prédio 63D - bairro Camobi, Santa Maria, RS CEP 97105-900, Brazil
| | - Juliana F Cargnelutti
- Departamento de Medicina Veterinária Preventiva (DMVP) - Av. Roraima, Universidade Federal de Santa Maria (UFSM), 1000, prédio 63D - bairro Camobi, Santa Maria, RS CEP 97105-900, Brazil.
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Krajden S, Summerbell RC, Datt A, Hawke M, Scott J. Monkey finger mycology? First case of otomycosis externa caused by Trichophyton simii after encounter with a monkey. Med Mycol Case Rep 2022; 37:17-18. [PMID: 35734193 PMCID: PMC9207075 DOI: 10.1016/j.mmcr.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/31/2022] [Accepted: 06/05/2022] [Indexed: 11/17/2022] Open
Abstract
Unilateral ear pain, ear canal blockage and reduced hearing in an 18-year-old Canadian male who had travelled to India revealed, on examination of a swab, secretions bearing unusual fungal filaments visually suggestive of dermatophyte elements. Culture yielded Trichophyton simii, an unusual skin infecting species with a worldwide distribution but most often seen from India. The patient recalled swimming in the Ganges River but also had had his ear manipulated by a street monkey.
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Affiliation(s)
- Sigmund Krajden
- St. Joseph's Health Centre, 30 The Queensway, Toronto, ON, M6R 1B5, Canada
| | - Richard C. Summerbell
- Sporometrics, 219 Dufferin St #20c, Toronto, ON, M6K 3J1, Canada
- Dalla Lana School of Public Health, 155 College St Room 500, Toronto, ON, M5T 3M7, Canada
- Corresponding author. Sporometrics, 219 Dufferin St #20c, Toronto, ON, M6K 3J1, Canada.
| | - Aswani Datt
- St. Joseph's Health Centre, 30 The Queensway, Toronto, ON, M6R 1B5, Canada
| | - Mike Hawke
- Faculty of Medicine, University of Toronto, M5S 1A8, Canada
| | - James Scott
- Sporometrics, 219 Dufferin St #20c, Toronto, ON, M6K 3J1, Canada
- Dalla Lana School of Public Health, 155 College St Room 500, Toronto, ON, M5T 3M7, Canada
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Malinvaud D, Shenouda K, Laccourreye L, Guiquerro S, Rubin F, Laccourreye O. Aural tuberculosis at the start of the 21st century. Literature review according to SWiM guidelines. Part 1: Clinical and diagnostic data. Eur Ann Otorhinolaryngol Head Neck Dis 2022; 139:343-349. [PMID: 35701295 DOI: 10.1016/j.anorl.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Review of the scientific literature dedicated to clinical data and diagnosis modalities for aural tuberculosis published since the start of the 21st century. MATERIAL AND METHODS Search of the Medline, Cochrane and Embase databases for the period 2000-2020. Selection of articles in English, French and Spanish devoted to clinical cases and series documenting clinical data and diagnosis for aural tuberculosis of articles by two authors. Analysis performed according to SWiM guidelines. Extraction of data on pre-established files documenting clinical and diagnostic data. RESULTS In total, 173 articles: 163 case reports (228 patients) and 10 cohorts (177 patients) from 49 countries were analyzed. Female/male sex ratio was 1.05, with ages ranging from less than 1 month to 87 years. Tuberculosis involved another site in 35.1% of cases. Aural involvement was bilateral in 19.7% of cases. Clinical presentation corresponded to otitis media (prior antibiotic treatment and auricular surgery in 41.4% and 10.1% of cases, respectively) without any pathognomonic symptoms or signs. Associated severe locoregional complications were seen in 32% of cases, with 23.2% and 13% incidence of peripheral facial palsy and severe intracranial complications, respectively. Time to diagnosis ranged from less than 1 month to 384 months, and was longer than 12 months in 26.5% of case reports, without significant correlation (P=0.29) with severe revelatory locoregional complications. Incidence of Mycobacterium tuberculosis detection ranged from 33.4% of documented cases in auricular secretions to 64.6% in polyps, granulomas, and/or biopsies. In the case reports, diagnosis with certainty was done in 58.3% of cases, while it was based on involvement of another site and on indirect criteria or positive clinical progression after treatment in the other 10.1% and 31.6%, respectively. CONCLUSION Aural tuberculous must always be considered in case of unfavorable progression of otitis. Definitive diagnosis is based on multiple auricular sample sites, polymerase chain reaction, and γ interferon blood assay.
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Affiliation(s)
- D Malinvaud
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - K Shenouda
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France
| | - L Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, institut Arthur-Vernes, 36, rue d'Assas, 75006 Paris, France
| | - S Guiquerro
- Bibliothèque universitaire Necker, université Paris Cité, 160, rue de Vaugirard, 75015 Paris, France
| | - F Rubin
- Clinique Saint-Vincent, 8, rue de Paris, CS 71027, 97404 Saint-Denis cedex, France
| | - O Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, université Paris Cité, AP-HP, 20, rue Leblanc, 75015 Paris, France.
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15
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Lochbaum R, Tewes S, Hoffmann TK, Greve J, Hahn J. [Typical emergencies in otorhinolaryngology-a monocentric analysis of the seasonal course]. HNO 2022; 70:601-608. [PMID: 35657418 PMCID: PMC9164187 DOI: 10.1007/s00106-022-01185-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
Hintergrund Die Inzidenz der Akutdiagnosen im Hals-Nasen-Ohren(HNO)-Bereich wird durch multiple Parameter beeinflusst, unter anderem meteorologische und saisonale Einflüsse. Durch ein besseres Verständnis dieser Faktoren könnten prophylaktische Ansätze entwickelt werden. Material und Methoden Über 6 Jahre erfolgte eine retrospektive Analyse aller Patienten, die sich aufgrund von typischen und weniger komplexen HNO-ärztlichen Krankheitsbildern wie Cerumen obturans, akuter Otitis externa und media, Nasenpyramidenfraktur, Epistaxis nasi, akuter Tonsillitis, akuter Rhinosinusitis oder eines Peritonsillarabszess in einer südwestdeutschen Universitätsklinik vorgestellt haben. Ergebnisse 32.968 Fälle wurden ausgewertet. Mit 24,5 % (8082 Fälle) war die Epistaxis nasi die häufigste Notfalldiagnose. Diese, wie auch die akute Otitis media und die akute Rhinosinusitis, traten signifikant häufiger in der kälteren Jahreshälfte auf. Es bestand keine signifikante Korrelation der Diagnose Nasenpyramidenfraktur mit besonderen Zeiten wie Feiertagen. Die akute Otitis externa korrelierte signifikant mit dem Zeitraum der Sommerferien. In Kalenderwoche 38 gab es die wenigsten und in der Kalenderwoche 52 die meisten Notfallvorstellungen. Schlussfolgerung Saisonale und meteorologische Faktoren spielen eine Rolle in der Krankheitsentstehung verschiedener HNO-ärztlicher Notfalldiagnosen.
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Affiliation(s)
- R Lochbaum
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - S Tewes
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - T K Hoffmann
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - J Greve
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland
| | - J Hahn
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinik Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
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Machado A, Santos M, Leitao B, Silva A, Coutinho M. Cleft palate and ventilation tubes: a prophylactic dilemma. J Laryngol Otol 2022;:1-5. [PMID: 35611594 DOI: 10.1017/S0022215122001232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study aimed to understand, in a long-term follow-up study, whether the placement of grommets had been necessary after cleft palate surgical correction. METHOD A case-control, retrospective study was carried out on consecutive paediatric patients who underwent surgical repair of a cleft palate. RESULTS The study population included 138 patients, divided into 2 groups: group 1 - patients in whom grommets were placed at the time of cleft palate surgery, and group 2 - patients in whom grommets were not placed at the time of cleft palate surgery. During the follow up, in groups 1 and 2, 65.2 per cent and 67.8 per cent, respectively, did not need subsequent grommet placement after cleft palate surgery. CONCLUSION Of patients, 56.5 per cent did not need ventilation tubes at any point during follow up. The placement of grommets is not innocuous; therefore, its use at the time of cleft palate surgical repair should be reconsidered.
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Kouhi A, Xia A, Khomtchouk K, Santa Maria PL. Minimally invasive trans-tympanic eustachian tube occlusion animal model. Int J Pediatr Otorhinolaryngol 2022; 156:111070. [PMID: 35228098 DOI: 10.1016/j.ijporl.2022.111070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 01/27/2022] [Accepted: 02/12/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Eustachian tube dysfunction is believed to be involved in the pathogenesis of many middle ear diseases including chronic suppurative otitis media. We aimed to describe a simple and reliable animal model of Eustachian Tube obstruction to further research into middle ear disorders. STUDY DESIGN Prospective cohort study in animals. SETTING University laboratory. SUBJECTS AND METHODS 30 mice C57Bl/6J (n = 15) and CBA/CaJ (n = 15) aged 6-8 weeks received transtympanic Eustachian tube occlusion on left ear trough an acute tympanic membrane perforation using thermoplastic latex used in dental procedures (gutta percha). Control mice (n = 6) received tympanic membrane perforation only. At two and four weeks, the mice were observed for signs of Eustachian tube dysfunction and compared to control ears. ET dysfunction was defined as presence of effusion in the middle ear. RESULTS 100% (n = 30) of the treated ears had otoscopic signs of Eustachian tube dysfunction at two weeks and the endpoint time of four weeks, compared to 0% in control mice (0/6). Temporary head tilt lasting up to 2 days were observed in 3 mice (10%). No other potential adverse events were recorded. No bacterial growth was determined in the middle ear fluid. CONCLUSION We describe a technically easy and reliable method for Eustachian tube occlusion in mice with an excellent success rate and minimal morbidity.
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Affiliation(s)
- Ali Kouhi
- Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, USA; Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Anping Xia
- Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, USA
| | - Kelly Khomtchouk
- Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, USA
| | - Peter Luke Santa Maria
- Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, USA.
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van der Toom HFE, van der Schroeff MP, Molenaar TL, Metselaar M, van Linge A, Vroegop JL, Pauw RJ. Revision surgery for chronically discharging mastoid cavities: mastoid obliteration with canal wall reconstruction versus non-obliteration surgery. Eur Arch Otorhinolaryngol 2021; 279:3881-3889. [PMID: 34705081 PMCID: PMC9249682 DOI: 10.1007/s00405-021-07138-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/12/2021] [Indexed: 11/26/2022]
Abstract
Purpose To evaluate the surgical results of revision canal wall down (CWD) surgery for chronically discharging mastoid cavities and to compare the non-obliteration approach to mastoid obliteration with canal wall reconstruction. Methods This is a retrospective cohort study. All adult patients (≥ 18 years) who underwent revision surgery for chronically draining mastoid cavities between January 2013 and January 2020 were included. Primary outcome measures included the dry ear rate, complications and postoperative hearing. Results 79 ears were included; 56 ears received revision CWD with mastoid obliteration and posterior canal wall reconstruction and 23 ears received CWD without mastoid obliteration. The dry ear rate at the most recent outpatient clinic visit (median 28.0 months postoperative) was significantly higher in the obliteration group with 96.4% compared to 73.9% for the non-obliteration group (p = .002). There were no differences in audiological outcome and incidence of complications between the two techniques. Conclusion We show that in our study population revision CWD surgery with mastoid obliteration and posterior canal wall reconstruction is superior to revision CWD surgery without mastoid obliteration in the management of chronically discharging mastoid cavities. In the obliteration group, a dry ear was achieved in 96.4% as this was 73.9% in the non-obliteration group. We found no differences in audiological outcome and in incidence of complications between the two techniques. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-021-07138-0.
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Affiliation(s)
- Hylke F E van der Toom
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - Marc P van der Schroeff
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Tim L Molenaar
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Mick Metselaar
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Anne van Linge
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Jantien L Vroegop
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Robert J Pauw
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Allen H, Winstanley J, Stubington TJ, Judd O. One year on: assessing the impact of coronavirus disease 2019 on demand for semi-urgent ENT services. J Laryngol Otol 2021; 135:829-33. [PMID: 34348818 DOI: 10.1017/S002221512100205X] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective This study investigated how the coronavirus disease 2019 pandemic has impacted on presentations to ENT first-on-call services. Methods All appointments to a rapid access triage clinic from 1 June to 31 August in 2019 and 2020 were reviewed retrospectively and their reasons for consultation classified. A binomial proportion test was used to determine whether the proportions of consultations per presentation differed significantly between years. This analysis was repeated with the number of unique patients per presenting complaint. Results The proportions of nine reasons for consultation differed significantly between 2019 and 2020, including an increase in otitis media and nasal trauma presentations, and a decrease in otitis externa and tonsillitis presentations. Reattendances caused some variation in the frequency of certain diagnoses. Conclusion Our data suggest a shift in the presentations to first-on-call services, which may be a result of changes in patient behaviour and access to healthcare services.
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García-Moreno FJ, Escobar-Castellanos M, Marañón R, Rivas-García A, Manrique-Rodríguez S, Mora-Capín A, Fernández-Llamazares CM. [Adecuacy of pediatric antimicrobial prescribing in the Emergency Department at discharge]. An Pediatr (Barc) 2021; 96:S1695-4033(20)30507-5. [PMID: 33583763 DOI: 10.1016/j.anpedi.2020.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/12/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION In January 2019, Community of Madrid's Health Department published a guide about the use of antimicrobials in outpatient children. Taking this regional Guide as reference, this study was aimed at estimating the adequacy of the antimicrobial stewardship at discharge from a pediatric Emergency Department (ED). Secondarily, the differences in adequacy according to the diagnosis and the prescriber were studied, and the agreement between this Guide and the protocols of the ED was assessed. MATERIAL AND METHODS An observational, descriptive, retrospective study was conducted on patients under 16 years old, with a diagnosis included in the regional Guide who were discharged from a pediatric ED between March of 2018 and February of 2019. Prescription was considered adequate when the indication, the antibiotic and the posology (dosage, dosing interval, length of treatment and route of administration) were correct. RESULTS 165 out of 648 (25,5%) infectious diseases processes analyzed received antimicrobial treatment. In 23 processes treated with antimicrobial, the adequacy could not be evaluated due to the absence of data necessary to assess any aspect of posology. Therapy was considered appropriate in 550/625 processes (88.0%). When antimicrobial treatment was prescribed, 70/142 (49.3%) were appropriate and no statistically significant differences in adequacy were found between prescribers. Posology was the worst handled point of the prescription (26.3%). Tract urinary infection, conjunctivitis and otitis media were the pathologies with the lowest adecuacy (44.4%; 50.0% and 52.2%) and presented the highest discrepancy between the Guide and the center protocols (k=0.308; k=0.000; k=0.586). CONCLUSIONS The adequacy of the management of infectious processes to the reference Guide in our pediatric ED was high, but it was below 50% when antimicrobial treatment was required. The degree of adequacy to the local protocols of the center was greater than to the regional Guide. This reveals a discrepancy between the 2documents that should be analyzed and corrected according to the available scientific evidence.
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Affiliation(s)
- Félix Jesús García-Moreno
- Servicio de Farmacia, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
| | | | - Rafael Marañón
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Sección de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Arístides Rivas-García
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Sección de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Silvia Manrique-Rodríguez
- Servicio de Farmacia, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; RETIC SAMID Carlos III (RD16/0022/0004), Madrid, España
| | - Andrea Mora-Capín
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Sección de Urgencias de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Cecilia M Fernández-Llamazares
- Servicio de Farmacia, Hospital General Universitario Gregorio Marañón, Madrid, España; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; RETIC SAMID Carlos III (RD16/0022/0004), Madrid, España
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Abstract
Upper respiratory tract infections are one of the most common challenges in ambulatory medicine. Effective evaluation involves identification, primarily through the history, of the dominant set of patient symptoms leading to accurate diagnosis. Certain more morbid illnesses that mimic common upper respiratory symptoms can also be excluded with this approach. Treatment should address patient preferences through an understanding of the limited utility of antibiotics and through tailored advisement of the numerous pharmacologic options for symptom relief.
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Affiliation(s)
- Fred N Pelzman
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 505 East 70th Street, New York, NY 10021, USA.
| | - Judy Tung
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 505 East 70th Street, New York, NY 10021, USA. https://twitter.com/JudyTungMD
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Torretta S, Capaccio P, Gaffuri M, Gaini LM, Borin M, Maruca A, Battilocchi L, Nitro L, Marchisio P, Pignataro L. ENT management of children with adenotonsillar disease during COVID-19 pandemic. Ready to start again? Int J Pediatr Otorhinolaryngol 2020; 138:110145. [PMID: 32499073 PMCID: PMC7253984 DOI: 10.1016/j.ijporl.2020.110145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 01/29/2023]
Abstract
Clinical manifestations of COVID-19 in children are milder, but the real burden of disease is unknown. After the lockdown, in our Region Lombardia we have been requested to progressively resume medical services including outpatient assessment and priority surgery. Therefore, we screened surgical waiting lists with identification of 47 children candidates to priority surgery (among 358). No homogeneous national health surveillance/screening programs are ongoing or have been conceived to test susceptible population among children/healthcare workers in preparation of coming down to routinely daily activities, and diagnostic strategies are not completely accurate in children. So, restoring medical services now might be untimely.
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Affiliation(s)
- Sara Torretta
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Pasquale Capaccio
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Biomedical Surgical Dental Science, University of Milan, Milan, Italy
| | - Michele Gaffuri
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Maria Gaini
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Borin
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Antonella Maruca
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Ludovica Battilocchi
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Letizia Nitro
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Marchisio
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Lorenzo Pignataro
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Riley B, Kawai K, Irace AL, Leung P, Adil E. Perioperative pain control and tympanostomy tube outcomes. Int J Pediatr Otorhinolaryngol 2020; 138:110337. [PMID: 33152955 DOI: 10.1016/j.ijporl.2020.110337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate perioperative pain management regimens as they relate to tympanostomy tube outcomes. STUDY DESIGN Retrospective chart review. SETTING Tertiary referral children's hospital. SUBJECTS and Methods: The medical records of patients ≤18 years old who underwent tympanostomy tube placement were reviewed for indications, perioperative pain medications, post anesthesia recovery unit (PACU) measures, and tympanostomy tube occlusion rates. RESULTS Four hundred and fifty-five patients met inclusion criteria. Median age was 1.7 years (interquartile range: 1.2-3.3 years). Recurrent acute otitis media (n = 239, 52.5%) was the most common indication. All patients were American Society of Anesthesiologists (ASA) class 1 (n = 244, 58.1%) or 2 (n = 176, 41.9%). Fentanyl alone (n = 321, 70.6%) was the most common intraoperative analgesic administered followed by ketorolac alone (n = 40, 8.8%), and fentanyl and ketorolac together (n = 58, 12.8%). There was no significant difference in FLACC pain score at discharge and recovery time (minutes) also did not differ by intraoperative analgesia group (34.3 ± 15.2 for fentanyl; 36.2 ± 13.0 for ketorolac; 31.0 ± 12.5 for fentanyl and ketorolac together). Forty nine patients (11.6%) had an occluded tympanostomy tube at follow-up. Patients ≤1 year of age had a significantly higher risk of tube occlusion than patients >1 year of age (23.7% vs. 8.9%; p < 0.001). There was no significant difference in tube occlusion rates based on indication for tube placement, history of tube placement, intraoperative findings, or intraoperative pain regimen. CONCLUSIONS Ketorolac is a reasonable non-narcotic alternative to fentanyl which provides equal pain control and does not increase tube occlusion rates.
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Affiliation(s)
- Bobbie Riley
- Department of Anesthesia, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
| | - Kosuke Kawai
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA, USA
| | - Alexandria L Irace
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Peggy Leung
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA
| | - Eelam Adil
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA, USA
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Rebay-Salisbury K, Janker L, Pany-Kucera D, Schuster D, Spannagl-Steiner M, Waltenberger L, Salisbury RB, Kanz F. Child murder in the Early Bronze Age: proteomic sex identification of a cold case from Schleinbach, Austria. Archaeol Anthropol Sci 2020; 12:265. [PMID: 33123298 PMCID: PMC7584537 DOI: 10.1007/s12520-020-01199-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
The identification of sex-specific peptides in human tooth enamel by nanoflow liquid chromatography-tandem mass spectrometry (nanoLC-MS/MS) represents a quantum leap for the study of childhood and social relations more generally. Determining sex-related differences in prehistoric child rearing and mortality has been hampered by the insufficient accuracy in determining the biological sex of juveniles. We conducted mass spectrometric analysis to identify sex-specific peptides in the dental enamel of a child from a settlement pit of the Early Bronze Age settlement of Schleinbach, Austria (c. 1950-1850 bc). Four perimortal impression fractures on the skull of a 5-6-year-old child indicate an intentional killing, with a co-buried loom weight as possible murder weapon. Proteomic analysis, conducted for the first time on prehistoric teeth in Austria, determined the child's sex as male. While we cannot conclusively determine whether the child was the victim of conflicts between village groups or was slain by members of his own community, we suggest that contextual evidence points to the latter. A possible trigger of violence was the follow-on effects of an uncontrolled middle ear infection revealed by an osteological analysis. The boy from Schleinbach highlights the potential for further investigation of gender-biased violence, infanticide and child murder based on the recently developed method of proteomic sex identification.
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Affiliation(s)
- Katharina Rebay-Salisbury
- Institute for Oriental and European Archaeology, Austrian Academy of Sciences, Hollandstraße 11–13, 1020 Vienna, Austria
| | - Lukas Janker
- Department of Analytical Chemistry, University of Vienna, Währinger Straße 38, 1090 Vienna, Austria
| | - Doris Pany-Kucera
- Institute for Oriental and European Archaeology, Austrian Academy of Sciences, Hollandstraße 11–13, 1020 Vienna, Austria
- Department of Anthropology, Natural History Museum, Burgring 7, 1010 Vienna, Austria
| | - Dina Schuster
- Department of Analytical Chemistry, University of Vienna, Währinger Straße 38, 1090 Vienna, Austria
| | - Michaela Spannagl-Steiner
- Institute for Oriental and European Archaeology, Austrian Academy of Sciences, Hollandstraße 11–13, 1020 Vienna, Austria
- Department of Anthropology, Natural History Museum, Burgring 7, 1010 Vienna, Austria
| | - Lukas Waltenberger
- Institute for Oriental and European Archaeology, Austrian Academy of Sciences, Hollandstraße 11–13, 1020 Vienna, Austria
| | - Roderick B. Salisbury
- Institute for Oriental and European Archaeology, Austrian Academy of Sciences, Hollandstraße 11–13, 1020 Vienna, Austria
- Institute of Prehistoric and Historical Archaeology, University of Vienna, Franz-Klein-Gasse 1, 1190 Vienna, Austria
| | - Fabian Kanz
- Center for Forensic Medicine, Medical University of Vienna, Sensengasse 2, 1090 Vienna, Austria
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Clausen G, Nemanic S, Vanegas J, Stieger-Vanegas SM, Poulsen KP. Computed tomography of tympanic bullae in pre-weaned dairy calves diagnosed with clinical respiratory disease. Vet J 2020; 264:105546. [PMID: 33012441 DOI: 10.1016/j.tvjl.2020.105546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 11/21/2022]
Abstract
Clinical disease from otitis media in calves is a significant problem in the dairy industry and evaluation of disease severity, chronicity, and imaging remains a challenge. Our objectives were to compare imaging findings in calves with an early diagnosis of respiratory disease to calves with treatment failure. This was a prospective study of 30 Jersey heifer calves, 26-95 days of age, with elevated clinical respiratory scores. Ten clinically healthy calves served as controls for clinical scoring. Three groups of calves were selected based on elevated scores using the McGuirk respiratory scoring system and treatment history. Group A included new cases, group B included primary treatment failures, and group C included multiple treatment failures. Calves underwent a skull CT, four view radiography, post-mortem photography of the tympanic bulla and bacteriological diagnostics. Imaging and post-mortem results were evaluated using normalized scoring schemes. Computed tomography imaging of the tympanic bulla differentiated calves early in the course of disease (group A) from calves that had not responded to treatment (groups B and C). Radiographs differentiated only group C from groups A and B. Use of a 35 degree angle dorsal-right or dorsal-left ventral oblique projection for radiography allowed effective evaluation of the tympanic bulla. Clinical respiratory scores were similar among all three groups. Computed tomography imaging can differentiate early from advanced otitis media. Radiographs, which can be performed in the field, also have utility to identify advanced otitis media to aid management decisions.
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Abstract
PURPOSE OF REVIEW The aim of this review is as follows: (1) to present the role of otitis as a warning sign for inborn errors of immunity (IEI), (2) to establish which patients presenting otitis should be investigated for IEI, (3) to review data about main IEI associated with otitis-prone patients. RECENT FINDINGS Otitis media is a very common infection in general population. The concept of otitis-prone children established a certain frequency of the infections in order to look for conditions leading to them. The confirmation of middle ear impairment by specialists has demonstrated better confiability. The hallmarks for immunologic evaluation are the presence of complications as mastoiditis and membrane perforation, failure to thrive, and additional respiratory symptoms. Humoral immunodeficiencies have been more frequently described in association with otitis-prone patients, for example, hypogammaglobulinemia, MBL deficiency, and IEI associated with major syndromes. Most of the patients with confirmed IEI present otitis as one of the recurrent infections. It is suggested the investigation of immune defects in patients with otitis, and the following warning signs are suggested: Otitis evolving with mastoiditis, abscesses, or systemic infections; no response to appropriate antibiotic therapy; otitis media associated with other infections; recurrent otitis leading to failure to thrive and general developmental delay; and family history of primary immunodeficiency and/or consanguinity.
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Yang N, Beaudoin PL, Nguyen M, Maillé H, Maniakas A, Saliba I. Subannular ventilation tubes in the pediatric population: Clinical outcomes of over 1000 insertions. Int J Pediatr Otorhinolaryngol 2020; 131:109859. [PMID: 31918244 DOI: 10.1016/j.ijporl.2020.109859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/31/2019] [Accepted: 01/01/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Long-term transtympanic tube insertions for chronic middle ear disease are associated with high rates of complications. The objective of this study was to examine the clinical outcomes achieved with an alternate technique, the subannular tube insertion, by determining mean tube lifespan, cumulative incidence of post-operative events and complications, audiometric changes and risk factors associated with earlier tube extrusion in the pediatric population. METHODS A retrospective chart review of all patients operated for subannular tube insertion between January 2007 and 2013 was conducted in a single pediatric tertiary care center. Exploratory Cox regression analysis was performed to identify potential risk factors. RESULTS A total of 1014 tubes from 459 patients were included in the study. Mean subannular tube lifespan was 41.3 months with median time of 35.0 months. Cumulative incidence of post-operative events in decreasing frequency were otorrhea (21.7%), tube blockage (16.0%), tympanic membrane retraction (12.5%), otitis media with effusion (10.0%), acute otitis media (6.4%), perforation (4.6%) and cholesteatoma formation (1.1%). For patients with available pre- and post-operative audiograms, mean air-bone gap improved from 19.5 dB to 7.0 dB after subannular tube insertion (p < 0.01). Increasing age and previous subannular tube insertion carried hazard ratios of 1.029 (p < 0.01) and 1.749 (p < 0.01) for tube extrusion respectively, while craniofacial anomalies and concomitant tympanoplasty at the time of tube insertion had hazard ratios of 0.795 (p < 0.01) and 0.680 (p = 0.03). CONCLUSIONS Subannular tube insertion appears to be a safe and effective alternate technique for middle ear ventilation in cases of intractable disease.
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Affiliation(s)
- Nathan Yang
- Division of Otorhinolaryngology, Head & Neck Surgery, University of Montreal, Otology and Neurotology, Sainte-Justine University Hospital Center (CHUSJ), Canada; University of Montreal, Faculty of Medicine, Canada
| | - Pier-Luc Beaudoin
- Division of Otorhinolaryngology, Head & Neck Surgery, University of Montreal, Otology and Neurotology, Sainte-Justine University Hospital Center (CHUSJ), Canada; University of Montreal, Faculty of Medicine, Canada
| | | | - Hélène Maillé
- Division of Otorhinolaryngology, Head & Neck Surgery, University of Montreal, Otology and Neurotology, Sainte-Justine University Hospital Center (CHUSJ), Canada; University of Montreal, Faculty of Medicine, Canada
| | - Anastasios Maniakas
- Division of Otorhinolaryngology, Head & Neck Surgery, University of Montreal, Otology and Neurotology, Sainte-Justine University Hospital Center (CHUSJ), Canada; University of Montreal, Faculty of Medicine, Canada
| | - Issam Saliba
- Division of Otorhinolaryngology, Head & Neck Surgery, University of Montreal, Otology and Neurotology, Sainte-Justine University Hospital Center (CHUSJ), Canada; University of Montreal, Faculty of Medicine, Canada; University of Montreal Hospital Centre Research Centre (CRCHUM), Montreal, QC, Canada.
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Tambella AM, Attili AR, Beribè F, Galosi M, Marchegiani A, Cerquetella M, Palumbo Piccionello A, Vullo C, Spaterna A, Fruganti A. Management of otitis externa with an led-illuminated gel: a randomized controlled clinical trial in dogs. BMC Vet Res 2020; 16:91. [PMID: 32192496 PMCID: PMC7083025 DOI: 10.1186/s12917-020-02311-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 03/11/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Canine otitis externa is a painful condition which can be challenging to treat due to difficulties in the administration of otic medication. This can be due to lack of owner compliance in the application of ear drops or due to the resentment that some dogs demonstrate when attempts are made to administer topical medication into a sensitive ear canal. The aim of the study was to assess the efficacy of a topical LED-illuminated gel (LIG) in canine otitis externa in comparison to standard of care therapy. Dogs with spontaneous otitis externa were randomly allocated in three groups: groups QW received LIG once weekly; BW received LIG twice weekly; group C received enrofloxacin and silver sulfadiazine twice daily. LIG consists of a topical application of a gel containing chromophores that, when illuminated by a LED lamp, re-emit fluorescent light which can stimulate physiological responses, promoting healing and controlling bacteria. The evaluation protocol (T0 to T5) considered clinical assessment (OTIS-3-index-scoring-system; pruritus-severity-scale; pain-severity-score; aural temperature), cytological scoring system, quali-quantitative bacteriologic assessment. RESULTS All groups (QW, n = 21; BW, n = 23; C, n = 20) showed improvement during the study (QW: P < 0.02 for cytological and pain scores, P < 0.003 for bacteriologic assessment, P < 10- 4 for pruritus, total OTIS-3 and temperature assessments; BW: P < 10- 4 for all clinical, cytological and bacteriologic assessments; C: P < 0.02 for all clinical and cytological assessments, P < 10- 4 for bacteriologic assessment). The highest clinical score reduction occurred in Group BW (P < 0.014 in T3; P < 0.001 in T4 and P < 10- 4 in T5). BW reached the clinically relevant effect level at T3 (- 3.26 ± 1.21 levels), QW reached it at T4 (- 3.24 ± 0.99), C did not reach it. No differences between groups were seen in the reduction of CFU/mL (T0-T5). CONCLUSIONS All treatment groups showed a positive clinical effect. LIG administered twice-a-week was the most favourable protocol of the study. LIG may be considered beneficial in the management of canine otitis externa; it seems to be effective in controlling the clinical condition, including the signs of inflammation and local pain, the bacterial growth, and it may help increasing treatment compliance.
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Affiliation(s)
- Adolfo Maria Tambella
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Anna Rita Attili
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Francesca Beribè
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Margherita Galosi
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Andrea Marchegiani
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Matteo Cerquetella
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Angela Palumbo Piccionello
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Cecilia Vullo
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Andrea Spaterna
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
| | - Alessandro Fruganti
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione, 93/95, 62024 Matelica, MC Italy
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Arisov MV, Indyuhova EN, Arisova GB. The use of multicomponent ear drops in the treatment of otitis of various etiologies in animals. J Adv Vet Anim Res 2020; 7:115-126. [PMID: 32219117 PMCID: PMC7096122 DOI: 10.5455/javar.2020.g400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE The objective of this study was to investigate the efficacy of newly developed multicomponent ear drops for the treatment of otitis caused by parasites, bacteria, and fungi in dogs, cats, ferrets, fancy rabbits, and foxes. MATERIALS AND METHODS A new drug for veterinary use was developed that contained levofloxacin hemihydrate (0.3%), clotrimazole (0.1%), dexamethasone sodium phosphate (0.1%), and moxidectin (0.01%). In the initial stage of otoacariasis (or the ear form of psoroptic scab), the drug was used twice with an interval of 5-7 days. When otoacariasis (psoroptic scab) was complicated by otitis of bacterial and/or fungal etiology, the drug was used as follows: instilled once a day, within 10-14 days in the ear canal for 2-5 drops of the drug. The study of therapeutic efficacy was performed on cats, dogs, ferrets, foxes, and fancy rabbits with ear pathology. RESULTS The recovery of cats, ferrets, dogs, and foxes after the double use of ear drops during otoacariasis was established. In the ear form of psoroptic scab in fancy rabbits after treatment, Psoroptes cuniculi mites were not detected. The specific (antimicrobial and antifungal) activity of the drug was confirmed in vivo using the following scheme of drug use: the drug was instilled once a day, within 10-14 days in the ear canal, 2-5 drops of the drug in animals with external otitis and otitis media. CONCLUSION The rational combination of active components developed in this study is effective and safe for use in animals with microbial diseases of the ears.
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Abstract
Adenomas are very rare tumors of the middle ear. They are benign neoplasms originating from the glandular components of the mucous membrane of the middle ear. The middle ear adenoma was first described by Hyams and Michaels in 1976, which was named an adenomatous tumor. This article reports the case of a 50-year-old female patient, who presented with recurrent right-sided dull otalgia and pulse synchronous tinnitis, which began 1 year prior to presentation, with the suspected diagnosis of a glomus tympanicum tumor. Following the otorhinolaryngological examination and imaging an unclear mesotympanal space-occupying lesion was detected. A transmeatal endoscopic complete removal of the tumor was carried out. The histopathological investigations enabled the diagnosis of an adenoma of the middle ear. Adenomas are a rare differential diagnosis of tumors of the middle ear. In cases with a suitable localization an adequate exposure and removal of this rare tumor can be achieved by a transmeatal endoscopic access.
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Affiliation(s)
- H Sudhoff
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Medizinische Fakultät OWL, Klinikum Bielefeld, Universität Bielefeld, Teutoburger Str. 50, 33604, Bielefeld, Deutschland.
| | - H-B Gehl
- Abteilung für Radiologie, Medizinische Fakultät OWL, Klinikum Bielefeld, Universität Bielefeld, Bielefeld, Deutschland
| | - F Brasch
- Institut für Pathologie, Medizinische Fakultät OWL, Klinikum Bielefeld, Universität Bielefeld, Bielefeld, Deutschland
| | - R Riemann
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Medizinische Fakultät OWL, Klinikum Bielefeld, Universität Bielefeld, Teutoburger Str. 50, 33604, Bielefeld, Deutschland
| | - I Todt
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Medizinische Fakultät OWL, Klinikum Bielefeld, Universität Bielefeld, Teutoburger Str. 50, 33604, Bielefeld, Deutschland
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Vaduva C, Gómez JIT, Zaid DM, Rivera-Rodríguez T. [Acute infectious disease of otolaryngology focus]. Medicine (Baltimore) 2019; 12:5339-5351. [PMID: 32287913 PMCID: PMC7143590 DOI: 10.1016/j.med.2019.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Infections are the most common cause of antibiotic prescription and one of the most frequent reasons for consultation in Primary Care. Among them, stand out acute media otitis and diffuse external otitis, acute pharyngitis and acute rhinosinusitis. Commonly they are viral and self-limited, so their complications are rare. Currently, the indiscriminate use of antibiotics have leaded to bacterial resistances; therefore antibiotic prescription should be more careful. Nowadays, several diagnostic strategies are available. In current updated etiological and pathophysiological factors of each infection, diagnostic and therapeutic strategy to be applied in Primary Care as well as the complications of each pathology and the referral indications to be assessed by specialists in the ENT area, will be reviewed.
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Affiliation(s)
- C Vaduva
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - J I Tato Gómez
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - D Mora Zaid
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - T Rivera-Rodríguez
- Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
- Universidad de Alcalá, Alcalá de Henares, Madrid, España
- Centro de Investigación Biomédica en Red (Ciber), Instituto de Salud Carlos III, Madrid, España
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Kirubaharane SI, Palani S, Alexander A, Sreenivasan A. Effect of chronic suppurative otitis media on distortion product otoacoustic emission input-output functions in conventional and ultra-high frequencies. J Laryngol Otol 2019; 133:995-1004. [PMID: 31630702 DOI: 10.1017/S0022215119002123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Detection and valid measurements of distortion product otoacoustic emissions are not influenced by cochlear status alone, but also by middle-ear status. There is a need to understand the use of ultra-high frequency distortion product otoacoustic emissions in cases of abnormal distortion product otoacoustic emission findings for conventional frequencies related to the middle-ear condition. METHOD The present study investigated distortion product otoacoustic emission input-output functions in conventional and ultra-high frequencies in: 37 adults with chronic suppurative otitis media (clinical group) and 37 adults with normal hearing sensitivity (control group). RESULTS There were significant reductions in distortion product otoacoustic emission amplitude and mean signal-to-noise ratio in the clinical group compared to the control group, especially for conventional frequencies. CONCLUSION There was a significant reduction in the rate of ears with measurable distortion product otoacoustic emissions in the clinical group, especially for conventional frequencies. The effect of chronic suppurative otitis media was more pronounced in the conventional frequency range compared to the smaller effect seen in the ultra-high frequency range.
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Abstract
Evidence-based recommendations are constantly being updated for various pediatric surgical procedures, including the role for tympanostomy tubes, as well as indications for adenoidectomy and tonsillectomy. With a growing body of research available on some of the most prevalent pediatric conditions, an update on the current concepts surrounding management is warranted.
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Affiliation(s)
- Cinzia L Marchica
- Pediatric Otolaryngology, Children's Healthcare of Atlanta, USA; Department of Otolaryngology Head and Neck Surgery, Emory University, 2015 Uppergate Dr., Atlanta, GA 30322, USA
| | - John P Dahl
- Pediatric Otolaryngology, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA; Department of Otolaryngology Head & Neck Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Nikhila Raol
- Pediatric Otolaryngology, Children's Healthcare of Atlanta, USA; Department of Otolaryngology Head and Neck Surgery, Emory University, 2015 Uppergate Dr., Atlanta, GA 30322, USA.
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Franz S, Högler S, Gumpenberger M, Dadak A. Intracranial abscess formation in an adult alpaca: a case report. BMC Vet Res 2019; 15:183. [PMID: 31164122 PMCID: PMC6549265 DOI: 10.1186/s12917-019-1930-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background Intracranial abscess formation is an extremely rare and sporadically documented disease in South American Camelids (SACs). Herein we report the first case of otogenic brain abscess formation in this species. Case presentation A 4 years old female alpaca was presented to our veterinary hospital with a 6 month history of neurologic disorder symptoms, mainly head tilt to the right and emaciation. A comprehensive workup (ultrasound and computed tomography) revealed irreversible cranial nerve abnormalities, extensive lesions in the region of external, middle and internal right ear including destruction of bony structures (tympanic bulla, parts of temporal bone) and severe brain deformation caused by an intracranial abscess. The lesion was up to 6x7x4 cm and occupying almost 40% of the cranial cavity. No pathological findings were evident in other organs or structures. The late referral of the alpaca at this advanced stage of destructive disease precluded surgical intervention. Conclusions This case report describes the clinical signs, diagnostic procedures and pathological findings in an adult female alpaca suffering from cranial nerve abnormalities caused by a massive otogenic brain abscess. Camelids suffering from otitis may not present with clinical signs until the pathology is severe. The importance of considering intracranial abscess formation as differential diagnosis in SACs showing the merest hint of nerve deficits cannot be emphasized enough in order to diagnose such pathological processes at an early and treatable stage.
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Affiliation(s)
- Sonja Franz
- Clinic for Ruminants, Clinical Unit of Ruminant Medicine, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Sandra Högler
- Institute of Pathology, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210, Vienna, Austria
| | - Michaela Gumpenberger
- Clinical Unit of Diagnostic Imaging, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210, Vienna, Austria
| | - Agnes Dadak
- Institute of Pharmacology and Toxicology, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210, Vienna, Austria
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Di Rienzo Businco L, Di Mario A, Tombolini M, Mattei A, Lauriello M. Eustachian tuboplasty and shrinkage of ostial mucosa with new devices : Including a proposal of a classification system. HNO 2019; 65:840-847. [PMID: 28361174 DOI: 10.1007/s00106-017-0346-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE A new combined approach to Eustachian tube dysfunction (ETD) employing new minimally invasive devices is described. STUDY DESIGN An anatomoclinical classification of ETD was conceived to allow correct categorization of patients and enable comparative studies to be performed. Herein, the authors report on their experience with a consecutive series of obstructive ETD patients treated by balloon dilation of the Eustachian tube using AERA (Acclarent, Menlo Park, CA, USA), combined with a quantic molecular resonance (QMR)-mediated rhinopharyngeal tubal ostial mucosa shrinkage technique with a dedicated "Mitto" hand piece (Telea, Sandrigo-Vicenza, Italy). METHODS A prospective study was conducted in 102 patients with ETD. Medical history, complete clinical ENT evaluation and oto-functional examinations were performed in all patients. In all cases, balloon dilatation of the Eustachian tube was performed via the transnasal approach under video-endoscopic control. This was followed by decongestion of the torus tubarius and the inferior turbinate by QMR, with immediate shrinkage of the mucosa of the turbinate and a reduction of the prolapse of the mucosal plica on the tubal ostium. RESULTS Comparison of pre- and postoperative oto-functional examinations revealed a significant improvement. The postoperative hearing symptoms were reduced in a statistically significant manner on the visual analog scale (VAS). It was possible to perform the postoperative "swallowing-opening-Toynbee-Valsalva" (SOTV) test in a significant percentage of cases compared to the preoperative test. CONCLUSION The combined surgical procedure of balloon tubodilation with simultaneous QMR-mediated shrinkage of the tubal ostial mucosa and reduction of the posterior portion of the inferior turbinate was found to be an effective, safe, and complete treatment for tubal dysfunction in the majority of patients.
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Affiliation(s)
- L Di Rienzo Businco
- Otorhinolaryngology Unit, S. Spirito Hospital, Lungotevere in Saxia, 1, 00193, Rome, Italy.
| | - A Di Mario
- Otorhinolaryngology Unit, S. Volto Clinic, Rome, Italy
| | - M Tombolini
- Otorhinolaryngology Unit, S. Volto Clinic, Rome, Italy
| | - A Mattei
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - M Lauriello
- Department of Experimental Medicine, University of L'Aquila, L'Aquila, Italy
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Nieminen H, Rinta-Kokko H, Jokinen J, Puumalainen T, Moreira M, Borys D, Schuerman L, Palmu AA. Effectiveness of the 10-valent pneumococcal conjugate vaccine among girls, boys, preterm and low-birth-weight infants - Results from a randomized, double-blind vaccine trial. Vaccine 2019; 37:3715-3721. [PMID: 31122856 DOI: 10.1016/j.vaccine.2019.05.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 04/25/2019] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Several studies have shown differences in susceptibility to infections and immune response to vaccines by sex. Prematurely born infants are at higher risk for pneumococcal diseases, with lower effectiveness for some vaccines compared to term infants. We have reported the effectiveness of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) on several endpoints in the Finnish Invasive Pneumococcal disease (FinIP) vaccine trial. Now, we present the results of a post-hoc analysis evaluating PHiD-CV10 effectiveness in subgroups by sex, gestational age, and birth weight. METHODS The FinIP trial was a phase III/IV cluster-randomized, double-blind trial. Infants enrolled < 7 months of age received PHiD-CV10 in two thirds of clusters (3 + 1 or 2 + 1 schedule) and hepatitis B vaccine as control in remaining third. Outcome data included invasive pneumococcal disease, pneumonia, tympanostomy tube placements, and antimicrobial purchases collected through national, routinely used health registers. Negative binomial model was used in the incidence and vaccine effectiveness estimation, and differences in incidences between subgroups were tested among control children. RESULTS Of the 30,527 infants enrolled 51% were boys. The incidences of hospital-diagnosed pneumonia and otitis-related outcomes were higher among boys in control groups. There were no significant sex differences in the vaccine effectiveness estimates. Altogether, 1519 (5%) infants were born before 37th gestational week. The incidences of pneumonia outcomes were higher among premature infants when compared to term infants. The vaccine effectiveness estimates among preterm infants were not statistically significant except for antimicrobial purchases, but all point estimates were at the same level among preterm infants as among term infants. There was no significant difference between 2 + 1 and 3 + 1 schedules in any of the subgroups analysed. CONCLUSION PHiD-CV10 had a similar effectiveness in both sexes, and seemed to be protective in preterm infants. TRIAL REGISTRATION ClinicalTrials.gov NCT00861380 and NCT00839254.
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Affiliation(s)
- H Nieminen
- Department of Public Health Solutions, National Institute for Health and Welfare, FinnMedi I, Biokatu 6, FI-33520 Tampere, Finland.
| | - H Rinta-Kokko
- Department of Public Health Solutions, National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
| | - J Jokinen
- Department of Public Health Solutions, National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
| | - T Puumalainen
- Department of Health Security, National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
| | - M Moreira
- GSK, Avenue Fleming 20, B-1300 Wavre, Belgium
| | - D Borys
- GSK, Avenue Fleming 20, B-1300 Wavre, Belgium
| | - L Schuerman
- GSK, Avenue Fleming 20, B-1300 Wavre, Belgium
| | - A A Palmu
- Department of Public Health Solutions, National Institute for Health and Welfare, FinnMedi I, Biokatu 6, FI-33520 Tampere, Finland
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Aboutalebian S, Mahmoudi S, Mirhendi H, Okhovat A, Abtahi H, Chabavizadeh J. Molecular epidemiology of otomycosis in Isfahan revealed a large diversity in causative agents. J Med Microbiol 2019; 68:918-923. [PMID: 31063125 DOI: 10.1099/jmm.0.000985] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To elucidate the clinical and microbial epidemiology of otomycosis in Isfahan, Iran. METHODOLOGY From January 2016 to January 2017 all patients clinically suspected of otomycosis at Al-Zahra Hospital, Isfahan, Iran were recruited. Specimens were taken using sterile swabs by an otorhinolaryngologist and subjected to culture and microscopy using potassium hydroxide and Giemsa stain. Isolated fungi were identified based on morphological and molecular characteristics. RESULTS Otomycosis was confirmed in 97/120 patients (80.8 %). Females (72.2 %) and patients aged 30-39 years (33 %) were more commonly affected than others. Manipulation of ear canal (62.9 %) was the most common predisposing factor. Pruritus was observed in 84.54 % of the patients followed by hearing impairment (81.4 %), and most episodes were detected over the summer (50.5 %). Culture was positive for 81 (83.5 %) of confirmed cases and molds were the most prevalent causative agents (n=51, 63 %) followed by yeasts (n=19, 23.4 %) and yeast/mold mixes (n=11, 13.6 %). For the 16 remaining patients, no growth was seen in culture despite a positive result on direct examination. In total, 92 isolates (63 molds and 29 yeasts) were recovered in culture. Application of molecular methods showed 18 fungal species and the vast majority of them belonged to Aspergillus (n=53, 57.6 %) and Candida genus. Among the species involved, Candida parapsilosis (n=22, 22.7 %) and Aspergillus tubingensis (n=15, 15.5 %) were the most encountered species. CONCLUSION Outcomes from this study showed a different picture of prevalence, where C. parapsilosis and A. tubingensis but not Aspergillus niger were the most species encountered from patients suffering from otomycosis.
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Affiliation(s)
- Shima Aboutalebian
- 1 Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Mahmoudi
- 2 Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- 3 Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Mirhendi
- 1 Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmadreza Okhovat
- 4 Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Abtahi
- 4 Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Javaher Chabavizadeh
- 1 Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Merino-Galvez E, Gomez-Hervas J, Perez-Mestre D, Llamas-Peiro JM, Perez-Gil E, Belda-Palazon M. Epidemiology of otorhinolaryngologic emergencies in a secondary hospital: analysis of 64,054 cases. Eur Arch Otorhinolaryngol 2019; 276:911-7. [PMID: 30805722 DOI: 10.1007/s00405-019-05331-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To determine the incidence and distribution of care in relation to urgent otorhinolaryngologic pathologies by the different medical specialist units. METHODS A descriptive, observational and retrospective study was conducted of patients seen by the Emergency Service at a secondary hospital over the course of 7 years (2011-2017). RESULTS A total of 546,701 patients were seen during the period in question, of which 64,054 presented with otorhinolaryngologic symptoms. The attendance rate was 450/1000 inhabitants/year. The most frequent diagnoses were upper respiratory tract infection, with 13,639 cases (21.3%), tonsillopharyngitis, with 10,150 cases (15.8%) and vertigo/dizziness with 8761 cases (13.7%). Patients seen by the Hospital Emergency Service physicians and those referred to the Otorhinolaryngology or Paediatric Units were analysed both together and separately. The Hospital Emergency Service dealt with 77.1% of the cases, and referred 15.4% to the Otorhinolaryngology Unit and 7.5% to the Paediatrics Unit. Within the subgroup of patients referred to the Otorhinolaryngology Unit, the most frequent diagnoses were problems related to inflammatory ear disease (25.6%), followed by cervicofacial trauma (15.4%) and bleeding with otorhinolaryngologic symptoms (12.5%). The percentage of hospital admissions for the entire sample was 3%, while for patients referred to the Otorhinolaryngology Unit this figure was 6.8%. CONCLUSIONS A large percentage of patients presenting at the Hospital Emergency Service do so with otorhinolaryngologic symptoms, and the vast majority are treated effectively by the physicians in that service and are referred to the specialist services on the basis of sound criteria.
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Zengel P. [Upper respiratory tract infections (sinusitis, otitis, laryngitis ect.)]. MMW Fortschr Med 2019; 161:40-44. [PMID: 30671826 DOI: 10.1007/s15006-019-0066-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Pamela Zengel
- HNOmedic, Institutstraße 14, D-81241, München, Deutschland.
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Michel V, Ulber C, Pöhle D, Köpke B, Engel K, Kaim U, Fawzy A, Funk S, Fornefett J, Baums CG, Eisenberg T. Clinical infection in house rats (Rattus rattus) caused by Streptobacillus notomytis. Antonie Van Leeuwenhoek 2018; 111:1955-1966. [PMID: 29671179 DOI: 10.1007/s10482-018-1085-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
Rat bite fever is an under-reported, under-diagnosed emerging zoonosis with worldwide distribution. Besides Spirillum minus, Streptobacillus moniliformis is the major causative microorganism although it usually colonises rats without any clinical signs. A group of house rats (Rattus rattus) kept in a zoo exhibition for educational purposes suffered from neurological signs including disorientation, torticollis, stall walking, ataxia and death. Gross pathological and histo-pathological examinations of the investigated rats revealed high-grade otitis interna et media, from which Streptobacillus notomytis was isolated in pure culture or as the predominant microorganism. This case series underlines a previously expressed hypothesis that R. rattus might be naturally colonised with S. notomytis, whereas the traditional rat bite fever organism, S. moniliformis, might be restricted to the Norway rat (Rattus norvegicus). However, the general paucity of Streptobacillus isolates, especially from their respective animal hosts, precludes definitive proof of these host tropisms. This is the first report of S. notomytis detection outside Asia and Australia and the first evidence for its role as a facultative pathogen in house rats.
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Affiliation(s)
- Viktoria Michel
- Naturschutz-Tierpark Görlitz e. V., Zittauer Str. 43, 02826, Görlitz, Germany
| | - Claudia Ulber
- Landesuntersuchungsanstalt für das Gesundheits- und Veterinärwesen Sachsen (LUA), Jägerstr. 8/10, 01099, Dresden, Germany
| | - Dietrich Pöhle
- Landesuntersuchungsanstalt für das Gesundheits- und Veterinärwesen Sachsen (LUA), Jägerstr. 8/10, 01099, Dresden, Germany
| | - Beate Köpke
- Landesuntersuchungsanstalt für das Gesundheits- und Veterinärwesen Sachsen (LUA), Jägerstr. 8/10, 01099, Dresden, Germany
| | - Katharina Engel
- Landesbetrieb Hessisches Landeslabor (LHL), Schubertstr. 60, 35392, Giessen, Germany
| | - Ute Kaim
- Landesbetrieb Hessisches Landeslabor (LHL), Schubertstr. 60, 35392, Giessen, Germany
| | - Ahmad Fawzy
- Landesbetrieb Hessisches Landeslabor (LHL), Schubertstr. 60, 35392, Giessen, Germany.,Faculty of Veterinary Medicine, Department of Medicine and Infectious Diseases, Cairo University, Giza Square, 12211, Egypt.,Institut für Hygiene und Infektionskrankheiten der Tiere, Justus-Liebig-Universität, Frankfurter Str. 89, 35392, Giessen, Germany
| | - Sophie Funk
- Veterinärmedizinische Fakultät, Zentrum für Infektionsmedizin, Institut für Bakteriologie und Mykologie, Universität Leipzig (IBML), An den Tierkliniken 29, 04103, Leipzig, Germany
| | - Juliane Fornefett
- Veterinärmedizinische Fakultät, Zentrum für Infektionsmedizin, Institut für Bakteriologie und Mykologie, Universität Leipzig (IBML), An den Tierkliniken 29, 04103, Leipzig, Germany
| | - Christoph Georg Baums
- Veterinärmedizinische Fakultät, Zentrum für Infektionsmedizin, Institut für Bakteriologie und Mykologie, Universität Leipzig (IBML), An den Tierkliniken 29, 04103, Leipzig, Germany
| | - Tobias Eisenberg
- Landesbetrieb Hessisches Landeslabor (LHL), Schubertstr. 60, 35392, Giessen, Germany. .,Institut für Hygiene und Infektionskrankheiten der Tiere, Justus-Liebig-Universität, Frankfurter Str. 89, 35392, Giessen, Germany.
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Pavić I, Babić I, Matijašić N, Hojsak I. Combined multichannel intraluminal impedance-pH monitoring should be used to diagnose reflux-related otitis media with effusion in children. Acta Paediatr 2018; 107:1642-1647. [PMID: 29603354 DOI: 10.1111/apa.14339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/26/2017] [Accepted: 03/22/2018] [Indexed: 12/14/2022]
Abstract
AIM This study investigated the diagnostic usefulness of combined multichannel intraluminal impedance-pH monitoring (MII-pH) in children with suspected reflux-related otitis media with effusion (OME) as existing data were scarce. METHODS This was a prospective study that included children up to seven years of age who underwent MII-pH due to OME lasting more than three months. The study was conducted in the Children's Hospital Zagreb, Croatia, from January 2014 to August 2016. RESULTS The study comprised 63 children (63% male) with a mean age of 4.7 years. Gastroesophageal reflux (GER) disease was detected by impedance in 22 (35%) of the children and by pH-metry in nine (14%). In children with OME, MII-pH found a median number of 24 proximal GER episodes, of which a median of nine was acidic and a median of 11 was weakly acidic. There was a significant positive correlation between the number of GER episodes and the presence of eosinophils in nasal swabs. CONCLUSION Both acidic and weakly acidic refluxes seemed to play a significant role in the pathogenesis of OME. Localised nasal eosinophilia may serve as a marker of extraoesophageal reflux in children with suspected reflux-related OME.
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Affiliation(s)
- Ivan Pavić
- Department of Pulmonology, Allergology and Immunology, Children's Hospital Zagreb, Zagreb, Croatia
| | - Irena Babić
- Otorhinolaryngology Department, Children's Hospital Zagreb, Zagreb, Croatia
| | - Nuša Matijašić
- Department of Pulmonology, Allergology and Immunology, Children's Hospital Zagreb, Zagreb, Croatia
| | - Iva Hojsak
- Referral Centre for Paediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
- University J.J. Strossmayer School of Medicine Osijek, Osijek, Croatia
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Nhan C, Bezdjian A, Saha S, Prakash S, Nguyen LHP, Daniel SJ. Safety of transtympanic application of probiotics in a chinchilla animal model. J Otolaryngol Head Neck Surg 2017; 46:63. [PMID: 29166927 DOI: 10.1186/s40463-017-0242-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 11/08/2017] [Indexed: 11/16/2022] Open
Abstract
Background Chronic suppurative otitis media can be recalcitrant and difficult to treat, particularly with the increasing occurrence of antibiotic resistance. Lactobacillus plantarum is a probiotic that has been shown to decrease S. aureus and P. aeruginosa growth in wounds, making it a good candidate for the treatment of chronic suppurative otitis media. However, before it can be applied in the ear, its ototoxicity potential must be evaluated. Methods A prospective controlled trial was conducted in a chinchilla animal model at the Animal care research facilities of the Montreal Children’s Hospital Research Institute to determine whether Lactobacillus plantarum is ototoxic when applied transtympanically. Ten chinchillas each had one ear randomly assigned to receive 109 CFU/mL of Lactobacillus plantarum solution, while the contralateral ear received saline. Auditory brainstem responses were measured bilaterally at 8, 20, 25 kHz before, at 7–10 days after application, and at 28 days after application of probiotic or saline. Facial nerve and vestibular function were assessed clinically. Results There were no statistically significant differences in hearing thresholds between control and experimental ears at 28 days after application. A difference of 11 dB was noted in the 25 kHz range at day 7–10, but resolved by day 28. No animals receiving probiotics developed vestibular nerve dysfunction. There was no histologic evidence of auditory hair cell damaged evidenced by scanning electron microscopy. Conclusion Our study suggests that a single application of Lactobacillus plantarum at 109 CFU/mL does not cause ototoxicity in a chinchilla animal model. These preliminary safety evaluations and the pathogen inhibitory effects of L. plantarum demonstrated by previous studies present this probiotic as a candidate of interest for further investigation. Electronic supplementary material The online version of this article (10.1186/s40463-017-0242-y) contains supplementary material, which is available to authorized users.
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Bansal M. Why Cannot We have an Etiological Classification for the Patients with Granular Myringitis? Indian J Otolaryngol Head Neck Surg 2017; 69:397-400. [PMID: 28929075 DOI: 10.1007/s12070-016-1003-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/06/2016] [Indexed: 10/21/2022] Open
Abstract
Though granular myringitis (GM) is not a very rare disease it does not have any classification. Its exact etiology is not known. The granulations on tympanic membrane also occur in association with other lesions of external auditory canal (EAC) and middle ear. The aims of this study were to know the etiological factors of GM and classify the disease according to its etiological factors and associated disorders of EAC and middle ear. Data were retrieved from the search of four electronic databases: PubMed, EMBASE, Cochrane Library, and Google scholar. Relevant articles were also sought by a hand search review of reference books. The databases were searched using the key words otitis externa, external otitis, granular myringitis, granular otitis externa and myringitis. Data were extracted using a pre-defined data-extraction form. The following data were recorded (1) etiological and predisposing conditions; (2) pathological features; (3) associated disorders of external and middle ear. The study proposes the etiological classification of GM. It suggests two major groups: primary and secondary. The primary GM is basically idiopathic and these patients do no have evidences of any other types of otitis media and otitis externa. In the secondary GM the cause is obvious and the patients usually have associated otitis media and/or lesions of external ear canal. Author speculates that habit of self ear cleaning/scratching is a specific etiological factor in cases of primary GM but more studies are required to confirm this theory.
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Affiliation(s)
- Mohan Bansal
- Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat India
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Affiliation(s)
- Sara Torretta
- Otolaryngology Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
| | - Paola Marchisio
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy
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Teixeira AGV, McArt JAA, Bicalho RC. Efficacy of tildipirosin metaphylaxis for the prevention of respiratory disease, otitis and mortality in pre-weaned Holstein calves. Vet J 2017; 219:44-8. [PMID: 28093111 DOI: 10.1016/j.tvjl.2016.12.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 11/09/2016] [Accepted: 12/07/2016] [Indexed: 11/21/2022]
Abstract
The aim of this study was to evaluate the efficacy of two metaphylactic approaches (long acting antibiotic injected once at 10 days of life or twice at 10 and 35 days of life) on the prevention of bovine respiratory disease (BRD), otitis and mortality in high-risk group-housed pre-weaned Holstein heifer calves. The antibiotic of choice for the metaphylactic approach was a long acting macrolide (tildipirosin) administered subcutaneously at the base of the neck at a dose of 1 mL per 45 kg body weight. A clinical trial was carried out on one dairy farm with random allocation of newborn calves to one of three treatments: (1) control (CTR); (2) one injection at 10 days of life (M1); and (3) two injections at 10 and 35 days of life (M2). Study heifers (n = 795) were reared in group pens of 25 calves per pen and fed unrestricted acidified non-saleable milk from day 1 to day 65 of life. Cox proportional hazard and general linear mixed models were used to evaluate the effect of treatment on mortality, BRD and otitis, and average daily weight gain. The birth weights, proportions of calves with inadequate transfer of passive immunity, proportions of calves born from primiparous dams and proportions of calves born from assisted parturitions were not different among CTR, M1 and M2 treatments. A significantly lower hazard of being affected with BRD and/or otitis (but not for BRD or otitis alone) was observed for M1 (hazard ratio, HR = 0.70, P = 0.009) and M2 (HR = 0.72, P = 0.01) when compared to the CTR group. Metaphylactic treatments had no effect on mortality, otitis and average daily weight gain during the pre-weaning period.
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Abstract
Otitis externa and media are frequently diagnosed disorders in rabbits and are particularly common in lop-eared breeds because of the specific anatomy of the ear canal. Medical management for otitis externa and media often provides only a temporary improvement in clinical signs. Surgery by means of partial or total ear canal ablation (PECA or TECA) combined with lateral bulla osteotomy (LBO) represents a feasible approach that is well tolerated and provides a good clinical outcome. Short-term complications associated with PECA/TECA-LBO include facial nerve paralysis and vestibular disease.
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Affiliation(s)
- Rebecca Csomos
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
| | - Georgia Bosscher
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA
| | - Christoph Mans
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA.
| | - Robert Hardie
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, USA.
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Stojković D, Barros L, Petrović J, Glamoclija J, Santos-Buelga C, Ferreira ICFR, Soković M. Ethnopharmacological uses of Sempervivum tectorum L. in southern Serbia: Scientific confirmation for the use against otitis linked bacteria. J Ethnopharmacol 2015; 176:297-304. [PMID: 26551879 DOI: 10.1016/j.jep.2015.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Sempervivum tectorum L. (Crassulaceae), known as houseleek, is used in traditional medicine in the treatment of ear inflammation. It can be spread as a pack on wounds, sores, burns, and abscesses and also on painful areas attacked by gout as a refrigerant and astringent. Drinking tea prepared from leaves of S. tectorum is recommended for ulcer treatment. The present study was designed to investigate ethopharmacological use of S. tectorum in the southern Serbia and to further scientifically justify and confirm effectiveness of the leaf juice used in ethnomedicine for ear inflammation, against otitis linked bacteria. MATERIAL AND METHODS Ethnopharmacological survey on the use of S. tectorum in southern Serbia was performed using semi structured questionnaires via a face-to-face interview. Chemical composition of the leaf juice regarding phenolic compounds and organic acids was analyzed. Antimicrobial activity was tested on bacteria isolated from ear swabs of the patients suffering from the ear pain (otitis). Anti-quorum-sensing activities of the juice were further investigated on Pseudomonas aeruginosa. RESULTS Ethnopharmacological survey revealed the use of S. tectorum in southern Serbia for the treatment of ear pain, warts, cancer, stomachache, ulcer and high blood sugar level with the highest fidelity level (FL) for the ear pain. The phenolic composition of the S. tectorum leaf juice consisted of flavonol glycosides, with kaempferol-3-O-rhamnosyl-glucoside-7-O-rhamnoside as the majority compound. Organic acids composition revealed malic acid as the most dominant one. Antimicrobial and anti-quorum-sensing activities of the juice showed to be promising. CONCLUSION Ethnopharmacological use of S. tectorum juice for treating ear pain is justified, since the juice possessed antimicrobial activity towards clinical isolates of bacteria linked to otitis.
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Affiliation(s)
- Dejan Stojković
- Institute for Biological Research "Siniša Stanković", Department of Plant Physiology, University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia.
| | - Lillian Barros
- Mountain Research Centre (CIMO), School of Agriculture, Polytechnic Institute of Bragança, Campus de Santa Apolónia, 1172, 5301-855 Bragança, Portugal
| | - Jovana Petrović
- Institute for Biological Research "Siniša Stanković", Department of Plant Physiology, University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
| | - Jasmina Glamoclija
- Institute for Biological Research "Siniša Stanković", Department of Plant Physiology, University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
| | - Celestino Santos-Buelga
- Grupo de Investigación en Polifenoles (GIP-USAL), Faculty of Pharmacy, University of Salamanca, Campus Miguel de Unamuno, 37007 Salamanca, Spain
| | - Isabel C F R Ferreira
- Mountain Research Centre (CIMO), School of Agriculture, Polytechnic Institute of Bragança, Campus de Santa Apolónia, 1172, 5301-855 Bragança, Portugal.
| | - Marina Soković
- Institute for Biological Research "Siniša Stanković", Department of Plant Physiology, University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade, Serbia
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Morris MC, Almudevar AL, Casey JR, Pichichero ME. Familial and microbiological contribution to the otitis-prone condition. Int J Pediatr Otorhinolaryngol 2015; 79:2174-7. [PMID: 26490785 PMCID: PMC4972179 DOI: 10.1016/j.ijporl.2015.09.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/24/2015] [Accepted: 09/30/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Our group has an ongoing clinical research project investigating the immunology of the otitis-prone (OP) phenotype. In light of evidence that this condition arises from underlying immunological defects, we examined our sample population of stringently defined OP (sOP) children suffering 3 episodes of acute otitis media within 6 months or 4 within a year for a familial association with the sOP phenotype. METHODS We analyzed the frequency of sOP within and between families and the nasopharyngeal (NP) otopathogen colonization patterns within and between families. RESULTS The presence of sOP siblings significantly predicted that additional children in the same family would likewise become sOP, with an odds ratio of 3.7 (95% CI 0.77-15.2, 95% lower bound 0.95). We further present evidence for an environmental contribution to this effect by means of prolonged exposure to otopathogens within family units. CONCLUSION sOP children have a significant familial association. The tendency of siblings to share similar patterns of microbial NP colonization contributes to this association. Further research is necessary to determine whether and to what extent genetics are involved.
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Affiliation(s)
- Matthew C. Morris
- Research Institute, Rochester Regional Health Systems, 1425 Portland Avenue, Rochester, NY 14621
| | - Anthony L. Almudevar
- Department of Biostatistics and Computational Biology, University of Rochester, 265 Crittenden Boulevard, Rochester, NY 14642
| | - Janet R. Casey
- Research Institute, Rochester Regional Health Systems, 1425 Portland Avenue, Rochester, NY 14621,Legacy Pediatrics, 1815 S Clinton Avenue No. 360, Rochester, NY 14618
| | - Michael E. Pichichero
- Research Institute, Rochester Regional Health Systems, 1425 Portland Avenue, Rochester, NY 14621,Legacy Pediatrics, 1815 S Clinton Avenue No. 360, Rochester, NY 14618,Correspondence: Michael E. Pichichero, MD, Rochester General Hospital Research Institute, 1425 Portland Avenue, Rochester, NY 14621, 585-922-5959,
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Voget M, Lorenz D, Lieber-Tenorio E, Hauck R, Meyer M, Cieslicki M. Is transmission electron microscopy (TEM) a promising approach for qualitative and quantitative investigations of polymyxin B and miconazole interactions with cellular and subcellular structures of Staphylococcus pseudintermedius, Escherichia coli, Pseudomonas aeruginosa and Malassezia pachydermatis? Vet Microbiol 2015; 181:261-70. [PMID: 26527257 DOI: 10.1016/j.vetmic.2015.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 09/29/2015] [Accepted: 10/02/2015] [Indexed: 11/30/2022]
Abstract
Antimicrobial therapy using a combination of polymyxin B and miconazole is effective against the main bacterial pathogens associated with otitis externa in dogs, and a synergistic effect of both drugs has been shown previously. The objective of the present investigation was to visualize ultrastructural changes after exposure of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus pseudintermedius and Malassezia pachydermatis to polymyxin B and miconazole by transmission electron microscopic (TEM). For this, cultures of E. coli, P. aeruginosa, S. pseudintermedius and M. pachydermatis were exposed to polymyxin B and miconazole, alone or in combination for 24 h. Ultrastructural changes were observed most frequently in the cell envelope of the four microorganisms. Exposure to polymyxin B seemed to cause more damage than miconazole within the range of concentrations applied. Treatment resulted in changes of the cell size: in E. coli, cell size increased significantly after treatment with either compound alone; in P. aeruginosa, cell size decreased significantly after treatment with polymyxin B and with miconazole; exposure of S. pseudintermedius to miconazole caused a decrease in cell size; in M. pachydermatis, cell size increased significantly after treatment with polymyxin B.; in E.coli, S. pseudintermedius and M. pachydermatis, cell size changed highly significant, in P. aeruginosa significantly after exposure to the combination of both compounds. In conclusion, by using a different approach than previous investigations, this study confirmed a clear combinatory effect of polymyxin B and miconazole against the tested microorganisms involved in canine otitis externa. It is the first time that visualization technologies were applied to compare the effect of single drugs to their combinatory effects on cellular and subcellular entities of selected bacterial and yeast species.
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Affiliation(s)
| | - Dorothea Lorenz
- Leibnitz Institut für molekulare Pharmakologie, Berlin, Germany
| | | | - Ruediger Hauck
- Freie Universität Berlin, Fachbereich Veterinärmedizin, Germany
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