Malignant otitis externa in a healthy non-diabetic patient.

Science.gov (United States)

Liu, Xiao-Long; Peng, Hong; Mo, Ting-Ting; Liang, Yong

2016-08-01

A healthy 60-year-old male was initially treated for external otitis, and subsequently received multiple surgeries including abscess drainage, temporal bone debridement, canaloplasty of the external auditory meatus, and fistula excision and was treated with numerous antibiotics at another hospital over a 1-year period. He was seen at our hospital on February 14, 2014 with a complaint of a non-healing wound behind the left ear and drainage of purulent fluid. He had no history of diabetes mellitus or compromised immune function. Computed tomography (CT) and magnetic resonance imaging (MRI) studies at our hospital showed osteomyelitis involving the left temporal, occipital, and sphenoid bones, the mandible, and an epidural abscess. Routine blood testing and tests of immune function were normal, and no evidence of other infectious processes was found. He was diagnosed with malignant otitis externa (MOE). Bone debridement and incision and drainage of the epidural abscess were performed, and vancomycin was administered because culture results revealed Corynebacterium jeikeium, Corynebacterium xerosis, and Enterococcus faecalis. MOE should be considered in healthy patients with external otitis who fail initial treatment.

The treatment of pseudoaneurysms with flow diverters after malignant otitis externa.

Science.gov (United States)

Németh, Tamás; Szakács, László; Bella, Zsolt; Majoros, Valéria; Barzó, Pál; Vörös, Erika

2017-12-01

Background We report a case of bilateral malignant otitis externa complicated with bilateral petrous internal carotid artery pseudoaneurysms and their successful treatment with a flow diverter. Case report A 68-year-old woman with serious complications of type II diabetes mellitus had malignant otitis externa on the right side. She was treated with combined antibiotic therapy and underwent mastoidectomy for mastoiditis. She presented at our hospital with acute hemorrhage from the right external auditory canal. The emergency computed tomography (CT) angiography revealed a multiobulated pseudoaneurysm at the petrous segment of the right internal carotid artery. The pseudoaneurysm was treated with a 5 × 40-mm Surpass flow diverter. Three months later, she developed a malignant external otitis on the left side. As the infection progressed, a left-sided mastoiditis, a brain abscess, and a pseudoaneurysm at the petrous segment of the left internal carotid artery developed. The pseudoaneurysm caused bleeding from the left ear, and was treated with a 5 × 50-mm Surpass flow diverter. No recurrent bleeding was observed. Four months later, a follow-up angiography showed complete occlusion of the pseudoaneurysm on the left side, but a residual aneurysm could be detected on the right side. One year after the first intervention, the follow-up CT and magnetic resonance angiography revealed the complete occlusion of the aneurysms bilaterally. Conclusion The use of a flow diverter appears to be an efficient and safe method to occlude carotid pseudoaneurysms even in an inflammatory milieu.

Skull base osteomyelitis in otitis externa: The utility of triphasic and single photon emission computed tomography/computed tomography bone scintigraphy

International Nuclear Information System (INIS)

Chakraborty, Dhritiman; Bhattacharya, Anish; Gupta, Ashok Kumar; Panda, Naresh Kumar; Das, Ashim; Mittal, Bhagwant Rai

2013-01-01

Skull base osteomyelitis (SBO) refers to infection that has spread beyond the external auditory canal to the base of the skull in advanced stages of otitis externa. Clinically, it may be difficult to differentiate SBO from severe otitis externa without bony involvement. This study was performed to determine the role of three phase bone scintigraphy (TPBS) and single photon emission tomography/computed tomography (SPECT/CT) in detecting SBO. We retrospectively analyzed records of 20 patients (14 M, 6 F) with otitis externa and suspected SBO. TPBS and SPECT/CT of the skull were performed. Findings were correlated with clinical, laboratory and diagnostic CT scan findings. All patients were diabetic with elevated erythrocyte sedimentation rate. A total of 18 patients had bilateral and two unilateral symptoms. Cranial nerves were involved in eight patients and microbiological culture of ear discharge fluid positive in seven. Early images showed increased temporal vascularity in nine patients and increased soft-tissue uptake in 10, while delayed images showed increased bone uptake in 19/20 patients. Localized abnormal tracer uptake was shown by SPECT/CT in the mastoid temporal (15), petrous (11), sphenoid (3) and zygomatic (1) and showed destructive changes in five. Thus, TPBS was found positive for SBO in 10/20 patients and changed the management in four. Our study suggests that TPBS with SPECT/CT is a useful non-invasive investigation for detection of SBO in otitis externa

Antimicrobial susceptibility and Ribosomal-RNA gene restriction patterns among Staphylococcus-intermedius from healthy dogs and from dogs sufferning from pyoderma or otitis-externa

DEFF Research Database (Denmark)

Pedersen, Karl; Wegener, Henrik Caspar

1995-01-01

A total of 60 Staphlococcus intermedius strains from dogs were investigated by their sensitivity to various antibiotics (50 strains) and by their rRNA gene restriction patterns (ribotyping) (60 strains). Fifteen isolates were from healthy dogs, 9 with otitis externa, and 36 with pyoderma, including......, enrofloxacin, and sulphonamides with trimethoprim. There were no significant differences in antimicrobial susceptibility patterns observed among isolates from pyoderma, otitis externa or healthy dogs. Among the 60 strains studied by ribotyping, 10 different ribotypes were identified: 6 different ribotypes...... among isolates from otitis externa, 8 among isolates from pyoderma, and 5 among isolates from healthy dogs. One ribotype (profile C) was dominant among the isolates from healthy dogs while another ribotype (profile A) was dominant among strains from dogs suffering from pyoderma. This profile...

Diagnosis and medical treatment of otitis externa in the dog and cat : review article

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L.S. Jacobson

2002-07-01

Full Text Available Otitis externa is no longer viewed as an isolated disease of the ear canal, but is a syndrome that is often a reflection of underlying dermatological disease. Causes are classified as predisposing (increase the risk of otitis ; primary (directly induce otitis, secondary (contribute to otitis only in an abnormal ear or in conjunction with predisposing factors and perpetuating (result from inflammation and pathology in ear, prevent resolution of otitis. Common primary causes include foreign bodies, hypersensitivity (particularly atopy and food allergy, keratinisation disorders (most commonly primary idiopathic seborrhoea and hypothyroidism and earmites, particularly in cats. A systematic diagnostic procedure is required to identify causes and contributing factors. This should include history, clinical examination, otoscopy and cytology in all cases and culture and sensitivity as well as otitis media assessment and biopsy in severe and recurrent cases. Ancillary tests may be required depending on the underlying cause. Treatment consists of identifying and addressing predisposing and primary factors ; cleaning the ear canal ; topical therapy ; systemic therapy where necessary ; client education ; follow-up ; and preventive and maintenance therapy as required.

Atividade antimicrobiana in vitro de produtos vegetais em otite externa aguda In vitro antimicrobial activity of plants in Acute Otitis Externa

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Janaina Cândida Rodrigues Nogueira

2008-02-01

Full Text Available Otite externa aguda é a inflamação do conduto auditivo externo, e plantas medicinais podem ser utilizadas, na cultura popular, para seu tratamento. OBJETIVO: Avaliar atividade antimicrobiana in vitro de Aleolanthus suaveolens, Caryophyllus aromaticus, Cymbopogon citratus, Matricaria chamomila, Pithecellobium avaremotemo, Plectranthus amboinicus e Ruta graveolens sobre agentes etiológicos de otite externa. CASUÍSTICA E MÉTODOS: A concentração inibitória mínima de extratos e óleos destas plantas foi obtida em amostras de otite externa. RESULTADOS: Staphylococcus aureus em 10 culturas, Pseudomonas aeruginosa em 8, Pseudomonas aeruginosa e Staphylococcus aureus, em associação, em 5 culturas e Candida albicans e Candida krusei em 4 culturas. P. aeruginosa foi resistente a todos os extratos e óleos essenciais testados; os extratos de A. suaveolens, P. avaremotemo e de R. graveolens foram inativos, o óleo essencial de C. aromaticus e M. chamomila foram ativos contra 3 cepas de S. aureus e as cepas de Candida; Sete das cepas de S. aureus foram sensíveis ao extrato de P. amboinicus, mas o óleo não mostrou atividade, 4 cepas de S.aureus e as cepas de Candida foram sensíveis ao óleo essencial de R. graveolens. CONCLUSÃO: Algumas plantas apresentaram resultados satisfatórios, dependendo do agente etiológico, porém se faz necessário estudos mais detalhados, para melhorar o aproveitamento destas plantas.Acute Otitis Externa is an inflammation of the outer auditory meatus, and according to popular saying, medicinal plant extracts can be used in its treatment. AIM: to assess the in vitro antimicrobial activity of the following plants: Aleolanthus suaveolens; Caryophyllus aromaticus; Cymbopogon citratus; Matricaria chamomila; Pithecellobium avaremotemo; Plectranthus amboinicus and Ruta graveolens on the germs that cause otitis externa. MATERIALS AND METHODS: the minimum inhibitory concentration of extracts and oils from these plants was

Traditional Mediterranean plants: characterization and use of an essential oils mixture to treat Malassezia otitis externa in atopic dogs.

Science.gov (United States)

Nardoni, Simona; Pistelli, Luisa; Baronti, Ilenia; Najar, Basma; Pisseri, Francesca; Bandeira Reidel, Rose Vanessa; Papini, Roberto; Perrucci, Stefania; Mancianti, Francesca

2017-08-01

Several plants extracts from Mediterranean countries are traditionally employed in skin troubles both in humans and in animals. Malassezia pachydermatis is a lipophylic yeast responsible for otitis externa and dermatitis in dogs and for cutaneous and systemic disease in humans. Five mixtures of essential oils obtained from Mediterranean plants (Citrus paradisi, Salvia sclarea, Ocimum basilicum, Rosmarinus officinalis, Citrus limon, Anthemis nobilis, Lavandula hybrida and Thymus vulgaris) provided with antifungal and/or anti-inflammatory action assayed in vitro, were tested in vivo versus M. pachydermatis to treat once daily for 2 weeks 25 atopic dogs with Malassezia otitis externa. Mixture composed by C. limon 1%, S. sclarea 0,5%, R. officinalis 1%, A. nobilis 0,5% yielded excellent results in all treated dogs. Despite of clinical resolution after all treatments the number of blastospores did not decrease. This study confirms recent findings suggesting a multifactorial alternative approach for the management of canine Malassezia otitis.

Impact of a terbinafine-florfenicol-betamethasone acetate otic gel on the quality of life of dogs with acute otitis externa and their owners.

Science.gov (United States)

Noli, Chiara; Sartori, Roberta; Cena, Tiziana

2017-08-01

Treatment of canine otitis externa with owner-administered products can be difficult. To evaluate otic treatment administered by a veterinarian on quality of life (QoL) of dogs with otitis externa and their owners, and on clinical and cytology parameters of otitis; compared to an owner-administered treatment. Fifty client-owned dogs randomly randomized into two groups and treated for 2 weeks. Veterinarians treated Group A dogs with a veterinary licensed otic gel on two occasions at a 1 week interval; owners treated Group B dogs once daily with a veterinary licensed otic drop based product along with twice weekly cleaning. Veterinarians evaluated otitis with the OTI-3 scale and semi-quantitative cytological examination on days 0, 7, 14 and 28. At each visit, owners assessed QoL with a validated questionnaire and pruritus with a Visual Analog Scale. Scores before and after treatment of each group, and differences between groups were analysed statistically. In both groups, all parameters improved significantly. There was a significantly higher improvement of QoL scores, for dogs and owners, in Group A, compared to Group B at all time points (P otitis externa and their owners, compared to an owner-administered topical otic therapy. © 2017 The Authors. Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of the ESVD and the ACVD.

Antibacterial and Antifungal Activity of Essential Oils against Pathogens Responsible for Otitis Externa in Dogs and Cats.

Science.gov (United States)

Ebani, Valentina V; Nardoni, Simona; Bertelloni, Fabrizio; Najar, Basma; Pistelli, Luisa; Mancianti, Francesca

2017-04-21

Background: Essential oils (EOs) are recommended by some veterinarians to treat otitis externa in pets, but data about their efficacy in scientific literature are very scant. Methods: Nine commercial EOs, from roman chamomile ( Anthemis nobilis L.), star anise ( Illicium verum ), lavender ( Lavandula hybrida ), litsea ( Litsea cubeba (Lour.) Pers.), basil ( Ocimum basilicum L.), oregano ( Origanum vulgare L. subsp. hirticum ), rosemary ( Rosmarinus officinalis L.), clary sage ( Salvia sclarea L.), and thyme ( Thymus vulgaris L.) were tested against bacterial and fungal pathogens previously isolated from dogs and cats with otitis externa. In particular, the analyses were carried out against Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus pseudointermedius , Aspergillus niger, Aspergillus fumigatus, Aspergillus terreus, Candida albicans, Candida tropicalis, Trichosporon sp., and Rhodotorula sp. Results: O. vulgare and S. sclarea showed superior antibacterial activity, even if not against all the strains. Trichosporon sp., C. albicans , and A. terreus were insensitive to most Eos, while other yeasts and molds showed different degrees of sensitivity. In particular, most fungi were inhibited by O. vulgare and R. officinalis . Conclusions: The obtained results suggest that some EOs could be included in treatment as an alternative therapeutic option in bacterial otitis complicated by fungi, in association with conventional drugs.

Temporal Bone Osteomyelitis: The Relationship with Malignant Otitis Externa, the Diagnostic Dilemma, and Changing Trends

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Jia-Cheng Chen

2014-01-01

Full Text Available Fifty-five patients hospitalized for osteomyelitis of the temporal bone between 1990 and 2011 were divided into two study groups: group 1 was patients collected from 1990 to 2001 and group 2 was composed of patients between 2002 and 2011. Clinical diagnostic criteria and epidemiologic data were analyzed to illustrate the altering features of osteomyelitis of the temporal bone. Group 1 patients were characterized by high prevalence of diabetes and more commonly suffered from otalgia, otitis externa and granulation tissue in the external auditory canal and higher positive culture for Pseudomonas aeruginosa. Noticeable changing trends were found between both groups, including declining prevalence of diabetes, fewer patients complaining of pain or presenting with otitis externa, and canal granulation, and increased variety of pathogens in group 2. We should highlight the index of clinical suspicion for osteomyelitis of the temporal bone, even in nondiabetic or immunocompetent patients. Painless otorrhea patients were also at risk of osteomyelitis of the temporal bone, especially patients with previous otologic operation. Increased multiplicity of pathogens amplified the difficulty of diagnosis for osteomyelitis of the temporal bone.

CT of malignant otitis externa

International Nuclear Information System (INIS)

Klose, K.C.; Elies, W.; Technische Hochschule Aachen

1991-01-01

Computed tomography was performed preoperatively in 20 patients suffering from malignant external otitis. The CT findings were nearly completely confirmed by the intraoperative findings. A circumscribed or diffuse thickening of the cartilaginous wall of the external auditory canal and an inflammatory infiltration of the subtemporal fossa are, in combination, most suspicious signs of malignant external otitis. Computed tomography enabels detailed information on the extension of the pneumatic system and the grade of involvement of bones and soft tissues in malignant external otitis. A modified classification of malignant external otitis based on computed tomographic findings is proposed. (orig.) [de

Malignant otitis externa: Variability of clinical course and difficulties of diagnostics

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Janićijević Miloš

2014-01-01

Full Text Available This paper shows the case of a 70-year-old diabetic patient who was admitted to the ORL and MFS clinic as an emergency case with the right ear otalgia, in the right mastoid extension, facialis paralysis and the right ear suppuration all of which lasted for a month before the hospitalization. On admission, the initial diagnostics stated canal skin edema of the external hearing canal which made the eardrum impossible to visualize. Granulations at the bottom of the canal were visible. During the admission, the patient was submitted to conservative and surgical treatments which confirmed that it was the case of malignant otitis externa.

Bacterial and fungal organisms in otitis externa patients without fungal infection risk factors in Erzurum, Turkey Organismos bacterianos e fúngicos em pacientes com otite externa sem fatores de risco para infecção fúngica em Erzurum, Turquia

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Murat Enoz

2009-10-01

Full Text Available AIM: To describe the bacterial and fungal organisms in otitis externa patients without other risk factors for fungal infections. STUDY DESIGN: Cross sectional cohort descriptive study. MATERIALS AND METHODS: Ear swabs were obtained from 362 patients aged 1 to 55 years old with clinically diagnosed otitis externa in Erzurum, Turkey, between January 2006 and April 2007, and cultured for aerobic and anaerobic bacteria and fungi, using EMB, 5% sheep's blood, chocolate agar, anaerobic blood agar plate, thioglycollate broth and sabaroud agar using standard microbiological technique to diagnose isolates. RESULTS: 219 cultures were positive and a total of 267 isolates were obtained. Of the isolates, 68.16% (n: 182 were aerobic or facultative bacteria, 1.12 % (3 were anaerobic bacteria, 30.71 % (82 were fungi and 17.5 % (38 were polymicrobial infections. CONCLUSION: Fungal organisms especially Candida species may be isolated from ears of otitis externa patients without fungal infection risk factors such as ear self-cleaning, local antimicrobial, antifungal or corticosteroid drops or systemic antimicrobial or antifungal agents within the preceding week. Bacterial and fungal cultures may be recommended, and anti-fungal agents may be added, to treatment regimens in patients with otitis externa.OBJETIVO: Descrever fungos e bactérias presentes em pacientes com otite externa sem fator de risco para infecções fúngicas. FORMA DE ESTUDO: Estudo descritivo de coorte transversal. MATERIAIS E MÉTODOS: Amostras por raspagem de cotonetes (swabs no ouvido foram obtidas de 362 pacientes com idades entre 1 e 55 anos, com diagnóstico clínico de otite externa em Erzurum, Turquia, entre janeiro de 2006 e abril de 2007. Essas amostras foram cultivadas em meio de cultura, 5% de sangue de ovelha, ágar chocolate, ágar sangue anaeróbio, banho em tioglicolato e ágar Saboroud, usando técnicas padrão de microbiologia para identificar os isolados. RESULTADOS: Obtivemos

Central skull base osteomyelitis as a complication of necrotizing otitis externa: Imaging findings, complications, and challenges of diagnosis

International Nuclear Information System (INIS)

Adams, A.; Offiah, C.

2012-01-01

Central skull base osteomyelitis is a rare, life-threatening complication of necrotizing or “malignant” otitis externa (NOE), which results in destruction of the skull base. The imaging appearances can be misinterpreted as malignancy but consideration of this diagnosis, both radiologically and clinically, is imperative to avoid the need for biopsy. The aim of this review is to highlight the pertinent imaging findings on computed tomography and magnetic resonance imaging as well as the potential complications of this condition.

Acute otitis media: characterization and risk factors

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Amalia Nieves Álvarez

2011-03-01

Full Text Available La otitis media aguda es una de las infecciones respiratorias superiores más frecuentes en la infancia, fundamentalmente en niños menores de seis años. Su elevada incidencia y recidiva se deben a la interacción entre diferentes factores de riesgo. El signo más específico de presentación es la otalgia, acompañándose de fiebre, malestar y disminución de la audición.Por la frecuencia de niños con otitis media aguda en las consultas externas y de urgencia del hospital, nos planteamos conocer su comportamiento en el grupo estudiado. Se realizó un estudio descriptivo longitudinal retrospectivo a los pacientes que acudieron a consulta de Otorrinolaringología con otitis media aguda del Hospital Pediátrico Universitario Centro Habana, ubicado en La Habana, en el período comprendido entre enero de 2006 hasta diciembre de 2009. Se caracterizaron los pacientes en cuanto a edad, sexo, factores predisponentes, manifestaciones clínicas, etapa clínica de la otitis, recurrencia y tratamiento. Resultados: El sexo masculino y los menores de cinco años fueron los más afectados. Los factores de riesgo predominantes fueron el tabaquismo pasivo, asistencia a círculos infantiles y lactancia materna insuficiente. Las manifestaciones clínicas más frecuentes fueron los síntomas catarrales, otalgia y fiebre. La otitis media con trasudado fue la etapa clínica más observada. El grupo de edades que mayor recurrencia presentó fue el de uno a cuatro años y la terapia antimicrobiana con amoxicilina fue la más utilizada.

Otite externa difusa aguda: um estudo prospectivo no verão do Rio de Janeiro Acute diffuse external otitis: a prospective study in Rio de Janeiro's summer

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Ricardo R. Figueiredo

2004-04-01

Full Text Available A Otite Externa Aguda é uma doença extremamente comum em países tropicais, especialmente no verão. Vários fatores predisponentes são identificáveis e o quadro clínico pode ser bastante variado, principalmente com relação à intensidade da otalgia. OBJETIVO: Avaliar, através de um estudo prospectivo no maior hospital de Emergências do Rio de Janeiro, a incidência e as características da otite externa no período de verão. FORMA DE ESTUDO: Estudo clínico com coorte transversal. MATERIAL E MÉTODO: 391 pacientes com otite externa atendidos no Serviço de ORL do Hospital Souza Aguiar foram avaliados em uma série de parâmetros clínicos e de tratamento, incluindo análise de possíveis fatores predisponentes. RESULTADOS: Os principais sintomas referidos foram otalgia, otorréia discreta e plenitude auricular. Os principais fatores predisponentes foram banho de mar e piscina e uso de cotonetes. CONCLUSÃO: A otite externa aguda é uma doença extremamente comum em países tropicais, especialmente no verão. A possível contaminação da água de praias e piscinas, embora descartada por vários autores como fatores predisponentes, pode ter alguma influência na sua patogênese.The acute external otitis is a very common disease in tropical countries, especially in summer. There are many predisposing factors and clinical features may vary, particularly the pain's severity. AIM: Evaluate, with a prospective study in Rio de Janeiro's largest Urgencies Hospital, the incidence and characteristics of the acute external otitis in summer. STUDY DESIGN: Clinical study with transversal cohort. MATERIAL AND METH: 391 patients with acute external otitis in Souza Aguiar Hospital were evaluated in several clinical and treatment parameters, including predisposing factors analysis. RESULTS Pain, moderate ear discharge and sensation of "full ear" were the most common complaints. Sea and pool baths and the use of ear sticks were the most common

Identificação e susceptibilidade antimicrobiana de microrganismos obtidos de otite externa aguda Identification and antimicrobial susceptibility of acute external otitis microorganisms

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Janaina Cândida Rodrigues Nogueira

2008-08-01

Full Text Available Otite externa aguda é a infecção do conduto auditivo externo, geralmente causada por flora polimicrobiana. OBJETIVO: Isolar, identificar e determinar a susceptibilidade antimicrobiana dos organismos causadores da otite externa (OE. MÉTODO: 27 swabs foram obtidos de 27 orelhas de pacientes portadores de OE para cultura e 22 microrganismos foram isolados para avaliação de susceptibilidade. A susceptibilidade in vitro foi obtida através do método de ágar difusão em disco e os resultados, interpretados de acordo com critérios clínico-laboratoriais padrão. RESULTADOS: 10 culturas positivas para S. aureus, 8 culturas para P.aeruginosa, 5 para P.aeruginosa e S.aureus e 4 para fungos (Candida albicans e C. krusei. Gentamicina e as quinolonas foram ativas contra todas as cepas testadas, havendo resistência significativa contra amoxicilina/clavulanato. As espécies de Candida testadas foram sensíveis à Anfotericina B, nistatina, fluconazol e clotrimazol e resistentes à miconazol. CONCLUSÃO: A otite externa aguda é uma infecção polimicrobiana, e o conhecimento apropriado da etiologia e susceptibilidade dos microrganismos irá contribuir para o uso racional de antibióticos e o sucesso do tratamento.Acute external otitis is a polymicrobial infectious disease. AIM: The purpose of this study was to isolate, identify and determine the Antimicrobial susceptibility of organisms causing otitis externa (OE. METHODS: twenty-seven swabs were taken from the ears of 27 patients with OE for culture and 22 microorganisms were isolate to evaluate sensitivity. In vitro susceptibility tests were performed by agar diffusion disk and results were interpreted according to Clinical Laboratory Standards. RESULTS: 10 Ear cultures were positive for S. aureus , 8 for P. aeruginosa, 5 for P. aeruginosa and S. aureus and 4 for fungal organisms (Candida albicans e C. Krusei. Gentamicin and quinolones were active against all bacteria tested and significant

First identification of methicillin-resistant Staphylococcus pseudintermedius strains among coagulase-positive staphylococci isolated from dogs with otitis externa in Trinidad, West Indies

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Francis Dziva

2015-12-01

Full Text Available Background: Otitis externa is a common inflammatory ear disease in dogs caused by a variety of pathogens, and coagulase-positive staphylococci are frequently isolated from such infections. Objective: To identify antimicrobial susceptibility profiles and methicillin-resistant strains among coagulase-positive staphylococci isolated from otitis externa in dogs. Methods: A cross-sectional study was performed over 2 years on 114 client-owned dogs presented to the Veterinary Teaching Hospital with a primary complaint of ear infections. Swabs were obtained from both ears and cultured for staphylococci which were subsequently confirmed as coagulase-positive using rabbit plasma. Antimicrobial susceptibility assays were assessed on all isolates followed by subsequent genetic analysis for species identification and detection of the mecA gene. Results: Sixty-five coagulase-positive staphylococci were isolated from 114 client-owned dogs. The isolates exhibited resistance against neomycin (58.5%, streptomycin (49.2%, penicillin (49.2%, polymyxin B (44.6%, tetracycline (36.9%, sulphamethoxazole/trimethoprim (33.8%, kanamycin (33.8%, doxycycline (32.3%, norfloxacin (23.1%, amoxicillin/clavulanate (20%, ciprofloxacin (20%, enrofloxacin (18.5%, gentamicin (16.9%, and cephalothin (9.2%. Forty (61.5% of the isolates were resistant to at least three or more antimicrobials and 10 were sensitive to all. Using a multiplex polymerase chain reaction assay based on species-specific regions of the thermonuclease (nuc gene, 38/65 (58.5% isolates were classified as Staphylococcus aureus, 23/65 (35.4% as S. pseudintermedius, 2/65 (3.1% as S. intermedius, and 2/65 (3.1% as S. schleiferi. Analysis for the mecA gene revealed two positive isolates of S. pseudintermedius which were oxacillin-resistant, representing a first report of such organisms in the Caribbean. Conclusion: Despite the relatively high prevalence of multidrug-resistant coagulase-positive staphylococci in

Necrotizing otitis externa: a new trend? Report of 6 atypical cases.

LENUS (Irish Health Repository)

Glynn, Fergal

2009-12-01

Necrotizing otitis externa (OE) is traditionally seen in elderly diabetics and immunocompromised patients. During a 7-year period at our institution, we treated 6 patients with necrotizing OE who were not diabetic, who were not immunocompromised, and who were relatively young (age range: 27 to 65 yr; mean: 42.8). The necrotizing OE in these patients was less aggressive but just as severe as its usual presentation in older diabetic or immunocompromised patients. All 6 patients had evidence of bony erosion on computed tomography of the temporal bones, although 4 had negative findings on technetium-99m scintigraphy. Four of the 6 patients required mastoid exploration and fascia lata grafting, and the other 2 chose to undergo extensive daily microdebridements and intravenous antibiotics followed by 6 weeks of oral antibiotics. We recommend that a diagnosis of necrotizing OE be kept in mind when evaluating any patient who presents with severe otalgia, particularly in the presence of Pseudomonas aeruginosa infection of the external auditory canal, edema, granulation tissue, and bony erosion.

Consensus of microbiology reporting of ear swab results to primary care clinicians in patients with otitis externa.

Science.gov (United States)

Geyer, M; Howell-Jones, R; Cunningham, R; McNulty, C

2011-01-01

Otitis externa is a ubiquitous inflammatory disease; although it arises most commonly from an infection, there is no consensus in the UK for the reporting of ear swab culture results. This study aims to review current microbiology laboratory reporting of ear swab specimens to primary care and reach an evidence-based consensus for a reporting policy. Fifty consecutive ear swab reports were reviewed from each of 12 laboratories in the South West region to determine and discuss reporting practice. The Health Protection Agency (HPA) GP Microbiology Laboratory Use Group reviewed the underlying evidence and worked towards a consensus of expert microbiology opinion for laboratory reporting of ear swab results using a modified version of the Delphi technique. A total of 487 reports from primary care were reviewed (54% female; 46% male). Cultures most commonly yielded Pseudomonas species (36%), Staphylococcus species (21%), Streptococcus species (15%) and fungi (11%). Five reporting policies were agreed: Policy 1: Common pathogens such as group A beta-haemolytic streptococci, Streptococcus pneumoniae, Staphylococcus aureus - Always reported by name with antibiotic susceptibilities. Policy 2: Pseudomonas species - Always reported, but antibiotic susceptibilities only reported in severe disease. Policy 3: Aspergillus, Candida, coliforms and Proteus species, as well as non-group A streptococci and anaerobes - Only reported if moderate numbers of colonies and it is the predominant organism present; if appropriate report antibiotic susceptibilities. Policy 4: Coagulase-negative staphylococci, diphtheroids and enterococci - Not reported by name; generic terms used and antibiotic susceptibilities not reported. Policy 5: When antibiotic susceptibilities reported these must include susceptibility to a topical antibiotic. It is suggested that laboratories should consider adopting this evidence-based reporting consensus for ear swab culture results from primary care patients with

Temporomandibular joint involvement as a positive clinical prognostic factor in necrotising external otitis.

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Yeheskeli, E; Eta, R Abu; Gavriel, H; Kleid, S; Eviatar, E

2016-05-01

Necrotising otitis externa is associated with high morbidity and mortality rates. This study investigated whether temporomandibular joint involvement had any prognostic effect on the course of necrotising otitis externa in patients who had undergone hyperbaric oxygen therapy after failed medical and sometimes surgical therapy. A retrospective case series was conducted of patients in whom antibiotic treatment and surgery had failed, who had been hospitalised for further treatment and hyperbaric oxygen therapy. Twenty-three patients with necrotising otitis externa were identified. The temporomandibular joint was involved in four patients (17 per cent); these patients showed a constant gradual improvement in C-reactive protein and were eventually discharged free of disease, except one patient who was lost to follow up. Four patients (16 per cent) without temporomandibular joint involvement died within 90 days of discharge, while all patients with temporomandibular joint involvement were alive. Three patients (13 per cent) without temporomandibular joint involvement needed recurrent hospitalisation including further hyperbaric oxygen therapy; no patients with temporomandibular joint involvement required such treatment. Patients with temporomandibular joint involvement had lower rates of recurrent disease and no mortality. Therefore, we suggest considering temporomandibular joint involvement as a positive prognostic factor in necrotising otitis externa management.

Comparison of Microbiological Flora in the External Auditory Canal of Normal Ear and an Ear with Acute Otitis Externa.

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Ghanpur, Asheesh Dora; Nayak, Dipak Ranjan; Chawla, Kiran; Shashidhar, V; Singh, Rohit

2017-09-01

Acute Otitis Externa (AOE) is also known as swimmer's ear. Investigations initiated during World War II firmly established the role of bacteria in the aetiology of Acute Otitis Externa. To culture the microbiological flora of the normal ear and compare it with the flora causing AOE and to know the role of normal ear canal flora and anaerobes in the aetiology. A prospective observational study was conducted on 64 patients clinically diagnosed with unilateral AOE. Ear swabs were taken from both the ears. Microbiological flora was studied considering diseased ear as test ear and the normal ear as the control. Aerobic and anaerobic cultures were done. Severity of the disease was assessed by subjective and objective scores. Effect of topical treatment with ichthammol glycerine pack was assessed after 48 hours and scores were calculated again. Patients with scores < 4 after pack removal were started on systemic antibiotics and were assessed after seven days of antibiotics course. Data was analysed using Paired t-test, Wilcoxon signed ranks test and Chi-square test. A p-value < 0.05 was considered significant. Pseudomonas aeruginosa (33%) was the most common bacteria cultured from the ear followed by Methicillin Resistant Staphylococcus aureus (MRSA) (18%). Patients with anaerobic organism in the test ear had severe symptoms and needed systemic antibiotic therapy. Most of the cases may respond to empirical antibiotic therapy. In cases with severe symptoms and the ones refractory to empirical treatment, a culture from the ear canal will not be a tax on the patient. This helps in giving a better understanding about the disease, causative organisms and helps in avoiding the use of inappropriate antibiotics that usually result in developing resistant strains of bacteria.

The external otitis necrotizing about 45 cases

International Nuclear Information System (INIS)

Chnitri, Sana

2005-01-01

Necrotizing external otitis is a serious infection of the ear canal, it can develop life-threatening. It occurs primarily in elderly diabetic or immunocompromised. Pseudomonas aeruginosa is the most common germ involved. This is a retrospective study of 45 cases of necrotizing otitis externa collected in ENT and CMF from the military hospital in Tunis and ENT and CMF of Rabta over a period of 10 years from 1994 to 2003 .

Aspergillus otitis in small animals--a retrospective study of 17 cases.

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Goodale, Elizabeth C; Outerbridge, Catherine A; White, Stephen D

2016-02-01

Aspergillus spp. are saprophytic opportunistic fungal organisms and are a common cause of otomycosis in humans. Although there have been case reports of Aspergillus otitis externa in dogs, to the best of the authors' knowledge, this is the first retrospective case series describing Aspergillus otitis in dogs and cats. To characterize signalment, putative risk factors, treatments and outcomes of a case series of dogs and cats with Aspergillus otitis. Eight dogs and nine cats diagnosed with Aspergillus otitis. A retrospective review of medical records from 1989 to 2014 identified animals diagnosed with Aspergillus otitis based on culture. All dogs weighed greater than 23 kg. The most common putative risk factors identified in this study were concurrent diseases, therapy causing immunosuppression or a history of an otic foreign body. Aspergillus otitis was unilateral in all study dogs and most cats. Concurrent otitis media was confirmed in three dogs and one cat, and suspected in two additional cats. Aspergillus fumigatus was the most common isolate overall and was the dominant isolate in cats. Aspergillus niger and A. terreus were more commonly isolated from dogs. Animals received various topical and systemic antifungal medications; however, otic lavage under anaesthesia and/or surgical intervention increased the likelihood of resolution of the fungal infection. Aspergillus otitis is uncommon, typically seen as unilateral otitis externa in cats and larger breed dogs with possible risk factors that include immunosuppression and otic foreign bodies; previous antibiotic usage was common. © 2015 ESVD and ACVD.

Otite externa necrotizante com paralisia facial periférica bilateral: relato de caso e revisão da literatura Necrotizing external otitis with periferic bilateral facial palsy: case report and literature review

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Antonio Antunes

2004-01-01

Full Text Available A otite externa necrotizante (OEN, conhecida no passado como otite externa maligna, é uma infecção potencialmente letal que começa usualmente no conduto auditivo externo e se estende à base do crânio ocorrendo, principalmente, em pacientes diabéticos idosos e que a despeito de antibioticoterapia prolongada está associada à morbidade elevada e mortalidade significante. Os autores apresentam o caso de um paciente adulto, diabético, com OEN e paralisia facial periférica bilateral que evoluiu com cura da infecção, porém sem melhora da paralisia.Necrotizing external otitis (NEO, known in the past as malignant external otitis, is a potencial letal infection which begins usually in the external ear canal and spreads to the base of the skull. It occurs mainly in diabetic elderly patients who despite prolonged antibioticotherapy is associated to high morbidity and significant mortality. The authors present a case of an adult diabetic patient who developed NOE associated with bilateral periferic facial palsy evoluting with cure of the infection but without facial improvement.

OTITIS MEDIA CON EFUSIÓN: DIAGNÓSTICO Y MANEJO PRÁCTICO

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Tocornal, Francisco; Labatut, Tomás

2016-01-01

La otitis media con efusión (OME) u otitis media serosa, se define por la presencia de fluido en el oído medio. Se trata de una de las patologías más frecuentes del oído. Tiene un curso autolimitado en la mayoría de los casos, sin embargo puede comprometer la audición del paciente por periodos de tiempo variable, llegando a veces a comprometer el desarrollo del lenguaje, el habla o el aprendizaje del sujeto. Puede tener manifestaciones en el equilibrio del paciente o producir cambios en la me...

Eficacia del tratamiento acupuntural en pacientes con epicondilitis humeral externa

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Ida Pantoja Fornés

2015-07-01

Full Text Available Se realizó una intervención terapéutica en 100 pacientes de 20-59 años, con epicondilitis humeral externa, atendidos en la Sala de Rehabilitación del Policlínico Comunitario Docente “Eduardo Mesa Llull”, del municipio de II Frente, de la provincia Santiago de Cuba, desde septiembre de 2013 hasta marzo de 2014, para evaluar la eficacia del tratamiento acupuntural en ellos. La muestra fue dividida en 2 grupos de 50 integrantes cada uno, seleccionados de forma aleatoria. Los del grupo de estudio fueron tratados con acupuntura más corriente Trabert y los del control con corriente Trabert solamente. Como principales resultados predominaron: el grupo etario de 40-49 años (64,0 %, el sexo femenino (66,0 % y los obreros de servicio (56,0 %. Se obtuvo que los tratados con acupuntura tuvieron una mejor evolución, de donde se infiere que la terapia empleada resultó efectiva para aliviar el dolor en quienes se aplicó

Malignant external otitis: early scintigraphic detection

International Nuclear Information System (INIS)

Strashun, A.M.; Nejatheim, M.; Goldsmith, S.J.

1984-01-01

Pseudomonas otitis externa in elderly diabetics may extend aggressively to adjacent bone, cranial nerves, meninges, and vessels, leading to a clinical diagnosis of ''malignant'' external otitis. Early diagnosis is necessary for successful treatment. This study compares the findings of initial radiographs, thin-section tomography of temporal bone, CT scans of head and neck, technetium-99m methylene diphosphonate (MDP) and gallium-67 citrate scintigraphy, and single-photon emission computed tomography (SPECT) for detection of temporal bone osteomylitis in ten patients fulfilling the clinical diagnostic criteria of malignant external otitis. Skull radiographs were negative in all of the eight patients studied. Thin-section tomography was positive in one of the seven patients studied using this modality. CT scanning suggested osteomyelitis in three of nine patients. Both Tc-99m and Ga-67 citrate scintigraphy were positive in 10 of 10 patients. These results suggest that technetium and gallium scintigraphy are more sensitive than radiographs and CT scans for early detection of malignant external otitis

KEJADIAN OTITIS EKSTERNA PADA MASYARAKAT PENEBEL TABANAN DAN YANGAPI BANGLI YANG BERKUNJUNG KE BAKTI SOSIAL STAF MEDIS FUNGSIONAL TELINGA HIDUNG TENGGOROKAN FAKULTAS KEDOKTERAN UNIVERSITAS UDAYANA - RUMAH SAKIT UMUM PUSAT SANGLAH PADA TAHUN 2012

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Putu Teguh Aryanugraha

2016-03-01

Full Text Available INCIDENCE RATE OF OTITIS EXTERNA IN SOCIETY OF PENEBEL AND YANGAPI BANGLI WHO VISITED THE SOCIAL ACTIVITY EAR NOSE THROAT DIVISION FACULTY OF MEDICINE UDAYANA UNIVERSITY– SANGLAH GENERAL HOSPITAL IN 2012 ABSTRACT Indonesia is a tropical country which in some places have there own temperature and humidity criteria factors predisposing to otitis externa is usually triggered by the growth of fungi that are responsible for the onset of otitis externa. The research was conducted in two places, namely in the village of Penebel Tabanan and the village of Yangapi Bangli. The aim to determine the prevalence of otitis externa, especially in people who follow social events in the village Penebel and Yangapi. This research was carried out by quantitative descriptive design with a population that is affordable and Yangapi Penebel villagers who come to charity ENT Division Sanglah Hospital. The incidence of OE in the village Penebel was 6 of 66 patients and in the village Yangapi was 3 of 96 patients. Variants OE in the village of the same Penebel lot of male patients men and women with a lifespan of 41 years and above, whereas the incidence in the village OE Yangapi more on men with an age range 21-30 years. At this research showed otitis externa patients who come to social event in both villages were 9 people from 162 patients who came to the social event ENT Division Sanglah Hospital. Keywords : Otitis externa, Gender, Age, people of Penebel and Yangapi village.

Cerclaje pericostal en el tórax batiente con construcción de costillas externas artificiales

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Bruk Bekele Jembere; Orestes N Mederos Curbelo; Jesús Valdés Jiménez; Juan Carlos Barreras Ortega; Carlos Alberto Romero Díaz; Alexis Cantero Ronquillo

2002-01-01

Se presenta un prototipo de fijador costal externo construido con duroaluminio maleable mediante la utilización del sistema de cerclaje AO, basado en una experiencia previa con un tórax inestable, en la cual se utilizó el sistema AO con costillas externas fabricadas de yeso y láminas de acero. La evolución de la enferma fue excelente lo que motivó a confeccionar el fijador costal reutilizable, el cual se usó después en otros 2 pacientes con resultados similares, uno de ellos con un tórax bati...

Emprego da vídeo-otoscopia no diagnóstico de otites externas de cães Video-otoscopy use in the diagnosis of external otitis in dogs

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Cíntia Lúcia Maniscalco

2009-11-01

Full Text Available O objetivo deste trabalho foi estudar a utilização da vídeo-otoscopia como método diagnóstico para otites externas de cães. Para tanto, foram utilizados 20 cães adultos. O grupo A foi formado por 10 animais (cinco machos e cinco fêmeas provenientes do canil da Universidade Estadual Paulista, Campus de Jaboticabal, sem sinais clínicos aparentes de otite externa, e o grupo B foi formado por 10 animais (cinco machos e cinco fêmeas encaminhados pelo setor de Clínica Médica do Hospital Veterinário da faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Campus de Jaboticabal, apresentando sinais clínicos de otite. Para realização dos exames, todos os animais foram submetidos ao mesmo protocolo anestésico (acepromazina na dose de 0,1mg kg-1 e tiletamina-zolazepan na dose de 10mg kg-1. Foram diagnosticadas três otites unilaterais e 13 bilaterais, e dentro dos achados estão secreção purulenta; epitélio ulcerado, hiperêmico ou hiperplásico; estenose do meato e alterações da membrana timpânica. A vídeo-otoscopia mostrou ser um método efetivo e um procedimento fundamental no auxílio diagnóstico e prognóstico das desordens auriculares.The objective of this study was the use of video-otoscopy as a method to diagnose external otitis in dogs. Hence 20 adult dogs were used. The group A was formed by 10 animals (5 males and 5 females with no apparent symptoms of the external otitis and the group B, formed by 10 animals (5 males and 5 females sent by the Medical Clinics section of the Veterinary Hospital at the Universidade Estadual Paulista - Câmpus Jaboticabal, with otitis symptoms. All the animals tested have undergone the same anesthesic protocol (acepromazine in a dosis of 0,1mg kg-1 and tiletamine-zolazepan in a dosis of 10mg kg-1. Three unilateral and 13 bi-lateral otitis were diagnosed and the findings include purulent secretion; ulcerated, hyperemic or hyperplasic epithelium; meathus stenosis

Ayudas externas para mejorar la independencia en personas con discapacidad visual

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Héctor Darío Escobar Gómez

Full Text Available En los últimos años se ha incrementado la investigación con respecto al desarrollo de ayudas que mejoren la independencia de los discapacitados visuales. El propósito de esta revisión es determinar la evidencia científica relacionada con ayudas externas para mejorar la independencia en personas con discapacidad visual severa o ceguera. Para efectuar el trabajo fueron consultadas las bases de datos de PubMed, Cochrane Database-Wiley Online Library, LILACS y Scielo, además de las publicaciones de la Organización Mundial de la Salud, el Instituto Nacional de Ciegos en Colombia, el Consejo Internacional de Oftalmología y los patrones preferidos de práctica en rehabilitación visual, de la Academia Americana de Oftalmología. Se incluyó un total de 43 artículos y documentos en los idiomas inglés, portugués y español para ser analizados. La mayoría de estos estudios fueron descriptivos, y no se encontraron ensayos controlados ni metanálisis. La tendencia observada es hacia ayudas tecnológicas con un diseño dirigido al usuario y cada vez más pequeñas, discretas, con múltiples funciones que comprenden sus actividades de la vida diaria.

Malassezia pachydermatis e outros agentes infecciosos nas otites externas e dermatites em cães Malassezia pachydermatis and other infectious agents in external otitis and dermatitis in dogs

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Márcia Nobre

1998-09-01

Full Text Available Malassezia pachydermatis (Pityrosporum canis faz parte da microbiota da pele e quando ocorrem alterações no microambiente local como aumento da umidade, da temperatura e do substrato, determinando uma elevação do número de células, ocorre a transição da forma comensal para o parasitismo. O objetivo deste trabalho foi determinar a prevalência da infeçâo por M. pachydermatis e outros agentes infecciosos nas otites externas e dermatites de cães. Foram analisadas 78 amostras de cães com otite, 36 amostras de cães com o conduto auditivo normal e 24 com dermatite. Todas as amostras foram submetidas ao exame direto. cultivo em ágar sangue e em ágar Sabouraud dextrose, acrescido de cloranfenicol e cicloheximida. Ao exame direto, 50% das amostras de otite e 16,6% das amostras de dermatite apresentaram numerosas células semelhante a M. pachydermatis, enquanto 83,3% das amostras de ouvidos saudáveis apresentaram ausência de células com esta morfologia. M. pachydermatis foi isolada em 25% das amostras do conduto auditivo normal, em 80,7% das amostras de otite e em 37,5% das amostras de dermatite. Foram também isolados das amostras de otite Staphylococcus intermédias, S. aureus, S. epidermidis, Pseudomonas aeruginosa, Proteus sp, Actinomyces sp, Streptococcus sp e Otodectes cynotis e das de dermatite Staphylococcus intermédias, S. áureas, S. epidermidis Microsporum canis, M. gypseum,. Trychophyton sp e Demodex canis. M. pachydermatis foi o agente com maior prevalência nas otites externas e dermatites, sendo um agente oportunista que causa otite e dermatite quando há uma alteração do microambiente.The Malassezia pachydermatis ( Pityrosporum canis is found in the whole skin microflora. It seems to occur as a consequence of changes in the local microenvironment, such as moist increase, temperature or substrate enhancement, generating a raising on cell quantity, which brings the transition from commensal form to parasitism. The

Evaluation of the Efficacy and Tolerability of Oral Ciprofloxacin used in the Comprehensive Treatment of External Bacterial Otitis: An Observational Prospective Study.

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Gurov, Alexander Vladimirovich; Kriukov, Andrey Ivanovich; Kunelskaya, Vera Yakovlevna; Isotova, Galina Nikolaevna; Shadrin, Georgiy Borisovich; Luchsheva, Yuliya Vladislavovna; Yakimov, Vladislav Olegovich; Garg, Amit; Akku, Shyam Prasad; Gupta, Namita

2017-10-01

Introduction  Otitis Externa is common ear infection with a prevalence of 1%. Objective  The objective of this study is to evaluate the clinical and microbiological efficacy and safety profile with oral ciprofloxacin in the external bacterial otitis (EBO) management. Methods  This is a prospective observational study conducted with EBO outpatients referred to the otorhinolaryngology center in Moscow between March and August 2013. Our study included patients from two cohorts, acute external bacterial otitis (AEBO) - Group 1 - and exacerbation of chronic otitis externa (CEBO) - Group 2. We administered Ciprofloxacin 500 mg twice daily with standard topical EBO treatment for up to 10 days. Patients underwent evaluation on study visit days 1, 3, 5, and 10 for the severity. Bacteriological examination of ear canal cultures took place on Day 1 and Day 10. Results  We collected data from 60 EBO outpatients (AEBO: N  = 30 and CEBO: N  = 30). Swimming was the major risk factor associated with the disease in addition to the most common pathogenic organisms - Staphylococcus aureus and Pseudomonas aeruginosa . was We attained complete resolution of the inflammatory process in 28 (93%) and 27 (90%) patients in the AEBO and CEBO group, respectively. We confirmed this by microbiological test with almost complete eradication of the causative organisms. Overall, we observed good positive dynamics of ear canal with no major side effects. Conclusion  We found that Ciprofloxacin 500 mg, when administered orally twice daily for 7 to 10 days in otitis externa patients is clinically and microbiologically effective and comparatively safer than other antimicrobials.

In vitro and in vivo activity of a killer peptide against Malassezia pachydermatis causing otitis in dogs.

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Cafarchia, Claudia; Immediato, Davide; Paola, Giancarlo Di; Magliani, Walter; Ciociola, Tecla; Conti, Stefania; Otranto, Domenico; Polonelli, Luciano

2014-05-01

In order to overcome the limitations inherent in current pharmacological treatments for Malassezia pachydermatis, the cause of otitis externa in dogs, the efficacy of a killer decapeptide (KP) was evaluated in vitro and in vivo. Sixteen dogs with naturally occurring M. pachydermatis otitis externa were enrolled, and the in vitro fungicidal activity of KP was evaluated using yeasts recovered from these animals. The therapeutic activity was evaluated in four groups of four animals each. The dogs were topically treated with KP (150 μl, 2 mg/ml) three times per week (group A) or every day (group B), treated with a scramble peptide every day (group C), or left untreated (group D). Assessment of clinical signs (pruritus, erythema, and lichenification and/or hyperpigmentation), expressed as mean of the total clinical index score (mTCIS), the population size of M. pachydermatis at the cytological examination (mean number of yeast cells at 40× magnification [mYC]), and culture testing (mean number of log10 CFU/swab [mCFU]), were conducted daily from the first day of treatment (T0) until two consecutive negative cultures (mCFU ≤ 2). KP showed an in vitro fungicidal effect against M. pachydermatis isolates, with an MFC90 value of 1 μg/ml. The mTCIS, mYC and mCFU were negative only in animals in group B after T8. Daily administration of KP for 8 days was safe and effective in controlling both clinical signs and the population size of M. pachydermatis causing otitis externa, thus offering an alternative to the currently available therapeutic or prophylactic protocols for recurrent cases of Malassezia otitis in dogs.

Comparing Cerumen Bacterial Flora in Acute Otitis Externa Patients and Healthy Controls

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Keyvan Kiakojori

2010-07-01

Full Text Available Introduction: In spite of the fact that acute otitis media is a systemic and symptomatic disease with sever otalgia, otitis media with effusion (OME is an asymptomatic and silent disease. OME is the most common cause of conductive hearing loss in children and has adverse effects on speech development and cognitive skills. Results: Among 1001 children under study, 57 subjects (5.7% were diagnosed with OME, more than 50% of which were asymptomatic. Periodic otalgia and turning up television volume were the most common symptoms. Conclusion: Regarding the improved knowledge on diagnosis and treatment of OME especially in younger children, hearing problems or cognitive and linguistic skills retardation may be avoided by promoting general information.

[The swimmer's otitis. An up to date and prevention options].

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Caramia, G; Serafini, V; Loggi, A

2013-01-01

The swimmer's otitis or acute otitis externa, is a pathology that often occurs in those who practice swimming at a competitive level. The same problem often occurs in the summer with the attendance of swimming pools and bathing areas. A survey made in the United States in 2007 confirms the dynamics of the onset of this pathology, because the contamination of fungi and bacteria in the waters of the swimming pools and the sea cause the inflammation of the epithelium of the auditory canal. To face this issue, in addition to a correct diagnosis, and the necessary and appropriate therapies, it may follow the use of these medicinal preparations. The first one (A) is protective-acting, the second one (B) is characterized as a preventive, hygroscopic, moistening, antiseptic and antimycotic-acting solution. Swimmers who have been using the two (pre-and post) preparations daily for about a year have reported sporadic episodes of otitis. However, there is no doubt that these two compounds deserve a meticulous clinical trial in order to confirm their preventive and therapeutic potentials in external acute otitis.

Perfil metabólico y factores asociados en pacientes con esquizofrenia bajo tratamiento con antipsicóticos que acuden a consulta externa en el Instituto Nacional de Salud Mental (Perú).

OpenAIRE

Ricapa, Miguel A.; Guimas, Luis B.; Ticse, Ray

2017-01-01

Objetivo: Describir el perfil metabólico y factores asociados en pacientes con esquizofrenia bajo tratamiento con antipsicóticos que acudieron a consulta externa en el Instituto Nacional de Salud Mental “Honorio Delgado–Hideyo Noguchi” durante un periodo de tres meses. Material y métodos: Estudio transversal, realizado entre mayo y julio del 2015. De manera consecutiva, fueron incluidos pacientes con esquizofrenia, en tratamiento con el mismo esquema antipsicótico por al menos 3 meses. Se tom...

Perfil metabólico y factores asociados en pacientes con esquizofrenia bajo tratamiento con antipsicóticos que acuden a consulta externa en el Instituto Nacional de Salud Mental (Perú)

OpenAIRE

Ricapa, Miguel A; Guimas, Luis B; Ticse, Ray

2016-01-01

Objetivos: Describir el perfil metabólico y factores asociados en pacientes con esquizofrenia bajo tratamiento con antipsicóticos que acudieron a consulta externa en el Instituto Nacional de Salud Mental “Honorio Delgado-Hideyo Noguchi” durante un periodo de tres meses. Material y métodos: Estudio transversal, realizado entre mayo y julio del 2015. De manera consecutiva, fueron incluidos pacientes con esquizofrenia, en tratamiento con el mismo esquema antipsicótico por al menos 3 meses. Se to...

OCCURRENCY OF MALASSEZIA PACHYDERMATIS AND OTHER INFECTIOUS AGENTS AS CAUSE OF EXTERNAL OTITIS IN DOGS FROM RIO GRANDE DO SUL STATE, BRAZIL (1996/1997 Ocorrência de Malassezia pachydermatis e de outros agentes etiológicos de otite externa em cães no estado do Rio Grande do Sul, BR (1996-1997

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Márcia de Oliveira Nobre

2001-10-01

Full Text Available The purpose of this work was to evaluate the frequency of Malassezia pachydermatis infection and other infectious agents in dogs with external otitis and with healthy auditory tubes. Clinical manifestations of external otitis were evaluated. Samples from the auditory tube of 102 dogs with otitis and from 32 healthy dogs were submitted to direct microscopic examination and cultured in blood agar and Sabouraud dextrose agar with chloramphenicol and cycloheximide. Direct examination showed more than ten cells of M. pachydermatis in 52.0% of the samples from dogs with otitis, but in only 21.8% of the healthy auditory tube samples. M. pachydermatis was isolated in 37.5% of the samples from dogs with healthy auditory tube and 76.5% (p0.05. Infection by M. pachydermatis was prevalent in the following breeds: Cocker Spainel, German Shepherd and Brazilian Fila. No differences were found in frequency of the infection in relation to age, sex and ear anatomy of the dogs. Otomycosis were predominantly ceruminous and erythematous. M. pachydermatis was the most frequent agent in external otitis.Este trabalho teve como objetivos estudar a ocorrência da Malassezia pachydermatis e de outros agentes etiológicos em cães com otite externa e com conduto auditivo externo hígido; caracterizar a otomicose por M. pachydermatis. Foram analisadas 32 amostras de cães com o conduto auditivo hígido e 102 de otite externa. Todas as amostras foram submetidas ao exame direto, cultivo em ágar sangue e em ágar Sabouraud dextrose acrescido de cloranfenicol e cicloheximida. Ao exame direto 52.0% das amostras de otite apresentaram mais de dez células de M. pachydermatis. Somente 21.8% das amostras de orelhas hígidas apresentaram no exame direto células com esta morfologia (uma a dez células. M. pachydermatis foi isolada em 37.5% das amostras do conduto auditivo hígido e em 76.5% das amostras de otite (p0.05. A infecção por M. pachydermatis foi prevalente em cães da ra

Cerclaje pericostal en el tórax batiente con construcción de costillas externas artificiales

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Bruk Bekele Jembere

2002-12-01

Full Text Available Se presenta un prototipo de fijador costal externo construido con duroaluminio maleable mediante la utilización del sistema de cerclaje AO, basado en una experiencia previa con un tórax inestable, en la cual se utilizó el sistema AO con costillas externas fabricadas de yeso y láminas de acero. La evolución de la enferma fue excelente lo que motivó a confeccionar el fijador costal reutilizable, el cual se usó después en otros 2 pacientes con resultados similares, uno de ellos con un tórax batiente con inestabilidad esternalA prototype of external costal fixators made of malleable hard aluminum by using the AO cerclage system was presented. It was based on a previous experience with an unstable chest, in which the AO system was used with external ribs made of plaster and steel plates.The excellent evolution of the female patient led to the making of the reusable costal fixator that was also used by 2 other patients with similar results. One of them had a beating thorax with sternal unstability

SPECT imaging in evaluating extent of malignant external otitis: case report

International Nuclear Information System (INIS)

English, R.J.; Tu'Meh, S.S.; Piwnica-Worms, D.; Holman, B.L.

1987-01-01

Otitis externa, a benign inflammatory process of the external auditory canal, is general responsive to local therapy. Some patients however, develop a less controllable disease leading to chondritis and osteomyelitis of the base of the skull. The direct invasive characteristic of the disease has led to the descriptive term malignant external otitis (MEO), more appropriately called necrotizing or invasive external otitis. Malignant external otitis is caused by an aggressive pseudomonas or proteus infection that almost exclusively occurs in elderly diabetic patients. The primary imaging modalities previously used in the diagnosis and evaluation of MEO were standard planar scintigraphic techniques with technetium-99M (/sup 99m/Tc) bone agents and gallium-67 ( 67 Ga), and pluridirectional tomography. The advent of high resolution computed tomography (CT) effectively allowed demonstration of the soft tissue extension and bone destruction associated with MEO, but still suffered from the low sensitivity constraints of all radiographic techniques in determining early inflammatory bone involvement. Recent work suggests that scintigraphic detection of MEO with /sup 99m/Tc-MDP and 67 Ga, combined with the cross-sectional resolution of single photon emission computed tomography (SPECT) may be of value in planning treatment of this inflammatory condition

Otitis media con efusión: estudio de casos y controles Otitis media with effusion: study of cases and controls

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Sonia Grisales

1992-01-01

Full Text Available Se realizó un estudio en 66 niños y 34 niñas de 2 a 12 años. Cincuenta fueron casos de otitis media con efusión (OME y 50 controles. El grupo etario más numeroso fue el de dos años. Los síntomas y signos más frecuentes fueron otalgia y fiebre (70% e hipoacusia (40%. Veintinueve casos (58% y sólo 12 controles (24% presentaron adenoides hipertróficas (p < 0.01 . La pérdida auditiva fue significativamente mayor en el grupo de casos y las curvas timpanométricas se relacionaron directamente con ella. No se demostró que la alergia fuera un elemento importante en la génesis de la OME, a diferencia de la hipertrofia de adenoides que constituyó nuestro hallazgo más importante.

Between July 1988 and May 1989 we studied 100 children aged2-14 years; there were fifty cases of otitis media with effusion (OME and fifty controls. Each group Included 33 boys and 17 girls. The predominant age group was 2 years. The most frequent clinical manifestations of OME were earache and fever (70% each and reduced hearing (40%. In 29 cases (58% and in only 12 controls (24% enlarged adenoids were found (p < 0.01 . impaired hearing was significantly most frequent In the cases and the tympanometric curves had direct relationship with reduced hearing. Despite Its high prevalence allergy was not found to be of importance In the etiology of OME; by contrast, enlarged adenoids were the most relevant determinant of this disease In our series.

externas de un hospital de Madrid en 2006

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Susana Granado de la Orden

2007-01-01

Full Text Available Fundamento: Para conocer la calidad de la asistencia sanitaria es imprescindible incorporar el punto de vista del paciente realizando estudios de satisfacción. Las encuestas de satisfacción precisan unas propiedades psicométricas que garanticen su fiabilidad y validez. El objetivo de este trabajo es diseñar y validar un cuestionario para conocer la satisfacción de los pacientes con las consultas externas hospitalarias. Métodos: Estudio de validación de un cuestionario autocumplimentado, diseñado por un grupo de expertos, compuesto por 12 preguntas que se aplicó a una muestra de 677 pacientes de las consultas externas del hospital Gregorio Marañón. Se analizó el comportamiento métrico del cuestionario en cuanto a validez de constructo, de criterio y capacidad predictiva y la consistencia interna. Resultados: Se analizó el comportamiento métrico del cuestionario respecto a la validez de constructo identificándose 2 factores “calidad clínica” y “calidad administrativa” que explican el 63% de la varianza, validez de criterio concurrente (coeficiente de correlación de Spearman de 0,85 respecto al criterio de referencia “satisfacción global con la atención recibida en consultas externas”, OR 1,19 respecto al criterio de referencia “conoce el nombre del médico que le atiende en la consulta”, capacidad predictiva del cuestionario medida mediante análisis discriminante obteniéndose un 84% de los casos clasificados correctamente y consistencia interna (Alfa de Cronbach 0,90. Conclusiones: El cuestionario reúne suficientes propiedades psicométricas como para que pueda ser considerado una herramienta útil y fiable para medir la satisfacción de los pacientes con las consultas externas hospitalarias.

Canje de deuda externa por conservación de la naturaleza

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Klaus Georg Binder

2001-12-01

Full Text Available El interés que tienen los países con grandes riquezas naturales en la reducción de su deuda externa y el interés que tienen los países industrializados en la conservación de la naturaleza se pueden combinar mediante un canje de deuda externa por conservación de naturaleza (Debt-for-Nature Swaps [swap (del inglés: cambio, canje]. Existen dos esquemas para el canje: (I Dos gobiernos, uno acreedor con interés en la protección de la naturaleza y otro deudor interesado en la disminución de la deuda externa, acuerdan la donación de la obligación a cambio de la conservación de la naturaleza. (II Un banco comercial de un país desarrollado, acreedor de un país en desarrollo con dificultades en la cancelación de la deuda, vende en el mercado secundario títulos de esta deuda por un precio menor que el de su valor nominal, pues sólo así logra disminuir la pérdida ocasionada por la no cancelación de dicha deuda. Una organización no gubernamental ambiental internacional compra la deuda y negocia con el país deudor la forma de cancelarla. Los canjes de deuda externa por conservación de la naturaleza representan un valioso complemento de la ayuda para el desarrollo orientada hacia el medio ambiente otorgada por los países industrializados, que sin duda deben desembolsar la contribución decisiva para la protección de ls grandes riquezas naturales en los países en desarrollo.

[Chronic otitis mediaChronic Otitis Media].

Science.gov (United States)

Kohles, N; Schulz, T; Eßer, D

2015-11-01

There are 2 different kinds of chronic otitis media: Otitis media chronica mesotympanalis and otitis media chronica epitympanalis (cholesteatoma). The incidence of chronic otitis media as reported in literature differs in a wide range. The incidence rates vary between 0.45 and 46%. Both, otitis media chronica mesotympanalis and cholesteatoma, lead to eardrum perforation due to lengthy and recurring inflammations. Furthermore, chronic otitis media is characterized by frequently recurring otorrhea and conductive hearing loss. Georg Thieme Verlag KG Stuttgart · New York.

Factores psicosociales relacionados con la intención migratoria externa de colombianos residentes en varios municipios vallecaucanos

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Javier Murillo Muñoz

2015-01-01

Full Text Available Objetivo . Estudiar la relación entre las variables psicosociales satisfacción con la vida, importancia del vínculo familiar, identidad nacional, importancia del dinero y apertura al cambio y la intención migratoria externa de colombianos residentes en varios municipios del Valle del Cauca para identificar cu á les son las mayores predictoras de la intención migratoria. Método . Estudio empírico con metodología cuantitativa-correlacional e intención predictiva, con 969 participantes seleccionados de manera no probabilística mediante la técnica bola de nieve, en la que contactos personales e institucionales iniciales condujeron al resto. Resultados. Los resultados indicaron que un porcentaje significativo de los participantes manifestaron intención de emigrar y mostraron una relación negativa y significativa de las variables satisfacción con la vida, importancia del vínculo familiar e identidad nacional con la intención migratoria, así como una relación positiva y significativa de las variables apertura al cambio e importancia del dinero con la misma intención migratoria. La identidad nacional emergió como el mayor predictor negativo y la apertura al cambio como el mayor predictor positivo de la intención migratoria. Conclusi ó n. La intención migratoria es un fenómeno multivariado en el que los factores psicológicos juegan un importante papel.

Expansión cutánea externa con endermología: un método alternativo complementario en reconstrucción mamaria diferida

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M. De la Cruz

2015-12-01

Full Text Available Con el objetivo de mejorar las técnicas de reconstrucción mamaria diferida, incorporamos la técnica de endermología como método de expansión cutánea externa para eliminar el plano cicatricial inextensible que se forma entre la fascia del pectoral y el tejido celular subcutáneo tras la cirugía radical. Se trata de un procedimiento sencillo, de bajo coste y de aplicación universal, que en estos casos enfocamos a evitar nuevas cicatrices, complicaciones de zonas donantes, ingresos hospitalarios prolongados y los riesgos quirúrgicos elevados propios de las técnicas de reconstrucción mamaria con colgajos libres o pediculados, así como los frecuentes resultados insatisfactorios de la reconstrucción con expansor y prótesis en pacientes radiadas. Cuando la piel presenta un grosor insuficiente o la paciente ha sido sometida a radioterapia previa, complementamos el tratamiento con lipotransferencia de grasa abdominal. Todos los tratamientos de expansión cutánea externa se realizan en consulta mediante un equipo Cellu m6 (LPG® endermologia, Francia. Tras la expansión, realizamos la reconstrucción como un aumento mamario simple con prótesis anatómica. Medimos la ganancia de elasticidad cutánea tras masaje y el grosor dermograso mediante test de pellizco. Realizamos la simetrización de la mama contralateral ptósica o hipertrófica en el momento de la colocación del implante o de la mastectomía subcutánea contralateral profiláctica en pacientes de riesgo. Incluimos en el estudio mujeres sin distinción de edad, tipo o tamaño de tumor, o si han recibido radio o quimioterapia. Con esta técnica, obtenemos resultados homogeneamente satisfactorios sin añadir nuevas cicatrices y mejorando la calidad de la piel y de la cicatriz de mastectomía.

La política externa de Dilma Rousseff: ¿menos de lo mismo?

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Andrés Malamud

2014-06-01

Full Text Available La política externa brasileña inicia cada siglo con una década fundacional. Entre 1902 y 1912, el barón de Río Branco definió las fronteras territoriales, los principios diplomáticos y el alineamiento internacional que –con matices y ajustes– regirían desde entonces. Durante la gestión al servicio de un presidente, Lula, con proyección planetaria, Brasil se convirtió en un actor global y multidimensional. La pregunta sobre el futuro de la política externa surge natural: ¿vendrán ahora décadas de pequeños ajustes hasta la próxima refundación o son esperables cambios significativos en el corto plazo? Es posible proyectar algunas tendencias, todas los cuales tienen un sustrato común: la aspiración de protagonismo global se mantendrá, pero combinada con medidas variables de retracción y reorientación.

Frequency and antimicrobial susceptibility of Staphylococcus pseudintermedius in dogs with otitis externa

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Carolina Boesel Scherer

2018-05-01

Full Text Available ABSTRACT: Infections by Staphyloccocus pseudintermedius in the skin of dogs have been object of studies, since such microorganisms often present multiple resistance to antibiotics. This study aimed to identify and evaluate the antimicrobial susceptibility of Staphylococcus pseudintermedius (SP strains isolated from dogs with otitis. Swabs from both ears of 52 dogs with otitis (n=104 were included. Bacteria were cultured using Muller-Hinton agar (supplemented with 5% equine blood and incubated at 37°C for 24 to 48 hours. All colonies underwent biochemical evaluation for identification of staphylococci. The identity of colonies as SP was confirmed by polymerase chain reaction. The antimicrobial susceptibility of SP strains was evaluated by disk diffusion. The presence of the gene mecA was evaluated in all SP isolates by PCR. Forty-four SP strains were isolated from swabs of 31 dogs (31/52, 59.6%. Seventy-five percent of the strains were susceptible to cephalexin and 93.2% to amoxicillin plus clavulanic acid. Less than 23% of the strains were susceptible to penicillin. For non-beta-lactam antimicrobials, 63.6% of the strains showed resistance to sulfamethoxazole-trimethoprim, 61.4% to tetracycline, and 38, 64% to enrofloxacin. Aminoglycoside resistance rate was 27.3% for gentamicin. Resistance to oxacillin in vitro was detected in 13 of the 44 strains (29, 55%. A total of 12 strains (27.3% were positive for mecA gene and five of these 12 strains were susceptible to in vitro oxacillin. Twenty-six (59, 1% strains were resistant to three or more classes of antimicrobials, and classified as multi resistant. Our results showed high frequency of SP and multi resistant isolates to antimicrobials commonly used in veterinary.

Antibiotics for acute otitis media in children

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María Pía Nitsche

2015-10-01

Full Text Available La otitis media aguda es una de las enfermedades infecciosas más comunes diagnosticadas en niños. Con respecto a su tratamiento, el uso de antibióticos sigue siendo controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos seis revisiones sistemáticas que en conjunto incluyen 18 estudios clínicos aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que los antibióticos disminuyen el dolor a las 48-72 horas y reducen el riesgo de perforación timpánica en niños con otitis media aguda, sin embargo no disminuyen el riesgo de recurrencia tardía y aumentan el riesgo de efectos adversos (rash, vómitos y diarrea.

Comportamiento de la otitis media aguda

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Gladys Fuentes Fernández

Full Text Available Introducción: la otitis media aguda es una complicación de las infecciones respiratorias agudas altas, frecuente en los niños menores de 5 años. Objetivos: caracterizar su comportamiento, según edad y sexo, e identificar algunos factores de riesgo en este grupo de edad. Métodos: se realizó un estudio descriptivo retrospectivo de 554 niños ingresados en el hospital Pediátrico de Centro Habana con el diagnóstico de otitis media aguda, durante los años 2006-2010. Los datos se recogieron de las historias clínicas. Resultados: la otitis media aguda fue más frecuente en el sexo masculino (58,7 % y en los menores de 1 año (53,1 %. El antecedente de bajo peso (33,9 % y la prematuridad (27,5 %, la asistencia a círculos infantiles (43,5 % y el hábito de fumar de los padres (58,4 %, además del antecedente de ingresos hospitalarios por otitis media en el mes previo a la aparición del episodio actual (59,0 %, constituyeron los principales factores de riesgo en el presente estudio. Conclusiones: la otitis media es una causa frecuente de ingresos hospitalarios, y se identifican como principales factores de riesgo la asistencia a círculos infantiles y el tabaquismo de algunos de los padres.

Relaciones entre el tamaño del pelo, el color de la piel y mucosas externas con la producción lechera en condiciones tropicales

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Manrique P. Luis Phanor

1995-06-01

Full Text Available

El objetivo de la investigación fue determinar las relaciones entre el tamaño del pelo, el color de la piel y el de las mucosas externas (hocico y párpados con los rendimientos productivos de vacas lecheras Lucerna, explotadas en condiciones de clima tropical en Bugalagrande, Colombia. Se utilizaron 1855 registros con datos en 180 y 305 días de lactación, producción total de leche y la duración de los períodos de lactancia. A las vacas se les asignó una de las tres categorías para el tamaño del pelo, una de las cuatro para el color de la piel y una de las tres para el color de las mucosas externas. Por medio del método de cuadrados mínimos se realizaron los respectivos análisis de varianza y con el apoyo de pruebas de medias, se demostró que el tamaño del pelo no fue una fuente de variación significativa, pero las mayores producciones se presentaron en el grupo de vacas con pelo corto o fino. La relación entre el color de la piel y los rendimientos productivos determinó diferencias estadísticas (P < 0.05 en los grupos de animales, donde las mayores producciones se presentaron en los de las vacas con piel negra y café clara. El color de las mucosas externas no influyó significativamente en los rendimientos de las vacas lecheras.

This research was conducted to find out the relationship among hair size, skin color and externals mucosa color (muzzle and evedil occular with milk production in cows of Lucerna's race, developed under tropical condition in Bugalagrande, Colombia. A total of 1855 records were analized in 180 and 305 days of milking, total production and lactation length. Each cow was classified under one of three categories for hair size, one of four categories for skin color and one of three categories for externals mucosa color. Harvey's statistical methods were used to analyse the data and the results showed up that the size of the hair was not a source of significative variation, but the larger milk

PERFIL DOS ATENDIMENTOS POR CAUSAS EXTERNAS EM HOSPITAL PÚBLICO

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Marlos Victor Fonsêca de Lima

2012-01-01

Full Text Available El objetivo fue identificar el perfil de los atendimientos por causas externas en la urgencia de un hospital público de referencia del Estado. Investigación descriptiva documental, con enfoque cuantitativo. En el análisis de datos, el período de enero a diciembre de 2009 se realizó 4.464 atendimientos por causas externas. La mayor frecuencia de las lesiones ocurrió en personas entre 21 y 40 años (37,70% y hombres (68,6%. Cuanto a las causas, las caídas (29% fue la mayor variable, seguido por accidente de motocicleta (17,98%, accidentes domiciliario (16,53%, agresión física (10,43% y accidente de motocicleta (8,84%. Se observó que 23,3% de los atendimientos realizados en la urgencia fueron de la población procedente de municipios aledaños. Hay, por lo tanto, la necesidad de mejorar la calidad de las informaciones acerca de las quejas motivadas por causas externas, principales causas de hospitalización y gastos en salud.

Mortalidad por causas externas en Medellín, 1999-2006

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Doris Cardona Arango

2008-01-01

Full Text Available Caracterizar el comportamiento de la mortalidad por causas externas en la ciudad de Medellín, Colombia, entre 1999-2006, según sexo, edad y causa básica de muerte fue el objetivo de este estudio descriptivo longitudinal, con fuente de información secundaria de 22 128 registros de defunción por causas externas. El análisis realizado es univariado y bivariado por sexo, grupos de edad y causa de muerte. Las causas externas registradas en el periodo fueron: 72.9 por ciento por homicidio; 15.3 por ciento, accidente de transporte; 7.3 por ciento, traumatismos; 4.2 por ciento, por suicidio, y por otras causas, 0.4 por ciento. La mayor tasa de mortalidad se presentó en el grupo de edad de 20 a 24 años (27.6 por cien mil habitantes, hecho que merece especial consideración por las implicaciones sociales, familiares y laborales que representa el fallecimiento de una persona en su etapa productiva.

Neumatoscopia e impedanciometría en el diagnóstico de la otitis media con efusión

OpenAIRE

Gilberto Eduardo Marrugo Pardo; Diana Lucía Gómez Rodríguez

2005-01-01

Antecedentes: las consecuencias de la otitis media con efusión crónica en la audición, en el desarrollo cognitivo, lingüístico y de habilidades comunicativas son las principales razones a considerar para la búsqueda, diagnóstico y tratamiento adecuado de esta patología en los niños.  Objetivo: comparar el rendimiento operativo de la neumatoscopia e impedanciometria como métodos diagnósticos de la efusión del oído medio.  Material y métodos: estudio de pruebas diagnósticas, recolección p...

Serum Antibody Response to Five Streptococcus pneumoniae Proteins during Acute Otitis Media in Otitis Prone and Non-Otitis Prone Children

Science.gov (United States)

Kaur, Ravinder; Casey, Janet R.; Pichichero, Michael E.

2011-01-01

Background Streptococcus pneumoniae (Spn) is one of the common bacteria responsible for episodic acute otitis media (AOM; non-otitis prone), recurrent AOM (otitis-prone) and AOM treatment failure (AOMTF) in children. Objective From a population of 268 children we sought to compare the serum IgG antibody titers to five different Spn proteins (PhtD, LytB, PcpA, PhtE and Ply) that are vaccine candidates in children with episodic AOM (n=34), who were otitis prone (n=35), and who had AOMTF (n=25) caused by Spn. Methods Antibody was quantitated by ELISA. Results At their acute AOM visit, anti-PhtD, -LytB, -PhtE and −Ply IgG antibody titers in otitis-prone children were significantly lower compared to non-otitis prone children (p otitis-prone, AOMTF and non-otitis prone children had no significant change in geometric mean IgG antibody titers against the five proteins (except for PhtE in children with AOMTF), but detailed analysis showed that about one-third of the children in each cohort had a 2-fold rise in antibody to the studied antigens. While non-otitis prone children had significant increases (p otitis-prone children either failed to show rises or the rises were significantly less than the non-otitis prone children. Conclusion Otitis-prone and AOMTF children mount less of an IgG serum antibody response than non-otitis prone children to Spn proteins following AOM and nasopharyngeal colonization. PMID:21487325

Predictor de Smith modificado mediante un modelo interno, robusto a perturbaciones externas no medibles.

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Fernando Castillo García

2010-11-01

Full Text Available Normal 0 21 false false false MicrosoftInternetExplorer4 Se propone una modificación de la estructura del predictor de Smith mediante un modelo interno que posibilita aumentar su rechazo al efecto de las per-turbaciones externas no medibles en comparación con la estructura clásica del predictor de Smith. Los resultados obtenidos se aplican en el diseño de un sistema de control del proceso de variación de la temperatura del jugo en los calentadores de una fábrica de azúcar. Los resultados de la simulación del sistema diseñado mostraron su efectividad y robustez en cuanto al rechazo de perturbaciones externas no medibles. Palabras claves: Predictor de Smith, predictor de Smith modificado, rechazo a perturbaciones externas no medibles, robustez de los sistemas de control.

Propuesta metodológica para medir la calidad del servicio de consulta externa en medicina general

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Mauricio Losada Otálora, Ph.d (c

2011-07-01

Full Text Available Este artículo ofrece una propuesta metodológica para medir la calidad del servicio de consulta externa con el modelo de la zona de tolerancia. Con una mezcla de entrevistas en profundidad, grupos focales, análisis factorial exploratorio y análisis factorial confirmatorio, se encontró que los usuarios de los servicios de consulta externa evalúan la calidad considerando la conveniencia del servicio, los elementos sustanciales del mismo y los aspectos profesionales/ humanos de quienes los atienden. El artículo incluye una guía para los gerentes sobre cómo aplicar, interpretar y utilizar los resultados de la metodología de evaluación propuesta. Finalmente, se señalan las limitaciones y se sugieren futuras líneas de investigación.

21 CFR 524.1484k - Neomycin sulfate, prednisolone, tetracaine, and squalane topical-otic suspension.

Science.gov (United States)

2010-04-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS OPHTHALMIC AND... in dogs and cats for treating acute otitis externa and as adjunctive therapy in management of chronic otitis externa. The product may also be used for treating moist dermatitis in dogs. (3) Limitations...

Update on Otitis Media in Children.

Science.gov (United States)

Schoem, Scott R.

1997-01-01

This article discusses otitis media in children. It addresses risk factors for otitis media, pathogenesis, diagnosis, bacteria causing otitis media, and treatment for acute otitis media, recurrent acute otitis media, and persistent otitis media with effusion, including antibiotics, steroids, allergy control, autoinflation, mechanical ventilation,…

Otitis media with effusion

Science.gov (United States)

OME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue ear ... from the tube and is swallowed. OME and ear infections are connected in two ways: After most ear ...

75 FR 16346 - Ophthalmic and Topical Dosage Form New Animal Drugs; Orbifloxacin, Mometasone Furoate Monohydrate...

Science.gov (United States)

2010-04-01

... posaconazole for the treatment of otitis externa in dogs. DATES: This rule is effective April 1, 2010. FOR... posaconazole) Otic Suspension for the treatment of otitis externa in dogs associated with susceptible strains... statement is required. Under section 512(c)(2)(F)(ii) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C...

Antibacterial action of geopropolis of Melipona quadrifaciata in cultivation of secretion of otitis in dogs

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Raísa Dias C

2017-05-01

Full Text Available Objective. The objective of the present paper was to test the in vitro antibacterial activity of the Mandaçaia (Melipona quadrifaciata bee’s geopropolis. Materials and methods. The experiment was carried out with secretion samples collected from animals with ear diseases evaluated at Unifeso’s Clinic School of Veterinary Medicine, where in vitro tests took place, antibiograns with alcoholic extract of geopropolis were made 10 test tubes (two tubes for each concentration of 50%, 60%, 70%, 80%, 90%. Results. Were not identified microorganisms at concentrations of 70, 80 and 90%. Conclusions. The geopropolis of Melipona quadrifasciata showed antibacterial activity in vitro against microorganisms from ear secretion of dogs with otitis externa.

Las redes sociales directivas externas y la estrategia corporativa.

OpenAIRE

Fernández Pérez, Virginia

2008-01-01

Este trabajo pretende aportar un punto de vista más amplio sobre el desarrollo de la toma de decisiones directiva relacionada con la elección e implantación de la estrategia corporativa, para lo que incorpora las redes sociales externas de los directivos como elemento explicativo del proceso, ya que son fuentes de información y referencias sociales muy importantes. Los contactos sociales pueden condicionar en gran medida el comportamiento estratégico de la organización y por tanto, su desempe...

External Otitis (Swimmer's Ear)

Science.gov (United States)

... otitis. Fungal external otitis (otomycosis), typically caused by Aspergillus niger or Candida albicans, is less common. Boils are ... in the ear. Fungal external otitis caused by Aspergillus niger usually causes grayish black or yellow dots (called ...

Sinusitis with eosinophilic otitis media

International Nuclear Information System (INIS)

Kawano, Toshiro; Ishitoya, Junichi; Tsukuda, Mamoru

2007-01-01

Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)

Sinusitis with eosinophilic otitis media

Energy Technology Data Exchange (ETDEWEB)

Kawano, Toshiro; Ishitoya, Junichi [Yokohama City Univ., Medical Center, Yokohama, Kanagawa (Japan); Tsukuda, Mamoru [Yokohama City Univ., Graduate School of Medicine, Yokohama, Kanagawa (Japan)

2007-09-15

Eosinophilic otitis media is an intractable inflammation of the middle ear combined with bronchial asthma. According to a national epidemiological investigation on eosinophilic otitis media, it is assumed that eosinophilic otitis media are combined with sinusitis in about 74% of their cases. On the other hand, organizational images of eosinophilic otitis media and eosinophilic sinusitis are similar, and steroid therapy is effective together, and it is thought that they are involved in the idea of one airway one disease, but the details of sinusitis combined with the eosinophilic otitis media are unidentified. Therefore, we examined the kinds of the sinusitis combined with eosinophilic otitis media. We diagnosed 18 cases (male: 2 cases, female: 16 cases) (average age: 54.6 years old) as eosinophilic otitis media according to the diagnostic criteria. And, by the CT views of a paranasal sinus, blood tests, existence of the nasal polyp, etc, we investigated the kinds of sinusitis combined with eosinophilic otitis media. It turned out that bronchial asthma was combined with eosinophilic otitis media in 17 of 18 cases (airway hypersensitivity did sthenia of one case, but the asthma did not yet developed), and 6 cases were combined with aspirin induced asthma (AIA), and 3 cases were combined with Churg-Strauss syndromes (CSS). 10 case (55.6%) of 17 eosinophilic otitis media were combined with eosinophilic sinusitis. And 4 cases (22.2%) of 17 eosinophilic otitis media were combined with chronic sinusitis, 4 cases (22.2%) of 17 eosinophilic otitis media were not combined with sinusitis. We concluded that eosinophilic otitis media was not always combined with eosinophilic sinusitis. The idea of one airway one disease was not applied to this examination. (author)

Drug: D10296 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available TN) Ciprofloxacin hydrochloride [DR:D02216], Dexamethasone [DR:D00292] ... ATC code: S02CA06 ... Treatment of infections (acute otiti...s media, acute otitis externa) ... PubChem: 163312327 ...

21 CFR 524.1484c - Neomycin sulfate, isoflupredone acetate, tetracaine hydrochloride ointment.

Science.gov (United States)

2010-04-01

... therapy in the horse, cat, and dog. It may also be used following amputation of dewclaws, tails and claws...) Conditions of use. (1) It is used in treating such conditions as acute otitis externa in dogs and to a lesser degree, chronic otitis externa in dogs. It also is effective in treating anal gland infections and moist...

Malignant otitis externa

Science.gov (United States)

... destroy the bones. The infection may affect the cranial nerves, brain, or other parts of the body if ... nervous system (neurological) exam may show that the cranial nerves are affected. If there is any drainage, the ...

Dependencia, restricción externa y transferencia de excedente en la Argentina (1970-2013

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Mariano Treacy

2015-05-01

Full Text Available En la historia argentina reciente, la emergencia de la restricción externa ha reflejado la incompatibilidad de sostener un proceso de crecimiento económico con elevación del poder adquisitivo de los salarios de los trabajadores sin experimentar problemas de desequilibrios en el sector externo. En este trabajo se intentará encuadrar estos límites en un marco de relaciones de dependencia que estructuran la economía mundial en países centrales, semiperiféricos y periféricos. Dado que las transformaciones del sistema mundial en los últimos cuarenta años han provocado una actualización y perfeccionamiento de los mecanismos por los cuales se transfiere el excedente desde las economías periféricas hacia las economías centrales, se elaborará un Índice Sintético de Transferencia de Excedente que permita caracterizar la salida de capitales en la Argentina en el período 1970-2013. Así, se intentará vincular la re-emergencia de la restricción externa con las características estructurales de la economía, de su articulación con la economía mundial y de la transferencia de excedente.

Caracterización clínico-epidemiológica de la otitis media aguda en pacientes pediátricos Clinicoepidemiological characterization of the acute otitis media in children

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Ileana Álvarez Lam

2011-09-01

Full Text Available Introducción: la otitis media aguda es una de las enfermedades infecciosas más frecuentes en la infancia, y constituye una de las causas más importantes de consultas médicas y prescripción de antibióticos en los menores de 5 años. Objetivo: determinar el comportamiento clínico epidemiológico de la enfermedad. Métodos: se realizó un estudio descriptivo, longitudinal prospectivo con 60 pacientes entre 1 mes y 14 años de edad con diagnóstico de otitis media aguda purulenta en el Hospital Pediátrico Docente "William Soler", durante el período de 1 año (enero a diciembre de 2008. Los datos clínicos se obtuvieron mediante una encuesta a los padres o tutores de los pacientes. A todos se les realizó timpanocentesis con cultivo y exudado nasofaríngeo. Las cepas aisladas fueron enviadas al Laboratorio Nacional de Referencia de S. pneumoniae y H. influenzae del Instituto de Medicina Tropical "Pedro Kourí" para la caracterización microbiológica y determinación de susceptibilidad antimicrobiana. Resultados: la enfermedad predominó en el grupo ubicado entre 12 y 23 meses (55 %, con mayor afectación del sexo masculino (52 %. La fiebre y las manifestaciones locales referidas a oído medio (irritabilidad, otalgia, llanto nocturno fueron los elementos clínicos referidos con mayor frecuencia. El cuidado fuera del hogar, la exposición al humo de tabaco y el destete precoz fueron los factores de riesgo más frecuentes. S. pneumoniae, H. influenzae no tipificable y S. epidermidis fueron los gérmenes aislados con mayor frecuencia. El 25 % de las cepas de S. pneumoniae tuvieron resistencia intermedia a la penicilina, pero no se reportó resistencia a cefalosporinas de tercera generación. El 98,4 % de los pacientes evolucionaron satisfactoriamente. Las complicaciones de la enfermedad se presentaron en 1,6 % de los casos. Conclusiones: la otitis media aguda es frecuente en niños menores de 36 meses, y está muy relacionada con la presencia

Técnicas de rehabilitación neuropsicológica en daño cerebral adquirido: ayudas de memoria externas y recuperación espaciada

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Karol Gutiérrez Ruíz

2009-01-01

Full Text Available Este artículo tuvo como objetivo realizar una revisión de las técnicas de recuperación espaciada y de ayudas de memoria externas, para la rehabilitación de personas con daño cerebral adquirido. Inicialmente se expusieron las alteraciones cognitivas y funcionales comunes en personas con daño cerebral y, posteriormente se describieron cada una de las técnicas, indicando en qué consiste cada una de ellas y mostrando los resultados de las investigaciones revisadas. Se determinó que la principal utilidad de las técnicas de recuperación espaciada y ayudas de memoria externas fue en el tratamiento de dificultades de memoria, aunque sólo en algunas ocasiones se evaluaron mejorías en medidas neuropsicológicas. La utilización de ayudas de memoria externas fue la técnica que en más ocasiones demostró ganancias en funcionalidad y mantenimiento a largo plazo.

Características de pacientes con parálisis cerebral atendidos en consulta externa de neuropediatría en un hospital peruano

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Judith R Vila

Full Text Available El objetivo del estudio fue describir las características de consulta neurológica y referencia de los niños con parálisis cerebral (PC. Estudio descriptivo retrospectivo. Se evaluaron las historias clínicas de los niños con PC asistentes a consulta externa de la unidad de Neuropediatría del Hospital Nacional Cayetano Heredia entre los años 2011 y 2012. Se incluyeron 81 niños, el 53,1% fueron varones; la PC espástica fue la más frecuente (72,8%, la encefalopatía hipóxico isquémica (28,1% y las malformaciones cerebrales (28,1% fueron las principales causas en neonatos a término. La edad media al momento del diagnóstico fue a los 4,1 ± 3,2 años, la epilepsia fue el motivo más frecuente de consulta neuropediátrica. El 58% fue hospitalizado al menos una vez. El tiempo de espera para ser atendido por terapia física tuvo una mediana de 2 meses (rango intercuartílico = 0,8 - 9. Concluimos que el diagnóstico de PC fue tardío, el tiempo de espera para acceder a la atención especializada fue prolongado. Se requieren protocolos y mayor eficiencia para atender en forma adecuada a los niños con PC.

Juntos, pero no tanto: un recorrido por la agenda de negociaciones comerciales externas del MERCOSUR (1991-2015)

OpenAIRE

Zelicovich, Julieta

2015-01-01

la dimensión externa del MERCOSUR en el período 1991-2015, constituida a partir de cuatro sub agendas, a saber: a) las negociaciones del patrimonio histórico; b) las negociaciones con socios de extra-zona Norte/ Sur; c) las negociaciones con socios de extra-zona Sur/ Sur; d) las negociaciones en los organismos multilaterales. Se sostiene que el MERCOSUR ha tenido un desempeño limitado en su accionar externo. Los problemas ...

Bone scanning in severe external otitis

International Nuclear Information System (INIS)

Levin, W.J.; Shary, J.H. III; Nichols, L.T.; Lucente, F.E.

1986-01-01

Technetium99 Methylene Diphosphate bone scanning has been considered an early valuable tool to diagnose necrotizing progressive malignant external otitis. However, to our knowledge, no formal studies have actually compared bone scans of otherwise young, healthy patients with severe external otitis to scans of patients with clinical presentation of malignant external otitis. Twelve patients with only severe external otitis were studied with Technetium99 Diphosphate and were compared to known cases of malignant otitis. All scans were evaluated by two neuroradiologists with no prior knowledge of the clinical status of the patients. Nine of the 12 patients had positive bone scans with many scans resembling those reported with malignant external otitis. Interestingly, there was no consistent correlation between the severity of clinical presentation and the amount of Technetium uptake. These findings suggest that a positive bone scan alone should not be interpreted as indicative of malignant external otitis

Características clínicas de pacientes llevados a monitoría externa de eventos

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José J. Carvajal

2014-09-01

Este es el primer estudio descriptivo de la monitoría externa de eventos llevado a cabo en Colombia. Desde el punto de vista epidemiológico y de diagnóstico electrocardiográfico, los hallazgos son similares a los resultados de estudios previos, con las limitaciones que ofrece un análisis de este tipo.

Integración vertical y contratación externa en los servicios generales de los hospitales españoles

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Puig-Junoy J.

2002-01-01

Full Text Available Objetivos: Este estudio analiza los factores que influyen en las decisiones de integración vertical/contratación externa de cuatro servicios generales (limpieza, lavandería, alimentación y seguridad y mantenimiento en los hospitales españoles (3.160 transacciones que corresponden a 790 hospitales. Métodos: Se presenta la estimación empírica de un modelo logístico de maximización de la utilidad de los hospitales, en el que intervienen no sólo factores relacionados con los costes de transacción, sino también otros relacionados con la intervención pública y la dimensión política. Resultados: El 55,7% de los hospitales contrata al menos uno de los servicios generales analizados. El servicio de limpieza es el que presenta un mayor grado de contratación externa (45,1%, seguido del servicio de seguridad y mantenimiento (32,5%. En cambio, el servicio de lavandería es el que presenta un mayor grado de integración vertical (94,3% junto con el de alimentación (80,1%. La dimensión del hospital (economías de escala, medida a través del número de camas, es una de las variables que influyen de forma importante la decisión de integración vertical o contratación externa de los servicios de limpieza, alimentación y mantenimiento y seguridad. Conclusiones: Las economías de escala contribuyen a una mayor integración vertical, mientras que la especialización y el carácter lucrativo favorecen la decisión de contratación externa. El servicio de lavandería tiene un comportamiento diferenciado de los demás, mostrando efectos que indican la posible presencia de activos específicos.

Computed tomography study of otitis media

International Nuclear Information System (INIS)

Bahia, Paulo Roberto Valle; Marchiori, Edson

1997-01-01

The findings of computed tomography (CT) of 89 patients clinically suspected of having otitis media were studied in this work. Such results were compared to clinical diagnosis, otoscopy, surgical findings and previous data. Among the results of our analysis, we studied seven patients with acute otitis media and 83 patients with chronic otitis media. The patients with acute otitis media have undergone CT examinations to evaluate possible spread to central nervous system. The diagnosis of cholesteatoma, its extension and complications were the main indication. for chronic otitis media study. The main findings of the cholesteatomatous otitis were the occupation of the epitympanun, the bony wall destruction and the ossicular chain erosion. The CT demonstrated a great sensibility to diagnose the cholesteatoma. (author)

Panel 7 : Otitis Media: Treatment and Complications

NARCIS (Netherlands)

Schilder, Anne G M; Marom, Tal; Bhutta, Mahmood F; Casselbrant, Margaretha L; Coates, Harvey; Gisselsson-Solén, Marie; Hall, Amanda J; Marchisio, Paola; Ruohola, Aino; Venekamp, Roderick P; Mandel, Ellen M

Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice.

Otitis media in Greenland children: acute, chronic and secretory otitis media in three- to eight-year-olds.

Science.gov (United States)

Pedersen, C B; Zachau-Christiansen, B

1986-12-01

The middle ear status was examined in 142 children aged three to eight years from Sukkertoppen and Kangamiut in Greenland. The investigation is based on social-pediatric and otologic histories and on objective examination using otomicroscopy and tympanometry. Three-fourths of the small children had a previous history of otitis, some with repeated instances. Otomicroscopic findings revealed suppurative, chronic otitis in 6% and sequelae of chronic otitis in 13%. Tympanometry disclosed a reduced middle ear pressure in another 26% of the ears examined. Comparison of children with healthy ears with the groups with affections of the middle ear showed a tendency to an increased risk of otitis in families at a low social stratum, whereas the mode of habitation seemed insignificant. Finally, a large milk intake both in connection with breast-feeding and later in life seemed to reduce the frequency of otitis. The investigation showed that acute otitis and chronic otitis media in particular are more prominent in Greenland than in Denmark. Attention is drawn to the handicap associated with a high incidence of chronic otitis media and the concomitant hearing loss to a population isolated in point of language. The successful achievements of a health information campaign and an active therapeutic program, which has reduced the prevalence of chronic otitis among the Innuit population native to Alaska and Canada, provides the rationale for an increased otologic effort in Greenland.

Panel 7: Otitis Media: Treatment and Complications.

Science.gov (United States)

Schilder, Anne G M; Marom, Tal; Bhutta, Mahmood F; Casselbrant, Margaretha L; Coates, Harvey; Gisselsson-Solén, Marie; Hall, Amanda J; Marchisio, Paola; Ruohola, Aino; Venekamp, Roderick P; Mandel, Ellen M

2017-04-01

Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified. A total of 1122 potential related articles were reviewed by the panel members; 118 relevant articles were ultimately included in this summary. Conclusions Recent literature and guidelines emphasize accurate diagnosis of acute otitis media and optimal management of ear pain. Watchful waiting is optional in mild to moderate acute otitis media; antibiotics do shorten symptoms and duration of middle ear effusion. The additive benefit of adenoidectomy to tympanostomy tubes in recurrent acute otitis media and otitis media with effusion is controversial and age dependent. Topical antibiotic is the treatment of choice in acute tube otorrhea. Symptomatic hearing loss due to persistent otitis media with effusion is best treated with tympanostomy tubes. Novel molecular and biomaterial treatments as adjuvants to surgical closure of eardrum perforations seem promising. There is insufficient evidence to support the use of complementary and alternative treatments. Implications for Practice Emphasis on accurate diagnosis of otitis media, in its various forms, is important to reduce overdiagnosis, overtreatment, and antibiotic resistance. Children at risk for otitis media and its complications deserve special attention.

Middle ear infection (otitis media) (image)

Science.gov (United States)

Otitis media is an inflammation or infection of the middle ear. Acute otitis media (acute ear infection) occurs when there is ... which causes production of fluid or pus. Chronic otitis media occurs when the eustachian tube becomes blocked ...

Tratamiento conservador en pacientes con retinoblastoma bilateral

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Juan C. Suárez

2008-11-01

Full Text Available OBJETIVO: comparar el tratamiento convencional del retinoblastoma bilateral, usado hasta hace algunos años, consistente en radioterapia o enucleación bilateral, con el tratamiento conservador actual que incluye termoterapia transpupilar (TTT o TTT/quimioterapia al menos en un ojo, en niños con diagnóstico de retinoblastoma bilateral. DISEÑO: estudio retrospectivo descriptivo. MUESTRA: 20 pacientes con diagnóstico de retinoblastoma bilateral que consultaron al Hospital Universitario San Vicente de Paúl, de Medellín, Colombia, entre 1997 y 2007. MÉTODO: se hizo enucleación del ojo con el tumor de mayor tamaño. En el otro ojo se hizo tratamiento con TTT, con el láser diodo (810 nm, spot amplio, solo o combinado con otras terapias. RESULTADOS: se dividió a los pacientes en dos grupos: 16 pacientes (32 ojos en el grupo 1 tratados conservadoramente y 4 pacientes (8 ojos en el grupo 2 con tratamiento convencional. El rango de edad fue de 1-72 meses en el grupo 1 y de 1-12 meses en el grupo 2. El tiempo de seguimiento fue de 7-67 meses para el grupo 1 y de 13-73 meses para el grupo 2. En el grupo 1 se hizo enucleación de 16 ojos (50%, radioterapia externa de uno (3,1%, quimioterapia más termoterapia de 5 (15,6% y quimioterapia más termoterapia más crioterapia de 10 (31,3%. En todos los pacientes se logró preservar al menos un ojo. En el grupo 2, se enuclearon 7 ojos (87,5% y se hizo radioterapia externa más enucleación en un paciente (12.5%. Además, todos los pacientes recibieron quimioterapia. CONCLUSIÓN: la terapia conservadora actual consistente en tratamiento local (termoterapia, crioterapia o braquiterapia y quimiorreducción permite preservar al menos un ojo y en algunos casos de los dos, muchas veces con buena agudeza visual, en niños con retinoblastoma bilateral; se evitan así la enucleación bilateral y la radioterapia externa usada en el tratamiento convencional con todos sus efectos secundarios. La enucleación contin

La validación externa y el rol que desempeña el equipo de pares externos en los procesos de autoevaluación de carreras

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Mora Aguilar, Carlos

2005-09-01

Full Text Available Este artículo ofrece una serie de consideraciones por seguir, en la fase final de los procesos de autoevaluación, denominada validación externa o evaluación externa. Por consiguiente, esta fase del proceso es guiada entre otras personas, por un equipo de evaluadores conformado por personal académico y profesional de alto nivel en su disciplina, que participa en la validación externa de carreras. Centrados en el equipo de evaluación externa, el artículo presenta una serie de características y funciones con que éste debe contar, con el propósito de ofrecer un insumo general para todas aquellas personas, que dentro y fuera del país, tengan la intención de conformar un equipo de evaluación externa, como también a todas aquellas que tengan la inquietud por conocer sobre estos temas. This article offers a series of considerations to follow, in the final phase of the autoevaluation processes, denominated external validation or external evaluation. Therefore, this phase of the process is guided, among other people, conformed by a high-level crew of academic and professional evaluators in their discipline. Centered around the team of external evaluation, the article presents a series of characteristics and functions which it must count on, in order to offer general rudiments for all of those who, in and outside the country, may have interest to know about these issues.

Otitis maligna del diabético: nuestra experiencia y revisión de la literatura Malignant otitis of the diabetic: our experience and literature review

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Pedro P. Morales Hechevarría

2002-04-01

Full Text Available Se realizó un estudio transversal en 22 diabéticos (18 tipo 2 y 4 tipo 1, mayores de 15 años, afectados de otitis maligna del diabético, para conocer las características clínicas y la evolución de estos pacientes. Se les confeccionó historia clínica completa (endocrinólogo y otológica minuciosa (otorrinolaringólogo. Se precisó la edad, sexo, tipo de tratamiento y tiempo de evolución de la DM, valores promedio de las glucemias, resultado del estudio bacteriológico de la secreción ótica, e imagenológico, así como síntomas y signos dependientes de esa otitis, complicaciones y resultado del tratamiento. Se empleó tratamiento insulínico intensivo y antibioticoterapia específica. La Pseudomona aeruginosa fue el germen causal más frecuente. La otalgia, el granuloma del conducto auditivo externo y el compromiso de los pares craneales (VII, IX y X fueron frecuentes. Se comprobó que más de la mitad de los pacientes egresaron mejorados o curados, no hubo fallecidos. Se observaron secuelas en 4 pacientes. Se presentó mayor frecuencia de OMD en los pacientes con DM tipo 2 con evolución mayor de 10 años. La causa más frecuente de indicación quirúrgica fue el granuloma del CAE. Se observaron las secuelas en 4 pacientes (18,2 %. Se concluyó que el diagnóstico precoz de la OMD, el tratamiento insulínico intensivo y una terapia con antibióticos adecuada puede disminuir significativamente la estadía hospitalaria, las secuelas y la mortalidad en estos pacientes.A cross-sectional study was conducted among 22 diabetics (18 type 2 and 4 type 1 over 15 that were affected by malignant otitis of the diabetic in order to know the clinical characteristics and evolution of these patients. A complete medical history (endocrinologist and a detailed otological history (ear, nose and throat specialist were made. Age, sex, type of treatment and time of evolution of diabetes mellitus, mean values of glycaemia, the result of the bacteriological

Acute otitis media in children

OpenAIRE

Cherpillod, Jacques

2011-01-01

Jacques CherpillodEar, Nose and Throat Department, Childrens’ University Hospital, Lausanne, SwitzerlandDate of preparation: 6th March 2011Conflict of interest: None declaredClinical question: What is the best treatment for acute otitis media in children?Results: Watchful waiting, followed by amoxicillin treatment, if necessary, is the best first-line treatment for acute otitis media in children aged six months or older.Keywords: acute otitis media, antibiotics, watchful waitin

Acute Otitis Media in Children.

Science.gov (United States)

Leung, Alexander K C; Wong, Alex H C

2017-01-01

Acute otitis media is a common childhood infection. Prompt diagnosis and appropriate treatment are very important. To review in depth the epidemiology, pathophysiology, clinical manifestations, diagnosis, complications and particularly treatment of acute otitis media in children. A PubMed search was completed in Clinical Queries using the key term "acute otitis media". Patents were searched using the key term "acute otitis media" from www.google.com/patents, http://espacenet.com, and www.freepatentsonline.com. Acute otitis media affects over 80% of children before their third birthday and 30 to 45% of these children have suffered two or more episodes. Streptococcus pneumoniae, nontypable Haemophilus influenzae, and Moraxella catarrhalis are the most frequently isolated middle-ear pathogens. The diagnosis is based on acute onset of symptoms such as otalgia and fever, middle ear inflammation such as erythema of the tympanic membrane, and middle ear effusion. The choice of treatment method depends on the age of the child, laterality, and the severity of the disease. Recent patents related to the management of acute otitis media are also retrieved and discussed. Antimicrobial treatment is recommended for all children less than two years of age, as well as in children ≥ two years of age who have a temperature ≥ 39oC; are toxic looking; have otalgia > 48 hours; have bilateral otitis media or otorrhea; have craniofacial abnormalities; are immunocompromised; or have uncertain access to follow-up. Amoxicillin is the drug of choice. Observation without antibiotic is an option in immunocompetent children ≥ two years of age who have an acute uncomplicated otitis media and non-severe illness if appropriate follow-up can be arranged. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Automated Diagnosis of Otitis Media: Vocabulary and Grammar

Science.gov (United States)

Kuruvilla, Anupama; Hoberman, Alejandro; Kovačević, Jelena

2013-01-01

We propose a novel automated algorithm for classifying diagnostic categories of otitis media: acute otitis media, otitis media with effusion, and no effusion. Acute otitis media represents a bacterial superinfection of the middle ear fluid, while otitis media with effusion represents a sterile effusion that tends to subside spontaneously. Diagnosing children with acute otitis media is difficult, often leading to overprescription of antibiotics as they are beneficial only for children with acute otitis media. This underscores the need for an accurate and automated diagnostic algorithm. To that end, we design a feature set understood by both otoscopists and engineers based on the actual visual cues used by otoscopists; we term this the otitis media vocabulary. We also design a process to combine the vocabulary terms based on the decision process used by otoscopists; we term this the otitis media grammar. The algorithm achieves 89.9% classification accuracy, outperforming both clinicians who did not receive special training and state-of-the-art classifiers. PMID:23997759

Otoscopic diagnosis of otitis media.

Science.gov (United States)

Isaacson, Glenn

2016-12-01

Accurate diagnosis of otitis media is important to prevent suffering and complications when infection is present, and unnecessary antibiotic use when infection is absent. The usual signs and symptoms of acute otitis media are unreliable guides in infants and young children. Similarly, middle ear effusions may present with little discomfort in older children. We therefore depend on examination of the tympanic membrane with an otoscope to make most diagnoses. This article aims to improve the accuracy of middle ear diagnosis by pneumatic otoscopy. It includes descriptions and photographs of the normal ear drum and illustrates the pathologic changes seen in acute otitis media, long-standing eustachian tube dysfunction and otitis media with effusion.

Acute otitis media in children

Directory of Open Access Journals (Sweden)

Cherpillod J

2011-06-01

Full Text Available Jacques CherpillodEar, Nose and Throat Department, Childrens’ University Hospital, Lausanne, SwitzerlandDate of preparation: 6th March 2011Conflict of interest: None declaredClinical question: What is the best treatment for acute otitis media in children?Results: Watchful waiting, followed by amoxicillin treatment, if necessary, is the best first-line treatment for acute otitis media in children aged six months or older.Keywords: acute otitis media, antibiotics, watchful waitin

Otitis media: viruses, bacteria, biofilms and vaccines.

Science.gov (United States)

Massa, Helen M; Cripps, Allan W; Lehmann, Deborah

2009-11-02

Otitis media typically presents as either acute otitis media (AOM), with symptoms including fever, otalgia, otorrhoea or irritability and short duration; or as otitis media with effusion (OME), which is often asymptomatic and characterised by accumulation of fluid in the middle ear. Diagnostic certainty of otitis media is challenging, given the young age of patients and variability of symptoms. Otitis media predominantly occurs as coincident to viral upper respiratory tract infections and/or bacterial infections. Common viruses that cause upper respiratory tract infection are frequently associated with AOM and new-onset OME. These include respiratory syncytial virus, rhinovirus, adenovirus, parainfluenza and coronavirus. Predominant bacteria that cause otitis media are Streptococcus pneumoniae, Moraxella catarrhalis, and non-typeable Haemophilus influenzae. Antibiotic therapy does not significantly benefit most patients with AOM, but long-term prophylactic antibiotic therapy can reduce the risk of otitis media recurrence among children at high risk. In Australia, 84% of AOM is treated with antibiotic therapy, which contributes to development of antibiotic resistance. Vaccine development is a key future direction for reducing the world burden of otitis media, but requires polymicrobial formulation and ongoing monitoring and modification to ensure sustained reduction in disease burden.

Importance of viruses in acute otitis media.

Science.gov (United States)

Nokso-Koivisto, Johanna; Marom, Tal; Chonmaitree, Tasnee

2015-02-01

Acute otitis media occurs as a complication of viral upper respiratory tract infection. Bacterial otopathogens and respiratory viruses interact and play important roles in acute otitis media development. A better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease. There has been increasing evidence that acute otitis media occurs during upper respiratory infection, even in the absence of nasopharyngeal bacterial colonization. Among the types of viruses associated with acute otitis media, respiratory syncytial virus continues to be the most commonly detected. It is still unclear whether viral load plays an important role in acute otitis media development, but symptomatic upper respiratory tract infection (as opposed to asymptomatic viral infection) is crucial. Widespread use of bacterial and viral vaccines in young children, including pneumococcal conjugate and influenza vaccines, has led to the reduction in otitis media-related healthcare use between 2001 and 2011. There has been no new vaccine against respiratory viruses other than influenza. Progress has been made toward the reduction of the burden of acute otitis media in the last decade. Success in reducing acute otitis media incidence will rely mainly on prevention of nasopharyngeal otopathogen colonization, as well as reduction in the incidence of viral upper respiratory tract infection.

Otitis media with effusion:diagnosis and treatment

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Ozgur Surmelioglu

2013-04-01

Full Text Available Otitis media with effusion (serous otitis media is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. Serous otitis media is the most common cause of hearing loss in children in the developed world. Hearing loss may be affected speech, cognitive, and psychological development of the childeren. In addition, otitis media with effusion is not only seen in children, this sign may present with signs of nasopharyngeal diseases. For this reason, especially in childhood otitis media with effusion should be treated by early diagnosis. [Archives Medical Review Journal 2013; 22(2.000: 194-208

Malignant external otitis: CT evaluation

International Nuclear Information System (INIS)

Curtin, H.D.; Wolfe, P.; May, M.

1982-01-01

Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medially towards the petrous apex leading to multiple cranial nerve palsies. The computed tomographic (CT) findings in malignant external otitis include obliteration of the normal fat planes in the subtemporal area as well as patchy destruction of the bony cortex of the mastoid. The point of exit of the various cranial nerves can be identified on CT scans, and the extent of the inflammatory mass correlates well with the clinical findings. Four cases of malignant external otitis are presented. In each case CT provided a good demonstration of involvement of the soft tissues at the base of the skull

Progressão continuada, supervisão escolar e avaliação externa: implicações para a qualidade do ensino

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VITOR HENRIQUE PARO

2011-01-01

Full Text Available Derivado de estudio más amplio sobre la estructura de la escuela, este artículo discute resultados de investigación cualitativa, realizada en escuela pública fundamental, sobre cuestiones relacionadas a progresión continuada, supervisión escolar y evaluación externa. Considerando su relación con cualidad de la enseñanza y evaluación escolar, esos temas son tratados desde un concepto de educación como práctica democrática, criticando la práctica pedagógica tradicional. Los datos y análisis sugieren que, cuanto a la progresión continuada, se enfatice la efectividad de la enseñanza en lugar de la aprobación o reprobación de grado; con relación a la supervisión escolar, que se procure desarrollar sus potencialidades de evaluación, asesoría y apoyo a la práctica pedagógica escolar y, con respeto a la evaluación externa, que se ultrapasen sus estrechos límites actuales, promoviendo su articulación con la supervisión escolar, de modo a superar la simple realización masiva de pruebas y testes.

Otitis media.

Science.gov (United States)

Schilder, Anne G M; Chonmaitree, Tasnee; Cripps, Allan W; Rosenfeld, Richard M; Casselbrant, Margaretha L; Haggard, Mark P; Venekamp, Roderick P

2016-09-08

Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; 'glue ear') and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during 'colds', viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibiotics for children with severe, persistent or recurrent infections. Management of OME largely consists of watchful waiting, with ventilation (tympanostomy) tubes primarily for children with chronic effusions and hearing loss, developmental delays or learning difficulties. The role of hearing aids to alleviate symptoms of hearing loss in the management of OME needs further study. Insertion of ventilation tubes and adenoidectomy are common operations for recurrent AOM to prevent recurrences, but their effectiveness is still debated. Despite reports of a decline in the incidence of OM over the past decade, attributed to the implementation of clinical guidelines that promote accurate diagnosis and judicious use of antibiotics and to pneumococcal conjugate vaccination, OM continues to be a leading cause for medical consultation, antibiotic prescription and surgery in high-income countries.

Competencias profesionales en la auditoria externa

OpenAIRE

Sánchez Henríquez, Jorge; Sálas Avila, José; Rodríguez Bustamante, Carla

2006-01-01

Se determinan las competencias que se requiere de un contador público y auditor a nivel de auditoria externa, bajo visiones específicas de competencias, la idea es conocer el concepto de competencias y su aplicación a un contador público y auditor, a través de analizar modelos teóricos y diferentes visiones sobre competencias. Por medio de una herramienta se ausculto el mercado laboral para determinar las competencias que le exige el ejercicio de la auditoria externa, a un contador público y ...

Tipificación molecular del Virus Papiloma Humano en mujeres con lesiones cervicales de alto grado y cáncer de cérvix atentidas en el área de colposcopía en consulta externa del ION Solca Guayaquil, periodo 2013 - 2014.

OpenAIRE

Morocho Molina, Nancy Jannet

2015-01-01

El Virus del Papiloma Humano (VPH) está asociado directamente con el desarrollo del cáncer de cérvix. Objetivo: tipificación y asociación de VPH de alto riesgo en pacientes con LIEAG y cáncer de cérvix que acudieron a la consulta externa del ION SOLCA-GUAYAQUIL, durante el período 2013- 2014. Metodología: el presente estudio fue de tipo descriptivo, observacional y analítico, los exámenes utilizados fueron el papanicolaou, colposcopia, biopsia de cérvix y tipificación viral del VPH medi...

Middle Ear Infection (Chronic Otitis Media) and Hearing Loss

Science.gov (United States)

... Marketplace Find an ENT Doctor Near You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic Otitis ... relations staff at newsroom@entnet.org . What is otitis media? Otitis media refers to inflammation of the middle ...

Infant otitis media and the use of secondary heating sources.

Science.gov (United States)

Pettigrew, Melinda M; Gent, Janneane F; Triche, Elizabeth W; Belanger, Kathleen D; Bracken, Michael B; Leaderer, Brian P

2004-01-01

This prospective study investigated the association of exposure to indoor secondary heating sources with otitis media and recurrent otitis media risk in infants. We enrolled mothers living in nonsmoking households and delivering babies between 1993 and 1996 in 12 Connecticut and Virginia hospitals. Biweekly telephone interviews during the first year of life assessed diagnoses from doctors' office visits and use of secondary home heating sources, air conditioner use, and day care. Otitis media episodes separated by more than 21 days were considered to be unique episodes. Recurrent otitis media was defined as 4 or more episodes of otitis media. Repeated-measures logistic regression modeling evaluated the association of kerosene heater, fireplace, or wood stove use with otitis media episodes while controlling for potential confounders. Logistic regression evaluated the relation of these secondary heating sources with recurrent otitis media. None of the secondary heating sources were associated with otitis media or with recurrent otitis media. Otitis media was associated with day care, the winter heating season, birth in the fall, white race, additional children in the home, and a maternal history of allergies in multivariate models. Recurrent otitis media was associated with day care, birth in the fall, white race, and a maternal history of allergies or asthma. We found no evidence that the intermittent use of secondary home heating sources increases the risk of otitis media or recurrent otitis media. This study confirms earlier findings regarding the importance of day care with respect to otitis media risk.

UNIVERSIDAD NACIONAL EXPERIMENTAL “RAFAEL MARÍA BARALT”: IMAGEN CORPORATIVA EXTERNA

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Julio Rafael Pire Morales

2014-04-01

Full Text Available El estudio tuvo como propósito describir la Universidad Nacional Experimental “Rafael María Baralt” desde su imagen corporativa externa en el municipio Miranda estado Zulia. El estudio fue de carácter descriptivo, con diseño no experimental transversal cuya población estuvo conformada por 2 grupos 18 sujetos denominados comerciantes del sector productivo y 384 jefes de las familias que habitan el 13 sectores de la Parroquia Altagracia, municipio Miranda a quienes se les aplicó un instrumento cuestionario de doble versión tipo Likert, cuya confiabilidad se alcanzó con la realización de una prueba piloto a 20 sujetos obteniendo un alfa cronbach de 0,8494. El análisis de los resultados se llevó a cabo con una estadística descriptiva a través de frecuencia absoluta y relativa tal como se observa en el siguiente apartado. Como conclusiones se resaltó. Los públicos responden tener una actitud positiva cuando opinan que la UNERMB ha contribuido en el desarrollo del Municipio Miranda y mejorado la calidad de vida de sus habitantes, al tiempo que la comunidad se siente orgullosa de contar con esta institución en el municipio Miranda.

International recognition of the Chronic Otitis Media Questionnaire 12.

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Kosyakov, S I; Minavnina, J V; Phillips, J S; Yung, M W

2017-06-01

The Chronic Otitis Media Questionnaire 12 was developed initially in the UK to assess patient-reported health-related quality of life associated with chronic otitis media. This study aimed to determine whether this tool is applicable to the Russian population, which has a materially different healthcare system. A total of 108 patients with different forms of chronic otitis media completed the Russian Chronic Otitis Media Questionnaire 12. The average Russian Chronic Otitis Media Questionnaire 12 score was 19.4 (standard deviation = 8.3). The internal consistency of the Russian Chronic Otitis Media Questionnaire 12 was high, with a Cronbach's alpha value of 0.860. The Russian version of the Chronic Otitis Media Questionnaire 12 was found to be a reliable tool for the assessment of health-related quality of life in patients with chronic otitis media. This sets the scene for international collaboration, using this tool to assess the effectiveness of surgical treatments even amongst countries with different healthcare systems.

Contrapulsación externa aumentada, un tratamiento no invasivo recomendado para la angina refractaria, valoración de la clase funcional y la calidad de vida

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Fernán Mendoza

2017-05-01

Conclusiones: La terapia de contrapulsación externa aumentada, mejora la calidad de vida y la clase funcional de angina y disnea en pacientes con angina refractaria y se convierte en un procedimiento no invasivo seguro y eficaz.

[Validation of the Otitis Media-6 Questionnaire for European Portuguese].

Science.gov (United States)

Lameiras, Ana Rita; Silva, Deodato; O'Neill, Assunção; Escada, Pedro

2017-05-31

Otitis media is one of the most prevalent childhood diseases. The impact of otitis media on quality of life of Portuguese children is unknown, because of the unavailability of a tool validated in European Portuguese to assess this consequence of otitis media. The Otitis Media-6 questionnaire (Otitis Media-6) is the most frequently used tool to assess health-related quality of life in children with otitis media. This study aims to create a version in the Portuguese language and culturally adapted to Portugal of the otitis media-6 questionnaire. The Otitis Media-6 questionnaire was translated and culturally adapted to the Portuguese language and population. Then, to assess the instrument psychometric properties, it was applied to a sample of Portuguese children with chronic otitis media with effusion or recurrent acute otitis media. The Portuguese version of Otitis Media-6 questionnaire demonstrated the following psychometric properties: construct validity for baseline (rs = 0.98) and change scores (rs = 0.97), internal consistency (α = 0.780), test-retest reliability (rs = 0.89) and responsiveness to clinical change (t(59) = 10.104). The simplicity and brevity of application of the instrument make it ideal for use in research and in clinical practice, enabling a more objective assessment of the extension of the otitis media impact in children quality of life and a more targeted therapeutic decision. The Portuguese version of the Otitis Media-6 questionnaire is a valid, reliable and sensitive instrument to evaluate the health-related quality of life in Portuguese children with otitis media.

Epidemiology of Intratemporal Complications of Otitis Media

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Maranhão, André

2014-01-01

Full Text Available Introduction Despite the advent of antibiotics and immunizations in the last century, complications of otitis media remain quite frequent, have high morbidity and mortality rates, and pose a challenge to the otorhinolaryngologist. Objective To establish the annual incidence of intratemporal complications of otitis media and prospectively evaluate patients via an analysis of epidemiologic and clinical aspects. Methods Prospective, observational study. Between February 2010 and January 2011, patients admitted to a tertiary care, university-based otology practice with diagnosis of otitis media and an associated intratemporal complication (ITC were included in the study. The following data were evaluated: age, sex, type of ITC, treatment, imaging tests findings, type and degree of hearing loss, and clinical outcome. The overall incidence of all complications and of each complication individually was determined. Results A total of 1,816 patients were diagnosed with otitis media. For 592 (33% individuals, the diagnosis was chronic otitis media; for 1,224 (67%, the diagnosis was acute otitis media. ITCs of otitis media were diagnosed in 15 patients; thus, the annual incidence of intratemporal complications was 0.8%. We identified 19 ITC diagnoses in 15 patients (3 patients had more than one diagnosis. Labyrinthine fistulae were diagnosed in 7 (36.8% individuals, mastoiditis in 5 (26.3%, facial palsy in 4 (21.1%, and labyrinthitis in 3 (15.8%. Conclusion The incidence of intratemporal complications in Brazil remains significant when compared with developed countries. Chronic otitis media with cholesteatoma is the most frequent etiology of intratemporal complications. Labyrinthine fistula is the most common intratemporal complication.

Influencia de las economías externas de distrito sobre la productividad empresarial: un enfoque multinivel

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María Jesús Ruiz Fuensanta

2010-01-01

Full Text Available El objetivo de este trabajo es estudiar los condicionantes de la productividad de la empresa ubicada en distritos industriales. Para ello, se toma como referencia el marco que proporciona una función de producción Cobb-Douglas donde se combinan tanto factores internos a la empresa como rasgos propios del distrito de pertenencia que la teoría vincula con el surgimiento de las economías externas de distrito. Esta función de producción es estimada empleando la técnica del análisis lineal jerárquico utilizando una muestra de 1.968 empresas manufactureras pertenecientes a 45 concretas localizaciones de la región de Castilla-La Mancha que reúnen los prerrequisitos para constituir un distrito industrial marshalliano. Los resultados obtenidos muestran que las economías externas de distrito explican una gran proporción de la variación inter-distritos de la productividad empresarial.

The Otitis Media-6 questionnaire

DEFF Research Database (Denmark)

Heidemann, Christian Hamilton; Godballe, Christian; Kjeldsen, Anette Drøhse

2013-01-01

The Otitis Media-6 questionnaire (OM-6) is the most frequently used instrument to measure health related quality of life in children with otitis media. The main objectives of this study are 1) to translate and cross-culturally adapt the OM-6 into Danish, and 2) to assess important psychometric...

Determination of eustachius tube ventilation functioning among benign type chronic suppurative otitis media and non-otitis media subjects using sonotubometry

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Ikhwan, M.; Hafil, A. F.; Bramanthyo, B.

2017-08-01

The Eustachian tube (ET) is responsible for the ventilation, protection, and cleaning of the middle ear. ET dysfunction plays an important role in the pathogenesis of otitis media cases, and thus the treatment and prognosis of these cases is extremely dependent on adequate ET function, which can ultimately affect the success rate of middle ear reconstruction practices. Data research on the ET’s ventilation function is needed to ensure the success of therapy and surgery treatments in the case of Chronic Suppurative Otitis Media (CSOM) patients. This study aims to investigate ET ventilation functioning in benign type CSOM and non-otitis media subjects and to develop another modality to measure ET ventilation functioning in patients with intact and perforated tympanic membranes. A comparative cross-sectional study of 36 benign type CSOM patients and 80 non-otitis media subjects will be conducted using sonotubometry and the rated parameter measurements of ET opening frequency, amplitude and ET opening duration. Malfunctioning ventilation of the ET is more common among benign type CSOM subjects (47%) than among non-otitis media subjects (18.75%). There is a significant difference (p = 0.002) between the ET ventilation functioning of benign type CSOM subjects and non-otitis media subjects—benign type CSOM subjects have rates of malfunctioning ET ventilation that are 3.88 times higher than those of non-otitis media subjects. Patients with benign type CSOM are more likely to experience malfunctioning ET ventilation than are non-otitis media subjects.

Costes laborales y competitividad externa de la economía andaluza (2007-2014)

OpenAIRE

Manuel Alejandro Cardenete; M. Carmen Delgado; Ricardo Molero-Simarro

2017-01-01

El objetivo de este artículo es analizar la evolución de la competitividad externa de la economía andaluza. Para ello se toman dos dimensiones principales de análisis: En primer lugar, se analiza la evolución de los costes laborales unitarios y su relación con el desempeño exportador andaluz a nivel agregado. En segundo lugar, se analizarán una serie de indicadores de la actuación tanto empresarial, como del sector público, en los ámbitos determinantes de la posición competitiva regional a ni...

Update on otitis media – prevention and treatment

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Qureishi A

2014-01-01

Full Text Available Ali Qureishi,1 Yan Lee,2 Katherine Belfield,3 John P Birchall,4 Matija Daniel,21Otolaryngology Head and Neck Surgery, Northampton General Hospital, Northampton, UK; 2NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, UK; 3Biomaterials Related Infection Group, 4Otorhinolaryngology Head and Neck Surgery, The University of Nottingham, Nottingham, UKAbstract: Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment.Keywords: otitis media, ear, hearing, infection, biofilm, antibiotics

Middle Ear Infection (Chronic Otitis Media) and Hearing Loss

Science.gov (United States)

... ENT Doctor Near You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic ... relations staff at newsroom@entnet.org . What is otitis media? Otitis media refers to inflammation of the ...

Adenoid ciliostimulation in children with chronic otitis media.

Science.gov (United States)

Andreoli, Steven M; Schlosser, Rodney J; Wang, Ling-Feng; Mulligan, Ryan M; Discolo, Christopher M; White, David R

2013-01-01

Adenoid hypertrophy and chronic adenoiditis are associated with an increased incidence of chronic otitis media. This study intends to determine the relationship between chronic otitis media and dynamic ciliary beat frequency in children undergoing adenoidectomy. Prospective, controlled study. Pediatric tertiary care hospital. Children undergoing adenoidectomy were enrolled. Patients were stratified according to their indication for surgery, including adenotonsillar hypertrophy with obstructive sleep apnea, chronic otitis media with effusion, or recurrent episodes of acute otitis media. Adenoids were harvested using the curette. Tissue was sectioned and allowed to equilibrate in basal media for 24 hours. Cilia-bearing tissue was then stimulated using isoproterenol or methacholine. Ciliary beat frequency was serially reordered and analyzed using the Sisson-Ammons Video Analysis software program. Baseline ciliary beat frequency was similar in all groups (N = 47, total). Using isoproterenol, children with chronic otitis media with effusion demonstrated a blunted dynamic ciliary response at 2 and 3 hours relative to control (P = .0176 and P = .0282). Methacholine-stimulated ciliary beat frequency was not different between each group. At 2 and 3 hours following isoproterenol stimulation, there was a significant blunting of dynamic ciliary beat frequency in children with chronic otitis media with effusion. This ciliary dysfunction may provide a physiological explanation related to chronic adenoiditis in children with chronic otitis media.

Evidence-based management of otitis media: a 5S model approach.

Science.gov (United States)

Wasson, J D; Yung, M W

2015-02-01

The 5S model proposes five hierarchical levels (systems, summaries, synopses, syntheses and studies) of pre-appraised evidence to guide evidence-based practice. This review aimed to identify and summarise pre-appraised evidence at the highest available 5S level for the management of different subsets of otitis media: acute otitis media, otitis media with effusion, chronic suppurative otitis media and cholesteatoma in both adults and children. Data sources were pre-appraised evidence resources. Evidence freely available from sources at the highest available level of the 5S model were summarised for this review. System level evidence exists for acute otitis media and otitis media with effusion. Summary level evidence exists for recurrent acute otitis media and medical management of chronic suppurative otitis media. There is an absence of randomised controlled trials to prove the efficacy of surgical management of chronic suppurative otitis media and cholesteatoma. Until randomised controlled trial data are generated, consensus publications on the surgical management of chronic suppurative otitis media and cholesteatoma should be used to guide best practice.

Evaluación de la transferencia de oxígeno en cultivos con lactococcus lactis empleando un sistema de fermentación con aireación externa

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Andrea Soler

2010-07-01

Full Text Available Título en inglés: Evaluating oxygen transfer in a Lactococcus lactis cultures using an external aeration fermentation system (EAFS Resumen En fermentaciones aerobias el oxígeno, como aceptor terminal de electrones en el proceso de respiración, comúnmente se constituye en limitante debido entre otros factores al diseño del biorreactor (factores geométricos, a las condiciones de operación de los fermentadores (condiciones ambientales requeridas en el cultivo, potencia transferida al cultivo por el sistema de agitación, propiedades del medio líquido, demanda de oxígeno por parte del microorganismo, sistema de aireación (concentración de oxígeno en el gas, solubilidad del oxígeno. La limitación de oxígeno se refleja en la fermentación con Lactococcus lactis cepa IBUN 34.1, en que presenta una baja disponibilidad de oxígeno desde muy temprano en la fase exponencial del cultivo. Para superar estas limitaciones se diseñó y desarrolló un sistema de suministro de oxígeno de alta tasa de transferencia, consistente en un sistema de fermentación con aireación externa (SFAE, el cual es comparado en este trabajo con el sistema tradicional de fermentador agitado dotado con dos turbinas tipo Rushton y aireación por difusor interno. En este trabajo se evalúa la operación del SFAE, se seleccionan y estudian algunas variables operacionales y su efecto sobre la transferencia de oxígeno gas-líquido. Los resultados indican que las variables que tienen efecto significativo sobre el coeficiente volumétrico global de transferencia de masa kLa son la agitación y el flujo de medio de cultivo que circula por el aireador externo denominado flujo de recirculación. Los valores de kLa obtenidos indican que con el fermentador convencional con aireación interna el mayor valor de kLa alcanzado fue de 40,68 (h-1, en tanto que con el SFAE se alcanzaron valores de 63,18 (h-1. Palabras clave: biorreactores; kLa; transferencia de ox

Acute otitis media.

Science.gov (United States)

Dickson, Gretchen

2014-03-01

One in 4 children will have at least 1 episode of acute otitis media (AOM) by age 10 years. AOM results from infection of fluid that has become trapped in the middle ear. The bacteria that most often cause AOM are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Differentiating AOM from otitis media with effusion (OME) is a critical skill for physicians, as accurate diagnosis will guide appropriate treatment of these conditions. Although fluid is present in the middle ear in both conditions, the fluid is not infected in OME as is seen in AOM patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Panel 3: Genetics and Precision Medicine of Otitis Media.

Science.gov (United States)

Lin, Jizhen; Hafrén, Hena; Kerschner, Joseph; Li, Jian-Dong; Brown, Steve; Zheng, Qing Y; Preciado, Diego; Nakamura, Yoshihisa; Huang, Qiuhong; Zhang, Yan

2017-04-01

Objective The objective is to perform a comprehensive review of the literature up to 2015 on the genetics and precision medicine relevant to otitis media. Data Sources PubMed database of the National Library of Medicine. Review Methods Two subpanels were formed comprising experts in the genetics and precision medicine of otitis media. Each of the panels reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a merged draft was created. The entire panel met at the 18th International Symposium on Recent Advances in Otitis Media in June 2015 and discussed the review and refined the content. A final draft was made, circulated, and approved by the panel members. Conclusion Many genes relevant to otitis media have been identified in the last 4 years in advancing our knowledge regarding the predisposition of the middle ear mucosa to commensals and pathogens. Advances include mutant animal models and clinical studies. Many signaling pathways are involved in the predisposition of otitis media. Implications for Practice New knowledge on the genetic background relevant to otitis media forms a basis of novel potential interventions, including potential new ways to treat otitis media.

Otitis Media: Beyond the Examining Room.

Science.gov (United States)

Welling, Deborah R; Ukstins, Carol A

2018-02-01

The management of hearing loss associated with otitis media is multifaceted. Clinical practice guidelines set the collaborative prescriptive standards for the medical management of otitis media in children. Treatment of this condition does not end with the medical practitioner. There are far-reaching effects of otitis media and its sequelae that permeate every aspect of patients' lives including physiological, educational, and psychosocial. Therefore, a comprehensive interprofessional treatment plan must be designed taking into consideration best practices from a range of professions to maximize clinical outcomes, including the treating physician, speech-language pathologist, clinical audiologist, educational audiologist, and professionals in the educational setting. Copyright © 2017 Elsevier Inc. All rights reserved.

Influencia de las economías externas de distrito sobre la productividad empresarial: un enfoque multinivel

Directory of Open Access Journals (Sweden)

María Jesús Ruiz Fuensanta

2010-01-01

Full Text Available El objetivo de este trabajo es estudiar los condicionantes de la productividad de la empresa ubicada en distritos industriales. Para ello, se toma como referencia el marco que proporciona una función de producción Cobb-Douglas donde se combinan tanto factores internos a la empresa como rasgos propios del distrito de pertenencia que la teoría vincula con el surgimiento de las economías externas de distrito. Esta función de producción es estimada empleando la técnica del análisis lineal jerárquico utilizando una muestra de 1.968 empresas manufactureras pertenecientes a 45 concretas localizaciones de la región de Castilla-La Mancha que reúnen los prerrequisitos para constituir un distrito industrial marshalliano. Los resultados obtenidos muestran que las economías externas de distrito explican una gran proporción de la variación inter-distritos de la productividad empresarial. Clasificación JEL: D24, L22, R30.

Skull base osteomyelitis: role of three phase and hybrid SPECT/CT bone scintigraphy

International Nuclear Information System (INIS)

Chakraborty, D.; Bhattacharaya, A.; Kamaleshwaran, K.K.; Mittal, B.R.; Aggarwal, K.; Singh, B.; Bhoil, A.

2010-01-01

Full text: Skull base osteomyelitis is the infection that has spread to the skull base, beyond the external auditory canal and seen in advanced stage of malignant otitis externa. Early diagnosis of this condition includes the use of bone scintigraphy since clinical assessment alone cannot differentiate the skull base osteomyelitis from the severe type of otitis externa in which there is no extension to the adjacent bone. Objective: To determine the role of three phase bone scintigraphy and delayed SPECT/CT in detection of skull base osteomyelitis in patients with malignant otitis externa. Material and Methods: Clinical records of 20 patients (14 Males and 6 Females; mean age 72 yrs) of otitis externa with suspected skull base involvement referred for bone scintigraphies were analyzed retrospectively. Three phase bone scintigraphy was acquired under dual detector gamma camera after intravenous injection of 20 mCi (740 MBq) 99m Tc-MDP followed by SPECT/CT of the skull. Scintigraphic findings were compared with clinical symptoms, signs and diagnostic CT scan findings. Results: All the patients except one were diabetic and having elevated ESR. 18 patients presented with bilateral symptoms and rest unilateral. Cranial nerves were involved in 8 patients (40%). Ear discharge culture sensitivity report was found in three patients; it was positive for Pseudomonas aeruginosa for two patients and in Diptheroids for one. In 9 patients (45%) increased flow of tracer and 10 patients (50%) increased blood pool phase in the temporal region was found. Delayed phase images showed increased uptake in skull bone in 19 patients (95%). Hybrid SPECT/CT of the skull localized areas of increased tracer uptake to the mastoid part in 15 patients (75%), petrous part in 11 patients (55%), sphenoid in 3 patients (15%) and zygomatic bone in one patient (5%) with CT showing destructive changes in 5 patients (25%) which were corroborated with diagnostic CT findings. SPECT/CT along with three phase

Ammianus adversas externae gentes : la geografía del Barbaricum en Amiano Marcelino

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Francisco Javier Guzmán Armario

1999-01-01

Full Text Available Las «externae gentes», pueblos que habitaban los territorios allende las fronteras del Imperio Romano, fueron descritas, por los autores clásicos, con una serie de rasgos negativos que las definían por oposición al fiambre mediterráneo. Uno de los más importantes rasgos de los bárbaros, quizás el origen de todos los demás, es el medio geográfico en que vivían. En un historiador como Amiano l\\ñarcelino, tan hostil hacia los elementos foráneos, la geografía del «Barbaricum» se revela como una elemento fundamental en sus «Res gestae».The «externae gentes», peoples that inhabited the territories beyond the frontiers of the Román Empire, were described, by the classical writters, with a serie or negativo features that defined them against the IVIediterranean man. One of the most important features of the barbarians, perhaps the source of everyone, is the geographical environment in which they lived. In an historian like Ammianus Marcellinus, so adverse towards the foreigners, the geography of the «Barbaricum» is presented as a fundamental element in his «Res gestae».

Eustachian tube three-dimensional reconstruction of secretory otitis media

International Nuclear Information System (INIS)

Yu Yafeng; Zhou Weirong; Bao Xueping; Li Min; Hu Zhenmin

2006-01-01

Objective: To study relationship between Eustachian tube and secretory otitis media and to explore the pathogeny of secretory otitis by three-dimensional reconstruction of Eustachian tube. Methods: Thirty cases of secretory otitis media (male 19, female 11) were selected randomly. Everyone was checked by otoscope and audiometry. Their bilateral Eustachian tubes were scanning by helix CT while making Valsalva's action. All images were passed on to work station to make three-dimensional reconstruction. Results: Four patients were found have Eustachian tube diseases, while most of patients' Eustachian tubes ventilated normally. Conclusions: Three-dimensional reconstruction of Eustachian tube can open out some pathogens of some secretory otitis medias. It will be helpful to diagnosis and therapy of secretory otitis media. (authors)

Serotype distribution of pneumococci isolated from pediatric patients with acute otitis media and invasive infections, and potential coverage of pneumococcal conjugated vaccines Distribución de serotipos de neumococos aislados de pacientes pediátricos con otitis media aguda e infecciones invasivas y su cobertura potencial a través de vacunas conjugadas

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Vanesa Reijtman

2013-03-01

Full Text Available A 16-month prospective, descriptive study was conducted on pneumococcal serotype distribution isolated from children with acute otitis media (AÜM and invasive infections (INV. Eighty-nine children with pneumococcal INV and 324 with a first episode of AOM were included. Bacterial pathogens (N = 326 were isolated from the middle-ear fluid of 250 patients. A total of 30 pneumococcal serotypes were identified. Prevalent serotypes were 14, 19A, 9V, 3, 19F, 6A, 23F, and 18C in AOM and 14, 1, 19A, 5, 12F, 6B, and 18C in INV. Potential coverage with PCV10 vaccine would be 46.5 % and 60.7 % for pneumococci involved in AOM and INV, respectively; it would be 71.7 % and 73 % with PCV13. PCV10, conjugated with a Haemophilus protein, would have an immunologic coverage of 39.9 % for AOM vs. 18.5 % with PCV13. However, differences in the prevention of INV were crucial for the decision to include the 13-valent vaccine in the national calendar for children less than two years old in Argentina.Se realizó un estudio prospectivo descriptivo sobre la distribución de serotipos de neumococos aislados de niños con otitis media aguda (OMA y con infecciones invasivas (INV en un período de 16 meses. Se incluyeron 89 niños con INV neumocócicas y 324 con un primer episodio de OMA. Trescientos cuarenta y seis patógenos se aislaron de las secreciones de oído medio obtenidas de 250 pacientes. Se identificaron 30 serotipos y los más prevalentes fueron el 14, 19A, 9V, 3, 19F, 6A, 23F y 18C en OMA y el 14, 1, 19A, 5, 12F, 6B y 18C en INV. La cobertura potencial con la vacuna PCV10 sería de 46,5 % y 60,7 % para neumococos involucrados en OMA y en INV, respectivamente; con la PCV13, esta sería de 71,7 % y 73 %. La PCV10 conjugada con una proteína de Haemophilus tendría una cobertura inmunológica del 39,9 % para OMA, contra una cobertura del 18,5 % de la PCV13. Sin embargo, las diferencias en la prevención de INV fueron determinantes a la hora de considerar

Quantitative bone and 67Ga scintigraphy in the differentiation of necrotizing external otitis from severe external otitis

International Nuclear Information System (INIS)

Uri, N.; Gips, S.; Front, A.; Meyer, S.W.; Hardoff, R.

1991-01-01

Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 ± 0.16 in patients with NEO and 1.08 ± 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 ± 0.24 in NEO patients and 1.05 ± 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic patients with severe external otitis and nondiabetic patients. The scintigraphic studies were also evaluated using a qualitative scoring method (scores 0 to +4), according to the intensity of the radiopharmaceutical uptake. This method was found to be inferior in the diagnosis of NEO compared with the quantitative method. We conclude that lesion-to-nonlesion ratios greater than 1.5 and 1.3 on bone and gallium 67 scintigraphy, respectively, are indicative of NEO. Quantitative bone scintigraphy, which is quicker to perform, may be used as a single imaging modality for the diagnosis of NEO

Las redes sociales directivas externas y la estrategia corporativa

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Fernández Pérez, Virginia

2008-11-01

Full Text Available Este trabajo pretende aportar un punto de vista más amplio sobre el desarrollo de la toma de decisiones directiva relacionada con la elección e implantación de la estrategia corporativa, para lo que incorpora las redes sociales externas de los directivos como elemento explicativo del proceso, ya que son fuentes de información y referencias sociales muy importantes. Los contactos sociales pueden condicionar en gran medida el comportamiento estratégico de la organización y por tanto, su desempeño. En particular, se han estudiado varias de las dimensiones de la estructura de dichas redes para profundizar en sus efectos. Estas dimensiones son el tamaño y la fortaleza y tienen diferente incidencia sobre las distintas etapas del proceso de toma de decisiones, siendo más importante el tamaño para la captación de información y oportunidades de negocio, dando lugar a comportamientos emprendedores y estrategias proactivas; mientras que la fortaleza suele estar relacionada con estrategias más conservadoras. Y todo ello nos deja entrever la importancia de las redes sociales directivas en general y como una adecuada estructura puede ser determinante para el éxito empresarial.

Influencia de las economías externas de distrito sobre la productividad empresarial: un enfoque multinivel

OpenAIRE

María Jesús Ruiz Fuensanta

2010-01-01

El objetivo de este trabajo es estudiar los condicionantes de la productividad de la empresa ubicada en distritos industriales. Para ello, se toma como referencia el marco que proporciona una función de producción Cobb-Douglas donde se combinan tanto factores internos a la empresa como rasgos propios del distrito de pertenencia que la teoría vincula con el surgimiento de las economías externas de distrito. Esta función de producción es estimada empleando la técnica del análisis lineal jerárqu...

Learning Disabilities and Conductive Hearing Loss Involving Otitis Media.

Science.gov (United States)

Reichman, Julie; Healey, William C.

1983-01-01

A review of research on the relationship of otitis media (ear infection) and learning/language/hearing disorders revealed that incidence of otitis media was twice as common in learning disabled as nonLD students; and that, in general, otitis-prone children scored below controls with frequent evidence of performance deficits. (CL)

Caracterización clínico-epidemiológica de la otitis media aguda en pacientes pediátricos

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Ileana Álvarez Lam

2011-09-01

Full Text Available Introducción: la otitis media aguda es una de las enfermedades infecciosas más frecuentes en la infancia, y constituye una de las causas más importantes de consultas médicas y prescripción de antibióticos en los menores de 5 años. Objetivo: determinar el comportamiento clínico epidemiológico de la enfermedad. Métodos: se realizó un estudio descriptivo, longitudinal prospectivo con 60 pacientes entre 1 mes y 14 años de edad con diagnóstico de otitis media aguda purulenta en el Hospital Pediátrico Docente "William Soler", durante el período de 1 año (enero a diciembre de 2008. Los datos clínicos se obtuvieron mediante una encuesta a los padres o tutores de los pacientes. A todos se les realizó timpanocentesis con cultivo y exudado nasofaríngeo. Las cepas aisladas fueron enviadas al Laboratorio Nacional de Referencia de S. pneumoniae y H. influenzae del Instituto de Medicina Tropical "Pedro Kourí" para la caracterización microbiológica y determinación de susceptibilidad antimicrobiana. Resultados: la enfermedad predominó en el grupo ubicado entre 12 y 23 meses (55 %, con mayor afectación del sexo masculino (52 %. La fiebre y las manifestaciones locales referidas a oído medio (irritabilidad, otalgia, llanto nocturno fueron los elementos clínicos referidos con mayor frecuencia. El cuidado fuera del hogar, la exposición al humo de tabaco y el destete precoz fueron los factores de riesgo más frecuentes. S. pneumoniae, H. influenzae no tipificable y S. epidermidis fueron los gérmenes aislados con mayor frecuencia. El 25 % de las cepas de S. pneumoniae tuvieron resistencia intermedia a la penicilina, pero no se reportó resistencia a cefalosporinas de tercera generación. El 98,4 % de los pacientes evolucionaron satisfactoriamente. Las complicaciones de la enfermedad se presentaron en 1,6 % de los casos. Conclusiones: la otitis media aguda es frecuente en niños menores de 36 meses, y está muy relacionada con la presencia

Temporal bone CT findings of tuberculous otitis media : comparison with chronic otitis media

Energy Technology Data Exchange (ETDEWEB)

Chang, Jeong A; Rho, Myung Ho; Kim, Young Min; Lee, Ho Seung; Choi, Pil Yeob; Seong, Young Soon; Kwon, Jae Soo; Lee, Sang Wook [Masan Samsung Hospital, Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of); Jung, Keon Sik [Pohang Sunrin Hospital, Pohang (Korea, Republic of)

1999-06-01

To compare the differential findings of tuberculous otitis media(TOM) with those of chronic sup purative otitis media with or without cholesteatoma, as seen on high resolution temporal bone CT. We retrospectively reviewed 14 cases of TOM, 30 cases of chronic suppurative otitis media(CSOM), and 30 cases of chronic otitis media with cholesteatoma(Chole). All had been pathologically confirmed. We evaluated the preservation of mastoid cells without sclerotic change, the location and extension of soft tissue to the external auditary canal, and erosion of ossicles, the tegmen tympani, scutum, bony labyrinth, facial nerve canal and sigmoid sinus, and the presence of intracranial complications. Soft tissue in the mastoid antrum was seen in all cases of TOM(100%), 29 cases of CSOM(96.7%), and 26 cases of Chole(86.7%). In contrast, the soft tissue in the entire middle ear cavity was noted in 13 cases of TOM(92.8%), 7 cases of CSOM(23.3%), and 12 cases of Chole(40%). Soft tissue extended to the superior aspect of the external auditory canal in 4 cases of TOM (28.6%) and 5 cases of Chole (16.7%). Mastoid air cells were seen in 9 cases of TOM (64.3%), 4 cases of CSOM (13.3%), and 3 cases of Chole(10%). Ossicular erosion was noted in 6 cases of TOM (42.9%), 12 cases of CSOM (40%), and 26 cases of Chole(86.7%), while in one case of TOM (7.1%), 5 cases of CSOM (16.7%), and 15 cases of Chole(50%) there was erosion of the scutum. In one case of TOM, follow-up CT study after 9 months of antituberculous medication without surgery revealed complete clearing of previously noted soft tissue in the middle ear cavity. Specific CT findings of TOM were not seen, but if there were findings of soft tissue in the entire middle ear cavity, soft tissue extension to the external auditory canal, preservation of mastoid air cells without sclerotic change, and intact scutum, TOM may be differentiated from other chronic otitis media.

Temporal bone CT findings of tuberculous otitis media : comparison with chronic otitis media

International Nuclear Information System (INIS)

Chang, Jeong A; Rho, Myung Ho; Kim, Young Min; Lee, Ho Seung; Choi, Pil Yeob; Seong, Young Soon; Kwon, Jae Soo; Lee, Sang Wook; Jung, Keon Sik

1999-01-01

To compare the differential findings of tuberculous otitis media(TOM) with those of chronic sup purative otitis media with or without cholesteatoma, as seen on high resolution temporal bone CT. We retrospectively reviewed 14 cases of TOM, 30 cases of chronic suppurative otitis media(CSOM), and 30 cases of chronic otitis media with cholesteatoma(Chole). All had been pathologically confirmed. We evaluated the preservation of mastoid cells without sclerotic change, the location and extension of soft tissue to the external auditary canal, and erosion of ossicles, the tegmen tympani, scutum, bony labyrinth, facial nerve canal and sigmoid sinus, and the presence of intracranial complications. Soft tissue in the mastoid antrum was seen in all cases of TOM(100%), 29 cases of CSOM(96.7%), and 26 cases of Chole(86.7%). In contrast, the soft tissue in the entire middle ear cavity was noted in 13 cases of TOM(92.8%), 7 cases of CSOM(23.3%), and 12 cases of Chole(40%). Soft tissue extended to the superior aspect of the external auditory canal in 4 cases of TOM (28.6%) and 5 cases of Chole (16.7%). Mastoid air cells were seen in 9 cases of TOM (64.3%), 4 cases of CSOM (13.3%), and 3 cases of Chole(10%). Ossicular erosion was noted in 6 cases of TOM (42.9%), 12 cases of CSOM (40%), and 26 cases of Chole(86.7%), while in one case of TOM (7.1%), 5 cases of CSOM (16.7%), and 15 cases of Chole(50%) there was erosion of the scutum. In one case of TOM, follow-up CT study after 9 months of antituberculous medication without surgery revealed complete clearing of previously noted soft tissue in the middle ear cavity. Specific CT findings of TOM were not seen, but if there were findings of soft tissue in the entire middle ear cavity, soft tissue extension to the external auditory canal, preservation of mastoid air cells without sclerotic change, and intact scutum, TOM may be differentiated from other chronic otitis media

La dimensión externa de la responsabilidad social empresarial de CANTV

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María Alejandra Ferrer

2013-01-01

Full Text Available El objetivo de este trabajo es describir la dimensión externa de la responsabilidad social empresarial de la Compañía Anónima Nacional Teléfonos de Venezuela (Cantv, principal proveedor de servicios de telecomunicaciones en Vene-zuela. La investigación es de tipo descriptiva, basada en los aportes de Gómez y Luis-Bassa (2005, Rendueles (2010, Ramírez, Miquelena, Galuppo, Bermúdez y Blanco (2010, y Aguirre, Pelekais y Paz (2012, entre otros. Se acude a la revisión de la información disponible en el portal web de Cantv relacionado con las iniciativas de responsabilidad social de la empresa. Se evidencia la presencia de elementos de la dimensión externa de la responsabilidad social dirigidos a diferentes ámbitos y beneficiarios. Sin embargo, la promoción y divulgación de los logros de los programas sociales llevados a cabo por resultan insuficientes para estimular la participación de la comunidad, así como de aliados sociales. Dado el carácter estratégico que se le concede a la responsabilidad social empresarial, los resultados de la inversión social de la entidad tendrán una repercusión importante en sus beneficios financieros en la medida en que sus logros sociales tengan una mayor divulgación.

La dimensión externa de la responsabilidad social empresarial de CANTV

Directory of Open Access Journals (Sweden)

María Alejandra Ferrer

2013-09-01

Full Text Available El objetivo de este trabajo es describir la dimensión externa de la responsabilidad social empresarial de la Compaía Anónima Nacional Teléfonos de Venezuela (Cantv, principal proveedor de servicios de telecomunicaciones en Venezuela. La investigación es de tipo descriptiva, basada en los aportes de Gómez y Luis-Bassa (2005, Rendueles (2010, Ramírez, Miquelena, Galuppo, Bermúdez y Blanco (2010, y Aguirre, Pelekais y Paz (2012, entre otros. Se acude a la revisión de la información disponible en el portal web de Cantv relacionado con las iniciativas de responsabilidad social de la empresa. Se evidencia la presencia de elementos de la dimensión externa de la responsabilidad social dirigidos a diferentes ámbitos y beneficiarios. Sin embargo, la promoción y divulgación de los logros de los programas sociales llevados a cabo por resultan insuficientes para estimular la participación de la comunidad, así como de aliados sociales. Dado el carácter estratégico que se le concede a la responsabilidad social empresarial, los resultados de la inversión social de la entidad tendrán una repercusión importante en sus beneficios financieros en la medida en que sus logros sociales tengan una mayor divulgación.

[Otitis media with effusion in children younger than 1 year].

Science.gov (United States)

Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

2016-06-01

To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2,500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score otitis media with effusion. Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Otitis Media and Children with Hearing Impairments: A Sequela.

Science.gov (United States)

Beattie, R. G. John L.

1991-01-01

This review of research on otitis media in children with existing hearing impairments concludes that the incidence of otitis media is probably higher than in the general population. The possible reasons for higher incidence, effects of otitis media on children with known losses, and the role of the classroom teacher are discussed. (Author/DB)

Ad Hoc Constitution of Topical Antibiotics Solution for Ear Dressing ...

African Journals Online (AJOL)

Background/ Purpose: In the management of chronic suppurative otitis media and otitis externa there are few cases where although an organism is cultured and isolated from the ear, there are either no antibiotic sensitive to the microbiological flora or the sensitive antibiotic is not available in the form of an ear drop, limiting ...

Surgical considerations and safety of cochlear implantation in otitis media with effusion.

Science.gov (United States)

Cevizci, Rasit; Dilci, Alper; Celenk, Fatih; Karamert, Recep; Bayazit, Yildirim

2018-06-01

To evaluate the effects of otitis media with effusion on surgical parameters, patient safety, perioperative and postoperative complications. Total 890 children who underwent cochlear implantation between 2006 and 2015 were included. The ages ranged from 12 months to 63 months (mean: 32 months). The patients were divided into two groups according to the presence or absence of otitis media with effusion; otitis media with effusion group and non-otitis media group. Of 890 children, 105 had otitis media with effusion prior to surgery. In non-otitis media with group, there were 785 children. The average duration of surgery was 60min (ranged from 28 to 75min) in non-otitis media group, and 90min (ranged from 50 to 135min) in otitis media with effusion group (peffusion during the surgery. There was no significant difference between the complications of groups with or without otitis media with effusion (p>0.05). In 5 of 105 patients, there was a ventilation tube inserted before cochlear implantation, which did not change the outcome of implantation. There is no need for surgical treatment for otitis media with effusion before implantation since otitis media with effusion does not increase the risks associated with cochlear implantation. Operation duration is longer in the presence of otitis media with effusion. However, otitis media with effusion leads to intraoperative difficulties like longer operation duration, bleeding, visualization of the round window membrane, cleansing the middle ear granulations as well as mastoid and petrous air cells. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluación externa en la LOMCE. Reválidas, exclusión y competitividad

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Ángel I. Pérez Gómez

2014-01-01

Full Text Available La evaluación de las competencias o cualidades humanas que cada aprendiz ha de desarrollar de manera singular para afrontar la complejidad de la era digital contemporánea es incompatible con las reválidas, test y pruebas externas estandarizadas, iguales para todos. Las cualidades más importantes del aprendizaje en la era digital —autodirección, iniciativa, creatividad, pensamiento crítico, solución de problemas y autoevaluación— son difícilmente evaluables mediante instrumentos baratos y masivos «de papel y lápiz», como los test estandarizados o las reválidas externas; requieren, por el contrario, herramientas y procesos más complejos, plurales y flexibles como la observación continua de los equipos docentes sobre el quehacer y los procesos y productos de los aprendices (Soto Gómez, 2014. La LOMCE,1 fiel exponente de la pedagogía conservadora del movimiento GERM,2 recupera las reválidas, pues apuesta por la estandarización de aprendizajes superficiales en lugar de potenciar el desarrollo singular de cada aprendiz hasta el máximo de sus posibilidades.

Zinc supplements for preventing otitis media.

Science.gov (United States)

Gulani, Anjana; Sachdev, Harshpal S

2014-06-29

Otitis media is inflammation of the middle ear and is usually caused by infection. It affects people of all ages but is particularly common in young children. Around 164 million people worldwide have long-term hearing loss caused by this condition, 90% of them in low-income countries. As zinc supplements prevent pneumonia in disadvantaged children, we wanted to investigate whether zinc supplements could also prevent otitis media. To evaluate whether zinc supplements prevent otitis media in adults and children of different ages. We searched CENTRAL (2014, Issue 1), MEDLINE (1950 to February week 4, 2014) and EMBASE (1974 to March 2014). Randomised, placebo-controlled trials of zinc supplements given at least once a week for at least a month for preventing otitis media. Two review authors independently assessed the eligibility and methodological quality of the included trials and extracted and analysed data. We summarised results using risk ratios (RRs) or rate ratios for dichotomous data and mean differences (MDs) for continuous data. We combined trial results where appropriate. No new trials were identified for inclusion in this update. We identified 12 trials for inclusion, 10 of which contributed outcomes data. There were a total of 6820 participants. In trials of healthy children living in low-income communities, two trials did not demonstrate a significant difference between the zinc-supplemented and placebo groups in the numbers of participants experiencing an episode of definite otitis media during follow-up (3191 participants); another trial showed a significantly lower incidence rate of otitis media in the zinc group (rate ratio 0.69, 95% confidence interval (CI) 0.61 to 0.79, n = 1621). A small trial of 39 infants undergoing treatment for severe malnutrition suggested a benefit of zinc for the mean number of episodes of otitis media (mean difference (MD) -1.12 episodes, 95% CI -2.21 to -0.03). Zinc supplements did not seem to cause any serious adverse

Tuberculous otitis media: a resurgence?

Science.gov (United States)

Kameswaran, M; Natarajan, K; Parthiban, M; Krishnan, P V; Raghunandhan, S

2017-09-01

Tuberculosis is a global health problem that is especially prevalent in developing countries such as India. Recently, atypical presentation has become more common and a high index of suspicion is essential. This study analysed the various presenting symptoms and signs of tuberculous otitis media and the role of diagnostic tests, with the aim of formulating criteria for the diagnosis. A total of 502 patients underwent tympanomastoidectomy over a two-year period. Microbiological and histopathological examinations and polymerase chain reaction analysis of tissue taken during tympanomastoidectomy were performed. A total of 25 patients (5 per cent) were diagnosed with tuberculous otitis media. Severe mixed hearing loss, facial palsy, labyrinthine fistula, post-aural fistula, perichondritis and extradural abscess were noted. There seems to be a resurgence in tuberculous otitis media in India. Microbiological, histopathological and polymerase chain reaction tests for tuberculosis are helpful for its diagnosis.

Traffic-related air pollution and otitis media

NARCIS (Netherlands)

Brauer, Michael; Gehring, Ulrike; Brunekreef, Bert; de Jongste, Johan; Gerritsen, Jorrit; Rovers, Maroeska; Wichmann, Heinz-Erich; Wijga, Alet; Heinrich, Joachim

BACKGROUND: Otitis media is one of the most common infections in young children. Although exposure to environmental tobacco smoke is a known risk factor associated with otitis media, little information is available regarding the potential association with air pollution. OBJECTIVE: We set out to

Pneumococcal conjugate vaccines for preventing otitis media

NARCIS (Netherlands)

Jansen, Angelique G S C; Hak, Eelko; Veenhoven, Reinier H; Damoiseaux, Roger A M J; Schilder, Anne G M; Sanders, Elisabeth A M

2009-01-01

BACKGROUND: Acute otitis media (AOM) is a very common early infancy and childhood disease. The marginal benefits of antibiotics on AOM, the increasing problem of bacterial resistance to antibiotics, and the huge estimated direct and indirect annual costs associated with otitis media (OM) have

Otitis media

NARCIS (Netherlands)

Rovers, MM; Schilder, AGM; Zielhuis, GA; Rosenfeld, RM

2004-01-01

Otitis media (OM) continues to be one of the most common childhood infections and is a major cause of morbidity in children. The pathogenesis of OM is multifactorial, involving the adaptive and native immune system, Eustachian-tube dysfunction, viral and bacterial load, and genetic and environmental

Otitis media with effusion in children younger than 1 year

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Renata Cantisani Di Francesco

2016-06-01

Full Text Available Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position, type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding.

Rare A2ML1 variants confer susceptibility to otitis media

Science.gov (United States)

Santos-Cortez, Regie Lyn P.; Chiong, Charlotte M.; Reyes-Quintos, Ma. Rina T.; Tantoco, Ma. Leah C.; Wang, Xin; Acharya, Anushree; Abbe, Izoduwa; Giese, Arnaud P.; Smith, Joshua D.; Allen, E. Kaitlynn; Li, Biao; Cutiongco-de la Paz, Eva Maria; Garcia, Marieflor Cristy; Llanes, Erasmo Gonzalo D.V.; Labra, Patrick John; Gloria-Cruz, Teresa Luisa I.; Chan, Abner L.; Wang, Gao T.; Daly, Kathleen A.; Shendure, Jay; Bamshad, Michael J.; Nickerson, Deborah A.; Patel, Janak A.; Riazuddin, Saima; Sale, Michele M.; Chonmaitree, Tasnee; Ahmed, Zubair M.; Abes, Generoso T.; Leal, Suzanne M.

2015-01-01

A duplication variant within middle-ear-specific gene A2ML1 co-segregates with otitis media in an indigenous Filipino pedigree (LOD score=7.5 at reduced penetrance) and lies within a founder haplotype that is also shared by three otitis-prone European- and Hispanic-American children, but is absent in non-otitis-prone children and >62,000 next-generation sequences. Seven additional A2ML1 variants were identified in six otitis-prone children. Collectively our studies support a role for A2ML1 in the pathophysiology of otitis media. PMID:26121085

Clinical role of vitamin D in prognosis of otitis media with effusion.

Science.gov (United States)

Akcan, Fatih Alper; Dündar, Yusuf; Akcan, Hümeyra Bayram; Uluat, Ahmet; Cebeci, Derya; Sungur, Mehmet Ali; Ünlü, İlhan

2018-02-01

To investigate the clinical role of Vitamin D in prognosis of Otitis media with effusion. This prospective-controlled study was conducted at otolaryngology department in Duzce University, Turkey. The study group comprised children who were diagnosed with Otitis media with effusion between September 2016 and February 2017. Control group was conducted with children underwent circumcision or inguinal hernia repair operations that confirmed with ENT examination they do not have any sign of otitis media. After 3 months of follow-up without any treatment, unresolved cases who were accepted as chronic otitis media with effusion were operated under general anesthesia for ventilation tube application. Study and control groups were assessed depending on the serum 25(OH)Vitamin D levels at the end of 3 months; otitis media with effusion and chronic otitis media with effusion. One-hundred-seventy-four children with otitis media with effusion and 80 control patients were included to the study. One-hundred-eight (62%) out of 174 patients with otitis media with effusion was completely recovered after a 3-months follow up. Of those 66 out of 174 children, they had persistent diseases, underwent ventilation tube insertion after a 3-months follow-up. The mean 25(OH)Vitamin D level was 18.98 ± 10.60 in otitis media with effusion group and 28.07 ± 14.10 in control group and the difference was statistically significant between the study and control group (p otitis media with effusion group whilst 35 out of 108 patients (32.4%) in complete recovery otitis media with effusion group (p = 0.021). The rate of 25(OH)Vitamin D deficiency was 25% in control group which was statistically different from chronic otitis media with effusion and recovery chronic otitis media with effusion groups (p = 0.006). This study not only shows the relationship between Vitamin D and otitis media with effusion development, but also demonstrates the effects of Vitamin D on otitis media with effusion

Frequency of otitis media based on otoendoscopic evaluation in preterm infants.

Science.gov (United States)

Coticchia, James; Shah, Priyanka; Sachdeva, Livjot; Kwong, Kelvin; Cortez, Josef M; Nation, Javan; Rudd, Tracy; Zidan, Marwan; Cepeda, Eugene; Gonik, Bernard

2014-10-01

This study was conducted to determine the frequency of otitis media in preterm neonates using otoendoscopy and tympanometry. Prospective study. Wayne State University, Hutzel Women's Hospital Neonatal Intensive Care Unit. Eighty-six preterm infants were included (gestational age otitis media. Kappa statistic and logistic regression were used for statistical analysis. Otoendoscopy was performed in 85 patients. The frequency of otoendoscopy-diagnosed otitis media was 72.9% (62/85). Tympanometry could be performed on 69.76% of the ears. There was 73.5% agreement between the findings of tympanometry and those of otoendoscopy. The association between the presence of otitis media and gestational age at birth was statistically significant. The lower the gestational age, the higher the frequency of otoendoscopy-diagnosed otitis media (P = .001). Otoendoscopically diagnosed otitis media is frequent in preterm neonates. There was agreement between the results of tympanometry and those of otoendoscopy. The frequency of otitis media increased with lower gestational age. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Otitis media in Indigenous Australian children: review of epidemiology and risk factors.

Science.gov (United States)

Jervis-Bardy, Jake; Sanchez, L; Carney, A S

2014-01-01

Otitis media represents a major health concern in Australian Indigenous children ('Indigenous children'), which has persisted, despite public health measures, for over 30 years. Global searches were performed to retrieve peer-reviewed and 'grey' literature investigating the epidemiology of and risk factors for otitis media in Indigenous children, published between 1985 and 2012. In Indigenous children, the prevalence of otitis media subtypes is 7.1-12.8 per cent for acute otitis media, 10.5-30.3 per cent for active chronic otitis media and 31-50 per cent for tympanic membrane perforation. The initial onset of otitis media in Indigenous children occurs earlier and persists for longer after the first year of life, compared with non-Indigenous children. Indigenous children are colonised by otopathogens more frequently, at younger ages and with a higher bacterial load. Poor community and domestic infrastructure, overcrowding and exposure to tobacco smoke increase the risk of otitis media in Indigenous children; however, the availability of swimming pools plays no role in the prevention or management of otitis media. Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.

Vestibular evaluation in children with otitis media with effusion.

Science.gov (United States)

Kolkaila, E A; Emara, A A; Gabr, T A

2015-04-01

Fifty per cent of children with serous otitis media may have some balance disturbances. To evaluate vestibular function in children with otitis media with effusion. The control group comprised 25 children with bilateral normal hearing and middle-ear function. The study group consisted of 30 children with bilateral otitis media with effusion; these were divided into 2 subgroups according to air-bone gap size. Measures included the Arabic Dizziness Handicap Inventory, an imbalance evaluation sheet for children, vestibular bedside tests for children, and air- and bone-conducted vestibular-evoked myogenic potential testing. Arabic Dizziness Handicap Inventory scores and some vestibular bedside test results were significantly abnormal, with normal video-nystagmography results, in children with otitis media with effusion. Air-conducted vestibular-evoked myogenic potentials were recorded in 73 per cent of children with otitis media with effusion, with significantly delayed latencies. Bone-conducted vestibular-evoked myogenic potentials were successfully detected in 100 per cent of children with otitis media with effusion with similar results to the control group. The Arabic Dizziness Handicap Inventory and vestibular bedside tests are valuable tools for detecting vestibular impairment in children. Bone-conducted vestibular-evoked myogenic potentials are useful for vestibular system evaluation.

Recurrent acute otitis media detracts from health-related quality of life.

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Kujala, T; Alho, O-P; Kristo, A; Uhari, M; Renko, M; Pokka, T; Koivunen, P

2017-02-01

Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months. Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire. The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children. Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement.

Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

Science.gov (United States)

Laulajainen-Hongisto, Anu; Aarnisalo, Antti A; Jero, Jussi

2016-10-01

Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.

Computed tomography in diagnostics of effluent otitis media

International Nuclear Information System (INIS)

Imomova, L.S.; Norboev, Z.; Kalandarov, S.Ch.

2011-01-01

This article is devoted to computed tomography in diagnostics of effluent otitis media. The purpose of present work is to assess the possibilities of computed tomography method of temporal bone in the diagnostics of otitis media.

Peripheral blood antigen presenting cell responses in otitis-prone and non-otitis-prone infants.

Science.gov (United States)

Surendran, Naveen; Nicolosi, Ted; Kaur, Ravinder; Pichichero, Michael E

2016-01-01

Stringently defined otitis-prone (sOP) children represent a new classification of the otitis-prone condition. Previous studies showed dysfunction in Ab, B-cell memory and T-cell memory responses. We sought to determine whether there are defects in numbers, phenotype and/or function of professional APC in the peripheral blood of sOP infants. APC phenotypic counts, MHC II expression and intracellular cytokine levels were determined in response to TLR7/8 (R848) stimulation by flow cytometry. Innate immune mRNA expression was measured using RT-PCR and cytokines were measured using Luminex technology. Significant (P otitis-prone (NOP) age-matched infants. No significant differences in APC activation or function were observed. Expression of various TLRs, intracellular signaling molecules and downstream cytokines was also not found to be significantly different between sOP and NOP infants. Higher numbers of APCs in sOP infants suggest the possibility of a persistent mucosal inflammatory status. Transcriptional and cytokine profiles of PBMCs among sOP infants suggest their systemic innate responses are not different compared to NOP infants. © The Author(s) 2015.

Korean clinical practice guidelines: otitis media in children.

Science.gov (United States)

Lee, Hyo-Jeong; Park, Su-Kyoung; Choi, Kyu Young; Park, Su Eun; Chun, Young Myung; Kim, Kyu-Sung; Park, Shi-Nae; Cho, Yang-Sun; Kim, Young-Jae; Kim, Hyung-Jong; Korean Otologic Society

2012-08-01

Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media.

Occurrence of otitis media in children and assessment of treatment options.

Science.gov (United States)

Nwokoye, N N; Egwari, L O; Olubi, O O

2015-08-01

Otitis media is a more frequent occurrence in children, and the disease may progress from an acute to chronic state if appropriate and timely intervention is not initiated. A total of 212 children aged 6 months to 10 years were examined and treated for otitis media, in a 13-month hospital-based study. Acute otitis media was diagnosed in 130 (61.3 per cent) of the patients. There were 82 (38.7 per cent) chronic suppurative otitis media cases. The incidence of acute otitis media and chronic suppurative otitis media in the first year of life was 54.6 per cent and 45.1 per cent respectively. Chronic suppurative otitis media patients were assigned to one of three treatment groups. Recovery occurred in 70.4 per cent of amoxicillin-treated patients, in 88.9 per cent of amoxicillin-clavulanic acid treated patients and in 96.4 per cent of culture and antibiotic sensitivity test patients. Relapses were seen only in the amoxicillin (five cases) and amoxicillin-clavulanic acid (two cases) groups. The success rate in patients treated with antibiotics makes this option mandatory for an established diagnosis.

Risk of childhood otitis media with focus on potentially modifiable factors

DEFF Research Database (Denmark)

Kørvel-Hanquist, Asbjørn; Koch, Anders; Lous, Jørgen

2018-01-01

Introduction Otitis media is the primary cause of antibiotic prescription in children. Two-thirds of all children experience at least one episode of otitis media before the age of 7 years. The aim of this study was to characterise the attributable effect of several modifiable risk exposures...... on the risk of >3 episodes of otitis media at age 18 months and 7 years within a large prospective national birth cohort. Methods The study used the Danish National Birth Cohort comprising information about otitis media and risk exposures from more than 50,000 mother-child pairs from the period 1996...... with an increased risk of >3 episodes of otitis media at 18 months of age and at 7 years of age. The fraction of children with otitis media attributed from breastfeeding lasting for less than 6 months was 10%. Introduction to daycare before the age of 12 months attributed with 20% of the cases of >3 episodes...

A historical vignette (20). A royal otitis.

Science.gov (United States)

Tainmont, J

2010-01-01

A royal otitis. The young king of France, Francis II, the eldest son of Henry II and Catherine de Medici, died in Orleans from the effects of the complications of a chronic otitis on 6 December 1560. Based on texts of the time, the paper discusses the nature of the illness, the treatment, and the medical and political entourage of the king.

Laser treatment of otitis media in children

Energy Technology Data Exchange (ETDEWEB)

Podoynitsyna, L.F.

1984-08-01

Clinical trials were conducted with the helium-neon LG-75 laser (632.8 nm, 0.1 W/cm/sup 2/) in the management of 50 children with acute and chronic otitis media. The sessions consisted of 30 sec irradiation directed at the middle ear through the external meatus for a period of 5 days. Positive results were obtained in 45 of the patients with cessation of discharge on the 2nd or 3rd day, and return of hearing by the end of the week. The remission was not permanent in one patient with recurrent otitis media. These observations indicate that the anti-inflammatory effects of helium-neon irradiation constitute an effective treatment modality in children with otitis media. 6 references.

Bacteriology and Antimicrobial Susceptibility of Otitis Media at ...

African Journals Online (AJOL)

Bernt Lindtjorn

2Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia, ... chronic otitis media like meningitis and brain abscess (8). ... because of difference in geography, local antimicrobial .... Table 1: Age and sex distribution of bacterial isolates of otitis media at Dessie Regional Health Research Laboratory ...

Malignant external otitis

International Nuclear Information System (INIS)

Dupuch, K.M.; Iryboz, T.; Firat, M.; Levy, C.; Tubiana, J.M.

1991-01-01

This paper illustrates the value of CT and MR in early diagnosis and spread of malignant external otitis. The authors retrospectively analyzed 15 patients with proved malignant external otitis examined with postcontrast high-resolution CT (15/15) and MR (6/15) (T1- and T2-weighting). Gallium studies were done in 6/15 patients. Early diagnosis was made when CT demonstrated a soft-tissue mass of the external auditory canal associated with scattered zones of cortical bone erosions (13/15). Spread of the disease was better delineated by MR than CT, especially skull base extension (6/15). Temporomandibular joint involvement with extension into parotid or/and masticator spaces 6/15 was as well detected with CT as with MR. If CT remains the first and best procedure for diagnosis, MR - despite its cost - appears a good procedure to depict exact anatomic spread, allowing therapeutic management

The transcriptome of a complete episode of acute otitis media.

Science.gov (United States)

Hernandez, Michelle; Leichtle, Anke; Pak, Kwang; Webster, Nicholas J; Wasserman, Stephen I; Ryan, Allen F

2015-04-03

Otitis media is the most common disease of childhood, and represents an important health challenge to the 10-15% of children who experience chronic/recurrent middle ear infections. The middle ear undergoes extensive modifications during otitis media, potentially involving changes in the expression of many genes. Expression profiling offers an opportunity to discover novel genes and pathways involved in this common childhood disease. The middle ears of 320 WBxB6 F1 hybrid mice were inoculated with non-typeable Haemophilus influenzae (NTHi) or PBS (sham control). Two independent samples were generated for each time point and condition, from initiation of infection to resolution. RNA was profiled on Affymetrix mouse 430 2.0 whole-genome microarrays. Approximately 8% of the sampled transcripts defined the signature of acute NTHi-induced otitis media across time. Hierarchical clustering of signal intensities revealed several temporal gene clusters. Network and pathway enrichment analysis of these clusters identified sets of genes involved in activation of the innate immune response, negative regulation of immune response, changes in epithelial and stromal cell markers, and the recruitment/function of neutrophils and macrophages. We also identified key transcriptional regulators related to events in otitis media, which likely determine the expression of these gene clusters. A list of otitis media susceptibility genes, derived from genome-wide association and candidate gene studies, was significantly enriched during the early induction phase and the middle re-modeling phase of otitis but not in the resolution phase. Our results further indicate that positive versus negative regulation of inflammatory processes occur with highly similar kinetics during otitis media, underscoring the importance of anti-inflammatory responses in controlling pathogenesis. The results characterize the global gene response during otitis media and identify key signaling and transcription factor

THE TREATMENT OF AERO-OTITIS MEDIA BY REDECOMPRESSION,

Science.gov (United States)

The precipitating event preceding the appearance of aero- otitis media is the development of a relative vacuum within the middle ear. The aim of...obtaining normal pressure relationships between the middle ear and the environment. In 27 of a group of 33 men with severe aero- otitis media , this

Chronic suppurative otitis media in Gombe, Nigeria | Ahmad ...

African Journals Online (AJOL)

Background: Chronic suppurative otitis media is a common problem in developing countries and it is necessary to determine the local epidemiology for ... Method: A retrospective study of 206 patients with chronic suppurative otitis media (COSM). ... Children within the age group of 0 – 10 years were the most affected.

Radiographic and computed tomographic evaluation of otitis media in the dog

International Nuclear Information System (INIS)

Love, N.E.; Kramer, R.W.; Spodnick, G.J.; Thrall, D.E.

1995-01-01

The purpose of this study was to compare computed tomography (CT) and radiography in the identification of canine middle ear disease. Fourteen canine patients underwent a radiographic “bullae series” and CT examination of the tympanic bullae. Confirmation of otitis media was based on surgery. The overall diagnostic accuracy of CT and radiographs regarding the diagnosis of otitis media was similar. Although a marked difference was not detected between radiographs and CT for detecting otitis media using Youden's index values, CT was a more sensitive test for the detection of otitis media

Allergic rhinitis is associated with otitis media with effusion

DEFF Research Database (Denmark)

Kreiner-Møller, E; Chawes, B L K; Thomasen, Per Caye

2012-01-01

Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested.......Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested....

A Rare Complication of Acute Otitis Media: Otitic Hydrocephalus

Directory of Open Access Journals (Sweden)

Ahmet Mutlu

2013-06-01

Full Text Available Acute otitis media is very common disorder in childhood. In this article we present a 6-years old boy who applied with diplopia, dysfunction of lateral eye movements on left eye, nausea, at 10th day of acute otitis media treatment. After the radiological images case was described as an otitic hydrocephalus clinic. Patient underwent medical treatment, lomboperitoneal shunt operation and simple mastoidectomy. We wanted to share the evaluation and the management steps of this very rare complication of acute otitis media.

l'otite externe nécrosante place de l'oxygénothérapie hyperbare

African Journals Online (AJOL)

HÔPITAL UNIVERSITAIRE FARHAT HACHED SOUSSE. * CENTRE ... Keywords : Necrotizing otitis externa; hyperbaric oxygen therapy; treatment. CAS CLINIQUES .... rapie hyperbare, mais la disponibilité d'un seul centre en. Tunisie. Auteurs.

Otitis Media Diagnosis for Developing Countries Using Tympanic Membrane Image-Analysis.

Science.gov (United States)

Myburgh, Hermanus C; van Zijl, Willemien H; Swanepoel, DeWet; Hellström, Sten; Laurent, Claude

2016-03-01

Otitis media is one of the most common childhood diseases worldwide, but because of lack of doctors and health personnel in developing countries it is often misdiagnosed or not diagnosed at all. This may lead to serious, and life-threatening complications. There is, thus a need for an automated computer based image-analyzing system that could assist in making accurate otitis media diagnoses anywhere. A method for automated diagnosis of otitis media is proposed. The method uses image-processing techniques to classify otitis media. The system is trained using high quality pre-assessed images of tympanic membranes, captured by digital video-otoscopes, and classifies undiagnosed images into five otitis media categories based on predefined signs. Several verification tests analyzed the classification capability of the method. An accuracy of 80.6% was achieved for images taken with commercial video-otoscopes, while an accuracy of 78.7% was achieved for images captured on-site with a low cost custom-made video-otoscope. The high accuracy of the proposed otitis media classification system compares well with the classification accuracy of general practitioners and pediatricians (~64% to 80%) using traditional otoscopes, and therefore holds promise for the future in making automated diagnosis of otitis media in medically underserved populations.

[Acute otitis media: could it be a sentinel indicator of health care?].

Science.gov (United States)

Cabrera-Gaytán, David Alejandro; Valle-Alvarado, Gabriel; Krug-Llamas, Ernesto; Grajales-Muñiz, Concepción

2014-01-01

Acute otitis media is the most common bacterial disease in children under five years; therefore, is one of the most common causes of pediatric consultation. Our objective was to determine the feasibility to consider this disease as a sentinel factor of medical attention. All the new cases of acute otitis media registered between 2008 and 2011 were collected and analyzed. Proportions, ratios, and incidence rates were determined. Also, the limits for proportions were calculated using mid P exact test. In children under five years, we observed 20 % of the cases of non-suppurative otitis media, and suppurative otitis media in 17 %. The reason for acute respiratory infection in relation to cases of otitis media in children of this age increased from 87:1 in 2008 to 53:1 in 2011. The reason of suppurative otitis media decreased in children under five years, even in 2009, when it was registered the highest number of new cases of acute respiratory infection. It was not feasible to determine if acute otitis media is a sentinel indicator; however, we could monitor medical attention indirectly.

Otitis Media and Related Complications among Children with Autism Spectrum Disorders

Science.gov (United States)

Adams, Daniel J.; Susi, Apryl; Erdie-Lalena, Christine R.; Gorman, Gregory; Hisle-Gorman, Elizabeth; Rajnik, Michael; Elrod, Marilisa; Nylund, Cade M.

2016-01-01

Acute otitis media (AOM) symptoms can be masked by communication deficits, common to children with autism spectrum disorders (ASD). We sought to evaluate the association between ASD and otitis media. Using ICD-9-CM diagnostic codes, we performed a retrospective case-cohort study comparing AOM, and otitis-related diagnoses among children with and…

Three cases of tuberculous otitis media

International Nuclear Information System (INIS)

Oh, Jin Hwan; Sung, Ki Joon; Kim, Myung Soon; Kwon, Taek Sang; Yoon, Byoung Moon

1998-01-01

We report the imaging features of three cases of tuberculous otitis media. All three patients underwent temporal bone CT scanning, and in two, additional MRI scanning was performed. The three cases showed soft tissue density in the external auditory canal, and in two, destruction of the trabeculation and internal cortex of the mastoid bone was noted. In two patients with facial palsy, erosion of the facial canal was seen. On MRI, abundant granulomatous tissue was noted in the middle ear cavity and mastoid air cells. In one case, abnormal enhancement of the cochlea, and of the facial and eighth cranial nerve in the internal acoustic canal was seen. Another case showed enhancement of the vestibule and lateral semicircular canal. If radiologic evaluation of chronic otitis media reveals destruction of the tegmen and trabeculation of the mastoid bone, together with abundant granulation tissue and enhancement of the internal ear, tuberculous otitis media may be included in the differential diagnosis

Three cases of tuberculous otitis media

Energy Technology Data Exchange (ETDEWEB)

Oh, Jin Hwan; Sung, Ki Joon; Kim, Myung Soon; Kwon, Taek Sang; Yoon, Byoung Moon [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of)

1998-07-01

We report the imaging features of three cases of tuberculous otitis media. All three patients underwent temporal bone CT scanning, and in two, additional MRI scanning was performed. The three cases showed soft tissue density in the external auditory canal, and in two, destruction of the trabeculation and internal cortex of the mastoid bone was noted. In two patients with facial palsy, erosion of the facial canal was seen. On MRI, abundant granulomatous tissue was noted in the middle ear cavity and mastoid air cells. In one case, abnormal enhancement of the cochlea, and of the facial and eighth cranial nerve in the internal acoustic canal was seen. Another case showed enhancement of the vestibule and lateral semicircular canal. If radiologic evaluation of chronic otitis media reveals destruction of the tegmen and trabeculation of the mastoid bone, together with abundant granulation tissue and enhancement of the internal ear, tuberculous otitis media may be included in the differential diagnosis.

Genetic and Environmental Determinants of Otitis Media in an Indigenous Filipino Population.

Science.gov (United States)

Santos-Cortez, Regie Lyn P; Reyes-Quintos, Ma Rina T; Tantoco, Ma Leah C; Abbe, Izoduwa; Llanes, Erasmo Gonzalo D V; Ajami, Nadim J; Hutchinson, Diane S; Petrosino, Joseph F; Padilla, Carmencita D; Villarta, Romeo L; Gloria-Cruz, Teresa Luisa; Chan, Abner L; Cutiongco-de la Paz, Eva Maria; Chiong, Charlotte M; Leal, Suzanne M; Abes, Generoso T

2016-11-01

To identify genetic and environmental risk factors for otitis media in an indigenous Filipino population. Cross-sectional study. Indigenous Filipino community. Clinical history and information on breastfeeding, tobacco smoke exposure, and swimming were obtained from community members. Heads of households were interviewed for family history and personal beliefs on ear health. Height and weight were measured. Otoscopic findings were described for the presence and character of perforation or discharge. An A2ML1 duplication variant that confers otitis media susceptibility was Sanger sequenced in all DNA samples. Co-occurrence of middle ear bacteria detected by 16S rRNA gene sequencing was determined according to A2ML1 genotype and social cluster. The indigenous Filipino population has a ~50% prevalence of otitis media. Young age was associated with otitis media (4 age strata; P = .004); however, age was nonsignificant as a bistratal or continuous variable. There was no association between otitis media and sex, body mass index, breastfeeding, tobacco exposure, or deep swimming. In multivariate analyses, A2ML1 genotype is the strongest predictor of otitis media, with an odds ratio of 3.7 (95% confidence interval: 1.3-10.8; P = .005). When otitis media diagnoses were plotted across ages, otitis media was observed within the first year of life, and chronic otitis media persisted up to adulthood, particularly in A2ML1-variant carriers. Among indigenous Filipinos, A2ML1 genotype is the primary risk factor for otitis media and main determinant of disease progression, although age, the middle ear microbiome, and social clusters might modulate the effect of the A2ML1 genotype. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

[The clinical classification of acute otitis media with special reference to tympanometry].

Science.gov (United States)

Subbotina, M V

We have developed a new clinical classification of acute otitis media (AOM) based on the previously proposed classifications of V.T. Palchun with co-workers (1997) and J. Jeger (1970) in which the letter near the stage of the pathological process roughly corresponds to the type of the tympanogram as follows: stage I (acute tubootitis): A, B, C; stage II (acute catarrhal otitis media): A, B, C; stage III (acute purulent otitis media, perforation stage); stage IV (acute purulent otitis media, post-perforation stage); stage V (resolution of otitis media): A - convalescence or recovery, B1 - exudate present in the tympanic cavity; B2 - persisting perforation; C - block of the auditory tube, O - the development of complications. This classification implies the necessity of tympanometry at the stage of diagnostics of AOM although it is not mandatory because the detection of exudate as a result of paracentesis at any of the stages of otitis media will allow to designate the stage of otitis either by letter A, B or C. The application of the new classification described in this article permits to more accurately than before determine the character of the pathological process in the middle ear during the course of acute otitis media which is of special importance in the clinical pediatric practice for the timely and adequate treatment of the children.

Epidemiology of acute otitis in pediatric patients

Directory of Open Access Journals (Sweden)

Maddalena Perotti

2011-03-01

Full Text Available Introduction. Acute otitis is one of the most common pediatric infectious diseases that requires an accurate diagnosis in order to direct appropriate therapy to reduce the risk of complications. In this study pathogens collected from pediatric patients and their antibiotic susceptibility patterns were evaluated. Methods. Between May 2009 and May 2010, 739 samples (swabs taken from nasopharynx in case of acute otitis media and/or from ears in case of acute external otitis, collected from 680 patients, suffering of otalgia, admitted to the emergency department of our Hospital were studied.The specimens were submitted for routine bacterial cultures and the susceptibility tests were performed according to Clinical Laboratory Standards. Nitrocefin was used to detect ß-lactamase activity. Results. 316 samples (42.8% of 739 were negative, 102 (13.8% were positive for Streptococcus pneumoniae, 97 (13.1% for Moraxella catarrhalis, 68 (9.2% for Haemophilus influenzae, 62 (8.4% for Pseudomonas aeruginosa, 49 (6.6% for Staphylococcus aureus, 36 (4.9% for Streptococcus pyogenes, 5 (0.7% for Gram negative and 4 (0.5% for Candida spp. Antibiotic susceptibility tests showed that amikacin, ceftazidime, ciprofloxacin, imipenem, meropenem and piperacillin/tazobactam were active against all Gram negative strains isolated.We found one strain of MRSA. Of 102 Streptococcus pneumoniae, 5 (4.9% were penicillin resistant and 25 (24.5% were erythromycin resistant, showing the prevalence of constitutive phenotype (80%. All M. catarrhalis strains were ß-lactamase producers while all H. influenzae were ß-lactamase negatives. Conclusions. The prevalent etiological agents in pediatric acute otitis are S. pneumoniae, M. catharralis, and H. influenzae, as reported in literature. In external acute otitis P. aeruginosa prevails in particular in summer.

Chrysoperla externa (Neuroptera: Chrysopidae and Utetheisa ornatrix (Lepidoptera: Arctiidae on organically grown Crotalaria juncea (Fabaceae Chrysoperla externa (Neuroptera: Chrysopidae e Utetheisa ornatrix (Lepidoptera: Arctiidae sobre Crotalaria juncea (Fabaceae cultivada organicamente

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M.A. Costa

2012-09-01

Full Text Available Chrysoperla externa (Neuroptera: Chrysopidae larvae can avoid foraging on plants of Crotalaria juncea (Fabaceae after the issuance of floral buds, when the prey of Utetheisa ornatrix (Lepidoptera: Arctiidae incorporate toxic pyrrolizidine alkaloids from this plant. This reduces the predation and favors increasing the number of adults and eggs of this defoliator on crops of this plant. The aim of the present paper was to evaluate some biological and ecological aspects of C. externa and U. ornatrix on the organic crop of C. juncea in the EMBRAPA Maize and Sorghum in Sete Lagoas, Minas Gerais State, Brazil. Chrysoperla externa and U. ornatrix were more abundant in the vegetative and flowering stages of C. juncea, respectively, with caterpillars of this defoliator feeding on leaves and seeds of this plant. The duration of the stages/instars, survival, lifetime fecundity, and oviposition showed that the branches of C. juncea are a suitable food for U. ornatrix. The abundance of adults and larvae of C. externa was lower in the flowering and pods stages of C. juncea, respectively, when the postures of U. ornatrix are present, probably due to the toxicity of the eggs of this prey to this predator. During these stages, C. externa may be reared with alternative hosts, and when the crops of C. juncea are scarce, an artificial diet should be used for rearing this defoliator in the laboratory for biological research and the development of biological control tactics.Larvas de Chrysoperla externa (Neuroptera: Chrysopidae podem evitar o forrageamento sobre plantas de Crotalaria juncea (Fabaceae após a emissão de botões florais, quando presas de Utetheisa ornatrix (Lepidoptera: Arctiidae incorporam alcalóides pirrolizidínicos tóxicos dessa planta. Isso reduz a predação e favorece o aumento do número de adultos e ovos desse desfolhador sobre cultivos dessa planta. O objetivo deste trabalho foi avaliar alguns aspectos biológicos e ecológicos de C

Otitis media in indonesian urban and rural school children.

Science.gov (United States)

Anggraeni, Ratna; Hartanto, Widya W; Djelantik, Bulantrisna; Ghanie, Abla; Utama, Denny S; Setiawan, Eka P; Lukman, Erica; Hardiningsih, Chintriany; Asmuni, Suprihati; Budiarti, Rery; Rahardjo, Sutji Pratiwi; Djamin, Riskiana; Mulyani, Tri; Mutyara, Kuswandewi; Carosone-Link, Phyllis; Kartasasmita, Cissy B; Simões, Eric A F

2014-10-01

Although the epidemiology of otitis media is well-known in industrialized countries, the extent of otitis media in developing Asian countries, especially in south East Asia is not well studied. To define the burden of otitis media and its sequelae in children 6-15 years of age, we enrolled elementary and junior high school children in 6 areas in rural and urban Indonesia. Randomly selected schools and classrooms were selected. All children were administered a questionnaire and had ear examinations, pneumatic otoscopy and screening audiometry. Children with any abnormality on examination or with a relevant history underwent diagnostic audiometry and tympanometry, if indicated. Of the 7005 children studied, 116 had chronic suppurative otitis media (CSOM), 30 had acute otitis media and 26 had otitis media with effusion. 2.7% of rural children had CSOM compared with 0.7% of urban children (P < 0.0001). The rates per 1000 of CSOM in rural Bali and Bandung were significantly higher (75 and 25, respectively) than in the rest of Indonesia (P < 0.05). In rural Bali, the rate per 1000 children of inactive CSOM was 63 in 6- to 9-year-old children, compared with 37 in children aged 13-15 years. Concomitantly, the rates of tympanosclerosis were 7 and 26/1000, respectively, in these age groups. In Indonesia, the prevalence of CSOM is relatively high with most disease occurring in rural areas. The high rates in rural Bali with early progression to tympanosclerosis suggest a significant burden of potentially vaccine preventable illness.

The Importance of Right Otitis Media in Childhood Language Disorders

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Paulino Uclés

2012-01-01

Full Text Available Studies relating chronic otitis media and language disorders in children have not reported consistent findings. We carried out the first selective study aimed at discerning the role of chronic right otitis media in children less than 3 years of age in language development. A total of 35 children were studied using a full linguistic protocol, auditory brainstem responses, and middle latency responses. Twelve children had a history of chronic exclusive right otitis media. Seventeen age-matched children were selected as controls. Also, three children having a history of chronic left otitis media were compared with three age-matched controls. Linguistic tests showed significant differences between patients and controls in phonetic, phonological, and syntax scores but not semantics. Correlation studies between linguistic scores and auditory evoked responses in the whole cohort showed a significant coefficient in phonetic and phonological domains. These results emphasize the causative effect of right ear chronic otitis media and indicate that it mainly impairs phonetic and phonological coding of sounds, which may have implications for prophylactic treatment of at-risk children.

Validation of the Otitis Media-6 Questionnaire for European Portuguese

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Ana Rita Lameiras

2017-05-01

Conclusion: The Portuguese version of the Otitis Media-6 questionnaire is a valid, reliable and sensitive instrument to evaluate the health-related quality of life in Portuguese children with otitis media.

Values Range of Tympanometric Gradient in Otitis Media With Effusion.

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Duzer, Sertac; Sakallioglu, Oner; Akyigit, Abdulvahap; Polat, Cahit; Cetiner, Hasan; Susaman, Nihat

2017-05-01

The aim of this study was to establish how reliable a given tympanogram is in predicting the presence or absence of a middle ear effusion, and to provide new views for the diagnostic information of tympanometry. The use of tympanometric gradient in addition to static admittance is the focus of this study. The authors enrolled 146 female and 129 male patients. The participants were allocated into groups as follow: Group A1 consisted of 50 healthy children. Group A2 consisted of 86 children with otitis media with effusion. Group B1 consisted of 85 healthy adults. Group B2 consisted of 54 adults with otitis media with effusion. All diagnostic otoscopic examination and tympanometry were performed in both ears. The authors analyzed the distribution of tympanograms in patients with otitis media with effusion and healthy controls. When the right and left ear canal volume of either children or adults with otitis media with effusion compared with healthy controls, no statistically significant different was observed (P > 0.05). On the other hand, the statistically significant difference was detected for the values of compliance, pressure and gradient of either children or adults with otitis media with effusion compared with healthy controls (P effusion. The authors think that tympanometric gradient may be useful to detect the otitis media with effusion.

High resolution CT in the investigation of bone destruction in the outer ear

International Nuclear Information System (INIS)

Koester, O.; Straehler-Pohl, H.J.; Bonn Univ.

1986-01-01

Eleven patients with known malignant tumours of the outer ear and three patients with otitis externa maligna were examined by high resolution CT. CT provided accurate information concerning soft tissue infiltration into the parotid or subtemporal tissues, and of the bony destruction in the mastoid, meatus and tympanic cavity. Absolute differentiation between a malignant tumour and otitis cisterna maligna is not possible, not even by high resolution CT. (orig.) [de

Costes laborales y competitividad externa de la economía andaluza (2007-2014

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Manuel Alejandro Cardenete

2017-12-01

Full Text Available El objetivo de este artículo es analizar la evolución de la competitividad externa de la economía andaluza. Para ello se toman dos dimensiones principales de análisis: En primer lugar, se analiza la evolución de los costes laborales unitarios y su relación con el desempeño exportador andaluz a nivel agregado. En segundo lugar, se analizarán una serie de indicadores de la actuación tanto empresarial, como del sector público, en los ámbitos determinantes de la posición competitiva regional a nivel microeconómico. El análisis de la evolución seguida por las variables en nuestra economía se hará en comparación con diversas economías y regiones del entorno. Los resultados obtenidos apuntan a que a pesar de que los costes laborales han seguido una marcada tendencia a la baja, hasta el momento, la crisis no se ha convertido en una oportunidad para mejorar de manera sustancial el posicionamiento de la economía andaluza.

Danish guidelines on management of otitis media in preschool children

DEFF Research Database (Denmark)

Heidemann, C. H.; Lous, J.; Berg, J.

2016-01-01

Introduction: Otitis media is one of the most common diseases in small children. This underlines the importance of optimizing diagnostics and treatment of the condition. Recent literature points toward a stricter approach to diagnosing acute otitis media (AOM). Moreover, ventilating tube treatment...... for recurrent AOM (RAOM) and chronic otitis media with effusion (COME) has become the most frequently performed surgical procedure in pre-school children. Therefore, the Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology, Head and Neck Surgery deemed it necessary to update...... the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME. Methods: The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation...

Treatment of acute otitis media in general practice

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Plejdrup Hansen, Malene; Jarbol, Dorte Ejg; Gahrn-Hansen, Bente

2012-01-01

Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged......Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged...

Chronic suppurative otitis media: Socio-economic implications in a ...

African Journals Online (AJOL)

Chronic suppurative otitis media: Socio-economic implications in a tertiary hospital in Northern Nigeria. ... This paper highlights the socio-economic burden of chronic suppurative otitis media on a ... minimum wage for individuals in our environment where the cost of health care is the sole responsibility of the patient.

Violência e mortes por causas externas

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Graciete Oliveira Vieira

2003-02-01

Full Text Available Através de um estudo ecológico caracterizou-se a violência e as mortes por causas externas em Salvador e Bahia utilizando-se dados da Fundação Nacional de Saúde-Ministério da Saúde, dos registros de mortalidade e das estimativas populacionais do IBGE. O risco de morrer por homicídio no Brasil é 3 vezes o do Estados Unidos, chegando a ser 40 vezes superior ao do Japão. Homicídio foi a primeira causa de anos potenciais de vidas perdidos (13,4% no Brasil (1997, seguido por acidentes de trânsito (10,6%. Causas externas foi a segunda causa de morte em Salvador e Bahia (1996. A violência tem raízes sócio-culturais e político-ideológicas e pode ser prevenida por ações intersetoriais e multidisciplinares.

Otitis media in Brazilian human immunodeficiency virus infected children undergoing antiretroviral therapy.

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Miziara, I D; Weber, R; Araújo Filho, B Cunha; Pinheiro Neto, C Diógenes

2007-11-01

To assess changes in the prevalence of otitis media, associated with the use of highly active antiretroviral therapy, in Brazilian human immunodeficiency virus (HIV) infected children. Division of otorhinolaryngology, Hospital das Clínicas, Sao Paulo University Medical School, Brazil. A cohort of 459 HIV-infected children aged below 13 years. The prevalence of otitis media and the serum cluster of differentiation four glycoprotein T lymphocyte count were compared for children receiving highly active antiretroviral therapy (with protease inhibitors) and those receiving standard antiretroviral therapy (without protease inhibitors). Otitis media was present in 33.1 per cent of the children. Children aged from zero years to five years 11 months receiving highly active antiretroviral therapy had a higher prevalence of acute otitis media (p=0.02) and a lower prevalence of chronic otitis media (p=0.02). Children who were receiving highly active antiretroviral therapy had a mean serum cluster of differentiation four glycoprotein T lymphocyte count greater than that of those who were receiving standard antiretroviral therapy (pBrazilian HIV-infected children was associated with a lower prevalence of chronic otitis media.

Computed tomography study of otitis media; A tomografia computadorizada no estudo das otites medias

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Bahia, Paulo Roberto Valle; Marchiori, Edson [Universidade Federal, Rio de Janeiro, RJ (Brazil). Dept. de Radiologia

1997-03-01

The findings of computed tomography (CT) of 89 patients clinically suspected of having otitis media were studied in this work. Such results were compared to clinical diagnosis, otoscopy, surgical findings and previous data. Among the results of our analysis, we studied seven patients with acute otitis media and 83 patients with chronic otitis media. The patients with acute otitis media have undergone CT examinations to evaluate possible spread to central nervous system. The diagnosis of cholesteatoma, its extension and complications were the main indication. for chronic otitis media study. The main findings of the cholesteatomatous otitis were the occupation of the epitympanun, the bony wall destruction and the ossicular chain erosion. The CT demonstrated a great sensibility to diagnose the cholesteatoma. (author) 25 refs., 10 figs.

Parental views on otitis media: systematic review of qualitative studies.

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Chando, Shingisai; Young, Christian; Craig, Jonathan C; Gunasekera, Hasantha; Tong, Allison

2016-10-01

This study aims to describe parental experiences and perspectives of caring for a child with otitis media. We conducted a systematic review of qualitative studies on parental perspectives on caring for a child with otitis media. We searched electronic databases to July 2015. Seventeen studies involving 284 participants from six countries were included. We identified seven themes: diminishing competency (guilt over failure to identify symptoms, helpless and despairing, fear of complications, disempowered and dismissed); disrupting life schedules (disturbing sleep, interfering with work, burden on family); social isolation (stigma and judgement, sick consciousness); threatening normal development (delaying growth milestones, impairing interpersonal skills, impeding education); taking ownership (recognising symptoms, diagnostic closure, working the system, protecting against physical trauma, contingency planning); valuing support (needing respite, depending on community, clinician validation); and cherishing health (relief with treatment success, inspiring resilience). The additional medical responsibilities and anxieties of parents caring for a child with otitis media, often discounted by clinicians, can be disempowering and disruptive. Chronicity can raise doubt about treatment efficacy and parental competency, and fears regarding their child's development. Care that fosters parental confidence and addresses their concerns about the child's development may improve treatment outcomes for children with otitis media. • Otitis media is a leading cause of conductive hearing loss in children. • Parental perception of the treatment burden of otitis media can potentially affect their confidence and ability to care for their child. What is New: • We identified five themes to reflect parental perspectives: diminishing competency, disrupting life schedules, social isolation, threatening normal development, taking ownership, valuing support, and cherishing health. �

Otitis Media: Coping with the Effects in the Classroom.

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Davis, Dorinne S.

This curriculum adaptation provides a methodology that enables the classroom teacher to recognize the needs of the otitis media-affected child in the classroom. It discusses areas of concern related to otitis media; suggests activities that can enhance these children's language skills; and shows ways to enhance the learning environment by…

Pathogenesis and diagnosis of otitis media with ANCA-associated vasculitis.

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Yoshida, Naohiro; Iino, Yukiko

2014-12-01

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is histologically characterized by systemic necrotizing vasculitis and is clinically classified into two phases, systemic or localized. Recently, otological symptoms such as otitis media and hearing loss, not previously often associated with AAV, have been reported in AAV cases. In these cases we propose a diagnosis of otitis media with AAV (OMAAV). The ANCA titer is important for the diagnosis of OMAAV, and in most cases rapid progressive hearing loss is observed as localized AAV. Peripheral facial nerve palsy or hypertrophic pachymeningitis are coupled with 25% of cases and 18% of cases respectively. Proteinase 3-ANCA (PR3-ANCA) positive otitis media causes granulomatous formation or middle ear effusion in the middle ear, on the other hand myeloperoxidase-ANCA (MPO-ANCA) positive otitis media predominantly presents as otitis media with effusion. The early diagnosed case and the sensorineural hearing loss not progressed deaf could be recovered by the immunosuppressive therapy. Delayed diagnosis of AAV occasionally leads to progression to the irreversible phase; therefore, diagnosis at the early-localized stage is important for treating AAV. In this review, we discuss the current understanding of this newly proposed concept of OMAAV.

Complementary and alternative medicine for pediatric otitis media.

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Levi, Jessica R; Brody, Robert M; McKee-Cole, Katie; Pribitkin, Edmund; O'Reilly, Robert

2013-06-01

To review the literature involving complementary and alternative medicine (CAM) for pediatric otitis media. Multiple modalities are discussed, including prevention involving breastfeeding, nutrition, and vaccination; symptomatic treatment involving homeopathy, natural health products, and probiotics; manual manipulations involving osteopathy and chiropractics; and traditional Chinese and Japanese medicine. The information presented will assist physicians in advising patients on their decision-making during the early stages of otitis media when antibiotics and surgery are not yet indicated. A systematic literature search was conducted through January 2012 in PubMed using MESH term "otitis media" in conjunction with "complementary therapies," "homeopathy," "manipulation, osteopathic," "manipulation, chiropractic," "acupuncture therapy," "probiotics," "naturopathy," and "xylitol." Theses searches yielded 163 unique results. Abstracts and titles were evaluated for relevance. Case reports, case series, randomized controlled trials, and basic science research were included. Publications not relevant to the discussion of alternative medicine in otitis media were excluded. Bibliographies were checked for further publications. Thirty-six unique publications were reviewed. Of all therapies in complementary and alternative medicine, only xylitol has been studied in well-designed, randomized, blinded trials; it is likely effective, but compliance limits its applicability. Management of acute otitis media begins with watchful waiting. Herbal eardrops may help relieve symptoms. Homeopathic treatments may help decrease pain and lead to faster resolution. Prevention should be emphasized with elimination of risk factors, such as second hand smoke and bottle-feeding, as well as maintaining nutrition and vaccinations. Vitamin supplementation may be helpful. Probiotics and xylitol may be beneficial as well. Traditional Chinese/Japanese therapies show promising results but remain

Otitis-Prone Children Produce Functional Antibodies to Pneumolysin and Pneumococcal Polysaccharides.

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Kirkham, Lea-Ann S; Wiertsema, Selma P; Corscadden, Karli J; Mateus, Tulia; Mullaney, Gemma L; Zhang, Guicheng; Richmond, Peter C; Thornton, Ruth B

2017-03-01

The pneumococcus is a major otitis media (OM) pathogen, but data are conflicting regarding whether otitis-prone children have impaired humoral immunity to pneumococcal antigens. We and others have shown that otitis-prone and healthy children have similar antibody titers to pneumococcal proteins and polysaccharides (vaccine and nonvaccine types); however, the quality of antibodies from otitis-prone children has not been investigated. Antibody function, rather than titer, is considered to be a better correlate of protection from pneumococcal disease. Therefore, we compared the capacities of antibodies from otitis-prone (cases) and healthy (controls) children to neutralize pneumolysin, the pneumococcal toxin currently in development as a vaccine antigen, and to opsonize pneumococcal vaccine and nonvaccine serotypes. A pneumolysin neutralization assay was conducted on cholesterol-depleted complement-inactivated sera from 165 cases and 61 controls. A multiplex opsonophagocytosis assay (MOPA) was conducted on sera from 20 cases and 20 controls. Neutralizing and opsonizing titers were calculated with antigen-specific IgG titers to determine antibody potency for pneumolysin, pneumococcal conjugate vaccine (PCV) polysaccharides, and non-PCV polysaccharides. There was no significant difference in antibody potencies between cases and controls for the antigens tested. Antipneumolysin neutralizing titers increased with the number of episodes of acute OM, but antibody potency did not. Pneumolysin antibody potency was lower in children colonized with pneumococci than in noncarriers, and this was significant for the otitis-prone group ( P otitis-prone children demonstrates that they respond to the current PCV and are likely to respond to pneumolysin-based vaccines as effectively as healthy children. Copyright © 2017 Kirkham et al.

Validación del Cuestionario de Lugar de Control del Dolor en estudiantes argentinos con cefaleas recurrentes

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Luciana Sofía Moretti

2015-01-01

Full Text Available Objetivo. Validar el Cuestionario de Lugar de Control del Dolor (CLCD en una muestra de estudiantes universitarios argentinos con cefaleas recurrentes. Método. Se empleó un muestreo no probabilístico intencional de 382 estudiantes universitarios de la ciudad de Córdoba (Argentina, que en los últimos seis meses habían sufrido de cefaleas. El 77.7% de la muestra fueron mujeres y el 22.3% varones, con una media de edad de 22.4 años (DE = 4.2. Se realizaron estudios para evaluar la estructura interna, consistencia interna y la validez externa del cuestionario. Resultados. El análisis factorial exploratorio mostró tres factores que explicaban un 39.79% de la varianza: (1 locus de control externo por profesionales de la salud, (2 locus de control externo por azar y (3 locus de control interno. Asimismo, los valores alfa de Cronbach para evaluar la consistencia interna de los factores resultaron óptimos (valores α comprendidos entre 0.80 y 0.86.Los análisis realizados para evaluar la validez externa del cuestionario, mediante el coeficiente de correlación de Pearson, revelaron que los factores locus de control externo por profesionales de la salud y los factores locus de control externo por azar correlacionaron positivamente con la intensidad del dolor (r = 0.15, p < 0.01; r = 0.23, p < 0.01, respectivamente, no obstante los valores obtenidos fueron bajos. Conclusión. Aunque presenta limitaciones en su validez externa, los estudios psicométricos realizados permiten concluir que el CLCD es un instrumento confiable y válido para evaluar locus de control en población universitaria argentina con dolor crónico ocasionado por cefaleas.

191 bacterial agents of otitis media and their sensitivity to some ...

African Journals Online (AJOL)

DR. AMINU

2010-06-01

Shamsuddeen, U., Usman A. D., Bukar, ... Key Words: Bacterial agents, otitis media, sensitivity, antibiotics, AKTH. INTRODUCTION. Otitis media is an .... Atlas R.M (1998) Microbiology Fundamentals and. Applications. Second edition ...

Eosinophilic Mucin Otomastoiditis and Otopolyposis: A Progressive Form of Eosinophilic Otitis Media.

Science.gov (United States)

Azadarmaki, Roya; Westra, William; Prasad, Sanjay

2015-09-01

The purpose of this study is to introduce and define a disease entity on a continuum of eosinophilic otitis media: eosinophilic mucin otomastoiditis and otopolyposis. A case of a 66-year-old woman with complicated chronic otitis media is reported. A literature review of the National Library of Medicine's online database, with a focus on eosinophilic otitis media and eosinophilic mucin rhinosinusitis, was performed. The authors report the case of a 66-year-old woman with a history of asthma, chronic rhinosinusitis, nasal polyposis, and chronic otitis media who presented with allergic middle ear mucin and otic polyps. Treatment involved a tympanomastoidectomy with removal of otic polyps and steroid therapy. Eosinophilic mucin otomastoiditis with otopolyposis is a disease entity on a continuum of eosinophilic otitis media. This disease process shares similarities with eosinophilic mucin rhinosinusitis. Otic polypectomy and steroids are suggested therapeutic measures. © The Author(s) 2015.

DEUDA EXTERNA Y DEUDA PÚBLICA SUSTENTABLES EN ARGENTINA

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Mario Eduardo Firmenich

2011-12-01

Full Text Available Las propuestas de solución de un problema estructural tan grave como el de la deuda externa de los países del Sur en general y de la Argentina en particular no debería ser algo de exclusiva responsabilidad de los gobiernos.Esto significa que todos los estamentos de la sociedad civil deben asumir su responsabilidad en construir una opinión pública sobre qué hacer frente al problema de la deuda externa, porque será el conjunto social el que se beneficiará de una correcta solución de este problema o el que sufrirá las gravísimas consecuencias de cualquier variante que, directa o indirectamente, termine agravandoel subdesarrollo y la pobreza.

The effects of ventilation tubes versus no ventilation tubes for recurrent acute otitis media or chronic otitis media with effusion in 9 to 36 month old Greenlandic children, the SIUTIT trial

DEFF Research Database (Denmark)

Demant, Malene Nøhr; Jensen, Ramon Gordon; Jakobsen, Janus Christian

2017-01-01

BACKGROUND: The prevalence of otitis media in Greenlandic children is one of the highest in the world. International studies have shown that otitis-prone children may benefit from tubulation of the tympanic membrane. However, it is unknown whether these results can be applied to Greenlandic......) in Greenlandic children aged 9-36 months with chronic otitis media with effusion or recurrent acute otitis media. With randomization stratified by otitis media subtype and trial site, a type 1 error of 5% and a power of 80%, a total of 230 participants are needed to detect a decrease of two visits to a health...... clinic during 2 years, which is considered the minimal clinical relevant difference. The primary outcome measure will be assessed blindly by investigating medical records. Secondary outcome measures are number of episodes of acute otitis media, quality of life, number of episodes of antibiotics...

Pediatric otitis media in Fiji: Survey findings 2015.

Science.gov (United States)

Fang, Te-Yung; Rafai, Eric; Wang, Pa-Chun; Bai, Chiy-Huey; Jiang, Peng-Long; Huang, Shu-Nuan; Chen, You-Ju; Chao, Yi-Ting; Wang, Chen-Hsu; Chang, Chia-Hsiu

2016-06-01

Otitis media (OM), as a common infectious disease, is a major cause of hearing impairment among the general population. OM remains a major public health threat in the Pacific islands, but the risks of OM have not been thoroughly explored in this region. The objective of this study is to investigate the prevalence, clinical features, and quality-of-life impacts of OM in Fiji. In the medical service trip entitled "Healing and Hope - Taiwan Cathay Heart and Hearing Medical Mission to Fiji" (TCHHMMF), we conducted a cross-sectional OM survey study in Suva and Sigatoka areas (Korolevu, Cuvu, and Lomawai) in the summer of 2015. The otitis media - 6 (OM-6) was used to survey the OM-related quality of life. In the 467 pediatric patients (aged 0-18 years old) screened, 13 (2.78%) have acute otitis media (AOM), 37 (7.92%) have otitis media with effusion (OME), and 19 (4.1%) have chronic otitis media (COM). Age (OR 0.53, 95% CI: 0.36-0.77) is a significant predictor of AOM, whereas male gender (OR 2.46, 95% CI: 1.13-5.37), smoke exposure (OR 2.81, 95% CI: 1.01-7.82), and concomitant chronic sinusitis (OR 6.05, 95% CI: 2.31-15.88) are significant predictors of OME. The mean OM-6 item scores are highest in caregiver concerns (3.8), physical suffering (3.7), and hearing loss (3.4) domains. OM is an important primary care disease in Fiji that remains under-served. It is critical to educate professionals, parents, and patients to detect and to improve care for OM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

KRITERIA DIAGNOSIS DAN PENATALAKSANAAN OTITIS MEDIA SUPURATIF KRONIS

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Fairuziah Bader Alkatiri

2016-03-01

Full Text Available ABSTRACT Introduction: Otitis media is an inflammation of part or all of the mucosa of the middle ear, Eustachian tube, mastoid antrum, and mastoid cells. Patients with middle ear disease often comes as a chronic stage that causes hearing loss and expense secretions. Patients complain of hearing loss that disrupt the function of the social, educational and professional. School-age children may show poor results at school. One type of otitis media is chronic suppurative otitis media (CSOM, which is a chronic infection of the middle ear with tympanic membrane perforation and discharge of secretions from the middle ear continuous or intermittent, usually accompanied by hearing loss. Secretions may be thin or thick, clear or in the form of pus. CSOM formerly called otitis media with perforated. Diagnosis is made by history, physical examination. Two types of classification that is often used is CSOM types of benign and malignant types, and based on the activity of secretions out. Management of sudden deafness include conservative with some medical therapy depends on the type of CSOM and accompanying complications. Case: Male patient, 47 years old, came with complaints of discharge from the left ear since 1 month ago. Discharge yellowish-white, slightly viscous, odorless, out a little, and not itchy. Patients with a history of diabetes. Patients admitted before the water could get into the ear while swimming in the sea. At the present status and status generalist within normal limits. On the left ear found mucopurulent secretions. On the left tympanic membrane perforation in the visible region of the central part postero superior. Keywords:otitis, chronic, ear.

Childhood otitis media is associated with dizziness in adulthood: the HUNT cohort study.

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Aarhus, Lisa; Tambs, Kristian; Hoffman, Howard J; Engdahl, Bo

2016-08-01

The objective of the study was to examine the association between otitis media in childhood and dizziness in adulthood. Longitudinal, population-based cohort study of 21,962 adults (aged 20-59 years, mean 40) who completed a health questionnaire in the Nord-Trøndelag Hearing Loss Study was conducted. At 7, 10 and 13 years of age, the same individuals underwent screening audiometry in a longitudinal school hearing investigation. Children found with hearing loss underwent an ear, nose and throat specialist examination. Adults diagnosed with childhood chronic suppurative otitis media (n = 102) and childhood hearing loss after recurrent acute otitis media (n = 590) were significantly more likely to have increased risk of reported dizziness when compared to adults with normal hearing as children at the school investigation and also a negative history of recurrent otitis media (n = 21,270), p otitis media and childhood hearing loss after recurrent acute otitis media are associated with increased risk of dizziness in adulthood. This might reflect a permanent effect of inflammatory mediators or toxins on the vestibular system. The new finding stresses the importance of treatment and prevention of these otitis media conditions.

Pneumococcal Conjugate Vaccines and Otitis Media: An Appraisal of the Clinical Trials

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Fletcher, Mark A.; Fritzell, Bernard

2012-01-01

Streptococcus pneumoniae is the predominant otitis media pathogen and its prevention through effective vaccination could diminish childhood illness and antibiotic use. This paper reviews 5 pneumococcal conjugate vaccine (PCV) trials that used otitis media as an endpoint: Northern California Kaiser Permanente (NCKP; vaccine, 7-valent PCV [PCV7]-CRM); Finnish Otitis Media (FinOM; vaccines, PCV7-CRM or PCV7-OMPC); Native American Trial (vaccine, PCV7-CRM); Pneumococcal Otitis Efficacy Trial (POET; vaccine, 11-valent PCV [PCV11]-PD). For the microbiological endpoint, vaccine efficacy against vaccine-serotype pneumococcal otitis media was about 60% across trials. Against the clinical endpoint of all episodes, vaccine efficacy was 7% (PCV7-CRM/NCKP), 6% (PCV7-CRM/FinOM), −1% (PCV7-OMPC/FinOM), and −0.4% (PCV7-CRM/Native American Trial); 34% against first episodes of ear, nose, and throat specialist-referral cases (PCV11-PD/POET). Both follow-up through 2 years of age, for the 5 trials, and long-term follow-up, for PCV7-CRM/NCKP and PCV7-CRM/FinOM, demonstrated greater vaccine efficacy against recurrent AOM and tympanostomy-tube placement, suggesting that vaccination against early episodes of AOM may prevent subsequent episodes of complicated otitis media. Although study designs varied by primary endpoint measured, age at follow-up, source of middle-ear fluid for culture, case ascertainment, and type of randomization, each clinical trial demonstrated vaccine efficacy against microbiological and/or clinical otitis media. PMID:22701486

The Role of Adenoid Mast Cells in the Pathogenesis of Secretory Otitis Media

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M. Faruk Oktay

2007-01-01

Full Text Available To investigate the possible role of adenoid mast cells in the etiology of secretory otitis media. Between 2001-2002, 25 patients with chronic adenoitis and chronic secretory otitis media and 25 patients with isolated adenoid hypertrophy were included to the study. Adenoidectomy performed to the all patients under general anesthesia. Adenoidectomy specimens were evaluated under the light microscopy and the number of mast cells were calculated for each patient. The number of mast cells were compared between two groups. The number of mast cells were between 4-84 in the otitis media with effusion and adenoid hypertrophy group (median:52, however it was between 2-63 (median: 23 in the isolated adenoid hypertrophy group. When comparing the two groups using Mann-Withney U test, the number of mast cells found to be significantly higher in the chronic secretory otitis media group (p<0.001.Based on our findings there is a relationship between increased adenoid mast cells and otitis media with effusion and these cells may have a possible role in the etiology of chronic secretory otitis media.

Pathologic Changes of the Peripheral Vestibular System Secondary to Chronic Otitis Media.

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da Costa Monsanto, Rafael; Erdil, Mehmet; Pauna, Henrique F; Kwon, Geeyoun; Schachern, Patricia A; Tsuprun, Vladimir; Paparella, Michael M; Cureoglu, Sebahattin

2016-09-01

To evaluate the histopathologic changes of dark, transitional, and hair cells of the vestibular system in human temporal bones from patients with chronic otitis media. Comparative human temporal bone study. Otopathology laboratory. To compare the density of vestibular dark, transitional, and hair cells in temporal bones with and without chronic otitis media, we used differential interference contrast microscopy. In the chronic otitis media group (as compared with the age-matched control group), the density of type I and type II hair cells was significantly decreased in the lateral semicircular canal, saccule, and utricle (P otitis media group in the posterior semicircular canal (P = .005), but that of type II cells was not (P = .168). The mean number of dark cells was significantly decreased in the chronic otitis media group in the lateral semicircular canal (P = .014) and in the posterior semicircular canal (P = .002). We observed no statistically significant difference in the density of transitional cells between the 2 groups (P > .1). The findings of our study suggest that the decrease in the number of vestibular sensory cells and dark cells could be the cause of the clinical symptoms of imbalance of some patients with chronic otitis media. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Quality of life in children with otitis media--a cohort study.

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Ryborg, Christina T; Søndergaard, Jens; Lous, Jørgen; Munck, Anders; Larsen, Pia V; Thomsen, Janus L

2014-02-01

Studies about health-related quality of life (HRQOL) in children with otitis media have primarily focused on short-term effects of the disease, and how treatment with insertion of ventilation tubes (VTs) affects the HRQOL. More knowledge is needed about how long-term HRQOL is associated with different factors like insertion of VT and use of antibiotics. We aimed to analyse HRQOL in children with otitis media 1 year after inclusion and to what extent insertion of VT, use of antibiotics, diagnoses, symptoms in the children, day-care attention, parental absence from work and parental smoking were associated with the long-term HRQOL in children with otitis media. A cohort study including 397 children was carried out. The children were followed for 13 months, and symptoms, HRQOL and so on were identified by means of questionnaires. HRQOL in children with otitis media was significantly improved after 13 months. The improvement of HRQOL was significantly lower for children with sleep problems compared with children without sleep problems. The improvement in HRQOL was significantly lower in children whose parents had been absent from work during the preceding 3 months due to the child' s otitis media compared with children with parents not being absent from their work. There were no statistically significant differences in the improvement of HRQOL in children who had received a VT during the follow-up period compared with children without a VT. HRQOL in children with otitis media was significantly improved after 13 months. The improvement in HRQOL was significantly lower for children with sleep problems. The improvement in HRQOL was significantly lower in children whose parents had been absent from work due to the child's otitis media. There were no statistically significant differences in the improvement of HRQOL in children who had received a VT during the follow-up period.

Household crowding associated with childhood otitis media hospitalisations in New Zealand.

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Bowie, Christopher; Pearson, Amber L; Campbell, Malcolm; Barnett, Ross

2014-06-01

To examine the association between hospitalisations for otitis media and area-level measures of household crowding among children in New Zealand. Counts of hospital admissions for otitis media by census area unit were offset against population data from the 2006 national census. Area-level household crowding, exposure to tobacco smoke in the home, equivalised income and individual-level characteristics age and sex were adjusted for. To examine effect modification by ethnicity, three separate poisson models were examined for the total, Māori and non-Māori populations. Household crowding was significantly associated with hospital admissions for otitis media after adjustment in all three models. Neighbourhoods with the highest compared to the lowest proportion of crowded homes exhibited incidence rate ratios of 1.25 (95%CI 1.12-1.37) in the total population, 1.59 (95%CI 1.21-2.04) in the Māori restricted model and 1.17 (95%CI 1.06-1.32) in the non-Māori restricted model. Otitis media hospitalisations are associated with area-level measures of household crowding and other risk factors in this ecological study. The largest increase in otitis media incidence relative to neighbourhood rates of household crowding was exhibited among Māori cases of otitis media. This study adds weight to the growing body of literature linking infectious disease risk to overcrowding in the home. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

Children hospitalized due to acute otitis media: how does this condition differ from acute mastoiditis?

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Laulajainen-Hongisto, Anu; Saat, Riste; Lempinen, Laura; Aarnisalo, Antti A; Jero, Jussi

2015-09-01

To evaluate the clinical picture and microbiological findings of children hospitalized due to acute otitis media and to analyze how it differs from acute mastoiditis. A retrospective review of the medical records of all children (0-16 years) hospitalized due to acute otitis media in the Department of Otorhinolaryngology at the Helsinki University Hospital, between 2003 and 2012. Comparison with previously published data of children with acute mastoiditis (n=56) from the same institute and period of time. The most common pathogens in the children hospitalized due to acute otitis media (n=44) were Streptococcus pneumoniae (18%), Pseudomonas aeruginosa (16%), Streptococcus pyogenes (14%), and Staphylococcus aureus (14%). One of the most common pathogens of out-patient acute otitis media, Haemophilus influenzae, was absent. Otorrhea was common in infections caused by S. pyogenes and otorrhea via tympanostomy tube in infections caused by P. aeruginosa. In children under 2 years-of-age, the most common pathogens were S. pneumoniae (43%), Moraxella catarrhalis (14%), and S. aureus (7%). S. pyogenes and P. aeruginosa were only found in children over 2 years-of-age. Previous health problems, bilateral infections, and facial nerve paresis were more common in children hospitalized due to acute otitis media, compared with acute mastoiditis, but they also demonstrated lower CRP values and shorter duration of hospital stay. The number of performed tympanostomies and mastoidectomies was also comparatively smaller in the children hospitalized due to acute otitis media. S. aureus was more common and S. pneumoniae, especially its resistant strains, was less common in the children hospitalized due to acute otitis media than acute mastoiditis. Acute otitis media requiring hospitalization and acute mastoiditis compose a continuum of complicated acute otitis media that differs from common out-patient acute otitis media. The bacteriology of children hospitalized due to acute otitis media

New vaccines against otitis media: projected benefits and cost-effectiveness.

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O'Brien, Megan A; Prosser, Lisa A; Paradise, Jack L; Ray, G Thomas; Kulldorff, Martin; Kurs-Lasky, Marcia; Hinrichsen, Virginia L; Mehta, Jyotsna; Colborn, D Kathleen; Lieu, Tracy A

2009-06-01

New vaccines that offer protection against otitis media caused by nontypeable Haemophilus influenzae and by Moraxella catarrhalis are under development. However, the potential health benefits and economic effects of such candidate vaccines have not been systematically assessed. We created a computerized model to compare the projected benefits and costs of (1) the currently available 7-valent pneumococcal conjugate vaccine, (2) a candidate pneumococcal-nontypeable H influenzae vaccine that has been tested in Europe, (3) a hypothetical pneumococcal-nontypeable H influenzae-Moraxella vaccine, and (4) no vaccination. The clinical probabilities of acute otitis media and of otitis media with effusion were generated from multivariate analyses of data from 2 large health maintenance organizations and from the Pittsburgh Child Development/Otitis Media Study cohort. Other probabilities, costs, and quality-of-life values were derived from published and unpublished sources. The base-case analysis assumed vaccine dose costs of $65 for the 7-valent pneumococcal conjugate vaccine, $100 for the pneumococcal-nontypeable H influenzae vaccine, and $125 for the pneumococcal-nontypeable H influenzae-Moraxella vaccine. With no vaccination, we projected that 13.7 million episodes of acute otitis media would occur annually in US children aged 0 to 4 years, at an annual cost of $3.8 billion. The 7-valent pneumococcal conjugate vaccine was projected to prevent 878,000 acute otitis media episodes, or 6.4% of those that would occur with no vaccination; the corresponding value for the pneumococcal-nontypeable H influenzae vaccine was 3.7 million (27%) and for the pneumococcal-nontypeable H influenzae-Moraxella vaccine was 4.2 million (31%). Using the base-case vaccine costs, pneumococcal-nontypeable H influenzae vaccine use would result in net savings compared with nontypeable 7-valent pneumococcal conjugate use. Conversely, pneumococcal-nontypeable H influenzae-Moraxella vaccine use would not

Otitis media: is precursor of delayed reading in Arabic speaking children?

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Azab, Safinaz Nagib; Rhman, Samir Shokr A

2014-04-01

To investigate the relation between otitis media in the language acquisition years and the occurrence of delayed reading between the ages of 7 and 10. Participants were 40 children, half of whom had a history of otitis media between the ages of birth and three years and half who were free of the disease. These children, now ages 7-10, were tested with the Stanford Beint and Arabic Dyslexia Assessment Test. Children with a history of otitis media scored over a year below grade level in reading and significantly below controls on Arabic Dyslexia Assessment tests as well as on the Verbal IQ factor on the Stanford Binet. Children with early onset otitis media (birth to three years) tend to be at greater risk for delayed reading than age-matched controls. Published by Elsevier Ireland Ltd.

The microbiome of otitis media with effusion.

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Chan, Chun Ling; Wabnitz, David; Bardy, Jake Jervis; Bassiouni, Ahmed; Wormald, Peter-John; Vreugde, Sarah; Psaltis, Alkis James

2016-12-01

The adenoid pad has been considered a reservoir for bacteria in the pathogenesis of otitis media with effusion. This study aimed to characterize the middle ear microbiota in children with otitis media with effusion and establish whether a correlation exists between the middle ear and adenoid microbiota. Prospective, controlled study. Middle ear aspirates adenoid pad swabs were collected from 23 children undergoing ventilation tube insertion. Adenoid swabs from patients without ear disease were controls. Samples were analyzed using 16S rRNA sequencing on the Illumina MiSeq platform. Thirty-five middle ear samples were collected. The middle ear effusion microbiota was dominated by Alloiococcus otitidis (23% mean relative abundance), Haemophilus (22%), Moraxella (5%), and Streptococcus (5%). Alloiococcus shared an inverse correlation with Haemophilus (P = .049) and was found in greater relative abundance in unilateral effusion (P = .004). The microbiota of bilateral effusions from the same patient were similar (P effusion microbiota were found to be dissimilar to that of the adenoid (P = .01), whereas the adenoid microbiota of otitis media with effusion and control patients were similar (P > .05) (permutational multivariate analysis of the variance). Dissimilarities between the local microbiota of the adenoid and the middle ear question the theory that the adenoid pad is a significant reservoir to the middle ear in children with otitis media with effusion. A otitidis had the greatest cumulative relative abundance, particularly in unilateral effusions, and shares an inverse correlation with the relative abundance of Haemophilus. NA Laryngoscope, 126:2844-2851, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

OTITIS MEDIA AGUDA. DIAGNÓSTICO Y MANEJO PRÁCTICO

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Dr. Francisco J. Krause

2016-11-01

Full Text Available La otitis media aguda es una patología infecciosa del oído medio muy frecuente. El diagnóstico es clínico, por lo que es fundamental un acucioso examen físico y una neumootoscopía para evaluar la movilidad timpánica. Hay dos tendencias respecto al manejo, tratamiento antibiótico inmediato u observación estricta (dependiendo de las características del paciente y del cuadro clínico. Los gérmenes más frecuentes son los virus, Neumococo, Haemophilus influenza y Moraxella catarrhalis. La prevalencia de cada uno de ellos varía según región geográfica y según la presencia de vacunación. La resistencia a antibióticos ha ido en aumento en estos años, pero aún puede considerarse sensible a amoxicilina por lo que se recomienda su uso como primera línea. En el caso de fracaso a tratamiento pueden utilizarse asociaciones con B-lactámicos y/o cefalosporinas, dejando en forma excepcional clindamicina o quinolonas. Aquellos niños con OMA recurrente requerirán evaluación por especialidad para mayor estudio y tratamiento.

Crises financeiras nos anos 1990 e poupança externa

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Luiz Carlos Bresser-Pereira

2011-01-01

Full Text Available Ao contrário do que afirma a análise econômica convencional, a causa principal das crises financeiras dos países emergentes dos anos 1990 e início dos anos 2000s começando pela do México (1994 e terminando com a da Argentina (2001 não foi fiscal, mas a decisão dos governos de promover o crescimento com poupança externa, isto é, com déficits em conta corrente. Como a taxa de câmbio tem outros determinantes além da absorção interna, o pressuposto dos déficits gêmeos com frequência não é válido. Essas foram de balanço de pagamentos e se caracterizaram por elevados déficits em conta corrente e forte aumento da dívida externa e/ou por forte aumento do déficit em conta corrente, que levaram os credores a se persuadirem que o problema do país era ou de liquidez ou de solvência, ou ambos, e decidirem, subitamente, suspender a rolagem da dívida externa do país. Um teste econométrico substancia a hipótese do trabalho.

Evaluación externa de la calidad analítica en hematología: una necesidad en América Latina

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Fink Nilda E.; Fernández Alberti Alejandra; Mazziotta Daniel

1997-01-01

La garantía de calidad analítica de un laboratorio clínico se logra mediante un sistema de control de calidad interno complementado por un programa de evaluación externa. Esa garantía es la base que fundamenta la confiabilidad de los resultados obtenidos por los laboratorios y su uso en el diagnóstico y tratamiento de las enfermedades. En los países de América Latina hay muchos laboratorios que no cuentan con sistemas apropiados de evaluación y control de la calidad. Dada la importancia de lo...

Profilaxis de la hipertensión arterial tipo III con el uso de la aspirina

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Rodríguez Santana, Maricela; García León, Lázaro; Valdés Suárez, Ernesto; Hernández Cabrera, Jesús

1997-01-01

Se realiza un estudio, en el período comprendido entre enero de 1994 hasta enero con 1995, de 104 gestantes diagnosticadas como hipertensas crónicas en la consulta externa del hospital docente ginecoobstétrico de Matanzas. Del total de la muestra, 54 fueron tratadas con dosis bajas en aspirina y en 50 no se aplicó este tratamiento. Las gestantes que utilizaron bajas dosis de aspirina, no desarrollaron hipertensión arterial tipo III (HTA III), ni se presentaron en las mismas complicaciones mat...

Distribuição espacial da violência: mortalidade por causas externas em Salvador (Bahia, Brasil

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Paim Jairnilson Silva

1999-01-01

Full Text Available O presente estudo teve como objetivo descrever a distribuição da mortalidade por causas externas no espaço urbano de Salvador, Estado da Bahia, Brasil, em 1991. Foram calculados indicadores de mortalidade por causas externas e por tipos específicos de violência. A mortalidade proporcional por causas externas foi de 15% e a taxa de mortalidade correspondeu a 78,0 óbitos por 100 000 habitantes. As taxas de mortalidade por homicídios e por acidentes de transporte foram de 32,2 e 21,8 por 100 000 habitantes, respectivamente. Os idosos apresentaram um maior risco de morte por causas externas, seguidos dos adultos jovens e adolescentes. No caso dos idosos, 38% das mortes foram por acidentes de transporte e 28%, por quedas. Em relação aos jovens, predominam os homicídios, especialmente no sexo masculino e na faixa etária de 15 a 29 anos. Constatou-se uma distribuição desigual da mortalidade por causas externas no espaço urbano, penalizando, especialmente no caso dos homicídios, as populações residentes em bairros pobres, com taxas superiores ao coeficiente médio de Salvador. É necessário desenvolver medidas de prevenção e controle, incluindo políticas públicas e ações programáticas de saúde, orientadas para o espaço social sujeito a maior risco de morte por causas externas.

Eosinophilic Otitis Media: CT and MRI Findings and Literature Review

International Nuclear Information System (INIS)

Chung, Won Jung; Lee, Jeong Hyun; Lim, Hyun Kyung; Yoon, Tae Hyun; Cho, Kyung Ja; Baek, Jung Hwan

2012-01-01

Eosinophilic otitis media (EOM) is a relatively rare, intractable, middle ear disease with extremely viscous mucoid effusion containing eosinophils. EOM is associated with adult bronchial asthma and nasal allergies. Conventional treatments for otitis media with effusion (OME) or for chronic otitis media (COM), like tympanoplasty or mastoidectomy, when performed for the treatment of EOM, can induce severe complications such as deafness. Therefore, it should be differentiated from the usual type of OME or COM. To our knowledge, the clinical and imaging findings of EOM of temporal bone are not well-known to radiologists. We report here the CT and MRI findings of two EOM cases and review the clinical and histopathologic findings of this recently described disease entity.

Eosinophilic Otitis Media: CT and MRI Findings and Literature Review

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Chung, Won Jung; Lee, Jeong Hyun; Lim, Hyun Kyung; Yoon, Tae Hyun; Cho, Kyung Ja; Baek, Jung Hwan [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

2012-06-15

Eosinophilic otitis media (EOM) is a relatively rare, intractable, middle ear disease with extremely viscous mucoid effusion containing eosinophils. EOM is associated with adult bronchial asthma and nasal allergies. Conventional treatments for otitis media with effusion (OME) or for chronic otitis media (COM), like tympanoplasty or mastoidectomy, when performed for the treatment of EOM, can induce severe complications such as deafness. Therefore, it should be differentiated from the usual type of OME or COM. To our knowledge, the clinical and imaging findings of EOM of temporal bone are not well-known to radiologists. We report here the CT and MRI findings of two EOM cases and review the clinical and histopathologic findings of this recently described disease entity.

Microbiomes of the normal middle ear and ears with chronic otitis media.

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Minami, Shujiro B; Mutai, Hideki; Suzuki, Tomoko; Horii, Arata; Oishi, Naoki; Wasano, Koichiro; Katsura, Motoyasu; Tanaka, Fujinobu; Takiguchi, Tetsuya; Fujii, Masato; Kaga, Kimitaka

2017-10-01

The aim of this study was to profile and compare the middle ear microbiomes of human subjects with and without chronic otitis media. Prospective multicenter cohort study. All consecutive patients undergoing tympanoplasty surgery for chronic otitis media or ear surgery for conditions other than otitis media were recruited. Sterile swab samples were collected from the middle ear mucosa during surgery. The variable region 4 of the 16S rRNA gene in each sample were amplified using region-specific primers adapted for the Illumina MiSeq sequencer (Illumina, CA, USA)). The sequences were subjected to local blast and classified using Metagenome@KIN (World Fusion, Tokyo, Japan). In total, 155 participants were recruited from seven medical centers. Of these, 88 and 67 had chronic otitis media and normal middle ears, respectively. The most abundant bacterial phyla on the mucosal surfaces of the normal middle ears were Proteobacteria, followed by Actinobacteria, Firmicutes, and Bacteroidetes. The children and adults with normal middle ears differed significantly in terms of middle ear microbiomes. Subjects with chronic otitis media without active inflammation (dry ear) had similar middle ear microbiomes as the normal middle ears group. Subjects with chronic otitis media with active inflammation (wet ear) had a lower prevalence of Proteobacteria and a higher prevalence of Firmicutes than the normal middle ears. The human middle ear is inhabited by more diverse microbial communities than was previously thought. Alteration of the middle ear microbiome may contribute to the pathogenesis of chronic otitis media with active inflammation. 2b. Laryngoscope, 127:E371-E377, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Relationship between chronic otitis media with effusion and overweight or obesity in children.

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Kaya, S; Selimoğlu, E; Cureoğlu, S; Selimoğlu, M A

2017-10-01

Otitis media with effusion and obesity are both common in childhood and might share some immunological alterations. This study aimed to investigate the relationship between chronic otitis media with effusion and childhood overweight or obesity, including the potential effects of adenoid or tonsillar hypertrophy on that relationship. This study included 60 children with chronic otitis media with effusion and 86 healthy children aged from 2 to 10 years. Measures of height and weight were used to calculate the body mass index, weight for height and weight z score. The prevalence of overweight or obesity was higher in children with chronic otitis media with effusion, according to the weight for height percentiles (p = 0.012). However, neither the presence of adenoid or tonsillar hypertrophy nor the degree of adenoid hypertrophy was associated with overweight or obesity. Overweight and obesity might be risk factors for developing chronic otitis media with effusion, or vice versa.

Intenções versus desempenho: o Brasil na política externa portuguesa (1976-2007

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Carmen Sofia Fonseca

2010-01-01

Full Text Available Partindo dos eixos orientadores da política externa portuguesa no pós-25 de Abril de 1974, o artigo visa compreender o enquadramento do Brasil nas opções da política externa portuguesa, centrando-se na análise dos programas dos Governos Constitucionais, nas visitas oficiais, no investimento português no Brasil e na influência da imigração brasileira na política externa. Pretendemos mostrar que, apesar das alterações exigidas pela democratização portuguesa, a relação com o Brasil subsistiu embora tenha prevalecido a retórica e o simbolismo sobre as concretizações práticas.

Microbiology of otitis media in Indigenous Australian children: review.

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Jervis-Bardy, J; Carney, A S; Duguid, R; Leach, A J

2017-07-01

To review research addressing the polymicrobial aetiology of otitis media in Indigenous Australian children in order to identify research gaps and inform best practice in effective prevention strategies and therapeutic interventions. Literature review. Studies of aspirated middle-ear fluid represented a minor component of the literature reviewed. Most studies relied upon specimens from middle-ear discharge or the nasopharynx. Culture-based middle-ear discharge studies have found that non-typeable Haemophilus influenzae and Streptococcus pneumoniae predominate, with Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pyogenes isolated in a lower proportion of samples. Alloiococcus otitidis was detected in a number of studies; however, its role in otitis media pathogenesis remains controversial. Nasopharyngeal colonisation is a risk factor for otitis media in Indigenous infants, and bacterial load of otopathogens in the nasopharynx can predict the ear state of Indigenous children. Most studies have used culture-based methods and specimens from middle-ear discharge or the nasopharynx. Findings from these studies are consistent with international literature, but reliance on culture may incorrectly characterise the microbiology of this condition. Advances in genomic technologies are now providing microbiologists with the ability to analyse the entire mixed bacterial communities ('microbiomes') of samples obtained from Indigenous children with otitis media.

Complicaciones de las otitis medias agudas y crónicas en el niño Complications of acute and chronic otitis media in the child

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Julianis Loraine Quintero Noa

2013-03-01

Full Text Available Gracias al descubrimiento de los antibióticos, la incidencia de complicaciones en las otitis medias agudas y crónicas ha descendido significativamente, aunque continúan siendo un peligro potencial de morbilidad y mortalidad. La disminución de las complicaciones puede condicionar retrasos diagnósticos por falta de sospecha clínica, enmascaramiento por tratamientos antibióticos previos y mal pronóstico, por lo cual siguen siendo procesos graves que ponen en peligro la vida del enfermo. Se definen actualmente con igual sistema de clasificación: extracraneales e intracraneales. Las primeras se subdividen en extratemporal e intratemporal, y constituyen un problema de salud en la población pediátrica a pesar del uso extendido de antibióticos. La evaluación clínico-otomicroscópica e imaginológica se reporta como criterio diagnóstico predictivo de sospecha y de confirmación. La parálisis facial, el vértigo, los vómitos, la cefalea, el dolor irradiado a la mastoides o a la región temporoparietal, y la hipertermia, deben alertar al médico sobre la presencia de una complicación supurada.Thanks to the discovery of antiobiotics, the incidence of complications in the chronic and acute otitis media has significantly decreased, though they remain a potential mortality and morbidity risk. The reduction of complications can be conditional on some diagnostic delays, on account of lack of clinical suspicions, symptoms disguised by previous antibiotic treatments and wrong prognosis; therefore, the complications continue to be severe processes that endanger the patient's life. They are currently classified as extracranial and intracranial. The former are divided into extratemporal and intratemporal and represent a health problem for the pediatric population despite the extended use of antibiotics. The clinical, otomicroscopic and imaging assessment is reported as a diagnostic criterion predictive of suspicions and of confirmation. Facial

Pattern of Chronic Suppurative Otitis Media at the National Ear Care ...

African Journals Online (AJOL)

Pattern of Chronic Suppurative Otitis Media at the National Ear Care Centre Kaduna, Nigeria. ... Background: Chronic suppurative otitis media constitutes a major cause of otorhinolaryngological clinic visits in Nigeria, therefore it is pertinent to determine the local ... Children under 10 years constituted the majority (n=64).

Acute otitis media with spontaneous tympanic membrane perforation.

Science.gov (United States)

Principi, N; Marchisio, P; Rosazza, C; Sciarrabba, C S; Esposito, S

2017-01-01

The principal aim of this review is to present the current knowledge regarding acute otitis media (AOM) with spontaneous tympanic membrane perforation (STMP) and to address the question of whether AOM with STMP is a disease with specific characteristics or a severe case of AOM. PubMed was used to search for all studies published over the past 15 years using the key words "acute otitis media" and "othorrea" or "spontaneous tympanic membrane perforation". More than 250 articles were found, but only those published in English and providing data on aspects related to perforation of infectious origin were considered. Early Streptococcus pneumoniae infection due to invasive pneumococcal strains, in addition to coinfections and biofilm production due mainly to non-typeable Haemophilus influenzae, seem to be precursors of STMP. However, it is unclear why some children have several STMP episodes during the first years of life that resolve without complications in adulthood, whereas other children develop chronic suppurative otitis media. Although specific aetiological agents appear to be associated with an increased risk of AOM with STMP, further studies are needed to determine whether AOM with STMP is a distinct disease with specific aetiological, clinical and prognostic characteristics or a more severe case of AOM than the cases that occur without STMP. Finally, it is important to identify preventive methods that are useful not only in otitis-prone children with uncomplicated AOM, but also in children with recurrent AOM and those who experience several episodes with STMP.

Mobile, one stage, bilateral ear surgery for chronic otitis media patients in remote areas

DEFF Research Database (Denmark)

Homøe, P; Sørensen, H C Florian; Tos, M

2009-01-01

OBJECTIVES: We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas....... MATERIALS AND METHODS: The study was longitudinal and prospective, with a two-year follow up. Seventeen East Greenlandic patients with bilateral chronic suppurative otitis media or chronic otitis media were selected. Their median age was 16 years; 53 per cent were female and 47 per cent male. Hearing...... were satisfied. There were no hearing hazards. CONCLUSIONS: The results of mobile, one stage, bilateral ear surgery conducted in Greenland for long-lasting chronic suppurative otitis media and chronic otitis media were acceptable and safe, and more ears underwent surgery at reduced cost compared...

Mcph1-deficient mice reveal a role for MCPH1 in otitis media.

Directory of Open Access Journals (Sweden)

Jing Chen

Full Text Available Otitis media is a common reason for hearing loss, especially in children. Otitis media is a multifactorial disease and environmental factors, anatomic dysmorphology and genetic predisposition can all contribute to its pathogenesis. However, the reasons for the variable susceptibility to otitis media are elusive. MCPH1 mutations cause primary microcephaly in humans. So far, no hearing impairment has been reported either in the MCPH1 patients or mouse models with Mcph1 deficiency. In this study, Mcph1-deficient (Mcph1(tm1a (/tm1a mice were produced using embryonic stem cells with a targeted mutation by the Sanger Institute's Mouse Genetics Project. Auditory brainstem response measurements revealed that Mcph1(tm1a (/tm1a mice had mild to moderate hearing impairment with around 70% penetrance. We found otitis media with effusion in the hearing-impaired Mcph1(tm1a (/tm1a mice by anatomic and histological examinations. Expression of Mcph1 in the epithelial cells of middle ear cavities supported its involvement in the development of otitis media. Other defects of Mcph1(tm1a (/tm1a mice included small skull sizes, increased micronuclei in red blood cells, increased B cells and ocular abnormalities. These findings not only recapitulated the defects found in other Mcph1-deficient mice or MCPH1 patients, but also revealed an unexpected phenotype, otitis media with hearing impairment, which suggests Mcph1 is a new gene underlying genetic predisposition to otitis media.

WITHDRAWN: Grommets (ventilation tubes) for recurrent acute otitis media in children.

Science.gov (United States)

Lau, Loretta; Mick, Paul; Nunez, Desmond A

2018-04-06

This is an update of a Cochrane review first published in The Cochrane Library in Issue 4, 2008 and previously updated in 2011.Acute suppurative otitis media is one of the most common infectious diseases in childhood. Recurrent acute otitis media is defined for the purposes of this review as either three or more acute infections of the middle ear cleft in a six-month period, or at least four episodes in a year. Strategies for managing the condition include the assessment and modification of risk factors where possible, repeated courses of antibiotics for each new infection, antibiotic prophylaxis and the insertion of ventilation tubes (grommets). To establish whether grommet insertion reduces the frequency of episodes of recurrent acute otitis media and the proportion of symptomatic children. The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2014, Issue 10); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 6 November 2014. Randomised controlled trials comparing grommet insertion versus control (antibiotics/other treatments/no treatment) for recurrent acute otitis media in children aged from 0 to 16 years. Two authors independently selected studies. Three authors independently assessed study quality and extracted data. We synthesised data descriptively. Two randomised controlled trials with a total of 148 participants are included in this review. The overall risk of bias in the studies is unclear.The first study randomised 95 children to grommets or control (antibiotic treatment of acute otitis media episodes). For the primary outcome, this study showed that grommet insertion leads to a mean reduction of 1.5 episodes of acute otitis media in the first six months after treatment. In six months of follow-up significantly more children in the

INTERFERENCIA ENTRE BACTERIAS COMENSALES DE FARINGE Y PATÓGENAS DE OÍDO MEDIO EN UN MODELO ANIMAL DE OTITIS MEDIA

Directory of Open Access Journals (Sweden)

LM Villafañe

2012-01-01

Full Text Available Objetivo: determinar in vivo la interacción entre bacterias comensales aisladas de faringe de niños sanos y S. pneumoniae, en un modelo animal (Chinchilla laniger de otitis media. Metodos: estudio experimental Intervenciones: Suspensiones de los serotipos 18A y 9V de Spn fueron inyectados intra-peritonealmente en dos chinchillas y luego recuperados mediante cultivo de órganos y sangre de las mismas. Empleando suspensiones de las cepas animalizadas se inocularon intranasalmente cuatro chinchillas, y solo a dos de ellas se le inoculo una mezcla de las bacterias comensales (Streptococcus mitis, Streptococcus parasanguinis. Con un otoscopio se examinó la evolución de la infección a los 7 y 14 días. Se sacrificaron los animales y se tomaron muestras de los oídos para un examen histológico. Resultados: Mediante otoscopia, se observó al día 14 que todos presentaron una membrana timpánica hiperémica sin efusión, presentándose con mayor intensidad en aquellos que recibieron el tratamiento. La histología confirmó que la administración del tratamiento no evitó que la infección evolucionara, advirtiéndose que las infectadas con el serotipo 8A y tratadas fueron las que presentaron el tejido epitelial menos comprometido respecto al resto. Conclusiones: Spn y las bacterias comensales podrían establecer una relación competitiva, y el efecto moderador en la progresión de la infección de otitis media dependería del serotipo involucrado.

Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis.

Science.gov (United States)

Steele, Dale W; Adam, Gaelen P; Di, Mengyang; Halladay, Christopher H; Balk, Ethan M; Trikalinos, Thomas A

2017-06-01

Tympanostomy tube placement is the most common ambulatory surgery performed on children in the United States. The goal of this study was to synthesize evidence for the effectiveness of tympanostomy tubes in children with chronic otitis media with effusion and recurrent acute otitis media. Searches were conducted in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Embase, and the Cumulative Index to Nursing and Allied Health Literature. Abstracts and full-text articles were independently screened by 2 investigators. A total of 147 articles were included. When feasible, random effects network meta-analyses were performed. Children with chronic otitis media with effusion treated with tympanostomy tubes compared with watchful waiting had a net decrease in mean hearing threshold of 9.1 dB (95% credible interval: -14.0 to -3.4) at 1 to 3 months and 0.0 (95% credible interval: -4.0 to 3.4) by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after placement of tympanostomy tubes. Associated adverse events are poorly defined and reported. Sparse evidence is available, applicable only to otherwise healthy children. Tympanostomy tubes improve hearing at 1 to 3 months compared with watchful waiting, with no evidence of benefit by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after tympanostomy tube placement, but the evidence base is severely limited. The benefits of tympanostomy tubes must be weighed against a variety of associated adverse events. Copyright © 2017 by the American Academy of Pediatrics.

[Cerebral artery infarction presented as an unusual complication of acute middle otitis].

Science.gov (United States)

Moscote-Salazar, Luis Rafael; Alcalá-Cerra, Gabriel; Castellar-Leones, Sandra Milena; Gutiérrez-Paternina, Juan José

2013-01-01

acute otitis media is a frequent disease in the pediatric age. About 2 % of all cases develop intracranial complications such as meningitis. The cerebral infarction originates meningitis and usually occurs in the venous system. The presence of a cerebral artery infarction secondary to acute otitis media is a rare cause described in the literature. a girl of 12 months who presented a febrile syndrome due to acute otitis media and mental confusion. On physical examination, she appeared sleepy with anisocoria, mydriasis in the right eye and left hemiparesis. The computed tomography examination showed extensive cerebral artery infarction. The patient's parents refused the proposed surgical treatment and the girl died 48 hours later. regardless of the current technological advances, the clinical prognosis of cerebral infarction associated with acute otitis media is bad. The focused neurological signs and progressive clinical deterioration should raise suspicion that antimicrobial therapy is not effective.

(Central Auditory Processing: the impact of otitis media

Directory of Open Access Journals (Sweden)

Leticia Reis Borges

2013-07-01

Full Text Available OBJECTIVE: To analyze auditory processing test results in children suffering from otitis media in their first five years of age, considering their age. Furthermore, to classify central auditory processing test findings regarding the hearing skills evaluated. METHODS: A total of 109 students between 8 and 12 years old were divided into three groups. The control group consisted of 40 students from public school without a history of otitis media. Experimental group I consisted of 39 students from public schools and experimental group II consisted of 30 students from private schools; students in both groups suffered from secretory otitis media in their first five years of age and underwent surgery for placement of bilateral ventilation tubes. The individuals underwent complete audiological evaluation and assessment by Auditory Processing tests. RESULTS: The left ear showed significantly worse performance when compared to the right ear in the dichotic digits test and pitch pattern sequence test. The students from the experimental groups showed worse performance when compared to the control group in the dichotic digits test and gaps-in-noise. Children from experimental group I had significantly lower results on the dichotic digits and gaps-in-noise tests compared with experimental group II. The hearing skills that were altered were temporal resolution and figure-ground perception. CONCLUSION: Children who suffered from secretory otitis media in their first five years and who underwent surgery for placement of bilateral ventilation tubes showed worse performance in auditory abilities, and children from public schools had worse results on auditory processing tests compared with students from private schools.

Infectious complications of pediatric cochlear implants are highly influenced by otitis media.

Science.gov (United States)

Vila, Peter M; Ghogomu, Nsangou T; Odom-John, Audrey R; Hullar, Timothy E; Hirose, Keiko

2017-06-01

Determine the incidence of ear infections in cochlear implant patients, evaluate the contribution of otitis media to complications, describe the bacteriology of otitis media in the cochlear implant population, the treatment provided at our center, and the long term outcome. Data collected included age at implantation, history of otitis media or ear tubes, etiology of hearing loss, inner ear anatomy, postoperative infections, time to infection, route of antibiotic administration, and interventions for infections. Categories of infection were acute otitis media, otitis media with effusion, tube otorrhea, meningitis, scalp cellulitis, and infection at the implant site. Middle ear infections were diagnosed in 37% of implanted ears. Extension of middle ear infections into the implant site occurred in 2.8% of all implants (n = 16). Of the 16 infected devices, 10 were successfully treated with antibiotic therapy and did not require explantation. The retained implant group and explanted group both included some middle ear microbes such as Haemophilus influenzae and Streptococcus pneumoniae, as well as skin flora such as Staphylococcus aureus. Otitis media in pediatric cochlear implant patients is a common event and usually does not lead to complications of the cochlear implant. However, when the ear infection spreads to the scalp and the implant site, it is still possible to eliminate the infection using antibiotic therapy, particularly when treatment is directed to the specific organism that is recovered from the infected space and the duration and route of antibiotic treatment is carefully considered. Copyright © 2017 Elsevier B.V. All rights reserved.

How many Layers has the Adventitia? - Structure of the Arterial Tunica Externa Revisited.

Science.gov (United States)

Witter, K; Tonar, Z; Schöpper, H

2017-04-01

Tunica adventitia or tunica externa is the outer layer of the blood vessel wall. It consists of connective tissue with vasa and nervi vasorum and plays a key role in vascular health. The aim of our study was to compare the wall layers beyond tunica media in arteries of different type and location. The following arteries of pig, dog and cat were processed histologically and analysed by light microscopy: aorta ascendens, arcus aortae, aorta thoracica, aorta abdominalis, arteria (a.) femoralis, a. tibialis cranialis, a. carotis communis, a. lingualis, a. basilaris, a. cerebralis media, a. testicularis and aa. jejunales. We found two layers of connective tissue outside the media: (1) a compact layer with many elastic fibres in muscular and few in elastic arteries and (2) an outer layer of loose connective tissue. The compact layer was missing in aorta ascendens, arcus aortae and intracranial vessels. Adventitial stripping removed only the loose connective tissue layer. In spite of the still present compact layer, stripped arteries were very flimsy. We suggest using the term 'tunica externa' for the compact connective tissue layer and 'tunica adventitia' for the outermost loose connective tissue layer as in other organs. The presence of the tunica externa differs between species, arteries and arterial side, as well as the removability of tunica adventitia and tunica externa by anatomical dissection. © 2016 Blackwell Verlag GmbH.

Otitis Media, Learning and Community.

Science.gov (United States)

McSwan, David; Clinch, Emma; Store, Ron

2001-01-01

A 3-year research project in Queensland (Australia) implemented educational and health strategies to ameliorate effects of otitis media at three schools in remote Aboriginal communities. The interdisciplinary model brought together health and education professionals, teacher aides, and the community, with the school being the lead agency. However,…

Preliminary results on scintigraphic evaluation of malignant external otitis

International Nuclear Information System (INIS)

Malamitsi, J.; Maragoudakis, P.; Papafragou, K.; Koukouliou, V.; Kalatzis, Y.; Adamopoulos, G.; Proukakis, C.

1993-01-01

Malignant external otitis (MEO) is a potentially fatal otitis occurring in diabetic and immunosuppressed patients, which may cause cranial nerve palsies and massive thrombophlebitis of the brain. We studied five diabetic patients with the clinical diagnosis of external otitis who were suspected of having MEO and one diabetic patient presumed cured from MEO. All of them underwent methylene diphosphonate, nanocolloid and gallium single-photon emission tomography studies with quantitative analysis on the basis of regions of interest and count profile curves. This combined assessment helped us to diagnose and follow-up soft tissue and temporal bone infection, especially in the case of transsphenoidal extension of the disease, since conventional radiology and computed tomography were of no particular help. On the basis of these results, we consider scintigraphic demonstration of skull base infection as a fourth criterion of MEO given that the classical Chandler's triad (diabetes, granuloma, and Pseudomonas aeruginosa) is not always present. (orig.)

Otitis Media and the Social Behavior of Day-Care-Attending Children.

Science.gov (United States)

Vernon-Feagans, Lynne; And Others

1996-01-01

Examined the relationship between early otitis media in children attending day care and children's subsequent behavior in the day care classroom when they were well. Found that day care children with chronic otitis media in the first three years of life play alone more often and have fewer verbal interactions with peers than nonchronic children.…

New Insights into Eosinophilic Otitis Media.

Science.gov (United States)

Kanazawa, Hiromi; Yoshida, Naohiro; Iino, Yukiko

2015-12-01

Eosinophilic otitis media (EOM) is a type of intractable otitis media that occurs mainly in patients with bronchial asthma (BA). In 2011, the diagnostic criteria for EOM were established. EOM is characterized by the presence of a highly viscous yellowish effusion containing eosinophils and immunoglobulin E (IgE), eosinophil chemoattractants, such as eosinophil cationic protein, interleukin-5, and eotaxin. Local sensitization against foreign agents such as fungi or bacteria (e.g., Staphylococcus aureus) may result in local IgE production in the middle ear and may be responsible for the severity of EOM. The clinical features of EOM closely resemble localized eosinophilic granulomatosis polyangiitis, therefore it is necessary to be vigilant to the symptoms of mononeuritis, polyneuritis, and skin purpura during diagnosis. Standard treatment for EOM is the instillation of triamcinolone acetonide into the mesotympanum. However, severe cases exhibiting strong inflammation and otorrhea are not easily controlled with antibiotics and/or corticosteroids. We proposed the introduction of a severity score to evaluate the severity of EOM. This score correlated with local IgE levels in middle ear effusion. Clinically, the risk factors associated with this severity score were body mass index, and the duration of bronchial asthma (from the onset of BA to the age of the first consultation of otitis media to our hospital). We emphasize that early diagnosis and adequate treatment are vital in preventing progressive and sudden hearing loss resulting from EOM.

Activation of NLRP3 inflammasome in human middle ear cholesteatoma and chronic otitis media.

Science.gov (United States)

Kariya, Shin; Okano, Mitsuhiro; Zhao, Pengfei; Kataoka, Yuko; Yoshinobu, Junko; Maeda, Yukihide; Ishihara, Hisashi; Higaki, Takaya; Nishizaki, Kazunori

2016-01-01

The nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome plays an important role in the pathogenesis of middle ear diseases. Modulation of inflammasome-mediated inflammation may be a novel therapeutic strategy for cholesteatoma and chronic otitis media. NLRP3 inflammasome is a critical molecule mediating interleukin (IL)-1β responses. However, the expression of NLRP3 in the pathogenesis of cholesteatoma and chronic otitis media has not been fully examined. This study sought to assess the expression of NLRP3, ASC (apoptosis-associated speck-like protein containing a caspase recruitment domain and a pyrin domain), and caspase-1 in middle ear tissues in patients with cholesteatoma or chronic otitis media. Middle ear tissue samples were obtained from patients with cholesteatoma or chronic otitis media. Control middle ear samples were collected during cochlear implant surgery of patients without middle ear inflammation. The expression of NLRP3, ASC, and caspase-1 were examined by reverse transcription polymerase chain reaction (RT-PCR) assay and immunohistochemical study. The levels of mRNA of NLRP3, ASC, and caspase-1 were significantly elevated in cholesteatoma and chronic otitis media as compared with that of normal controls. The proteins of NLRP3, ASC, and caspase-1 were observed in infiltrating inflammatory cells in cholesteatoma and chronic otitis media.

Evidence of functional cell-mediated immune responses to nontypeable Haemophilus influenzae in otitis-prone children

Science.gov (United States)

Seppanen, Elke; Tan, Dino; Corscadden, Karli J.; Currie, Andrew J.; Richmond, Peter C.; Thornton, Ruth B.

2018-01-01

Otitis media (OM) remains a common paediatric disease, despite advances in vaccinology. Susceptibility to recurrent acute OM (rAOM) has been postulated to involve defective cell-mediated immune responses to common otopathogenic bacteria. We compared the composition of peripheral blood mononuclear cells (PBMC) from 20 children with a history of rAOM (otitis-prone) and 20 healthy non-otitis-prone controls, and assessed innate and cell-mediated immune responses to the major otopathogen nontypeable Haemophilus influenzae (NTHi). NTHi was a potent stimulator of inflammatory cytokine secretion from PBMC within 4 hours, with no difference in cytokine levels produced between PBMC from cases or controls. In the absence of antigen stimulation, otitis-prone children had more circulating Natural Killer (NK) cells (potitis-prone and non-otitis-prone children (potitis-prone children are functional and respond to NTHi. CD8+ T cells and NK cells from both cases and controls produced IFNγ in response to polyclonal stimulus (Staphylococcal enterotoxin B; SEB), with more IFNγ+ CD8+ T cells present in cases than controls (pOtitis-prone children had more circulating IFNγ-producing NK cells (potitis-prone children mounted innate and T cell-mediated responses to NTHi challenge that were comparable to healthy children. These data provide evidence that otitis-prone children do not have impaired functional cell mediated immunity. PMID:29621281

¿por qué no se mejoran los niños con trastornos por déficit de atención con hiperactividad?

OpenAIRE

Chica Úrzula, Heydy Luz; Vásquez, Rafael

2014-01-01

Introducción. Durante el año 2004, en consulta externa e interconsultas del servicio de psiquiatría infantil, se hicieron 1454 valoraciones, correspondientes a 592 pacientes. De éstas, 536 fueron por trastorno deficitario de atención con hiperactividad (TDAH), correspondientes a 240 pacientes. Se preguntó al paciente y familiares si la condición que motivó la consulta se encontraba mejor, peor o igual. Según el registro en el sistema, 76% estaban igual o peor; 23% mejor y 1% no contestó. Se h...

Information on co-morbidities collected by history is useful for assigning Otitis Media risk to children.

Science.gov (United States)

Casselbrant, Margaretha L; Mandel, Ellen M; Doyle, William J

2016-06-01

Determine if a 2-Step multivariate analysis of historical symptom/sign data for comorbid diseases can abstract high-level constructs useful in assigning a child's "risk" for different Otitis Media expressions. Seventeen items related to the symptom/sign expression of hypothesized Otitis Media comorbidities were collected by history on 141 3-year-old children. Using established criteria, the children were assigned to 1 of 3 groups: Control (no significant past Otitis Media, n=45), Chronic Otitis Media with Effusion (n=45) and Recurrent Acute Otitis Media (n=51). Principal Component Analysis was used to identify factors representing the non-redundant shared information among related items and Discriminant Analysis operating on those factors was used to estimate the best predictor equation for pairwise group assignments. Six multivariate factors representing the assignable comorbidities of frequent colds, nasal allergy, gastroesophageal disease (specific and general), nasal congestion and asthma were identified and explained 81% of the variance in the 17 items. Discriminant Analysis showed that, for the Control-Chronic Otitis Media with Effusion comparison, a combination of 3 factors and, for the Control-Recurrent Acute Otitis Media comparison, a combination of 2 factors had assignment accuracies of 74% and 68%, respectively. For the contrast between the two disease expressions, a 2-factor combination had an assignment accuracy of 61%. These results show that this analytic methodology can abstract high-level constructs, comorbidities, from low-level data, symptom/sign scores, support a linkage between certain comorbidities and Otitis Media risk and suggest that specific comorbidity combinations contain information relevant to assigning the risk for different Otitis Media expressions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The human otitis media with effusion: a numerical-based study.

Science.gov (United States)

Areias, B; Parente, M P L; Santos, C; Gentil, F; Natal Jorge, R M

2017-07-01

Otitis media is a group of inflammatory diseases of the middle ear. Acute otitis media and otitis media with effusion (OME) are its two main types of manifestation. Otitis media is common in children and can result in structural alterations in the middle ear which will lead to hearing losses. This work studies the effects of an OME on the sound transmission from the external auditory meatus to the inner ear. The finite element method was applied on the present biomechanical study. The numerical model used in this work was built based on the geometrical information obtained from The visible ear project. The present work explains the mechanisms by which the presence of fluid in the middle ear affects hearing by calculating the magnitude, phase and reduction of the normalized umbo velocity and also the magnitude and phase of the normalized stapes velocity. A sound pressure level of 90 dB SPL was applied at the tympanic membrane. The harmonic analysis was performed with the auditory frequency varying from 100 Hz to 10 kHz. A decrease in the response of the normalized umbo and stapes velocity as the tympanic cavity was filled with fluid was obtained. The decrease was more accentuated at the umbo.

Otitis Media: Effect on a Child's Learning.

Science.gov (United States)

Gdowski, Becky S.; And Others

1986-01-01

The paper reviews the relationship between otitis media, auditory processing, language, and learning development. Suggestions are provided for identifying and managing students with suspected histories of the condition. (CL)

Evaluación externa de la calidad analítica en hematología: una necesidad en América Latina

Directory of Open Access Journals (Sweden)

Fink Nilda E.

1997-01-01

Full Text Available La garantía de calidad analítica de un laboratorio clínico se logra mediante un sistema de control de calidad interno complementado por un programa de evaluación externa. Esa garantía es la base que fundamenta la confiabilidad de los resultados obtenidos por los laboratorios y su uso en el diagnóstico y tratamiento de las enfermedades. En los países de América Latina hay muchos laboratorios que no cuentan con sistemas apropiados de evaluación y control de la calidad. Dada la importancia de los diagnósticos basados en datos hematológicos, durante el XI Congreso Latinoamericano de Bioquímica Clínica (México, 1993 la Organización Panamericana de la Salud patrocinó un curso de control de la calidad en hematología en el que participaron Argentina, Chile, Cuba, México, Paraguay, República Dominicana y Uruguay. Como parte del curso se produjeron materiales de control: solución estándar secundario de cianmetahemoglobina (HICN, solución concentrada estabilizada de hemoglobina (Hb y sangre entera humana preservada con seudoleucocitos. Estos materiales fueron enviados a laboratorios de los siete países participantes para su uso en procedimientos analíticos, con objeto de llevar a cabo posteriormente una evaluación externa del desempeño individual y de la comparabilidad de los resultados en conjunto. Las tareas asignadas fueron: 1 determinación de hemoglobina, hematocrito, y glóbulos rojos y blancos con los métodos en uso en cada laboratorio; 2 registro de los datos obtenidos en formularios especiales para la notificación de datos y 3 envío de dichos formularios al coordinador de cada país. Los resultados fueron analizados en función de los procedimientos analíticos y de los países participantes. Los valores de referencia se establecieron por consenso general de todos los participantes después de someterse al método estadístico de truncamiento. El análisis comparado de los resultados mostró coeficientes de variaci

Aetiology and pathology of otitis media with effusion in adult life.

Science.gov (United States)

Mills, R; Hathorn, I

2016-05-01

To gather and analyse information concerning the aetiology and pathology of otitis media with effusion in adults. A review of the English language literature from 1970 to the present was conducted. The available evidence suggests that otitis media with effusion in adult life is best viewed as a syndrome with a number of causes, including: infiltration of the eustachian tube by nasopharyngeal carcinoma and other local malignancies; changes in the middle ear and eustachian tube induced by radiotherapy; and systemic disease. There is now a body of evidence specifically related to the aetiology and pathology of otitis media with effusion in adult life. However, further research is required to fill in the gaps in our knowledge and understanding of this condition.

FREQUENCY OF MALASSEZIA SPP. IN DOGS PRESENTING EXTERNAL OTITIS

Directory of Open Access Journals (Sweden)

N. R. Magalhães

2017-12-01

Full Text Available The external otitis is defined as an inflammation of the dog external ear canal and it is considered a common disease in dogs. It is a disease of multifactorial etiology, where one of the main microrganisms associated to the illness is the Malassezia ssp. Therefore, this work aimed to determine the frequency of Malassezia spp. by auricular cytology in dogs that present clinical signs of external otitis. Were used 23 dogs attended in a veterinary clinic located in Sinop-MT. The material was collected using a dry swab, where each extremity was inserted in one of the auditory canal (right and left, which was rotated, removed from the ear and rolled on the glass slide. First the glass slide was microscopically observed (objective 4X, for viewing mites, and then, the sample was fixed by heat and stained with Panoptic. Once stained, the glass slide was examined (objective 40X and 100X. Among the 23 dogs evaluated, 60.9% were positive for Malassezia spp., 8.7% were positive for the Otodectes cynotis mite, and also 30,4% of the animals showed mixed infection with Malassezia ssp. and bacteria. With this study, it can be concluded that Malassezia ssp. was found more frequently in at the auditory canal of dogs with that presents external otitis, associated or acting alone, indicating the importance of this yeast in cases of otitis.

Tratamiento Quirúrgico de la Otitis Media y el Colesteatoma

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Jorge García Gómez

1991-06-01

Full Text Available

Presentado en la sesión plenaria de la Academia Americana de Otorrinolaringología. San Diego, California Septiembre 13, 1990

Resumen y conclusiones

Presentamos a la Academia nuestra experiencia de 38 años en cirugía de la otitis media y el colesteatoma y consideramos que esta cirugía es de alta incidencia en la práctica quirúrgica del Otorrinolaringólogo en América Latina.

La etiología, la patogénesis y el tratamiento quirúrgico del colesteatoma presenta todavía muchas incógnitas y controversias y el tratamiento ideal está por resolver.

El colesteatoma congénito se diagnostica hoy con más frecuencia gracias a la detección temprana por medio del TAC y M.R.I.

En el tratamiento quirúrgico, tanto las técnicas cerradas como abiertas tienen claras indicaciones. El cirujano decide cuál es la más apropiada de acuerdo con la evaluación pre-operatoria y los hallazgos durante el acto quirúrgico y debe estar preparado para operar todas las estructuras anatómicas del hueso temporal.

En nuestra experiencia recomendamos el injerto de fascia terporar para la reconstrucción de la membrana timpánica y los homoinjertos de hueso y cartílago para reconstruir la cadena osicular.

La ausencia total del estribo sigue siendo un problema enla reconstrucción de la Cadena y debe practicarse en un segundo tiempo, si hay patología activa en el oído medio.

La técnica abierta, removiendo la pared posterior del conducto ha sido en nuestras manos, la que nos ha dado mejores resultados a largo plazo. Se enumeran las indicaciones y técnicas en la técnica abierta y cerrada y la conducta a seguir en caso de fístula del laberinto, lo mismo que nuestro criterio en el colesteatoma de los niños.

Después de cinco años de control en nuestra experiencia, la recurrencia del colesteatoma por técnica abierta fué del 8% y por técnica cerrada del 30

Otitis Media and Caregiver Quality of Life

DEFF Research Database (Denmark)

Heidemann, Christian Hamilton; Godballe, Christian; Kjeldsen, Anette Drøhse

2014-01-01

OBJECTIVE: Otitis media in children may have a considerable impact on caregiver quality of life. The disease-specific Caregiver Impact Questionnaire is designed to assess caregiver quality of life in relation to child otitis media. Assessment of the psychometric properties of this instrument...... is limited. This study assesses the psychometric properties of this instrument including validity, reproducibility, responsiveness, and interpretability. STUDY DESIGN: Longitudinal validation study. SETTING: Secondary care units. METHODS: Analyses were based on data from 435 families. Validity was assessed...... Danish version of the Caregiver Impact Questionnaire is a valid and reproducible measurement tool that is also sensitive to measuring change in the current setting. A change score representing minimal important change as perceived by the respondent is proposed. Results of this study support the use...

Management of chronic otitis media by subtotal petrosectomy.

Science.gov (United States)

Altuna, Xabier; Navarro, Juan José; Goiburu, Miren; Palicio, Idoia

2016-01-01

Subtotal petrosectomy is the complete exenteration of all air cell tracts of the temporal bone. The isthmus of the Eustachian tube is obliterated and the external auditory canal is closed. The aim of this study was to describe the use of this technique in the management of certain cases of chronic otitis media. We conducted a retrospective revision of the patients treated in our Institution with this technique for chronic otitis media in a 5-year period (2008-2012). All charts were reviewed and data from the otomicroscopy, audiometry, radiology, surgical findings, postoperative complications and follow-up (including diffusion magnetic resonance imaging, MRI) of a minimum of 24 months were collected. In this period petrosectomy was performed on 28 patients for chronic otitis media. We treated 13 cases as primary cases, while 15 cases were secondary (patients that had already undergone another procedure in that ear). Fifteen cases had no serviceable hearing. Only 1 case had an immediate postoperative complication (infection); during the posterior follow-up, 2 cases had to be reoperated for diffusion restriction in the mastoid area revealed in the MRI 2 years after surgery. A subtotal petrosectomy is rarely performed for the treatment of chronic otitis media. However, it is a technique that we have to keep in mind for the treatment of certain cases where there is recurrence and deep hearing loss, as well as in cases with good cochlear reserve if the disease coexists with other complications. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

A study of bacterial pathogens and antibiotic susceptibility patterns in chronic suppurative otitis media.

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Mofatteh, M R; Shahabian Moghaddam, F; Yousefi, M; Namaei, M H

2018-01-01

To assess the frequency of bacterial agents in chronic suppurative otitis media and the antibiotic susceptibility patterns of isolates among patients. A total of 185 patients clinically diagnosed with chronic suppurative otitis media were interviewed and middle-ear effusion samples were collected using sterile swabs. All bacterial isolates were identified by conventional microbiological methods. Antibiotic susceptibility patterns of the isolates were determined by Kirby-Bauer disc diffusion. Staphylococci spp. (64.9 per cent) were the most prevalent bacteria isolated, followed by Klebsiella spp. (12.9 per cent) and Pseudomonas aeruginosa (10.3 per cent). The most effective antibiotic for treatment of bacterial chronic suppurative otitis media was ciprofloxacin. Statistical analysis showed no significant difference in bacterial infestations among chronic suppurative otitis media patients and the antimicrobial susceptibility patterns of the bacterial isolates based on gender and age (p > 0.05). Our findings highlight the importance of a continuous and periodic evaluation of the bacteriological profile and antibiotic susceptibility patterns in chronic suppurative otitis media patients for efficacious treatment of the infection.

[Surgical treatment of patients with exudative otitis media].

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Dmitriev, N S; Mileshina, N A

2003-01-01

The article concerns peculiarities of surgery for chronic exudative otitis media (CEOM). The significance of miringotomy, tympanostomy, tympanotomy and tympanoantrotomy is demonstrated. The experience of the authors in surgical treatment and postoperative management of CEOM is reviewed. Of primary importance is valid selection of patients for each operation and choice of ventilatory tubes depending on the disease stage. Incidence rate and causes of recurrences in respect to the patients' age are presented and the role of follow-up in prevention of CEOM recurrences is shown. Use of temporal bone computed tomography in CEOM is specified. Key words: exudative otitis media, tympanostomy, ventilation tubes, CT of the temporal bone.

Biological and behavior aspects of Chrysoperla externa (Hagen, 1861 on cotton plantsAspectos biológicos e comportamentais de Chrysoperla externa (Hagen, 1861 em algodoeiro

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Luciano Pacelli Medeiros Macedo

2010-02-01

Full Text Available It was aimed to study biological and behavior aspects of larvae and adults of Chrysoperla externa in greenhouse, on cotton plants. Recently hatched larvae were released on the upper third of cotton plants, which were previously infested with Aphis gossypii,. After emergence, adults were separated by sex and packed in cylindrical PVC recipients with cotton plant. We evaluated the duration of each larval, pre-pupal and pupal periods, pre-oviposition, oviposition, effective oviposition and post-oviposition periods, male and female logevity, daily and total oviposition capacity. The behavior of pupal stage was also evaluated, which released three larvae of the 3rd instar per cotton plant and they were put on the lower, medium and upper sections. As treatments, it was used naked soil, dried leaves from cotton plant, crushed rock nº 1; and crushed rock nº 1 + dried leaves. Larvae from different instars were released on the upper section of the cotton plants infested with A. gossypii to verify the search timing that marked the period the prey was exposed to the predator. C. externa larvae passed through all the phases of their biological cycle and there was no significant influence on the type of the soil covering used on pupal stage, since all of them were significantly higher on naked soil. There was no significative difference on the prey search by C. externa larvae.Objetivou-se estudar aspectos biológicos e comportamentais de larvas e adultos de Chrysoperla externa em casa-de-vegetação, em plantas de algodão. Larvas recém eclodidas foram liberadas no terço superior de plantas de algodão previamente infestadas com Aphis gossypii, onde permaneceram até a pupação. Após a emergência, adultos foram separados por sexo, acondicionados em recipientes cilíndricos de PVC contendo uma planta de algodoeiro. Avaliaram-se a duração de cada ínstar, dos períodos larval, pré-pupal e pupal, dos períodos de pré-oviposição, oviposi

76 FR 39883 - Design of Clinical Trials for Systemic Antibacterial Drugs for the Treatment of Acute Otitis...

Science.gov (United States)

2011-07-07

...] Design of Clinical Trials for Systemic Antibacterial Drugs for the Treatment of Acute Otitis Media... Clinical Trials for Systemic Antibacterial Agents for the Treatment of Acute Otitis Media. This public... the treatment of acute otitis media (middle ear infection). Discussions will focus on [[Page 39884...

The effect of indoor air pollutants on otitis media and asthma in children

Energy Technology Data Exchange (ETDEWEB)

Daigler, G.E.; Markello, S.J.; Cummings, K.M. (State Univ. of New York, Buffalo (USA))

1991-03-01

This case-control study investigated the possible association between home environmental air pollutants and their effect on otitis media and asthma in children. Patients with physician-diagnosed otitis (n = 125, 74% response), with asthma (n = 137, 80% response), and controls (n = 237, 72% response) from a private pediatric practice seen between October 1986 and May 1987 were studied. A questionnaire inquired about housing characteristics (i.e., age, insulation, heating system) and sources of indoor air pollution such as cigarette smoking, use of woodburning stoves, household pets, etc. Analysis of the responses confirmed previous findings of significant relationships between maternal smoking (P = .021), and the presence of pets (P = .034) and the occurrence of asthma. A newly reported relationship between exposure to woodburning stoves and the occurrence of otitis (P less than .05) was reported. This implicates yet another risk factor (wood burning) in the etiology of otitis media.

Interferencia entre bacterias comensales de faringe y patogénesis de oído medio en un modelo animas de otitis media

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LM Villafane

2013-01-01

Full Text Available Objetivo: determinar in vivo la interacción entre bacterias comensales aisladas  de faringe de niños sanos y S. pneumoniae, en un modelo animal (Chinchilla laniger de otitis media. Metodos: estudio experimental Intervenciones: Suspensiones de los serotipos 18A y 9V de Spn fueron inyectados intra-peritonealmente en dos chinchillas y luego recuperados mediante cultivo de órganos y sangre de las mismas. Empleando suspensiones de las cepas animalizadas se inocularon intranasalmente cuatro chinchillas, y solo a dos de ellas se le inoculo una mezcla de las bacterias comensales (Streptococcus mitis, Streptococcus parasanguinis. Con un otoscopio se examinó la evolución de la infección a los 7 y 14 días. Se sacrificaron los animales y se tomaron muestras de los oídos para un examen histológico. Resultados: Mediante otoscopia, se observó al día 14 que todos presentaron una membrana timpánica hiperémica sin efusión, presentándose con mayor intensidad en aquellos que recibieron el tratamiento. La histología confirmó que la administración del tratamiento no evitó que la infección evolucionara, advirtiéndose que las infectadas con el serotipo 8A y tratadas fueron las que presentaron el tejido epitelial menos comprometido respecto al resto. Conclusiones: Spn y las bacterias comensales podrían establecer una relación competitiva, y el efecto moderador en la progresión de la infección de otitis media dependería del serotipo involucrado.

Lack of efficacy of a decongestant-antihistamine combination for otitis media with effusion ("secretory" otitis media) in children. Results of a double-blind, randomized trial.

Science.gov (United States)

Cantekin, E I; Mandel, E M; Bluestone, C D; Rockette, H E; Paradise, J L; Stool, S E; Fria, T J; Rogers, K D

1983-02-10

In a double-blind, randomized trial of 553 infants and children who had otitis media with effusion ("secretory" otitis media), we compared the efficacy of a four-week course of an oral decongestant-antihistamine combination (pseudoephedrine hydrochloride, 4 mg per kilogram of body weight per day, and chlorpheniramine maleate, 0.35 mg per kilogram per day) with that of placebo. Among patients with initially unilateral disease, resolution of middle-ear effusion occurred at four weeks in 38 per cent of those treated with placebo and 34 per cent of those treated with drug (P = 0.74). Among patients with initially bilateral disease the corresponding proportions were 19 and 21 per cent, respectively (P = 0.67). Side effects were reported more often among drug-treated than placebo-treated patients. Decongestant-antihistamine combinations do not appear to be indicated for the treatment of otitis media with effusion in infants and children.

HAART impact on prevalence of chronic otitis media in Brazilian HIV-infected children.

Science.gov (United States)

Weber, Raimar; Pinheiro Neto, Carlos Diógenes; Miziara, Ivan Dieb; Araújo Filho, Bernardo Cunha

2006-01-01

The advent of new antiretroviral drugs such as protease inhibitors has generated sensible changes in morbity and mortality in HIV-infected patients. To evaluate the impact of Highly Active Antiretroviral Therapy (HAART) on the prevalence of chronic otitis media in HIV-infected pediatric population. We analyzed medical charts of 471 children aged zero to 12 years and 11 months with HIV infection from an Ambulatory of ENT and AIDS. Children were divided according to the age: 0 to 5 years and 11 months and 6 to 12 years and 11 months and classified as having chronic otitis media based on history, physical examination, audiologic and tympanometric data. Prevalence of chronic otitis media, as well as CD4+ lymphocyte count were compared between groups in use of HAART and the group without HAART. Out of 459 children, 65 (14.2%) had chronic otitis media. We observed that in children aged 0 to 5 years and 11 months who were taking HAART there was significant lower prevalence of chronic otitis media (p=0.02). The use of HAART was associated to higher mean CD4+ lymphocyte count (pmedia in HIV infected children, probably due to increase in mean CD4+ lymphocyte count.

MUSCULACIÓN EN GIMNASIOS: APROXIMACIÓN A LOS MOTIVOS PARA ENTRENAR CON PESAS

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Féliz Arbinaga Ibarzábal

2002-12-01

Full Text Available El estudio piloto que presentamos pretende llevar a cabo un primer análisis sobre la motivación que muestra un grupo de 55 personas (72,73% de hombres y 27,27% de mujeres para realizar actividades de musculación mediante entrenamiento con pesas en gimnasios. El instrumento utilizado para evaluar la motivación ha sido la Escala de Motivación en el Deporte (E.M.D de Brière, Vallerand, Blais y Pelletier (1995 adaptada por López (2000. De los resultados se destaca que el motivo principal para iniciarse en el entrenamiento con pesas en gimnasios varía entre hombres y mujeres. Éstas, en el 66,7% de los casos, dicen acudir para controlar el peso frente al 15% de los hombres; mientras éstos acuden principalmente para mantener la forma física (50%. La muestra nos refleja una población joven, siendo las mujeres quienes suelen puntuar más en el factor de regulación introyectada (p < 0.05 mientras los varones lo hacen en regulación externa (p < 0.001. En este sentido, son los varones quienes más desean parecerse a compañeros con mayor desarrollado muscular (p = 0.01118, siendo aquellos que más se comparan los que desearían llegar a competir (p = 0.01967. Éstos últimos se ven en mayor medida influenciados por una regulación externa (p = 0.011 y una motivación intrínseca al conocimiento (p = 0.005.

Nasal carriage of Staphylococcus schleiferi from healthy dogs and dogs with otitis, pyoderma or both.

Science.gov (United States)

May, Elizabeth R; Kinyon, Joann M; Noxon, James O

2012-12-07

In veterinary medicine, Staphylococcus schleiferi was previously assumed to be an inhabitant of carnivore skin, however, more recently, it has been repeatedly documented in the literature as both an inhabitant and as a pathogen. In order to determine the frequency of nasal carriage, and the methicillin susceptibility pattern of S. schleiferi from healthy dogs as well as dogs with otitis and/or pyoderma, a prospective study including 24 dogs with healthy ears and skin, 27 dogs with healthy ears and pyoderma, 15 dogs with otitis without pyoderma and 20 dogs with both otitis and pyoderma was performed. Specimens were obtained and cultured and isolates were identified as S. schleiferi based on growth and biochemical characteristics. S. schleiferi was isolated from the nares of 1 healthy dog, 3 dogs with recurrent pyoderma, 2 dogs with recurrent otitis, and 1 dog with both recurrent otitis and pyoderma. One of the S. schleiferi isolates was methicillin resistant. Nasal carriage of S. schleiferi does occur in healthy dogs as well as dogs with otitis and pyoderma. Methicillin resistant and sensitive S. schleiferi can be found in the nares of dogs with diseased ears and skin. Copyright © 2012 Elsevier B.V. All rights reserved.

Diseño y validación de un cuestionario para evaluar la satisfacción de los pacientes atendidos en las consultas externas de un hospital de Madrid en 2006

OpenAIRE

Susana Granado de la Orden; Cristina Rodríguez Rieiro; María del Carmen Olmedo Lucerón; Ana Chacón García; Dolores Vigil Escribano; Paz Rodríguez Pérez

2007-01-01

Fundamento: Para conocer la calidad de la asistencia sanitaria es imprescindible incorporar el punto de vista del paciente realizando estudios de satisfacción. Las encuestas de satisfacción precisan unas propiedades psicométricas que garanticen su fiabilidad y validez. El objetivo de este trabajo es diseñar y validar un cuestionario para conocer la satisfacción de los pacientes con las consultas externas hospitalarias. Métodos: Estudio de validación de un cuestionario ...

[Usefulness of fenspiride in the treatment of acute otitis media in children].

Science.gov (United States)

Zielnik-Jurkiewicz, Beata; Jurkiewicz, Dariusz

2005-06-01

Acute otitis media is very general disease and concerns every child practically. The shortening the time of treatment as well as quick decrease of symptoms, and mainly the pain have large meaning in treatment of this disease. Combined treatment of fenspiride and typical treatment of otitis media permits as our investigations show on quicker and observed at children's larger number decrease of symptoms in children with acute otitis media. The aim of the study was to observe effectiveness of combined treatment with antibiotic and fenspiride in children with acute otitis media. The study comprised 40 children (mean age 8.2 years). The diagnosis of acute otitis media based on medical history data, otolaryngological examination and audiometry (tone and impedance). Children with GERD, hypersensitivity to amoxicillin and fenspiride as well as hypertrophy of adenoid were excluded from the study. Children were divided in two equal groups randomly. All children received amoxicillin in dose 80 mg/kg/day in three partite doses (Amotaks, Polfa Tarchomin Poland) as well as oxymethazolin 0.05% nasal drops 3 x day 1-2 drops (0.05% Nasivin, Merck Germany). In children from second group fenspiride was applied in dose 2 ml/kg/day in three divided doses (Eurespal, Servier Francja) additionally. Treatment was provided by 10 days. During the treatment parents made record of recession in 10 point scale, estimating following parameters: the pain of ear, bother, raised the temperature of body, loss of appetite, vomiting, diarrhea, otorrhea and crying. After end of treatment control otolaryngological and audiological examinations were performed. In studied children symptoms were similar, and the pain of ear was in both groups main suffering. Vomiting and diarrhea the most seldom were observed. In children with acute otitis media treated additionally with fenspiride statistically significant (pfenspiride in comparison to children treated only with antibiotic. Earlier return of hearing and

Relationship between Eustachian tube dysfunction and otitis media with effusion in radiotherapy patients.

Science.gov (United States)

Akazawa, K; Doi, H; Ohta, S; Terada, T; Fujiwara, M; Uwa, N; Tanooka, M; Sakagami, M

2018-02-01

This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion. The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose-volume histogram parameters. Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes. The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.

Acute Otitis due to Vibrio fluvialis after Swimming

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Ping-Jen Chen

2012-01-01

Full Text Available A 40-year-old female presented with purulent exudate through the left auditive duct and pain in the left ear region, which intensified during mastication. After collection of the pus from the left ear lesion, amoxicillin-clavulanic acid for seven days was prescribed for a presumed diagnosis of acute otitis. Four days later, the pus culture grew V. fluvialis which is further identified by API 20E identification system (bioMérieux. Following the successful completion of a course of antibiotics, the patient recovered completely and without complication. To the best of our knowledge, this is the first case of Vibrio fluvialis otitis after swimming in an immunocompetent patient.

[Incidence of complications of otitis media].

Science.gov (United States)

Zernotti, M E; Casarotto, C; Tosello, M L; Zernotti, M

2005-02-01

Determine the incidence of otological and endocranial complications of acute otitis media, taking into account previous treatments and the development of complications. Retrospective follow-up study between March 1996-2003 including 16 patients: 9 men, 7 women. Nine patients (56.25%) had intracranial complications and seven otological ones. In the first group, 6 developed meningitis by Streptococcus pneumoniae, one sigmoid sinus thromboflebitis, one multiple abscesses, and one subdural empiema and encephalitis. Otological complications were six acute mastoiditis and the other one a facial paralysis. The child with thromboflebitis underwent mastoidectomy and closed meningeal comunication; 5 of the acute mastoiditis were operated on and the other received traditional treatment. The meningitis received medication. Two died, one because of a subdural empiema and the other due to meningitis. Despite the advances made by antibiotherapy and diagnosis, the complications of otitis media are still frequent. The pediatrician and otorhinolaryngologist should be on the alert for these as well as for Pneumococcus and its high resistance.

What Does Tympanostomy Tube Placement in Children Teach Us About the Association Between Atopic Conditions and Otitis Media?

Science.gov (United States)

Juhn, Young J.; Wi, Chung-Il

2014-01-01

Otitis media is the most common infection second only to viral upper respiratory infection in the outpatient setting. Tympanostomy tube insertion (TTI) is the most common ambulatory surgical procedure in the United States. While many risk factors for otitis media have been identified, atopic conditions have been under-recognized as risk factors for recurrent and persistent otitis media. Given that asthma and other atopic conditions are the most common chronic conditions during childhood, it is worth examining the association between atopic conditions and risk of otitis media, which can provide insight into how atopic conditions influence the risk of microbial infections. This paper focuses its discussion on otitis media, however it is important that the association between atopic conditions and risk of otitis media be interpreted in the context of the association of atopic conditions with increased risks of various microbial infections. PMID:24816652

Epidemiology and Management of Otitis Media in Children.

Science.gov (United States)

Giebink, G. Scott; Daly, Kathy

1990-01-01

This article focuses on definitions of middle ear inflammation (otitis media), the epidemiology of this disorder, brief considerations of pathophysiology and management, and possible future therapies. (DB))

Reduced Serum IgG Responses to Pneumococcal Antigens in Otitis-Prone Children May Be Due to Poor Memory B-Cell Generation

Science.gov (United States)

Sharma, Sharad K.; Casey, Janet R.

2012-01-01

A low level of serum antibody to antigens expressed by Streptococcus pneumoniae has been proposed to explain the susceptibility of children to recurrent episodes of acute otitis media (hereafter, “otitis-prone children”). By use of enzyme-linked immunospot assays, the percentages of memory B cells to pneumococcal protein antigens PhtD, LytB, PcpA, PhtE, and Ply were compared between otitis-prone and non–otitis-prone children at the time of acute otitis media or nasopharyngeal colonization with S. pneumoniae. We found significantly lower percentages of memory B cells to 3 pneumococcal protein antigens (PhtD, PhtE, and Ply) and reduced antigen-specific immunoglobulin G concentrations in otitis-prone children, compared with non–otitis-prone children. PMID:22383675

Echinacea purpurea and osteopathic manipulative treatment in children with recurrent otitis media: a randomized controlled trial

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Worden Katherine A

2008-10-01

Full Text Available Abstract Background Recurrent otitis media is a common problem in young children. Echinacea and osteopathic manipulative treatment have been proposed as preventive measures, but have been inadequately studied. This study was designed to assess the efficacy of Echinacea purpurea and/or osteopathic manipulative treatment (OMT for prevention of acute otitis media in otitis-prone children. Methods A randomized, placebo-controlled, two-by-two factorial trial with 6-month follow-up, conducted 1999 – 2002 in Tucson, Arizona. Patients were aged 12–60 months with recurrent otitis media, defined as three or more separate episodes of acute otitis media within six months, or at least four episodes in one year. Ninety children (44% white non-Hispanic, 39% Hispanic, 57% male were enrolled, of which 84 had follow-up for at least 3 months. Children were randomly assigned to one of four protocol groups: double placebo, echinacea plus sham OMT, true OMT (including cranial manipulation plus placebo echinacea, or true echinacea plus OMT. An alcohol extract of Echinacea purpurea roots and seeds (or placebo was administered for 10 days at the first sign of each common cold. Five OMT visits (or sham treatments were offered over 3 months. Results No interaction was found between echinacea and OMT. Echinacea was associated with a borderline increased risk of having at least one episode of acute otitis media during 6-month follow-up compared to placebo (65% versus 41%; relative risk, 1.59, 95% CI 1.04, 2.42. OMT did not significantly affect risk compared to sham (44% versus 61%; relative risk, 0.72, 95% CI 0.48, 1.10. Conclusion In otitis-prone young children, treating colds with this form of echinacea does not decrease the risk of acute otitis media, and may in fact increase risk. A regimen of up to five osteopathic manipulative treatments does not significantly decrease the risk of acute otitis media. Trial registration ClinicalTrials.gov Identifier: NCT00010465

Política externa como política pública: uma análise pela regulamentação constitucional brasileira (1967-1988

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Michelle Ratton Sanchez

2006-11-01

Full Text Available O objetivo deste trabalho é relacionar os debates sobre política externa e política pública, a partir de uma perspectiva constitucional. Para afastar o consenso de que a política externa sempre foi considerada como "externa" aos estados e distinta de toda e qualquer política doméstica - e assim de toda e qualquer política pública -, buscou-se identificar as políticas interna, externa e internacional como um continuum de um mesmo processo decisório. A partir desses pressupostos teóricos, apresentou-se uma análise da distribuição de competências da política externa brasileira nas constituições de 1967 e 1988, com o intuito de identificar, no contexto de redemocratização do Brasil possíveis alterações na regulamentação da política externa que sugerissem a incorporação de uma concepção de gestão poliárquica, que a aproximasse das demais políticas públicas. Por fim, compararam-se os mecanismos disponíveis na Constituição de 1988 para o controle da política externa e das políticas públicas em geral, a fim de proceder-se à sua aproximação e verificar a aplicabilidade dos mecanismos relativos às políticas públicas para controle da política externa.

21 CFR 524.1484f - Neomycin sulfate, prednisolone acetate, tetracaine hydrochloride eardrops.

Science.gov (United States)

2010-04-01

..., to a lesser degree, chronic otitis externa in dogs and cats. It is indicated as treatment or adjunctive therapy of certain ear conditions in dogs and cats caused by or associated with neomycin... hypersensitivity or allergy. If such signs are noted, therapy should be stopped.1 (3) Federal law restricts this...

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African Journals Online (AJOL)

Microbial Profile and Antimicrobial Susceptibility of Isolates From Dogs with Otitis Externa in Kenya Abstract · Vol 29 (2005) - Articles Clinical, Laboratory Diagnosis and Treatment of Ehrlichial Infections in Dogs: A Review Abstract · Vol 29 (2005) - Articles Some Clinical Features of Osteoarthritis of the Hip Joint in Adult Dogs ...

75 FR 4692 - Ophthalmic and Topical Dosage Form New Animal Drugs; Miconazole, Polymixin B, and Prednisolone...

Science.gov (United States)

2010-01-29

... nitrate, polymixin B sulfate, and prednisolone acetate for the treatment of otitis externa in dogs. DATES... SUROLAN (miconazole nitrate, polymixin B sulfate, and prednisolone acetate) Otic Suspension in dogs for... Cosmetic Act (21 U.S.C. 360b(c)(2)(F)(ii)), this approval qualifies for 3 years of marketing exclusivity...

Magnetic resonance imaging findings in a red kangaroo (Macropus rufus) with otitis.

Science.gov (United States)

Okeson, Danelle M; Coke, Rob L; Kochunov, Peter; Davis, M Duff

2008-12-01

Magnetic resonance imaging (MRI) was performed on an adult, male Red kangaroo (Macropus rufus) with a history of nonspecific neurologic signs and acute discharge from the left ear. MRI revealed findings consistent with otitis and possible osteomyelitis of the temporal and mastoid bones. To the authors' knowledge, this is the first report of otitis and MRI findings in a kangaroo.

Risk of childhood otitis media with focus on potentially modifiable factors: A Danish follow-up cohort study.

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Kørvel-Hanquist, Asbjørn; Koch, Anders; Lous, Jørgen; Olsen, Sjurdur Frodi; Homøe, Preben

2018-03-01

Otitis media is the primary cause of antibiotic prescription in children. Two-thirds of all children experience at least one episode of otitis media before the age of 7 years. The aim of this study was to characterise the attributable effect of several modifiable risk exposures on the risk of >3 episodes of otitis media at age 18 months and 7 years within a large prospective national birth cohort. The study used the Danish National Birth Cohort comprising information about otitis media and risk exposures from more than 50,000 mother-child pairs from the period 1996-2002. Logistic regression models were used to estimate odds ratios for the risk factors and to calculate the population attributable fraction. Short time with breastfeeding, early introduction to daycare, cesarean section, and low compliance to the national vaccination program were all associated with an increased risk of >3 episodes of otitis media at 18 months of age and at 7 years of age. The fraction of children with otitis media attributed from breastfeeding lasting for less than 6 months was 10%. Introduction to daycare before the age of 12 months attributed with 20% of the cases of >3 episodes of otitis media. Short duration of breastfeeding, early introduction into daycare, cesarean section, and low compliance with the national vaccination program increased the risk of experiencing >3 episodes of otitis media at 18 months, and at 7 years of age. These are factors that all can be modulated. Copyright © 2018 Elsevier B.V. All rights reserved.

Fortalezas internas y externas de adolescentes que no consumen alcohol

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Mydori Harumi Téllez Vásquez

2017-06-01

Full Text Available Introducción: el consumo de alcohol en adolescentes mexicanos es un problema de salud pública, que requiere enfocar los esfuerzos de investigación en la prevención. Este estudio se basa en el modelo de fortalezas de Benson (2007, quien plantea que los jóvenes poseen recursos individuales y contextuales que promueven un desarrollo positivo y limitan el involucramiento en conductas de riesgo. Objetivo: analizar las diferencias en fortalezas internas y externas entre estudiantes de secundaria que presentan diferentes niveles de consumo de alcohol. Metodo: participaron 990 estudiantes de secundarias públicas de la Ciudad de México, 52.1% mujeres y 47.9% hombres, de una media de edad de 13.6 años. Se evaluaron siete fortalezas internas y siete externas. Resultados: 53.9% de los participantes nunca ha usado alcohol, 28.3% sí lo ha consumido pero nunca o sólo una vez ha abusado, y 17.8% reportó haber abusado del consumo en el último mes. Hombres y mujeres que no han usado alcohol reportaron puntajes significativamente más altos en fortalezas internas. En el caso de las fortalezas externas, los jóvenes sin consumo fueron los que obtuvieron puntajes más altos, excepto en amigos saludables (tanto hombres como mujeres, y en apoyo y supervisión del padre (hombres. Conclusiones: los resultados contribuyen a la explicación del consumo de alcohol en jóvenes y proporcionan elementos para el diseño de intervenciones, pues señalan las fortalezas que deben promoverse para evitar que los jóvenes consuman alcohol a edades tempranas.

Danish guidelines on management of otitis media in preschool children.

Science.gov (United States)

Heidemann, C H; Lous, J; Berg, J; Christensen, J J; Håkonsen, S J; Jakobsen, M; Johansen, C J; Nielsen, L H; Hansen, M P; Poulsen, A; Schousboe, L P; Skrubbeltrang, C; Vind, A B; Homøe, P

2016-08-01

Otitis media is one of the most common diseases in small children. This underlines the importance of optimizing diagnostics and treatment of the condition. Recent literature points toward a stricter approach to diagnosing acute otitis media (AOM). Moreover, ventilating tube treatment for recurrent AOM (RAOM) and chronic otitis media with effusion (COME) has become the most frequently performed surgical procedure in pre-school children. Therefore, the Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology, Head and Neck Surgery deemed it necessary to update the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME. The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted between July and December 2014. The quality of the existing literature was assessed using AGREE II (Appraisal of Guidelines for Research & Evaluation), AMSTAR (assessing the Methodological Quality of Systematic Reviews), QUADAS-2 (Quality of Diagnostic Accuracy Studies), Cochrane Risk of Bias Tool for randomized trials and ACROBAT-NRSI (A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies). The working group consisted of otolaryngologists, general practitioners, pediatricians, microbiologists and epidemiologists. Recommendations for AOM diagnosis, surgical management for RAOM and COME, including the role of adenoidectomy and treatment of ventilating tube otorrhea, are proposed in the guideline. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

EXPERIENCE OF TREATMENT WITH FENSPIRIDE IN CHILDREN WITH CHRONIC EXUDATIVE OTITIS MEDIA AFTER TYMPANOSTOMY

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L.A. Toropova

2009-01-01

Full Text Available The trial presents the analysis of factors predisposing to exudative otitis media development in 709 children, needing regular audiologist’s check-up. It was shown that dominating risk factor of auditory tube’s function disorders is hypertrophy of palatine tonsil (it was detected in 69% of children. Besides, doctors from children’s out-patient clinics often use conservative treatment in children with chronic exudative otitis media. Analysis of data obtained at the time of treatment of 180 hospitalized children under the age 1–17 years old with exudative otitis media showed that combination of tympanostomy with fenspiride (Erespal allows achieving of more significant decrease (1.3 times low audibility threshold of different oscillations than in children from control (treated without fenspiride.Key words: children, exudative otitis media, timpanostomy, fenspiride.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(4:102-105

Fisetin administration improves LPS-induced acute otitis media in mouse in vivo

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Li, Peng; Chen, Dan; Huang, Yang

2018-01-01

Acute otitis media is one of the most common infectious diseases worldwide in spite of the widespread vaccination. The present study was conducted to explore the effects of fisetin on mouse acute otitis media models. The animal models were established by lipopolysaccharide (LPS) injection into the middle ear of mice via the tympanic membrane. Fisetin was administered to mice for ten days through intragastric administration immediate after LPS application. Hematoxylin and eosin (H&E) staining was performed and the pro-inflammatory cytokines, including interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-6 and VEGF, were measured through enzyme-linked immunosorbent assay (ELISA) method and RT-qPCR analysis. Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway was detected by immunoblotting assays. Reactive oxygen species (ROS) generated levels were determined through assessment of anti-oxidants, and TXNIP/MAPKs signaling pathways were explored to reveal the possible molecular mechanism for acute otitis media progression and the function of fisetin. Fisetin reduced mucosal thickness caused by LPS. In fisetin-treated animals, pro-inflammatory cytokine release was downregulated accompanied with TLR4/NF-κB inactivation. ROS production was significantly decreased in comparison to the LPS-treated group. The TXNIP/MAPKs signaling pathway was inactivated for fisetin treatment in LPS-induced mice with acute otitis media. The above results indicated that fisetin improved acute otitis media through inflammation and ROS suppression via inactivating TLR4/NF-κB and TXNIP/MAPKs signaling pathways. PMID:29568876

Fisetin administration improves LPS-induced acute otitis media in mouse in vivo.

Science.gov (United States)

Li, Peng; Chen, Dan; Huang, Yang

2018-07-01

Acute otitis media is one of the most common infectious diseases worldwide in spite of the widespread vaccination. The present study was conducted to explore the effects of fisetin on mouse acute otitis media models. The animal models were established by lipopolysaccharide (LPS) injection into the middle ear of mice via the tympanic membrane. Fisetin was administered to mice for ten days through intragastric administration immediate after LPS application. Hematoxylin and eosin (H&E) staining was performed and the pro-inflammatory cytokines, including interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-6 and VEGF, were measured through enzyme-linked immunosorbent assay (ELISA) method and RT-qPCR analysis. Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway was detected by immunoblotting assays. Reactive oxygen species (ROS) generated levels were determined through assessment of anti-oxidants, and TXNIP/MAPKs signaling pathways were explored to reveal the possible molecular mechanism for acute otitis media progression and the function of fisetin. Fisetin reduced mucosal thickness caused by LPS. In fisetin-treated animals, pro-inflammatory cytokine release was downregulated accompanied with TLR4/NF-κB inactivation. ROS production was significantly decreased in comparison to the LPS-treated group. The TXNIP/MAPKs signaling pathway was inactivated for fisetin treatment in LPS-induced mice with acute otitis media. The above results indicated that fisetin improved acute otitis media through inflammation and ROS suppression via inactivating TLR4/NF-κB and TXNIP/MAPKs signaling pathways.

Evaluación externa: características y vivencias del equipo de pares

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Quesada Pacheco, Allen

2006-08-01

Full Text Available Resumen: La Evaluación Externa es la fase que sigue a la Autoevaluación de programas académicos a nivel superior. Este proceso consiste en constatar y validar, desde la perspectiva externa, cómo se sitúa el programa evaluado respecto al modelo de evaluación, tanto a través de un análisis documental, como a través de una visita. Este artículo se centra particularmente en la validación externa de programas académicos de acuerdo a los lineamientos del Sistema Centroamericano de Evaluación y Acreditación de la Educación Superior (SICEVAES.Analiza el papel de los pares externos, sus compromisos y responsabilidades. Se describen las etapas del desarrollo de la vista por el equipo de pares y comparte aportaciones significativas del equipo de pares durante la realización de la visita como insumo enriquecedor al proceso de evaluación externa.Abstract:The External Evaluation is the phase that follows the self-evaluation of programs or institutions at the university level. This process verifies and validates, from an external perspective, the real scenario of the study program or faculty unit that has undergone a self-evaluation process regarding the evaluation model utilized, through an analysis of documents and through an on-site visit. The main concern of this article is on the external evaluation of study programs based on the regulations of the Central American System for Evaluation and Accreditation of Higher Education. This paper analyzes the role, obligations and responsibilities of members of the evaluation group. It describes the stages for the development of the visit and shares significant on-site experiences that can enrich the external evaluation process.

Consulta externa en instituciones de salud de Hidalgo, México, según la opinión de los usuarios

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Ortiz Espinosa Rosa María

2003-01-01

Full Text Available OBJETIVO: Identificar y evaluar los factores asociados con la calidad de la atención en las consultas externas de los hospitales del sector público en el estado de Hidalgo, México, mediante la opinión que manifiestan los usuarios. MATERIAL Y MÉTODOS: Se aplicó un diseño transversal, comparativo y analítico en 15 hospitales públicos del estado de Hidalgo, México. La muestra, compuesta por 9 936 encuestados (con un poder de 85% y un nivel de significación de 95%, fue seleccionada mediante muestreo aleatorio simple entre las personas atendidas en las consultas externas de julio de 1999 a diciembre de 2000. Se analizó la calidad de la atención según la escala de Likert. Para el análisis estadístico se empleó la regresión logística no condicional. RESULTADOS: La calidad de la atención fue percibida como buena por 71,37% de los encuestados y como mala por 28,63%. La mala calidad se percibió mayormente en las instituciones de la seguridad social (39,41% frente a. 19,42%. Se observó satisfacción en 84,94% de los encuestados, de los cuales 49,2% esperaban una mejor atención. El 16% refirió que regresaría al mismo hospital por no tener otra opción para su atención y 2% manifestó que no regresaría. La mayor escolaridad y los ingresos económicos superiores se asociaron con la percepción de mala calidad y la desaprobación del tiempo de espera (razón de posibilidades [RP]: 2,3; IC95%: 2,02 a 2,82, del tiempo que duró la consulta (RP: 2,3; IC95%: 2,02 a 2,82 y del mal trato por parte del médico (RP: 4,22; IC95%: 3,6 a 4,8. CONCLUSIONES: Los principales elementos que definen la mala calidad de la atención, según los usuarios, son los largos tiempos de espera, las omisiones en las acciones de revisión y diagnóstico, la complejidad de los trámites de consulta y el maltrato por parte del personal que presta los servicios.

Morbilidad pediátrica maxilofacial en consulta externa: Análisis de 1 año

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Manuel Estrada Sarmiento

1997-12-01

Full Text Available Se realizó un estudio prospectivo de 193 pacientes pediátricos que asistieron por primera vez a la consulta externa de cirugía maxilofacial en el Hospital General Provincial Docente "Carlos Manuel de Céspedes" de Bayamo, durante el período comprendido entre el 1ro de enero de 1994 y el 31 de diciembre de 1994, con afecciones bucofaciales. Se halló un predominio de los pacientes en los grupos de edades de 10 a 14 años y del sexo masculino y con una mayor frecuencia en los pacientes del área rural. Los dientes retenidos ocuparon el primer lugar en las afecciones bucofaciales detectadas. De los pacientes estudiados el 47,2 % recibió ingreso hospitalario. Se comentan los resultados obtenidos y se comparan éstos con la literatura médica revisada.A prospective study on 193 pediatric patients was carried out. Patients attended for the first time the outpatient service of Maxillofacial Surgery at "Carlos Manuel de Céspedes" General Provincial Teaching Hospital, Bayamo, during January 1, 1994-December 31, 1994. All patients presented with oral and facial disorders. Subjects in the age group of 10-14 years and males were found to be predominant and the greatest frequency was found among subjects from rural areas. Impacted teeth ranked first place among oral and facial disorders detected. From the patients studied 47.2 % was admitted to hospital. Results obtained are discussed and they are compared with those found in the medical literature revised.

Attitude Of Self Ear Cleaning In Black Africans: Any Benefit? | Afolabi ...

African Journals Online (AJOL)

Wax removal compromises the integrity of the ear's defenses. It is a leading cause of otitis externa, Otomycosis and impaired hearing. Aims of the study are to assess the knowledge and implication of self ear cleaning among black Africans. Material and methods: A prospective study carried out at the Tundun-wada ...

Antibiotics in Pregnancy Increase Children's Risk of Otitis Media and Ventilation Tubes

DEFF Research Database (Denmark)

Pedersen, Tine Marie; Stokholm, Jakob; Thorsen, Jonathan

2017-01-01

OBJECTIVES: To study the association between antibiotic intake in pregnancy and the development of otitis media and placement of ventilation tubes (VTs) in the offspring under the hypothesis that antibiotics in pregnancy may alter the offspring's propensity for disease. STUDY DESIGN: Data from...... the 700 children in the Copenhagen Prospective Studies on Asthma in Childhood 2010 unselected birth cohort study were used. Information on maternal antibiotic use and other exposures during pregnancy was collected prospectively from interviews and validated in national registries. Otitis media episodes...... were registered in a prospective diary for 3 years. Information regarding children's VTs was obtained from national registries. RESULTS: There were 514 children who had diary information and were included in the analysis regarding otitis media episodes. For VTs analysis, 699 children were included...

Progression of changes in the sensorial elements of the cochlear and peripheral vestibular systems: The otitis media continuum.

Science.gov (United States)

Monsanto, Rafael da Costa; Schachern, Patricia; Paparella, Michael M; Cureoglu, Sebahattin; Penido, Norma de Oliveira

2017-08-01

Our study aimed to evaluate pathologic changes in the cochlear (inner and outer hair cells and stria vascularis) and vestibular (vestibular hair cells, dark, and transitional cells) sensorial elements in temporal bones from donors who had otitis media. We studied 40 temporal bones from such donors, which were categorized in serous otitis media (SOM), serous-purulent otitis media (SPOM), mucoid/mucoid-purulent otitis media (MOM/MPOM), and chronic otitis media (COM); control group comprised 10 nondiseased temporal bones. We found significant loss of inner and outer cochlear hair cells in the basal turn of the SPOM, MOM/MPOM and COM groups; significant loss of vestibular hair cells was observed in the MOM/MPOM and COM groups. All otitis media groups had smaller mean area of the stria vascularis in the basal turn of the cochlea when compared to controls. In conclusion, our study demonstrated more severe pathologic changes in the later stages of the continuum of otitis media (MOM/MPOM and COM). Those changes seem to progress from the basal turn of the cochlea (stria vascularis, then inner and outer hair cells) to the middle turn of the cochlea and to the saccule and utricle in the MOM/MPOM and COM stages. Copyright © 2017 Elsevier B.V. All rights reserved.

Ophthalmomyiasis externa by Musca domestica in a case of orbital metastasis

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Rose Mary Tomy

2013-01-01

Full Text Available Infestation of the living tissues of the eye, ocular adnexae or orbit by larvae of flies of the order Diptera is known as ophthalmomyiasis. Ophthalmomyiasis externa is a limited superficial infestation of external ocular structures such as conjunctiva and adnexae. A case of follicular carcinoma thyroid with orbital metastasis presenting as ophthalmomyiasis externa is reported. The patient presented with foul smelling ulcers of the medial and lateral orbital walls of the right eye extending into the lids and nose, teeming with maggots. Computerized Tomography (CT showed widespread bone destruction with extension into surrounding sinuses. Over 200 maggots were manually removed after immobilisation with turpentine oil instillation. Entomological examination showed it to be a case of accidental myiasis caused by the common housefly Musca domestica. The patient was managed conservatively and the ulcer cavities filled up with healthy granulation tissue. This case is presented on account of its rarity.

Previsivelmente incoerente: Uma análise preliminar da política externa de Donald Trump

OpenAIRE

Vinha, Luís da

2017-01-01

A eleição de Donald Trump tomou o mundo de surpresa. Trump venceu as eleições presidenciais americanas apresentando um programa de política externa com um forte sentimento de afiliação nacional. Muitos estados aliados e comentadores estão preocupados com o facto de que Trump possa encetar uma inversão temporária do internacionalismo tradicional americano ou mesmo hipotecar a ordem liberal global. Os primeiros meses da presidência Trump evidenciam uma política externa marcada pela incoerência....

Theories of otitis media pathogenesis, with a focus on Indigenous children.

Science.gov (United States)

Wiertsema, Selma P; Leach, Amanda J

2009-11-02

Otitis media is a common childhood illness associated with hearing loss, social disadvantage and medical costs. Prevalence and severity are high among Indigenous children. Respiratory bacterial and viral pathogens ascend the eustachian tube from the nasopharynx to the middle ear, causing inflammation, fluid accumulation, and bulging of the tympanic membrane, with or without pain. Among Australian Indigenous children, ear disease commences earlier in life, and involves multiple strains of bacterial pathogens at high density that persist longer. Persistent nasal discharge, overcrowded living conditions (particularly exposure to many children) and poor facilities for washing children perpetuate a vicious cycle of transmission and infection. Risk factors include environmental tobacco smoke, season, lack of breastfeeding, younger age and immature immune system, and possibly genetic factors. The innate immune system is a critical first response to infection, particularly as passive maternal antibodies decline and during the maturation of the infant adaptive immune response. The relative contributions of innate factors to protection from otitis media are currently not well understood. A diversity of antibodies that target strain-specific and conserved antigens are generated in response to natural exposure to otitis media pathogens (or to vaccines). Deficiencies in these antibodies may explain susceptibility to recurrent infections. Incremental contributions from all these elements are likely to be important in otitis media susceptibility versus protection. Effective medical and social strategies to prevent early age of onset are urgently needed.

Neutrophil Extracellular Traps and Fibrin in Otitis Media: Analysis of Human and Chinchilla Temporal Bones.

Science.gov (United States)

Schachern, Patricia A; Kwon, Geeyoun; Briles, David E; Ferrieri, Patricia; Juhn, Steven; Cureoglu, Sebahattin; Paparella, Michael M; Tsuprun, Vladimir

2017-10-01

Bacterial resistance in acute otitis can result in bacterial persistence and biofilm formation, triggering chronic and recurrent infections. To investigate the middle ear inflammatory response to bacterial infection in human and chinchilla temporal bones. Six chinchillas underwent intrabullar inoculations with 0.5 mL of 106 colony-forming units (CFUs) of Streptococcus pneumoniae, serotype 2. Two days later, we counted bacteria in middle ear effusions postmortem. One ear from each chinchilla was processed in paraffin and sectioned at 5 µm. The opposite ear was embedded in epoxy resin, sectioned at a thickness of 1 µm, and stained with toluidine blue. In addition, we examined human temporal bones from 2 deceased donors with clinical histories of otitis media (1 with acute onset otitis media, 1 with recurrent infection). Temporal bones had been previously removed at autopsy, processed, embedded in celloidin, and cut at a thickness of 20 µm. Sections of temporal bones from both chinchillas and humans were stained with hematoxylin-eosin and immunolabeled with antifibrin and antihistone H4 antibodies. Histopatological and imminohistochemical changes owing to otitis media. Bacterial counts in chinchilla middle ear effusions 2 days after inoculation were approximately 2 logs above initial inoculum counts. Both human and chinchilla middle ear effusions contained bacteria embedded in a fibrous matrix. Some fibers in the matrix showed positive staining with antifibrin antibody, others with antihistone H4 antibody. In acute and recurrent otitis media, fibrin and neutrophil extracellular traps (NETs) are part of the host inflammatory response to bacterial infection. In the early stages of otitis media the host defense system uses fibrin to entrap bacteria, and NETs function to eliminate bacteria. In chronic otitis media, fibrin and NETs appear to persist.

[The specific microbiological and clinical features of acute otitis media].

Science.gov (United States)

Gurov, A V; Levina, Yu V; Guseva, A L; Elchueva, Z G; Efimova, S P; Gordienko, M V

The objective of the present study was to elucidate the specific features of the clinical course of acute otitis media as well as the peculiarities of the vestibular function and the microbial paysage associated with this pathological condition under the present-day conditions. The study included 135 patients presenting with acute otitis media (AOM) at different stages of the disease. The discharge obtained from the tympanic cavity of all the patients was examined with the use of polymerase chain reaction in real time, audiological and vestibulogical methods. The distinctive features of acute otitis medium associated with Streptococcus pneumoniae infection were found to be the intense pain syndrome with the symptoms of intoxication, well apparent inflammatory changes in the tympanic membrane as revealed by otoscopy, the increased frequency of sensorineural impairment of hearing, and the characteristic type B tympanometric curve. Typical of AOM associated with Haemophilus influenza infection are the mild pain syndrome, weak changes in the tympanic membrane as revealed by otoscopy, conductive hearing loss, and the type C tympanometric curve.

Fotoluminiscencia en obleas de Silicio con iluminación LED

OpenAIRE

Almendros Abad, Víctor

2017-01-01

Actualmente, la técnica de fotoluminiscencia se usa cada vez más para observar defectos en estados iniciales de la fabricación de obleas de Silicio (fase inicial del proceso de fabricación de una célula solar), aunque también se emplea para observar defectos en las células solares finales. La iluminación externa de una oblea o célula solar produce una emisión de fotones los cuales son recogidos con un sistema de detección. Normalmente la fuente de iluminación es láser, pero ...

CYTOLOGICAL FEATURES OF FENSPIRIDE USAGE IN TREATMENT OF CHRONIC EXUDATIVE OTITIS MEDIA

OpenAIRE

O. Yu. Mezentseva; F. N. Zavjyalov; A. A. Vorobjeva; L. P. Popova; M. V. Rodionova

2012-01-01

The cytological investigation of exudates, obtained during tympanostomies, showed the predomination of inflammatory-regenerative cytograms types when using Fenspiride (Eurespal) in treatment of secretory stage of chronic exudative otitis media. Received data confirm, that treatment with this drug shortens the course of exudative otitis media and contributes to more rapid change from destructive to reparative stage of inflammation, which prevents the development of adhesive process in the midd...

Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion.

Science.gov (United States)

Hussein, A; Fathy, H; Amin, S M; Elsisy, N

2017-10-01

To evaluate the effects of oral steroids alone or followed by intranasal steroids versus watchful waiting on the resolution of otitis media with effusion in children aged 2-11 years. A total of 290 children with bilateral otitis media with effusion were assigned to 3 groups: group A was treated with oral steroids followed by intranasal steroids, group B was treated with oral steroids alone and group C was managed with watchful waiting. Patients were evaluated with audiometry and tympanometry. The complete resolution rates of otitis media with effusion were higher in groups A and B than in group C at six weeks. There were no significant differences in otitis media with effusion resolution rates between the groups at three, six and nine months. Oral steroids lead only to a quick resolution of otitis media with effusion, with no long-term benefits. There was no benefit of using intranasal steroids in the management of otitis media with effusion.

Indications and radiological findings of acute otitis media and its complications.

Science.gov (United States)

Pont, Elena; Mazón, Miguel

Most cases of acute otitis media resolve with antibiotics and imaging is not required. When treatment fails or a complication is suspected, imaging plays a crucial role. Since the introduction of antibiotic treatment, the complication rate has decreased dramatically. Nevertheless, given the critical clinical relevance of complications, the importance of early diagnosis is vital. Our objective was to review the clinical and radiological features of acute otitis media and its complications. They were classified based on their location, as intratemporal or intracranial. Imaging makes it possible to diagnose the complications of acute otitis media and to institute appropriate treatment. Computed tomography is the initial technique of choice and, in most cases, the ultimate. Magnetic resonance is useful for evaluating the inner ear and when accurate evaluation of disease extent or better characterization of intracranial complications is required. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Childhood suppurative otitis media in Abakaliki: Isolated microbes ...

African Journals Online (AJOL)

2011-03-05

Mar 5, 2011 ... Background: Suppurative otitis media (SOM) is the most common pediatric problem ... Objective: Determine the bacteriology of SOM in children in Abakaliki and .... to chronicity caused by its attendant social and neurological.

Pneumococcal conjugate vaccines for preventing otitis media

NARCIS (Netherlands)

Fortanier, Alexandre C.; Venekamp, Roderick P.; Boonacker, Chantal W. B.; Hak, Eelko; Schilder, Anne G. M.; Sanders, Elisabeth A. M.; Damoiseaux, Roger A. M. J.

2014-01-01

BACKGROUND: Acute otitis media (AOM) is a very common respiratory infection in early infancy and childhood. The marginal benefits of antibiotics for AOM in low-risk populations in general, the increasing problem of bacterial resistance to antibiotics and the huge estimated direct and indirect annual

[Acute otitis media in the children: etiology and the problems of antibacterial therapy].

Science.gov (United States)

Protasova, I N; Per'yanova, O V; Podgrushnaya, T S

The objective of the present review was to summarize the currently available literature data on etiology of acute otitis media in the children, the role of biofilms in the development of this pathology, and sensitivity of its principal causative factors to various antibiotic medications. The secondary objective was to elaborate the practical guidelines for the prevention of acute otitis media in the children.

ESTUDO DA FREQUÊNCIA DE Malassezia pachydermatis EM CÃES COM OTITE EXTERNA NO RIO GRANDE DO SUL

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Patrícia da Silva Nascente

2010-10-01

Full Text Available External otitis is a common auditory meatus infirmity diagnosed in dogs and cats sent to veterinarian clinics. The etiology varies according to combinations of predisposing, primary and perpetuating factors, responsible for the disease. Malassezia pachydermatis is considered a normal inhabitant of the skin and can occasionally become an opportunistic pathogen of the external canal of dogs and cats. This study aimed to investigate the presence of M. pachydermatis in canine external otitis. The presence of yeast in external otitis of dogs sent to 168 veterinary hospitals in the Federal Universities of Rio Grande do Sul and Pelotas, as well as to clinics and private kennels was investigated. The sampling was performed with a sterile swab moistened with saline solution, rubbing it in the ear canal. Direct examination was performed from swabs of the collected material, stained by Gram method and examined under optical microscopy (1000X. It was seeded on Sabouraud Dextrose Agar with chloramphenicol and incubated at 32°C for up to ten days when the yeasts were identified. From the 168 cases of external otitis, M. pachydermatis was isolated in 139 (82.7% cases. In this study, there was no difference regarding gender and age of the animals. The frequency of isolation in samples with positive scores on direct examination was significantly higher (p <0.05 than in samples with negative score. It was verified that there is a seven times-higher probability of isolating M. pachydermatis from samples with positive direct examination. It was concluded that M. pachydermatis is commonly isolated in canine external otitis cases, without significant difference in relation to sex and age. Animals with ear shifts (eg. English Cocker Spaniel are more affected by external otitis; however, there is no difference in proportion of the number of isolation of M. pachydermatis among the races.

Tensor veli palatini electromyography for monitoring Eustachian tube rehabilitation in otitis media.

Science.gov (United States)

Picciotti, P M; Della Marca, G; D'Alatri, L; Lucidi, D; Rigante, M; Scarano, E

2017-05-01

The pathogenesis of otitis media is related to Eustachian tube dysfunction. The tensor veli palatini muscle actively opens the Eustachian tube and promotes middle-ear ventilation. This study describes a technique for paratubal electromyography that uses a surface, non-invasive electrode able to record tensor veli palatini muscle activity during swallowing. Twenty otitis media patients and 10 healthy patients underwent tensor veli palatini electromyography. Activity of this muscle before and after Eustachian tube rehabilitation was also assessed. In 78.5 per cent of patients, the electromyography duration phase and/or amplitude were reduced in the affected side. The muscle action potential was impaired in all patients who underwent Eustachian tube rehabilitation. This study confirmed that Eustachian tube muscle dysfunction has a role in otitis media pathogenesis and showed that muscle activity increases after Eustachian tube rehabilitation therapy.

Genetic polymorphisms in immunoresponse genes TNFA, IL6, IL10, and TLR4 are associated with recurrent acute otitis media

NARCIS (Netherlands)

Emonts, Marieke; Veenhoven, Reinier H.; Wiertsema, Selma P.; Houwing-Duistermaat, Jeanine J.; Walraven, Vanessa; de Groot, Ronald; Hermans, Peter W. M.; Sanders, Elisabeth A. M.

2007-01-01

OBJECTIVE. Cytokines and other inflammatory mediators are involved in the pathogenesis of otitis media. We hypothesized that polymorphisms in inflammatory response genes contribute to the increased susceptibility to acute otitis media in otitis-prone children. PATIENTS AND METHODS. DNA samples from

Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections.

Science.gov (United States)

Martines, Francesco; Salvago, Pietro; Ferrara, Sergio; Messina, Giuseppe; Mucia, Marianna; Plescia, Fulvio; Sireci, Federico

2016-01-01

Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (potitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (potitis media in children exposed to smoke respectively of 166% and 277% (potitis media are common childhood diseases strongly associated with low parental educational attainment (p=0.0001), exposure to smoke (p=0.0001), indoor exposure to mold (p=0.0001), laryngopharyngeal reflux disease (p=0.0002) and the lack of breast-feeding (p=0.0014); an increased risk of otitis media recurrences was observed in the presence of allergy, persistent cough and runny nose (p=0

Wax Impaction in Nigerian School Children. | Eziyi | East and ...

African Journals Online (AJOL)

Background: Impacted wax has been classified as an ear disease. It can cause pain, itching, tinnitus hearing loss or otitis externa. The prevalence of cerumen impaction varies. The aim of this study was to determine the prevalence of impacted ear wax in primary school children and to determine, if there is any association ...

Clinical evidence in the management of swimmer's ear

African Journals Online (AJOL)

“Swimmer's ear” or acute otitis externa is a term that is used commonly by medical practitioners and patients. It refers to an inflammatory condition of the external auditory canal, with anatomical regions which may stretch distally to the pinna and proximally to the tympanic membrane of the ear.1 The prevalence in swimmers ...

CYTOLOGICAL FEATURES OF FENSPIRIDE USAGE IN TREATMENT OF CHRONIC EXUDATIVE OTITIS MEDIA

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O. Yu. Mezentseva

2012-01-01

Full Text Available The cytological investigation of exudates, obtained during tympanostomies, showed the predomination of inflammatory-regenerative cytograms types when using Fenspiride (Eurespal in treatment of secretory stage of chronic exudative otitis media. Received data confirm, that treatment with this drug shortens the course of exudative otitis media and contributes to more rapid change from destructive to reparative stage of inflammation, which prevents the development of adhesive process in the middle ear.

Hearing Loss in otitis media with effusion- Types and management- A study of hundred cases

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Sriram Nathan

2012-01-01

Full Text Available Introduction- Serous Ottis media or otitis media with effusion is a common cause of hearing loss of acute onset. The common presentation will be a block or reduced hearing possible after a travel or flight. Most of the cases present with conductive hearing loss while some may present with mixed or even pure sensory hearing loss. Background- we study hundred patients diagnosed with serous otitis media for the type of hearing loss and characterize the management strategy. Conclusion- Serous otitis media is a common cause of hearing loss which is mostly conductive and is amenable to treatment while some rare cases which may persist may require assistive hearing with amplification. Although sensorineral hearing loss is rare in otitis media, it is seen in practice along with mixed hearing loss. The pathophysiology of the neural affection of hearing loss remains a mystery although many theories exist.

Costos del tratamiento de las telangiectasias y várices tronculares con escleroterapia con espuma en el Hospital "Freyre de Andrade" de La Habana

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Anai García Fariñas

2013-03-01

Full Text Available Objetivo: determinar cuánto cuesta por paciente el tratamiento de várices por la técnica de escleroterapia con espuma en la consulta externa de Angiología y Cirugía Vascular del Hospital C.Q. "Freyre de Andrade". Método: evaluación económica del tipo descripción de costo. Se estudió el costo directo institucional del tratamiento ambulatorio para várices en extremidades inferiores con escleroterapia con espuma y donde el principio activo fue Polidocanol al 0,5% a una dosis de 2ml. Se emplearon las partidas recursos humanos, material gastable y medicamento. Se determinó el costo promedio por paciente, total y según tipo de consulta. Resultados: el costo total por paciente atendido fue de 68,60 pesos cubanos. El costo medio por paciente de la consulta de clasificación fue de 0,18 centavos de pesos cubanos (DS 95%= 0,12. El costo medio de la consulta de tratamiento fue de 50,60 pesos cubanos (DS 95%=7,65. No hubo diferencias significativas entre los diferentes tipos de varices a tratar. Conclusiones: el costo directo institucional del tratamiento de telangiectasias y varices tronculares con escleroterapia con espuma fue similar. A corto plazo, el tratamiento de las várices con escleroterapia con espuma genera menores costos que la opción quirúrgica.

Influence of Pneumococcal Conjugate Vaccine on Acute Otitis Media with Severe Middle Ear Inflammation: A Retrospective Multicenter Study.

Science.gov (United States)

Sugino, Hirotoshi; Tsumura, Shigeru; Kunimoto, Masaru; Noda, Masuhiro; Chikuie, Daisuke; Noda, Chieko; Yamashita, Mariko; Watanabe, Hiroshi; Ishii, Hidemasa; Tashiro, Toru; Iwata, Kazuhiro; Kono, Takashi; Tsumura, Kaoru; Sumiya, Takahiro; Takeno, Sachio; Hirakawa, Katsuhiro

2015-01-01

The Japanese guidelines for acute otitis media in children recommend classifying acute otitis media by age, manifestations and local findings, and also recommend myringotomy for moderate-grade cases with severe local findings, severe-grade cases, and treatment-resistant cases. The heptavalent pneumococcal conjugate vaccine was released in Japan in February 2010. In Hiroshima City, public funding allowing free inoculation with this vaccine was initiated from January 2011, and the number of vaccinated individuals has since increased dramatically. This study investigated changes in the number of myringotomies performed to treat acute otitis media during the 5-year period from January 2008 to December 2012 at two hospitals and five clinics in the Asa Area of Hiroshima City, Japan. A total of 3,165 myringotomies for acute otitis media were performed. The rate of procedures per child-year performed in otitis media in 1-year-old infants decreased significantly in the 2 years after the introduction of public funding for heptavalent pneumococcal conjugate vaccine compared to all years before introduction (potitis media in reducing the financial burden of myringotomy. In addition, this vaccine may help prevent acute otitis media with severe middle ear inflammation in 1-year-old infants.

Otitis and autism spectrum disorders

OpenAIRE

Tajima-Pozo, Kazuhiro; Zambrano-Enriquez, Diana; De Anta, Laura; Zelmanova, Julie; De Dios Vega, Jose Luis; Lopez-Ibor, Juan Jose

2010-01-01

The case of a 5-year-old child diagnosed as having pervasive developmental disorder (PDD), autistic type, from age 1 is reported. After surgery of vegetation in middle ear for repetitive otitis, the child presented an improvement in autistic behaviours, previously expressed as impaired social interactions, qualitative abnormalities in communication, a marked delay in language development, echolalia, stereotypies and self-aggressive behaviours. The aim of this paper is to bring attention to oc...

Sensibilización de placas para ensayos inmunoenzimáticos con antígenos vacunales

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Rolando Ochoa

2001-12-01

Full Text Available Se describe un procedimiento de sensibilización de placas para ensayos inmunoenzimáticos (ELISA con antígenos vacunales. Se define como concentración óptima de sensibilización aquella donde se alcanza la mayor densidad óptica con los sueros estándares y la menor con los sueros negativos y el blanco reactivo. Como modelo se emplean ensayos indirectos correspondientes a los antígenos de captura: toxoide tetánico, diftérico y la vesícula de membrana externa de meningococo B, materia prima activa de la vacuna antimeningocócica VA-MENGOC-BC. Esta metodología permite alcanzar un mayor recubrimiento de la fase sólida, lo cual incrementa la sensibilidad de los ensayos. La ocupación de espacios libres en la placa se hizo más evidente con antígenos de menor peso molecular, como los toxoides diftérico y tetánico.

Validación de un método de determinación del polisacárido B residual en vesículas de membrana externa de Neisseria meningitidis

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Jannete Rico

2010-08-01

Full Text Available La Cromatografía Líquida de Alta Resolución-Fluorescencia ha resultado ser una herramienta sensible para la detección de trazas en productos farmacéuticos y es utilizada frecuentemente para la cuantificación de algunos polisacáridos de origen bacteriano que poseen ácido siálico como unidad repetitiva. En este trabajo nos planteamos como objetivo establecer y validar el método de HPLC_Fluorescencia, para determinar el contenido de polisacárido B residual en vesículas de membrana externa de Neisseria meningitidis. Para ello se realizó el montaje del método HPLC-FL, utilizando una columna de fase reversa C18 (Ultrasphere ODS, Beckman, USA y se evaluaron seis lotes de vesículas de membrana externa de diferentes cepas Cu 385/83 y NZ 228. Se demostró que este método permitió la cuantificación de polisacárido B de una forma específica y exacta, y que cumplía con todos los parámetros de validación establecidos para un método de determinación de trazas mediante HPLC.

Recurrent otorrhea in chronic suppurative otitis media

DEFF Research Database (Denmark)

Jensen, Ramon Gordon; Johansen, Helle Krogh; Bjarnsholt, Thomas

2017-01-01

Dispersal of bacteria from a biofilm in the middle ear, serving as a bacterial reservoir, could explain the recurrent and chronic nature of chronic suppurative otitis media (CSOM). The objective of this study is to investigate if the same strains of bacteria could be detected in repeated episodes...

Cervical spinal tuberculosis with tuberculous otitis media ...

African Journals Online (AJOL)

Prompt and effective response to anti tuberculosis drugs informed the diagnosis of tuberculosis of the cervical vertebra and tuberculous otitis media with multiple cranial nerve palsies. This case underscores the value of high index of suspicion, thorough and complete clinical evaluation in any patient with chronic symptoms ...

Antibiotics for acute otitis media in children

NARCIS (Netherlands)

Venekamp, R.P.; Sanders, S.; Glasziou, P.P.; Mar, C.B. Del; Rovers, M.M.

2013-01-01

BACKGROUND: Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA, Canada and Australia. OBJECTIVES: To assess the effects of antibiotics for children with AOM. SEARCH METHODS: We

Polymorphisms in Toll-like receptors 2 and 4 genes and their expression in chronic suppurative otitis media.

Science.gov (United States)

Jotic, Ana; Jesic, Snezana; Zivkovic, Maja; Tomanovic, Nada; Kuveljic, Jovana; Stankovic, Aleksandra

2015-12-01

Toll-like receptors (TLRs) have a prominent role in inducing innate immune response. It has been suggested that regulation of TLRs is involved in the pathogenesis of chronic otitis media. TLR 2 and TLR 4 polymorphisms were connected with susceptibility to acute otitis and chronic otitis with effusion. The objective of this study was to establish expression of TLR 2 and 4 on middle ear mucosa in different types of chronic suppurative otitis media (CSOM), and the influence of gene polymorphisms TLR 2 Arg753Gln and TLR 4 Thr399Ile and Asp299Gly to susceptibility to CSOM. Middle ear mucosa and full blood samples were obtained from 85 patients with chronic suppurative otitis media with and without cholesteatoma. Control group for mucosal TLR expression consisted of 71 samples of middle ear mucosa taken from patients with otosclerosis, and control group for DNA polymorphism consisted of 100 full blood samples in healthy subjects. DNA polymorphism detection was done with restriction fragment length polymorphism in RT PCR. Expression of TLR 2 and 4 was determined with immunohistochemical staining. TLR 2 and TLR 4 expression on the middle ear mucosa was not influenced by age of the patients with chronic otitis media. Incidence of TLR 2 Arg753Gln polymorphism was significantly higher in patients with chronic otitis media, compared to control group. Significant association between TLR 2 Arg753Gln polymorphism and different types of mucosal changes in patients with chronic otitis media was established. TLR 2 and 4 expression on experimental group mucosa was significantly different compared to control group, where there was no expression (p=0.000). Strong dependence of TLR 2 and TLR 4 expression on middle ear mucosa with different mucosal changes and immunohistochemical activity after staining was detected. Certain polymorphisms in TLR genes could be indicative for susceptibility to chronic otitis media. Expression of TLR 2 and 4 on middle ear mucosa was more dependable on

[Analysis of related factors of recurrent otitis media with effusion in children].

Science.gov (United States)

Zhu, Z; Zheng, G X; Li, Q; Shi, Q L; Zhou, H G; Fang, R P

2017-08-05

Objective: To investigate the influencing factors of recurrent episodes of otitis media with effusion in children. Method: A retrospective summary of the clinical data of 210 cases of children with otitis media with effusion, 75 cases of recurrence after treatment, 135 cases were recovered, the recurrence of the related factors and after symptomatic treatment effect is analyzed. Result: Logistic regression analysis results found that adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°) and sinusitis (including choanal polyp), a positive allergens, upper respiratory tract infection, the stomach esophagus regurgitation, cleft palate, younger age has significant effect on recurrence of otitis media with effusion, have significant difference ( P gender, passive smoking history and previous medical history of otitis media with effusion has no obvious statistical significance ( P > 0.05). Through the comparison among different age groups, adenoidectomy Ⅲ °, Ⅳ ° hypertrophy tract infections in > 3-6 years old group has significant effect ( P 3-6 years OME recurrence has significant effect ( P different conditions to take symptomatic treatment, 75 cases (123 ears) were cured 96 ears (78.05%), 19 ears were improved (15.45%), the total effective rate was 93.50%, ineffective in 8 ears (6.50%). Conclusion: Adenoid hypertrophy (Ⅲ°, Ⅳ°), tonsil hypertrophy (Ⅳ°), sinusitis, nasal polyps, allergic diseases and upper respiratory tract infection gastroesophageal reflux, cleft palate and younger age may be adverse factors related to recurrent otitis media with effusion in children, the clinical doctors should pay attention to these symptoms, according to different causes, adopt individualized treatment plan, make children get the best treatment as soon as possible. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Consequences of evolution: is rhinosinusitis, like otitis media, a unique disease of humans?

Science.gov (United States)

Bluestone, Charles D; Pagano, Anthony S; Swarts, J Douglas; Laitman, Jeffrey T

2012-12-01

We hypothesize that if otitis media is most likely primarily a human disease due to consequences of evolution, rhinosinusitis may also be limited to humans for similar reasons. If otitis media, with its associated hearing loss, occurred in animals in the wild, they probably would have been culled out by predation. Similarly, if rhinosinusitis occurred regularly in animals, they likely would have suffered from severely decreased olfactory abilities, crucial for predator avoidance, and presumably would likewise have been selected against evolutionarily. Thus, both otitis media and rhinosinusitis-common conditions particularly in infants and young children-appear to be essentially human conditions. Their manifestation in our species is likely due to our unique evolutionary trajectory and may be a consequence of adaptations, including adaptations to bipedalism and speech, loss of prognathism, and immunologic and environmental factors.

Fusobacterium necrophorum otitis and mastoiditis in infants and young toddlers.

Science.gov (United States)

Stergiopoulou, T; Walsh, T J

2016-05-01

There is an increased recovery of Fusobacterium necrophorum from cases of otitis media and mastoiditis in the pediatric population. These infections may be highly severe, causing local osteomyelitis, bacteremia, and Lemierre's syndrome. The severity and difficulties in providing optimal treatment for these infections may be especially difficult in this age group due to immunological immaturity and delayed presentation. In this review of literature, we present and analyze the clinical presentation, management, and outcome of otic infections caused by F. necrophorum in infants and young toddlers less than 2 years old. Search in Pubmed was conducted for reported cases in the English literature for the time period of the last 50 years. Twelve well-described cases were retrieved with F. necrophorum otitis and mastoiditis and complications reported in all cases. Treatment included both intravenously with antimicrobial agents (beta lactams plus metronidazole) and mastoidectomy. Lemierre's syndrome and Lemierre's syndrome variants developed in 60 % of the patients. Dissemination of the infection as distal osteomyelitis and septic shock were also reported. The outcome was favorable in all the cases. Otitis and mastoiditis infections in children less then 2 years old are invasive infections, and severe complications can occur.

Antibacterial activity, chemical composition, and cytotoxicity of leaf's essential oil from Brazilian pepper tree (Schinus terebinthifolius, Raddi)

OpenAIRE

Silva, A.B.; Silva, T.; Franco, E.S.; Rabelo, S.A.; Lima, E.R.; Mota, R.A.; Câmara, C.A.G. da; Pontes-Filho, N.T.; Lima-Filho, J.V.

2010-01-01

The antibacterial potential of leaf's essential oil (EO) from Brazilian pepper tree (Schinus terebinthifolius Raddi) against staphylococcal isolates from dogs with otitis externa was evaluated. The minimum inhibitory concentration of EO ranged from 78.1 to 1,250 fg/mL. The oil was analyzed by GC and GC/MS and cytotoxicity tests were carried out with laboratory animals.

Enhanced Web-Based Otitis Study Case vs. Simple Paper-Case: Impact on Medical Student Objective Structured Clinical Exam Performance

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Michael H. Malloy, M.D., M.S.

2002-01-01

Full Text Available Background: Distance education methods have taken on greater importance as medical student education has moved off campus into the community. What the best methods are for conveying information to students at distant sites has not been determined. Objective: To determine if students at distant community sites who received an otitis media study case by e-mail that was enhanced with a referral to a web-based otitis study case, performed better on otitis OSCE stations than students who received the same case not enhanced with visuals or referrals to a web-based otitis case. Design/Methods: Students were randomized by community site to receive either the enhanced (E or simple otitis study case (S. Students were e-mailed an otitis media study case during the 5th week of the rotation. Those randomized to the E-case received a case that started with a case scenario followed by a "Task" that instructed them to go to this web address: http://www.aap.org/otitismedia/www/vc/ear/index.cfm (American Academy of Pediatrics Otitis Web Site. They were then to select "Case 1" which was a continuation of the case scenario present on their e-mail. A list of learning objectives was also printed on the e-mail. Students receiving the S-case viewed the same case scenario and objectives, but were not instructed to go to the web page. All students rotated through two OSCE otitis stations. In the first station they interviewed a simulated patient(OSCE-SP and counseled her on the management of her 12 month old with otitis. Within that station they viewed a video of a pneumoscopic exam of two ears, one ear with otitis and the other ear normal. At the 2nd otitis station the student presented the case to a faculty and was asked a series of questions about otitis media(OSCE-PR. Scores on the two stations were compared by group. Results: There were 198 students who took the OSCE. 178 (90% responded to a survey that indicated they had opened and read the e-mailed case. There

Contemporary concepts in management of acute otitis media in children.

Science.gov (United States)

Rettig, Eleni; Tunkel, David E

2014-10-01

Acute otitis media (AOM) is a common disease of childhood. AOM is most appropriately diagnosed by careful otoscopy with an understanding of clinical signs and symptoms. The distinction between AOM and chronic otitis media with effusion should be emphasized. Treatment should include pain management, and initial antibiotic treatment should be given to those most likely to benefit, including young children, children with severe symptoms, and those with otorrhea and/or bilateral AOM. Tympanostomy tube placement may be helpful for those who experience frequent episodes of AOM or fail medical therapy. Recent practice guidelines may assist the clinician with such decisions. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessment of senses of hearing and balance in chronic suppurative otitis media

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Babić Borivoj

2008-01-01

Full Text Available Chronic suppurative otitis media is among the most frequent illnesses treated in ENT wards. To establish the diagnosis, otomicroscopy alone usually suffice. Assessing the sense of hearing, often the sense of balance, too, is mandatory. Assessment of hearing will show the extent of conductive and sensorineural hearing loss. Apart from this, sometimes, when the finding is not obvious, it is necessary to conduct audiological investigation in more detail in order to establish whether the diagnosis of chronic suppurative otitis media is correct. Existence and extent of conductive hearing loss or confIrmation of tympanic membrane perforation by tympanometry can help a great deal. Also, some new results about the site of perforation and the middle ear volume influence on conductive hearing loss may help have a better insight into chronic suppurative otitis media. Assessing the sense of balance may show dysfunctions with not yet necessarily permanent damage: perilymphatic fistula and benign paroxysmal positional vertigo (BPPV. Unilateral or bilateral damage may be diagnosed with appropriate tests of vestibuloocular reflex (VOR: spontaneous nystagmus, head impulse test, head shaking test. These bedside tests do not require bulky, expensive equipment for stimulus delivery or special equipment for recording nystagmus. In addition, their significance is their ability to provide enough information without performing caloric testing which is contraindicated in chronic suppurative otitis media.

Comportamento da erva-mate (Ilex paraguariensis St. Hil. em consórcio silvicultural.

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Luisilvio Pes

2009-09-01

Full Text Available Normal 0 21 false false false MicrosoftInternetExplorer4 O presente trabalho foi realizado no Campus da Universidade Federal de Santa Maria e teve por objetivo determinar o comportamento da erva-mate (Ilex paraguariensis St. Hil. cultivada em sistema de consórcio silvicultural. A metodologia adotada constituiu-se da implantação de três tratamentos, correspondentes aos sistemas de consórcio erva-mata x Pinus sp., erva-mate x bracatinga e erva-mate x capoeira. A análise dos resultados levou às seguintes conclusões: os melhores resultados de desenvolvimento da erva-mate são obtidos nos consórcios com bracatinga e Pins sp. e, o pior, na caopeira; as variações externas dos fatores do meio são amenizadas pelas outras espécies do consórcio; índices elevados de luminosidade não promovem maior produção de matéria seca, nem os índices muito baixos.

Development of an ear cap in chronic suppurative otitis media using additive manufacturing and TRIZ.

Science.gov (United States)

Mawale, Mahesh B; Kuthe, Abhaykumar; Mawale, Anupama M; Dahake, Sandeep W

2018-06-01

The prevalence rate of chronic suppurative otitis media is high and its treatment continues to be a challenge for the otorhinolaryngologists. Due to middle ear infection, there may be pain, hearing loss and spontaneous rupture of the eardrum which results in perforation. Infections can cause a hole in the eardrum as a side effect of otitis media. The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. This article describes the development of ear cap using additive manufacturing and TRIZ (a collaborative tool) to prevent the entry of water in the ear during chronic otitis media.

Roles para la docencia universitaria concordantes con las demandas educacionales del nuevo siglo

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Patricio Montero Lagos

2004-01-01

Full Text Available Las demandas educacionales del nuevo siglo requieren modificar sustantivamente los roles del estudiante y del docente en la docencia universitaria convencional. En este trabajo se presentan cinco cambios internos y seis externos ocurridos en las últimas décadas, que afectan la eficacia interna y externa de los procesos de formación académica y profesional, para que jóvenes y adultos puedan desarrollar un proyecto de vida personal integrado socialmente. Luego, basados en la aplicación de una combinación de ambientes presenciales y virtuales en la docencia de pregrado de la Universidad de Santiago de Chile, se ejemplifican, mediante situaciones de enseñanza y aprendizaje, tareas clave de los roles de estudiantes y profesores, consistentes con las demandas educacionales actuales. Se concluye con un breve comentario sobre los nuevos desafíos que deben enfrentar los participantes de la docencia de acuerdo con nuevos roles para la educación universitaria del tercer milenio.

Perfil de mortalidade por causas externas entre Adventistas do Sétimo Dia e a população geral

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Ana Paula Costa Velten

Full Text Available Resumo Este estudo teve por objetivo comparar o perfil de mortalidade por causas externas entre Adventistas do Sétimo Dia e população geral do Espírito Santo no período de 2003 a 2009. Realizou-se busca dos Adventistas no banco nominal do Sistema de Informação sobre Mortalidade de posse das informações dos Adventistas fornecidas pelas sedes administrativas da instituição. Os óbitos por causas externas ocorridos no período estudado foram então separados em dois grupos: Adventistas e população geral. Os Adventistas apresentaram menor mortalidade proporcional por causas externas (10% que a população geral (19%, sendo o sexo masculino o principal responsável por essa diferença. Em ambos os grupos os óbitos predominaram na faixa de 20 a 29 anos. As mortes por causas acidentais foram mais expressivas entre os Adventistas (68,08% enquanto as mortes por causas intencionais relacionadas às agressões e lesões autoprovocadas foram mais significativas na população geral (53,67% de todas as mortes. A razão de mortalidade padronizada para as causas externas foi 41,3, sendo assim ser Adventista reduziu a mortalidade em 58,7%. Acredita-se que o benefício dos Adventistas verificado em relação à mortalidade por causas externas possa estar relacionado à recomendação de abstinência do consumo de álcool por esse grupo.

Trends in doctor consultations, antibiotic prescription, and specialist referrals for otitis media in children : 1995-2003

NARCIS (Netherlands)

Plasschaert, Astrid I O; Rovers, Maroeska M; Schilder, Anne G M; Verheij, Theo J M; Hak, Eelko

BACKGROUND: Reported trends regarding the incidence of otitis media and antibiotic prescription rates are inconsistent. OBJECTIVE: Our goal was to assess changes in incidence of consultation rates, antibiotic prescription, and referral rates for otitis media in children over the years 1995-2003.

Antibody levels after regular childhood vaccinations in the immunological screening of children with recurrent otitis media.

NARCIS (Netherlands)

Wiertsema, S.P.; Sanders, E.A.M.; Veenhoven, R.H.; Heerbeek, N. van; Hof, S. van den; Berbers, G.A.; Rijkers, G.T.

2004-01-01

Recurrent otitis media may be related to defects in specific antibody production, as suggested previously. This might be reflected in lower antibody responses to vaccinations administered in the context of the national childhood vaccination program in children suffering from recurrent otitis media.

Otitis Media in a New Mouse Model for CHARGE Syndrome with a Deletion in the Chd7 Gene

Science.gov (United States)

Tian, Cong; Yu, Heping; Yang, Bin; Han, Fengchan; Zheng, Ye; Bartels, Cynthia F.; Schelling, Deborah; Arnold, James E.; Scacheri, Peter C.; Zheng, Qing Yin

2012-01-01

Otitis media is a middle ear disease common in children under three years old. Otitis media can occur in normal individuals with no other symptoms or syndromes, but it is often seen in individuals clinically diagnosed with genetic diseases such as CHARGE syndrome, a complex genetic disease caused by mutation in the Chd7 gene and characterized by multiple birth defects. Although otitis media is common in human CHARGE syndrome patients, it has not been reported in mouse models of CHARGE syndrome. In this study, we report a mouse model with a spontaneous deletion mutation in the Chd7 gene and with chronic otitis media of early onset age accompanied by hearing loss. These mice also exhibit morphological alteration in the Eustachian tubes, dysregulation of epithelial proliferation, and decreased density of middle ear cilia. Gene expression profiling revealed up-regulation of Muc5ac, Muc5b and Tgf-β1 transcripts, the products of which are involved in mucin production and TGF pathway regulation. This is the first mouse model of CHARGE syndrome reported to show otitis media with effusion and it will be valuable for studying the etiology of otitis media and other symptoms in CHARGE syndrome. PMID:22539951

Association of microRNA 146 with middle ear hyperplasia in pediatric otitis media.

Science.gov (United States)

Samuels, Tina L; Yan, Justin; Khampang, Pawjai; MacKinnon, Alexander; Hong, Wenzhou; Johnston, Nikki; Kerschner, Joseph E

2016-09-01

Toll-like receptor signaling activated by bacterial otitis media pathogens in the middle ear has been shown to play a key role in OM susceptibility, pathogenesis and recovery. Recent studies implicate microRNA 146 (miR-146) in regulation of inflammation via negative feedback of toll-like receptor signaling (TLR) in a wide variety of tissues, however its involvement in otitis media is unknown. Human middle ear epithelial cells were stimulated with proinflammatory cytokines, interleukin 1 beta or tumor necrosis factor alpha, for two to twenty-four hours. Middle ear biopsies were collected from children with otitis media with effusion (n = 20), recurrent otitis media (n = 9), and control subjects undergoing cochlear implantation (n = 10). miR-146a, miR-146b expression was assayed by quantitative PCR (qPCR). Expression of miR-146 targets involved in TLR signaling, IRAK1 and TRAF6, was assayed by qPCR in middle ear biopsies. Middle ear biopsies were cryosectioned and epithelial thickness measured by a certified pathologist. Proinflammatory cytokines induced expression of miR-146 in middle ear epithelial cells in vitro. Middle ear miR-146a and miR-146b expression was elevated in otitis media patients relative to control subjects and correlated with middle ear epithelial thickness. A trend towards inverse correlation was observed between miR-146 and TRAF6 expression in the clinical population. This report is the first to assess miRNA expression in a clinical population with OM. Findings herein suggest miR-146 may play a role in OM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Otitis media with effusion: experiences of children with cleft palate and their parents.

Science.gov (United States)

Tierney, Stephanie; O'Brien, Kevin; Harman, Nicola L; Sharma, Ravi K; Madden, Colm; Callery, Peter

2015-01-01

To explore the views of children with cleft palate and their parents about daily life with otitis media with effusion and associated hearing loss. A qualitative study. Semistructured interviews were used to collect data from parents. Participatory techniques, including activities on a tablet computer, were used to collect data from children. Framework analysis was applied to interview transcripts. Two English cleft units. A purposive sample of parents of 37 children aged 0 to 11 years with experience of otitis media with effusion. Their children also took part if aged 6 to 11 years (n = 22). Themes related to the following: (1) emotions (frustration, anger, sadness, happiness, anxiety), (2) educational experiences (struggling at school, having to sit at the front of the class, requiring extra support, missing lessons for appointments or due to ear infections), (3) social interactions (isolation, communication, reliance on siblings, participation in activities). A number of areas of interviewees' everyday life were affected by the presence of otitis media with effusion. Parents may need to be forewarned about the possible ongoing nature of this condition and its impact on a child's social and emotional experiences. Children may also benefit from age-appropriate information about otitis media with effusion and its treatment, including information on hearing tests, to help reduce any anxiety.

UNA REVISIÓN DE LOS DETERMINANTES DE LA ESTRUCTURA Y EL RECAUDO TRIBUTARIO: EL CASO LATINOAMERICANO TRAS LA CRISIS DE LA DEUDA EXTERNA

Directory of Open Access Journals (Sweden)

Víctor Mauricio Castañeda Rodríguez

2012-12-01

Full Text Available En este documento se analizan, desde la economía política, los determinantes que pueden explicar la dinámica de la estructura y el recaudo tributario, tomando como referencia el caso de América Latina y las reformas adoptadas parcialmente después de la crisis de la deuda externa para mostrar su pertinencia, dada la heterogeneidad que se encuentra al respecto entre países de la región. Finalmente, con el fin de constatar la importancia de los factores discutidos en términos cuantitativos, se presenta una revisión de trabajos empíricos, aunque concentrando la atención en aquellos que se ocupan de la estructura tributaria.

Surgical success of boomerang-shaped chondroperichondrial graft in pediatric chronic otitis media cases.

Science.gov (United States)

Dundar, Riza; Kulduk, Erkan; Soy, Fatih Kemal; Aslan, Mehmet; Yukkaldiran, Ahmet; Guler, Osman Kadir; Ozbay, Can

2015-06-01

To reveal the success of boomerang-shaped chondroperichondrial graft (BSCPG) in pediatric chronic otitis media cases. A total of 43 pediatric patients (age 7-16 years) who had undergone type 1 tympanoplasty with the diagnosis of chronic otitis media between March 2010 and March 2013 were included in this retrospective study. The main outcome measures were the graft success rate and level of hearing improvement. Graft intake success rate was 90.7%. Mean preoperative and postoperative air-bone gap values were 20.51 ± 4.34 dB SPL and 9.32 ± 5.64 dB SPL, respectively (p Boomerang-shaped chondroperichondrial grafting technique seems to be a successful alternative in the management of pediatric chronic otitis media cases. It has relatively higher grade graft success rate. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Microbiological profile from middle ear and nasopharynx in patients suffering from chronic active mucosal otitis media

International Nuclear Information System (INIS)

Khattak, S.F.; Sheikh, N.A.; Aleem, A.; Farooq, M.; Nadeem, K.

2017-01-01

Chronic otitis media is described as a tympanic membrane perforation and ear discharge for more than six weeks duration. Ascending infection from the nasopharynx into the middle ear cleft has been attributed to prevent resolution of chronic otitis media. This research aims to determine the association between the microbiological flora of the nasopharynx with that of the middle ear in patients suffering from chronic (active) mucosal otitis media. Methods: Our study is a hospital-based cross-sectional survey. It was conducted from December 2015 to February 2017 at the Department of ENT, Combined Military Hospital, Abbottabad. Ear and nasopharyngeal swabs were obtained from 65 patients of chronic active mucosal otitis media and sent for microbiological analysis. Microbiological culture and sensitivity test was performed to identify the microbial spectrum of each specimen. Performa bearing the result of otoscopy, aspirate and swabs were completed for middle ear and the nasopharyngeal culture with reference to each patient. Descriptive statistics and Pearson's chi square analysis were performed using SPSS-22. Results: Staphylococcus aureus and Pseudomonas aeruginosa are foremost micro-organisms found in otorrhea culture isolated from patients of chronic active mucosal otitis media. Majority of the cultures from nasopharynx of these patients did not reveal any growth after incubation for 48 hours. Conclusion: A statistically insignificant association exists between the microbiological spectrum of the middle ear and the nasopharynx of patients suffering from chronic active mucosal otitis media. Micro organisms' exposure from a perforated tympanic membrane remains leading cause of persistent otorrhea, rather than ascending infection through the Eustachian tube. (author)

Cervical spinal tuberculosis with tuberculous otitis media ...

African Journals Online (AJOL)

The case of a 65 year old Nigerian trader who presented with headache, chronic ear ache with otorrhoea, persistent neck pain and found to be diabetic on further evaluation is presented. She was hitherto managed as a case of otitis external malignans without any improvement but rather her clinical condition worsened with ...

Antibiotics for acute otitis media in children

NARCIS (Netherlands)

Venekamp, Roderick P.; Sanders, Sharon L.; Glasziou, Paul P.; Del Mar, Chris B.; Rovers, Maroeska M.

2015-01-01

BACKGROUND: Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA, Canada and Australia. This is an update of a Cochrane review first published in The Cochrane Library in Issue 1, 1997

Otitis Media in Young Children with Disabilities.

Science.gov (United States)

Zeisel, Susan A.; Roberts, Joanne E.

2003-01-01

This study examined the prevalence of otitis media with effusion (OME) in 14 children (ages 8-66 months) with developmental disabilities attending center-based childcare. Although younger children had more OME than older children, children with Down syndrome had the highest incidence of OME regardless of age. Implications of OME for fluctuating…

[Erespal effectiveness in exudative otitis media].

Science.gov (United States)

Levina, Iu V; Luchikhin, L A; Krasiuk, A A

2003-01-01

Standard conservative treatment of exudative otitis media (EOM) was performed in 82 patients, but 44 of them received adjuvant fenspiride (erespal) in a dose 80 mg per os 3 times a day for 10 days. Dynamic pure tone audiometry, tympanometry and subjective response demonstrated higher treatment efficiency in the erespal group. Therefore, it is recommended to include erespal in combined conventional therapy of EOM.

Bacterial Dynamics of Chronic Suppurative Otitis Media in Makurdi ...

African Journals Online (AJOL)

AOM) and chronic suppurative otitis media (CSOM) and their antibiotic susceptibility ... Screening of children < 5 years for CSOM at clinics, primary schools, nurseries and children rehabilitation centres should be considered and antibiotic ...

Differences in innate immune response gene regulation in the middle ear of children who are otitis prone and in those not otitis prone

Science.gov (United States)

Casey, Janet; Pichichero, Michael

2016-01-01

Objective: Acute otitis media (AOM) causes an inflammatory response in the middle ear. We assessed differences in innate immune responses involved in bacterial defense at onset of AOM in children who were stringently defined as otitis prone (sOP) and children not otitis prone (NOP). Study Design: Innate immune genes analysis from middle ear fluid (MEF) samples of children. Methods: Genes of toll-like receptors (TLR), nod-like and retinoic acid-inducible gene-I-like receptors, downstream effectors important for inflammation and apoptosis, including cytokines and chemokines, were studied from MEF samples by using a real-time polymerase chain reaction array. Protein levels of differentially regulated genes were measured by Luminex. Results: Gene expression in MEF among children who were sOP was significantly different in upregulation of interleukin 8, secretory leukocyte peptidase inhibitor, and chemokine (C-C motif) ligand 3, and in downregulation of interferon regulatory factor 7 and its related signaling molecules interferon alpha, Toll-like receptor adaptor molecule 2, chemokine (C-C motif) ligand 5, and mitogen-activated protein kinase 8 compared with children who were NOP. Differences in innate gene regulation were similar when AOM was caused by Streptococcus pneumoniae or nontypeable Haemophilus influenzae. Conclusion: Innate-immune response genes are differentially regulated in children who were sOP compared with children with NOP. PMID:28124644

The Effect of Breastfeeding on Childhood Otitis Media

DEFF Research Database (Denmark)

Kørvel-Hanquist, Asbjørn; Djurhuus, B D; Homøe, P

2017-01-01

PURPOSE OF REVIEW: The purpose of this review is to summarize the literature regarding the association between breastfeeding and childhood otitis media (OM), with focus on the literature published within the past 5 years. The review comprises original articles and recent reviews. RECENT FINDINGS...

Management of chronic mucosal otitis media in children

NARCIS (Netherlands)

van der Veen, E.L.

2010-01-01

Chronic mucosal otitis media (COM) is one of the most common infectious diseases in children worldwide. As it causes considerable morbidity and is a major global cause of hearing impairment, establishing its most effective treatment is important. It is generally accepted that antibiotic eardrops

Increased susceptibility to otitis media in a Splunc1-deficient mouse model

Science.gov (United States)

Bartlett, Jennifer A.; Meyerholz, David K.; Wohlford-Lenane, Christine L.; Naumann, Paul W.; Salzman, Nita H.; McCray, Paul B.

2015-01-01

ABSTRACT Otitis media (inflammation of the middle ear) is one of the most common diseases of early childhood. Susceptibility to otitis is influenced by a number of factors, including the actions of innate immune molecules secreted by the epithelia lining the nasopharynx, middle ear and Eustachian tube. The SPLUNC1 (short palate, lung, nasal epithelial clone 1) protein is a highly abundant secretory product of the mammalian nasal, oral and respiratory mucosa that is thought to play a multifunctional role in host defense. In this study we investigated Splunc1 expression in the ear of the mouse, and examined whether this protein contributes to overall host defense in the middle ear and/or Eustachian tube. We found that Splunc1 is highly expressed in both the surface epithelium and in submucosal glands in these regions in wild-type mice. In mice lacking Splunc1, we noted histologically an increased frequency of otitis media, characterized by the accumulation of leukocytes (neutrophils with scattered macrophages), proteinaceous fluid and mucus in the middle ear lumens. Furthermore, many of these mice had extensive remodeling of the middle ear wall, suggesting a chronic course of disease. From these observations, we conclude that loss of Splunc1 predisposes mice to the development of otitis media. The Splunc1−/− mouse model should help investigators to better understand both the biological role of Splunc1 as well as host defense mechanisms in the middle ear. PMID:25765466

The evaluation of the angles of Eustachian tubes in the patients with chronic otitis media on the temporal computerized tomography.

Science.gov (United States)

Aksoy, S; Sayin, I; Yazici, Z M; Kayhan, F T; Karahasanoglu, A; Hocaoglu, E; Inci, E

2016-01-01

Chronic otitis media (COM), affecting all over the world and in a wide range of age groups in Turkey, is an important cause of ear discharge and hearing loss. The main clinical manifestations are tympanic membrane perforation, ear, nose and throat problems. On the tympanic membrane perforation becomes persistent and cholesteatoma development, there are a lot of opinions today. Especially in the pathology associated with otitis media with effusion eustachian tube, it is known that COM and cholesteatoma develop. In our study, we interpreted 210 patients' temporal computed tomography (CT). Seventy of these 210 patients had otitis media with cholesteatoma, 70 patients had only otitis media without cholesteatoma, and 70 patients had no otitis media. The eustachian tubes were evaluated using temporal CT multiplanar reconstruction method. Angles with the horizontal plane of the eustachian tube and Reid and tubotympanic angles were measured. The angles between eustachian tube and horizontally oriented Reid plane of the patients with cholesteatoma were found to be significantly lower than the patients with otitis media without cholesteatoma and the patients with no history of otitis media. For the tubotympanic angle, no statistically significant differences were observed between the groups. These results suggest that the decrease in the angle with the horizontal plane of Reid in the eustachian tube in adults may play a significant role in the etiology of cholesteatoma.

Integración vertical y contratación externa en los servicios generales de los hospitales españoles Vertical integration and contracting-out in generic hospital services in Spain

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J. Puig-Junoy

2002-04-01

Full Text Available Objetivos: Este estudio analiza los factores que influyen en las decisiones de integración vertical/contratación externa de cuatro servicios generales (limpieza, lavandería, alimentación y seguridad y mantenimiento en los hospitales españoles (3.160 transacciones que corresponden a 790 hospitales. Métodos: Se presenta la estimación empírica de un modelo logístico de maximización de la utilidad de los hospitales, en el que intervienen no sólo factores relacionados con los costes de transacción, sino también otros relacionados con la intervención pública y la dimensión política. Resultados: El 55,7% de los hospitales contrata al menos uno de los servicios generales analizados. El servicio de limpieza es el que presenta un mayor grado de contratación externa (45,1%, seguido del servicio de seguridad y mantenimiento (32,5%. En cambio, el servicio de lavandería es el que presenta un mayor grado de integración vertical (94,3% junto con el de alimentación (80,1%. La dimensión del hospital (economías de escala, medida a través del número de camas, es una de las variables que influyen de forma importante la decisión de integración vertical o contratación externa de los servicios de limpieza, alimentación y mantenimiento y seguridad. Conclusiones: Las economías de escala contribuyen a una mayor integración vertical, mientras que la especialización y el carácter lucrativo favorecen la decisión de contratación externa. El servicio de lavandería tiene un comportamiento diferenciado de los demás, mostrando efectos que indican la posible presencia de activos específicos.Objectives: This study examines the factors that influence make or buy decisions corresponding to four generic services (housekeeping, laundry, food services, and maintenance and security in Spanish hospitals (3,160 transactions in 790 hospitals. Methods: The empirical estimation of a logistic model based on hospital utility maximization is presented

Acute otitis media associated bilateral sudden hearing loss: case report and literature review.

Science.gov (United States)

Smith, A; Gutteridge, I; Elliott, D; Cronin, M

2017-07-01

Sudden sensorineural hearing loss is a rare otological condition with potential for dire outcomes including permanent hearing loss. Although the majority of cases are deemed idiopathic, bilateral sudden sensorineural hearing loss represents a rare subset typically related to systemic conditions, with higher morbidity and mortality. A controversial association with acute otitis media has been reported, with few bilateral cases published in the literature. A very rare case of bilateral sudden sensorineural hearing loss associated with acute otitis media is described, with a review of the literature. The limited evidence available suggests that acute otitis media with tinnitus and/or bacterial pathology may have an increased risk of sudden sensorineural hearing loss, which is consistent with the case described. Although there is no sufficiently powered published evidence to provide definitive treatment guidelines, the literature reviewed suggests that early myringotomy and antibiotics may greatly improve treatment outcomes.

Association of surfactant protein A polymorphisms with otitis media in infants at risk for asthma

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Bracken Michael B

2006-08-01

Full Text Available Abstract Background Otitis media is one of the most common infections of early childhood. Surfactant protein A functions as part of the innate immune response, which plays an important role in preventing infections early in life. This prospective study utilized a candidate gene approach to evaluate the association between polymorphisms in loci encoding SP-A and risk of otitis media during the first year of life among a cohort of infants at risk for developing asthma. Methods Between September 1996 and December 1998, women were invited to participate if they had at least one other child with physician-diagnosed asthma. Each mother was given a standardized questionnaire within 4 months of her infant's birth. Infant respiratory symptoms were collected during quarterly telephone interviews at 6, 9 and 12 months of age. Genotyping was done on 355 infants for whom whole blood and complete otitis media data were available. Results Polymorphisms at codons 19, 62, and 133 in SP-A1, and 223 in SP-A2 were associated with race/ethnicity. In logistic regression models incorporating estimates of uncertainty in haplotype assignment, the 6A4/1A5haplotype was protective for otitis media among white infants in our study population (OR 0.23; 95% CI 0.07,0.73. Conclusion These results indicate that polymorphisms within SP-A loci may be associated with otitis media in white infants. Larger confirmatory studies in all ethnic groups are warranted.

Antibacterial activity, chemical composition, and cytotoxicity of leaf?s essential oil from brazilian pepper tree (schinus terebinthifolius, raddi)

OpenAIRE

Silva, A.B.; Silva, T.; Franco, E.S.; Rabelo, S.A.; Lima, E.R.; Mota, R.A.; da C?mara, C.A.G.; Pontes-Filho, N.T.; Lima-Filho, J.V.

2010-01-01

The antibacterial potential of leaf?s essential oil (EO) from Brazilian pepper tree (Schinus terebinthifolius Raddi) against staphylococcal isolates from dogs with otitis externa was evaluated. The minimum inhibitory concentration of EO ranged from 78.1 to 1,250 ?g/mL. The oil was analyzed by GC and GC/MS and cytotoxicity tests were carried out with laboratory animals.

Antibacterial activity, chemical composition, and cytotoxicity of leaf's essential oil from Brazilian pepper tree (Schinus terebinthifolius, Raddi

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A.B. Silva

2010-03-01

Full Text Available The antibacterial potential of leaf's essential oil (EO from Brazilian pepper tree (Schinus terebinthifolius Raddi against staphylococcal isolates from dogs with otitis externa was evaluated. The minimum inhibitory concentration of EO ranged from 78.1 to 1,250 fg/mL. The oil was analyzed by GC and GC/MS and cytotoxicity tests were carried out with laboratory animals.

Antibacterial activity, chemical composition, and cytotoxicity of leaf's essential oil from brazilian pepper tree (schinus terebinthifolius, raddi).

Science.gov (United States)

Silva, A B; Silva, T; Franco, E S; Rabelo, S A; Lima, E R; Mota, R A; da Câmara, C A G; Pontes-Filho, N T; Lima-Filho, J V

2010-01-01

The antibacterial potential of leaf's essential oil (EO) from Brazilian pepper tree (Schinus terebinthifolius Raddi) against staphylococcal isolates from dogs with otitis externa was evaluated. The minimum inhibitory concentration of EO ranged from 78.1 to 1,250 μg/mL. The oil was analyzed by GC and GC/MS and cytotoxicity tests were carried out with laboratory animals.

Antibacterial activity, chemical composition, and cytotoxicity of leaf’s essential oil from brazilian pepper tree (schinus terebinthifolius, raddi)

Science.gov (United States)

Silva, A.B.; Silva, T.; Franco, E.S.; Rabelo, S.A.; Lima, E.R.; Mota, R.A.; da Câmara, C.A.G.; Pontes-Filho, N.T.; Lima-Filho, J.V.

2010-01-01

The antibacterial potential of leaf’s essential oil (EO) from Brazilian pepper tree (Schinus terebinthifolius Raddi) against staphylococcal isolates from dogs with otitis externa was evaluated. The minimum inhibitory concentration of EO ranged from 78.1 to 1,250 μg/mL. The oil was analyzed by GC and GC/MS and cytotoxicity tests were carried out with laboratory animals. PMID:24031476

Antibiotics for otitis media with effusion in children

NARCIS (Netherlands)

Venekamp, R.P.; Burton, M.J.; van Dongen, T.M.A.; van der Heijden, G.J.; van Zon, A.; Schilder, A.G.M.

2016-01-01

Background Otitis media with effusion (OME) is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. Since most cases of OME will resolve spontaneously, only children with persistent middle ear effusion and

Percepción sobre uso de alcohol y tabaco en familiares de niños enfermos: Consulta externa del hospital materno infantil del guasmo sur. Guayaquil - Ecuador

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Ayala Loor Esperanza

2004-01-01

Full Text Available Las enfermeras siempre deben preguntar a sus clientes sobre problemas con uso abusivo de alcohol en sus familias, independientemente de la especialidad de la profesional. El objetivo de esta investigación fue describir la concepción de familiares de niños pequeños con problemas de salud atendidos en un servicio de consulta externa sobre el hábito del uso del alcohol y el tabaco. Se entrevistó a 9 familiares y las entrevistas fueran analizadas bajo el análisis del contenido. La existencia de alcohol en la familia afloró como una queja. De 9 entrevistadas 6 tienen en diferentes generaciones presencia de consumidores de alcohol y tabaco. Las entrevistadas que identificaron conductas recurrentes de abuso de consumo de alcohol y tabaco utilizaron recursos auto correctivos buscando la estabilidad de un cambio dinámico intrafamiliar, sin éxito. El problema principal es la falta de autoridad de las mujeres, típica de la familia latinoamericana.

Acute external otitis as debut of acute myeloid leukemia - A case and review of the literature.

Science.gov (United States)

Slengerik-Hansen, Joachim; Ovesen, Therese

2018-03-01

Acute leukemia is a well known childhood cancer. The relation between leukemia and otological symptoms has long been established but is highly rare as a debut symptom of leukemia. External otitis is a common condition affecting many children, and most cases are successively treated with topical medicine. Here we present a child with acute external otitis later shown to be the debut symptom of acute myeloid leukemia, to our knowledge the first specific case described. We have reviewed the literature to find red flags for suspicion of severe disease in case of acute external otitis. Copyright © 2018 Elsevier B.V. All rights reserved.

Ear Problems in Swimmers

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Mao-Che Wang

2005-08-01

Full Text Available Acute diffuse otitis externa (swimmer's ear, otomycosis, exostoses, traumatic eardrum perforation, middle ear infection, and barotraumas of the inner ear are common problems in swimmers and people engaged in aqua activities. The most common ear problem in swimmers is acute diffuse otitis externa, with Pseudomonas aeruginosa being the most common pathogen. The symptoms are itching, otalgia, otorrhea, and conductive hearing loss. The treatment includes frequent cleansing of the ear canal, pain control, oral or topical medications, acidification of the ear canal, and control of predisposing factors. Swimming in polluted waters and ear-canal cleaning with cotton-tip applicators should be avoided. Exostoses are usually seen in people who swim in cold water and present with symptoms of accumulated debris, otorrhea and conductive hearing loss. The treatment for exostoses is transmeatal surgical removal of the tumors. Traumatic eardrum perforations may occur during water skiing or scuba diving and present with symptoms of hearing loss, otalgia, otorrhea, tinnitus and vertigo. Tympanoplasty might be needed if the perforations do not heal spontaneously. Patients with chronic otitis media with active drainage should avoid swimming, while patients who have undergone mastoidectomy and who have no cavity problems may swim. For children with ventilation tubes, surface swimming is safe in a clean, chlorinated swimming pool. Sudden sensorineural hearing loss and some degree of vertigo may occur after diving because of rupture of the round or oval window membrane.

Epidemiology, natural history, and risk factors: panel report from the Ninth International Research Conference on Otitis Media

DEFF Research Database (Denmark)

Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn

2010-01-01

The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute...

Diferenciais de raça/cor da pele em anos potenciais de vida perdidos por causas externas Diferenciales de raza/color de la piel en años potenciales de vida perdidos por causas externas Race/skin color differentials in potential years of life lost due to external causes

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Edna Maria de Araújo

2009-06-01

ún raza/color de la piel. MÉTODOS: Se realizó estudio descriptivo en Salvador, BA, con 9.626 registros de óbitos por causas externas entre 1998 y 2003. Los datos se obtuvieron del Instituto Médico Legal e Instituto Brasilero de Geografía y Estadística. El indicador "años potenciales de vida perdidos" fue utilizado para identificar diferenciales entre grupos erarios, de raza/color de la piel y sexo. RESULTADOS: Las muertes por causas externas determinaron pérdida de 339.220 años potenciales de vida, de los cuales 210.000 fueron debidos a los homicidios. Individuos negros murieron en edades más precoces y perdieron 12,2 veces más años potenciales de vida debido a homicidios que individuos blancos. A pesar de que la población negra (pardos y negros era tres veces mayor que la población blanca, el número de años perdidos de la primera fue 30 veces superior. La población de negros era 11,4% menor que la población blanca, pero presentó años perdidos casi tres veces mayor. Aún después de la estandarización por edad, se mantuvo las diferencias observadas en el indicador de años potenciales perdidos/100.000 hab y en las razones entre estratos según raza/color. CONCLUSIONES: Los resultados muestran diferenciales en la mortalidad por causas externas según raza/color de la piel en Salvador. Los negros tuvieron mayor pérdida de años potenciales de vida, mayor número promedio de años no vividos y murieron, en promedio, en edades más precoces por homicidios, accidentes de tránsito y demás causas externas.OBJECTIVE: Deaths by external causes represent one of the most important challenges for public health and are the second cause of death in Brazil. The aim of this study was to analyze differentials in mortality by external causes according to race/skin color. METHODS: A descriptive study was carried out in Salvador, Northeastern Brazil, using 9,626 cases of deaths by external causes between 1998 and 2003. Data were obtained from the Forensic Medicine

Epidemiology, natural history, and risk factors: panel report from the Ninth International Research Conference on Otitis Media

DEFF Research Database (Denmark)

Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn

2010-01-01

The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute an...... vaccine in infants. The panel report also recommends short and long term goals for current and future OM research.......The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute...... and chronic OM and OM with effusion, and conveys information on newly discovered genetic factors. In this report, researchers have described declining rates of OM diagnosis, antibiotic prescriptions, offices visits for OM, and middle ear surgery since the licensure and routine use of pneumococcal conjugate...

Otitis media with effusion in an allergic animal model: A functional and morphological study.

Science.gov (United States)

Kim, Dong-Kee; Park, Hyu Eun; Back, Sang-A; Park, Hyang Rim; Kim, Soo Whan; Park, Yooyeon; Yeo, Sang Won; Park, Shi-Nae

2016-05-01

Allergy is considered as one of important etiologic factor of otitis media with effusion (OME). In present study, we evaluated the causal effect of allergy on OME in an animal model, and investigated the secondary effect of bacterial infection. Allergy and control animals were subdivided into groups with and without intratympanic injection of lipopolysaccharide (IT-LPS). Allergic otitis media was induced via intraperitoneal ovo-albumin injection with intranasal challenge. We assessed the occurrence of OME in allergic animals and the effect of IT-LPS on allergic otitis media. We also investigated the Th1 and Th2 responses in the middle-ear mucosa. Hearing of the animals was measured by ABR and DPOAE. OME was observed in 75% of the allergic animals. After IT-LPS, 100% of the control and allergy groups showed otitis media. Light microscopy revealed that the middle-ear mucosa of animals of both groups also was significantly increased after IT-LPS, and the Th1 response (IL-2 and IFN-γ) and Th2 response (IL-5 and IL-13) cytokines were expressed at higher levels in the allergy group with IT-LPS than in control group with IT-LPS. Hearing tests between the allergy and control group with IT-LPS did not reveal any differences. Our findings may be direct evidence of an allergic causal effect on OME. Th2 response cytokines were strongly expressed in allergic OME, and the inflammatory reaction to LPS was more intense in the allergic group, which indicates that otitis media related to allergy can be severely aggravated by an inflammatory reaction to bacterial infection. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

High-Dose Amoxicillin with Clavulanate for the Treatment of Acute Otitis Media in Children

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Chia-Huei Chu

2014-01-01

Full Text Available Objective. This study uses the acute otitis media clinical practice guideline proposed in 2004 as a reference to evaluate whether antibiotics doses that are in line with the recommendations lead to better prognosis. The study also attempts to clarify possible factors that influence the outcome. Study Design. Retrospective cohort study. Subjects and Methods. A total of 400 children with acute otitis media were enrolled. The dosage of amoxicillin was considered to be appropriate when in accord with clinical practice guidelines, that is, 80–90 mg/kg/day. The outcome was defined according to the description of tympanic membrane on medical records. Multivariate logistic regression was used to analyze the relationship between antibiotic dosage and prognosis after adjusting for baseline factors. Results. The majority of prescriptions were under dosage (89.1% but it was not noticeably associated with outcome (P= 0.41. The correlation between under dosage and poor prognosis was significant in children below 20 kg with bilateral acute otitis media (odds ratio 1.63; 95% CI 1.02–2.59, P=0.04. Conclusion. Treating acute otitis media in children, high-dose amoxicillin with clavulanate as recommended in the clinical practice guideline was superior to conventional doses only in children under 20 kg with bilateral diseases.

The effects of ventilation tubes versus no ventilation tubes for recurrent acute otitis media or chronic otitis media with effusion in 9 to 36 month old Greenlandic children, the SIUTIT trial: study protocol for a randomized controlled trial.

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Demant, Malene Nøhr; Jensen, Ramon Gordon; Jakobsen, Janus Christian; Gluud, Christian; Homøe, Preben

2017-01-19

The prevalence of otitis media in Greenlandic children is one of the highest in the world. International studies have shown that otitis-prone children may benefit from tubulation of the tympanic membrane. However, it is unknown whether these results can be applied to Greenlandic children and trials on the effects of ventilation tubes in high-risk populations have, to our knowledge, never been conducted. The trial is an investigator-initiated, multicentre, randomized, blinded superiority trial of bilateral ventilation tube insertion versus treatment as usual (no tube) in Greenlandic children aged 9-36 months with chronic otitis media with effusion or recurrent acute otitis media. With randomization stratified by otitis media subtype and trial site, a type 1 error of 5% and a power of 80%, a total of 230 participants are needed to detect a decrease of two visits to a health clinic during 2 years, which is considered the minimal clinical relevant difference. The primary outcome measure will be assessed blindly by investigating medical records. Secondary outcome measures are number of episodes of acute otitis media, quality of life, number of episodes of antibiotics administration and proportion of children with tympanic membrane perforations. This trial will provide evidence-based knowledge of the effects of ventilation tubes in children with middle ear infections from the high-risk Greenlandic population. Furthermore, this trial will improve the understanding of conducting randomized clinical trials in remote areas, where management of logistical aspects is particularly challenging. ClinicalTrials.gov, NCT02490332 . Registered on 14 February 2016.

Causas externas e mortalidade materna: proposta de classificacao

OpenAIRE

Alves, Mercia Maria Rodrigues; Alves, Sandra Valongueiro; Antunes, Maria Bernadete de Cerqueira; Santos, Dirce Luiza Pereira dos

2013-01-01

OBJETIVO: Analisar os óbitos por causas externas e causas mal definidas em mulheres em idade fértil ocorridos na gravidez e no puerpério precoce. MÉTODOS: Foram estudados 399 óbitos de mulheres em idade fértil de Recife, PE, de 2004 a 2006. A pesquisa utilizou o método Reproductive Age Mortality Survey e um conjunto de instrumentos de investigação padronizados. Foram usados como fontes de dados laudos do Instituto Médico Legal, prontuários hospitalares e da Estratégia Saúde da Família e ...

Ten Year Study of the Stringently Defined Otitis Prone Child in Rochester, NY

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Pichichero, Michael E.

2016-01-01

This review summarizes a prospective, longitudinal 10-year study in Rochester NY with virtually every clinically diagnosed acute otitis media (AOM) confirmed by bacterial culture of middle ear fluid. Children experiencing 3 episodes within 6 months or 4 episodes in 12 months were considered stringently-defined otitis prone (sOP). We found stringent diagnosis compared with clinical diagnosis reduced the frequency of children meeting the OP definition from 27% to 6% resulting in 14.8% and 2.4% receiving tympanostomy tubes, respectively. Significantly more often RSV infection led to AOM in sOP than non-otitis prone (NOP) children that correlated with diminished total RSV-specific serum IgG. sOP children produced low levels of antibody to Streptococcus pneumoniae and Haemophilus influenzae candidate vaccine protein antigens and to routine pediatric vaccines. sOP children generated significantly fewer memory B cells, functional and memory T cells to otopathogens following NP colonization and AOM than NOP children and they had defects in antigen presenting cells. PMID:27273691

The psychosocial impact of hearing aids in children with otitis media with effusion.

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Qureishi, A; Garas, G; Mallick, A; Parker, D

2014-11-01

In children, otitis media with effusion is treated using grommets or hearing aids. Parents considering treatment options express concerns regarding the psychosocial impact of hearing aids in terms of self-esteem and bullying. This study assessed the psychosocial impact of hearing aid use. A cross-sectional study was undertaken comparing hearing aid users to non hearing aid users with regard to their attitudes towards hearing aids. All subjects, who had been diagnosed with otitis media with effusion, were aged less than 16 years, were without disability and attended mainstream schools. A questionnaire was designed and utilised. The study comprised 47 children with hearing aids and 50 with grommets. Significant between-group differences (p negative perceptions of non hearing aid users were not reported by hearing aid users. Children with hearing aids do not suffer from bullying or low self-esteem to the extent perceived by parents. This information is useful for informed decisions regarding treatment of otitis media with effusion.

Otitis Media and Its Sequelae in Kenyan Schoolchildren.

Science.gov (United States)

Simões, Eric A F; Kiio, Francis; Carosone-Link, Phyllis J; Ndegwa, Serah N; Ayugi, John; Macharia, Isaac M

2016-12-01

The goal of this study was to obtain representative Kenyan data on the point prevalence of acute otitis media (AOM) and its sequelae (otitis media with effusion [OME] and chronic suppurative otitis media [CSOM]), a major cause of preventable hearing loss in children in developing countries. In Africa, there are limited studies on the prevalence of AOM and its sequelae in children. Study subjects were children aged 2 to 15 years and were enrolled from randomly selected preprimary and primary schools. After parental or guardian consent, subjects had a questionnaire administered, otoscopy and tympanometry were done, and audiometry was performed on those with ear problems detected on these examinations. A total of 9825 (75%) children was from rural schools. The prevalence of CSOM was 15 of 1000, OME was 15 of 1000, and AOM was 7 of 1000 children. Rural Rift Valley schoolchildren had the highest prevalence of CSOM (24 of 1000) compared with other regions (12 of 1000; P < .0001). Ear discharge occurred before 3.5 years in 50% of 901 children with ear discharge. A history of ear discharge was associated with abnormal tympanograms (odds ratio [OR], 11.9-19.2) and mild-to-severe hearing loss (OR, 21.6-38.6), even in children without ear disease (OR, 10.7-24.4). The burden of AOM sequelae in Kenyan preschool and schoolchildren is significant, and it occurs mostly in the first 4 years of life. By preventing early recurrent AOM, pneumococcal vaccination might partly avert nonreversible sequelae. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Seletividade de inseticidas usados na cultura da macieira a ovos de Chrysoperla externa (Hagen, 1861 (Neuroptera: Chrysopidae Selectivity of insecticides used in apple orchards to eggs of Chrysoperla externa (Hagen, 1861 (Neuroptera: Chrysopidae

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Antônio José Ferreira

2005-08-01

Full Text Available Neste trabalho, foi avaliado o efeito de inseticidas sobre ovos de duas populações de Chrysoperla externa (Hagen, 1861 (Neuroptera: Chrysopidae. O trabalho foi realizado em laboratório (25±2°C, UR de 70±10% e fotofase de 12 horas avaliando-se inseticidas, nas concentrações indicadas pelos fabricantes e/ou que estão em fase de pesquisa para o controle da mariposa-oriental, lagarta-enroladeira e mosca-das-frutas na cultura da macieira. Os produtos e dosagens (g ou mL do p.c. 100L-1 de água avaliados foram: fosmet (Imidan 500 PM - 200, metoxifenozide (Intrepid 240 SC - 60, tebufenozide (Mimic 240 SC - 60, benzoato de emamectina (Proclaim 5 SG - 15, spinosad (Tracer 480 SC - 20, etofenprox (Trebon 100 SC - 150, clorpirifós etil (Lorsban 480 BR - 150 e testemunha (somente água. As pulverizações foram realizadas em ovos com até 12 horas de idade, utilizando-se torre de Potter. Avaliaram-se a viabilidade dos ovos, o período embrionário, e a sobrevivência das larvas de primeiro e segundo estádios provenientes dos ovos tratados. A toxicidade dos produtos foi determinada em função da mortalidade acumulada do predador durante o seu desenvolvimento, classificando-os conforme escala proposta pela IOBC. As duas populações de C. externa apresentaram o mesmo padrão de resposta aos produtos fitossanitários avaliados quando aplicados sobre ovos. Fosmet, metoxifenozide, tebufenozide, benzoato de emamectina, spinosad e etofenprox foram considerados inócuos, e clorpirifós etil levemente nocivo a ovos de C. externa, provocando a redução de 43,7% na viabilidade dos ovos e afetando em 20% a sobrevivência das larvas de primeiro estádio originadas dos ovos tratados.The effect of some insecticides on eggs of two populations of Chrysoperla externa (Hagen, 1861 (Neuroptera: Chrysopidae were evaluated under laboratory conditions (25±2°C, RH of 70±10% and 12 hours-photophase. The compounds were used at commercial or research concentrations

Validation of a Portuguese version of the health-related quality of life measure for active chronic otitis media (COMQ-12).

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Fonseca, Anna Carolina Oliveira; Ramos, Pedro; Balsalobre, Fernando A; Freitas, Edson L; Phillips, John S; Yung, Matthew W; Bento, Ricardo F

2017-09-01

Measuring the impact on quality of life, especially after the beginning of the treatment, is becoming increasingly important in healthcare. The aim of this study was to translate the Chronic Otitis Media Questionnaire-12 (COMQ-12) into Portuguese language and validate this version in a group of patients with chronic otitis media. The Portuguese version of COMQ-12 was obtained by translation and back translation. Portuguese speaking patients with a history of active chronic otitis media were asked to complete the COMQ-12 Portuguese version. Cronbach's α coefficient was calculated for an estimation of the internal consistency of the questionnaire. A total of 100 patients were included in the study; 49 women and 51 men, with a mean age of 39 years (range 12-77 years, median 40 years). The average COMQ-12 score was 29, out of a maximum score of 60. Cronbach's α result for the Portuguese version of the COMQ-12 was 0.85, indicating a high internal consistency. The participants presented with different forms of chronic otitis media, and almost all domains of the COMQ-12 questionnaire were able to differentiate between patients with healed chronic otitis media and patients with cholesteatoma or wet tympanic membrane perforation. Showing that patients with healed chronic otitis media have a better quality of life, measured by the COMQ-12, is a first step to guarantee the questionnaire's validity. The next step will consist on routinely using the questionnaire in patients undergoing surgery for chronic otitis media in order to evaluate their quality of life after treatment. The COMQ-12 Portuguese version showed high reliability, and may be used as an assessment of quality of life in patients with chronic otitis media. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. All rights reserved.

Human evolutionary history: consequences for the pathogenesis of otitis media.

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Bluestone, Charles D; Swarts, J Douglas

2010-12-01

The pathogenesis of otitis media is multifactorial, but the role of evolution on its development has not been addressed. We posit that the high prevalence of middle-ear disease is most likely restricted to humans, in contrast to other wild species, because the associated hearing loss would have reduced the fitness of affected individuals as a result of predation. We present here the possible consequences of two human adaptations that may have resulted in ubiquitous otitis media: the interaction of bipedalism and increased brain size, and the loss of facial prognathism resulting from speech or cooking. As a consequence of our adaptation for bipedalism, the female pelvic outlet is constricted, which, in the context of a rapidly enlarging brain, results in humans being born 12 months too soon. Significantly, immature eustachian tube structure and function, in conjunction with an immature immune system, helps to explain the high incidence of otitis media in the first year of life. But the persistence of middle-ear disease beyond this stage is not explained by "immaturity." The morphology of the palate changed with the adaptations that produced facial flattening, with concomitant effects on eustachian tube function. These changes resulted in relatively poor human physiologic tubal function in comparison to the nonhuman primate. Copyright © 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

Método para redução de mancha nas vedações externas de edifícios.

OpenAIRE

Flávio Leal Maranhão

2009-01-01

O permanente contato das vedações externas dos edifícios com os materiais integrantes das vedações externas dos edifícios (fachadas e telhados) com os agentes de degradação provocam o surgimento de manchas, que normalmente estão associadas à deposição de poluentes e a proliferação de microorganismos. Para inibir o surgimento dessas manchas existem, atualmente, diversos métodos disponíveis, sendo que nenhum tem se mostrado efetivo. Esta tese de doutorado, com base em um extenso programa labora...

Anatomy of virgin and mature externae of Loxothylacus texanus, parasitic on the dark blue crab Callinectes rathbunae (Crustacea

DEFF Research Database (Denmark)

Alvarez, Fernando; Bortolini, José Luis; Høeg, Jens Thorvald

2010-01-01

the reproductive biology and the taxonomy of these specialized parasites. We use scanning electron microscopy and histological methods to study the anatomy of juvenile and the mature externae of the rhizocephalan barnacle Loxothylacus texanus parasitizing the blue crab Callinectes rathbunae. We put emphasis......, as is characteristic for the genus Loxothylacus. The internal anatomy of the mature externa of L. texanus is in most features similar to that seen in other species of the Sacculinidae, which comprises the majority of rhizocephalan species. However, the single receptacle creates a situation where the two implanted...

Prevalence and Management of Otitis Media with Effusion Amongst the School Going Children of a Rural Area in Puducherry

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Sharath Babu K

2016-04-01

Full Text Available Background :  Otitis Media with Effusion(OME also known as  Secretory Otitis Media, has been identified as the commonest middle ear condition causing deafness in children in developed countries. Neither the indication for surgical treatment nor the types and number of procedures used are uniform. Possible treatment includes myringotomy with or without insertion of ventilation tube either alone or with adenoidectomy and occasionally tonsillectomy. Aims and Objectives :  To assess the prevalence and the different modes of presentation of Otitis Media with Effusion among the rural school children of Puducherry and to assess the improvement in hearing after 6 months of surgical intervention done on patients with Otitis Media with Effusion. Materials and Methods:  A school screening camp was conducted on 600 children in the age group of 5-12 years in a government middle school near our medical college hospital for identifying children with Otitis Media with Effusion. Students with Otitis Media with Effusion were further classified into 4 groups for various interventional procedures namely adenotonsillectomy with bilateral grommet insertion (Group A, adenoidectomy with bilateral grommet insertion (Group B, bilateral grommet insertion (Group C,  bilateral myringotomy with wide field incision in the antero-inferior quadrant (Group D. Result : The prevalence was almost in equal proportions in the age group between 5-12 years and the overall prevalence of Otitis Media with Effusion among the study population was 13.3%. The adenotonsillectomy with bilateral grommet insertion procedure had shown a significant improvement in hearing, which was measured by using pure tone audiometry by assessing the mean air-bone gap, which was 9.81, 8.27 and 6.73 at the end of 6 weeks, 3 months and 6 months respectively, when compared to the other procedures.   Conclusion : Adenotonsillectomy with bilateral grommet insertion should be considered in a child with Otitis

Comparative effectiveness of the methods adenoidectomy in cнildren with exudative otitis media

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Gusakov A.

2016-03-01

Full Text Available Actuality: A thorough sanation of the nasopharynx is essential for successful treatment of the exudative otitis media (EOM. The literature describes in detail the state of the nasopharynx after different types of adenoidectomy. The classifications of the location of the remnants of lymphoid tissue and the extent of scarring in the nasopharynx are given.The subject of this work is to trace the relationship of postoperative nasopharyngeal changes with recurrent EOM. Objective: To study the immediate and long-term results of different methods of surgical treatment of hypertrophy of the nasopharyngeal lymphoid tissue in children with exudative otitis media. Materials and Methods: This paper presents information on the results of treatment of 62 children of 5–7 years suffering from exudative otitis media. Observations were carried out in two groups of patients. The first group included 28 children previously undergone adenoidectomy, with the signs of recurrent exudative otitis. The second group included 34 children with exudative otitis previously untreated surgically. The task of the investigation is to study the effectiveness of endonasal and extranasal methods of surgical removal of nasopharengeal lymphoid tissue with a minimum probability of scar obliteration of the mouth of the Eustachian tube. Results and discussion: The priority method in nasopharengeal surgery in children is extranasal access with shaver technology in conjunction with cold plasma surgery. The using of these methods gives a clear visualization of the operating field under conditions of moderately bleeding wound. On the other hand, endonasal approach is associated with traumatization of the nasal mucosa with incomplete volume visualization of the surgical field. This combination can result in a longer healing of the surgical wound, the formation of adhesions of the nasal cavity and scarring in the nasopharynx. Complete visualization of the operating field significantly

Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: the Generation R study

NARCIS (Netherlands)

Labout, J.A.; Duijts, L.; Lebon, A.; Groot, R. de; Hofman, A.; Jaddoe, V.V.; Verbrugh, H.A.; Hermans, P.W.M.; Moll, H.A.

2011-01-01

Acute otitis media is the most frequent diagnosis in children visiting physicians' offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a population-based

EXPERIENCE OF TREATMENT WITH FENSPIRIDE IN CHILDREN WITH CHRONIC EXUDATIVE OTITIS MEDIA AFTER TYMPANOSTOMY

OpenAIRE

L.A. Toropova; T.V. Zhuikova; N.I. Marysheva; A.I. Nikolaeva; Yu.S. Maiorova

2009-01-01

The trial presents the analysis of factors predisposing to exudative otitis media development in 709 children, needing regular audiologist’s check-up. It was shown that dominating risk factor of auditory tube’s function disorders is hypertrophy of palatine tonsil (it was detected in 69% of children). Besides, doctors from children’s out-patient clinics often use conservative treatment in children with chronic exudative otitis media. Analysis of data obtained at the time of treatment of 180 ho...

Treatment of Recurrent Eczematous External Otitis with Honey Eardrops: A Proof-of-Concept Study.

Science.gov (United States)

Henatsch, Darius; Nabuurs, Cindy H; van de Goor, Rens M; Wolffs, Petra F; Stokroos, Robert J

2017-10-01

Eczematous external otitis is a chronic inflammatory disease and often difficult to treat. Our objective was to investigate the clinical effect and in vitro antibacterial potential of medical honey eardrops as treatment of eczematous external otitis. In a prospective study, 15 patients diagnosed with recurrent eczematous external otitis were treated with medical honey eardrops for 2 weeks. The following clinical outcomes were evaluated: visual analog scale of ear complaints, score of eczema, and eradication of bacterial infection. Furthermore, the antibacterial effect of honey eardrops against different bacterial strains was tested in vitro. Treatment resulted in less discomfort and itching and decreased signs of eczema, with high patient satisfaction and without adverse reactions. Honey eardrops showed a strong in vitro inhibitory activity against all tested strains but did not eradicate Staphylococcus aureus infection in vivo. The results of this preliminary study indicate a possible role of honey eardrops in eczematous ear disease.

Auditoría externa: responsabilidades cuando se trabaja con otros profesionales

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Padin, María Belén

2008-11-01

Full Text Available Cuando un Contador Público es contratado como auditor externo se compromete a emitir un informe en el cual expresará su opinión sobre los estados contables del ente (puede suceder que el auditor finalmente deba abstenerse de opinar, pero esta es una excepción, ya que lo normal es que cuando se requieren los servicios de un auditor se espera que emita un informe. Al aceptar ser designado como auditor externo, el contador público acepta también las responsabilidades que recaen sobre él. Que son inherentes a su desempeño profesional y que están regidas por las normas profesionales dentro de las cuales debe encuadrar su actividad. A lo largo de este trabajo, se estudiará qué responsabilidades recaen sobre el auditor cuando actúa en colaboración con otros profesionales. Los casos específicos que se estudiarán son: 1 responsabilidad por la utilización del trabajo de otro auditor; 2 consideración del trabajo de auditoria interna; y 3 utilización del trabajo de un experto. Para ello se mencionarán las normas internacionales de auditoria (NIA que tratan cada tema en específico, y alguna norma en particular que exista de otro organismo al respecto.

Perfeccionismo, afectividad y satisfacción con la vida en educación física. [Perfectionism, affectivity and life satisfaction in physical education].

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Antonio Méndez-Giménez

2015-07-01

Full Text Available El perfeccionismo en la adolescencia ha sido asociado a altos niveles de desajuste y trastorno psicológico y bajos niveles de bienestar subjetivo y ajuste psicológico. Pero, no todas las dimensiones del perfeccionismo son insanas y desadaptativas. Mediante un análisis path se exploró un modelo para determinar cómo son las relaciones entre las dimensiones del perfeccionismo (autoexigencia y presión externa, la afectividad (positiva y negativa y la satisfacción con la vida, en el contexto de la educación física. Participaron 388 estudiantes de 1º a 4º de Secundaria (222 varones y 166 mujeres; M = 14.24 ± 1.45 años. La autoexigencia predijo de manera positiva y directa la satisfacción con la vida; el afecto positivo también medió esta relación. La presión externa predijo directa y negativamente la satisfacción con la vida, cuya relación fue también mediada por el afecto negativo. Los resultados confirman una dimensión saludable de perfeccionismo (autoexigencia y otra no saludable (presión externa en la adolescencia. Abstract Perfectionism during adolescence has been associated to high levels of psychological unbalance and distress, and low levels of subjective wellness and psychological adjustment. However, not all dimensions of perfectionism are negative and maladaptive. A path analysis was used to explore a model to determine the relations between two dimensions of perfectionism (Self-imposed and External pressures, affectivity (positive and negative and life satisfaction in physical education. 388 1st to 4th secondary students (222 males and 166 females; M = 14.24 ± 1.45 years agreed to participate. Self-imposed positively predicted life satisfaction, while positive affect mediated this effect. External pressures negatively predicted life satisfaction and negative affect mediated this effect. Results confirm a healthy dimension of perfectionism (self-imposed, and an unhealthy dimension (external pressures in adolescence.

Seletividade de agrotóxicos utilizados em pomares de pêssego a adultos do predador Chrysoperla externa (Hagen, 1861 (Neuroptera: Chrysopidae Selectivity of pesticides used in peach orchard on adults of Chrysoperla externa (Hagen, 1861 (Neuroptera: Chrysopidae

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Rodolfo Vargas Castilhos

2011-03-01

Full Text Available A seletividade de dezesseis agrotóxicos utilizados na produção integrada e convencional de pêssego foi avaliada sobre a fase adulta de Chrysoperla externa através de bioensaios de exposição residual conduzidos em laboratório (temperatura de 25±1ºC, umidade relativa 70±10% e fotofase 14 horas, utilizando-se de metodologia prescrita pela "International Organization for Biological Control" (IOBC. Os agrotóxicos (% de ingrediente ativo na calda azoxystrobina (0,016, captana (0,192, dodina (0,126, folpete (0,200, mancozebe (0,256, mancozebe + oxicloreto de cobre (0,140 + 0,096, tebuconazole (0,320, abamectina (0,002, óleo mineral 1 (2,420, óleo mineral 2 (1,920, dicloreto de paraquate (0,300 e glifosato (1,440 foram inócuos; deltametrina (0,002 foi levemente nocivo e dimetoato (0,160, fosmete (0,160 e malationa (0,240 foram nocivos a adultos de C. externa.The selectivity of sixteen pesticides used in integrated and conventional peach production was evaluated on adults of Chrysoperla externa (Hagen,1861 (Neuroptera: Chrysopidae under bioassays in laboratory conditions (temperature of 25±1ºC, relative humidity 70±10% and 14 hours photophase, using the "International Organization for Biological Control" (IOBC methodology. The pesticides (% active ingredient azoxystrobin (0.016, captan (0.192, dodine (0.126, pholpet (0.200, mancozeb (0.256, mancozeb + cooper oxichloride (0.140 + 0.096, tebuconazole (0.320, abamectin (0.002, mineral oil 1 (2.420, mineral oil 2 (1.920, paraquat dichloride (0.300 and gliphosate (1.440 were harmless; deltametrin (0.002 was slightly harmful and dimetoate (0.160, phosmet (0.160 and malathion (0.240, were harmful to C. externa adults.

Clinical Characteristics of Chronic Perforated Otitis Media in Different Age Groups.

Science.gov (United States)

Hasegawa, Masayo; Shinnabe, Akihiro; Kanazawa, Hiromi; Iino, Yukiko; Yoshida, Naohiro

2017-08-01

We aimed to analyze preoperative and intraoperative clinical characteristics of chronic perforated otitis media by patient age. We analyzed 137 tympanoplasties for chronic perforated otitis media in 133 patients. Exclusion criteria were ear adhesions, cholesteatoma, and a history of tympanoplasty. Patients were divided into a younger group (aged 15-39 years), a middle group (40-64 years), and an elderly group (≥65 years). We compared tympanoplasty technique (using Wullstein classification), mastoid air-cell area measured by temporal bone computed tomography, preoperative aeration of the temporal bone, mean preoperative hearing (at 500 Hz, 1000 Hz, and 2000 Hz), and patch effect calculated by the pre- and post-patch air-bone gap at frequencies of 250 Hz and 500 Hz among the three age groups. Although type I tympanoplasty was performed most frequently in all age groups, it was performed significantly less often in the elderly group (pgroup (page groups (pgroups. The mean patch effect was significantly better in the younger group than in middle or elderly groups (p<0.05). The less pneumatized mastoid and ossicular diseases in elderly patients with chronic perforated otitis media suggest that they had longer lasting and more severe childhood middle ear pathologies than did younger patients.

Fatal Lemierre's syndrome as a complication of chronic otitis media ...

African Journals Online (AJOL)

a high index of suspicion should be maintained, as it remains a ... developed Lemierre's syndrome secondary to untreated chronic otitis ... This septic thrombophlebitis gives rise to septic microemboli that can disseminate throughout the body ...

Herbal medicines for treating acute otitis media: A systematic review of randomised controlled trials.

Science.gov (United States)

Son, Mi Ju; Kim, Young-Eun; Song, Young Il; Kim, Yun Hee

2017-12-01

This systematic review aimed to assess the clinical evidence for the widespread use of herbal medicines in treating acute otitis media. Eleven electronic databases, including MEDLINE, EMBASE, and the CENTRAL were searched, without language limitations. All randomised controlled trials involving the use of herbal medicines, alone or in combination with conventional therapies, for acute otitis media were included. We identified 4956 studies, of which seven randomised clinical trials met the inclusion criteria. The overall risk of bias of the included trials was relatively high or unclear. Treatment with Longdan-xiegan decoction or Shenling-baizhu powder, combined with antibiotics, appeared to be more effective than treatment with antibiotics alone in terms of the proportion of patients with total symptom recovery. Moreover, combination treatment of Sinupret ® and antibiotics facilitated the recovery of middle ear conditions and hearing acuity. Despite some indications of potential symptom improvement, the evidence regarding the effectiveness and efficacy of herbal medicine for acute otitis media is inconclusive due to the poor quality of trials included. Moreover, we only analysed seven trials in this review. Therefore, to properly evaluate the effectiveness of herbal medicine for acute otitis media, systematic reviews based on more rigorously designed randomized trials are warranted in the future. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

aerobic bacteria in safe type chronic suppurative otitis media

African Journals Online (AJOL)

PUBLICATIONS1

Ciprofloxacin and gentamicin appear to be the best choices for empiric therapy in patients with CSOM. In contrast, the use of amoxyclav, cotrimoxazole, cefuroxime, cefaclor and ceftriaxone should be discour- aged. INTRODUCTION. Chronic suppurative otitis media (CSOM) is a persistent inflammatory disorder of the middle.

Desenvolvimento larval de Chrysoperla externa alimentada com Aphis gossypii provenientes de três cultivares de algodoeiro

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Eunice Cláudia Schlick-Souza

2011-10-01

Full Text Available O objetivo deste trabalho foi avaliar os aspectos biológicos de Chrysoperla externa alimentadas com Aphis gossypii provenientes de três cultivares de algodoeiro (FMT 701, Acala 90 e Delta Opal. O experimento foi conduzido no Laboratório de Fitossanidade da Universidade Estadual de Mato Grosso do Sul (UEMS, Unidade de Cassilândia (MS. Os adultos de C. externa foram mantidos em gaiolas de PVC, em sala climatizada. As larvas do predador foram individualizadas em placas de Petri e alimentadas diariamente com pulgões advindos das diferentes cultivares. Larvas que se alimentaram de indíviduos da cultivar FMT 701 apresentaram a viabilidade menor do que as que alimentaram dos afídeos criados nas cultivares Delta Opal e Acala 90. Observou-se redução do consumo diário nas larvas de terceiro ínstar que se alimentaram dos pulgões advindos da cultivar Acala 90. Consequentemente, larvas supridas com pulgões criados nas cultivares Delta Opal e Acala 90, tiveram menor peso, 3,60 e 3,90 mg respectivamente, diferindo significativamente da FMT 701. De modo geral, é possível a utilização de C. externa no controle de A. gossypii nas cultivares estudadas.

Otitis Media: Implications of Fluctuating, Conductive Hearing Loss on Learning and Behaviour in High School Age Students.

Science.gov (United States)

Stenton, Jan

This paper provides an overview of the effects of otitis media on the learning and behavior of children and youth. It begins by describing the conductive hearing loss that is caused by otitis media and the classroom behavior that can result, including poor concentration and attention, disobedience, irritability, and poor social skills. Discussed…

Nonencapsulated Streptococcus pneumoniae causes otitis media during single-species infection and during polymicrobial infection with nontypeable Haemophilus influenzae.

Science.gov (United States)

Murrah, Kyle A; Pang, Bing; Richardson, Stephen; Perez, Antonia; Reimche, Jennifer; King, Lauren; Wren, John; Swords, W Edward

2015-07-01

Streptococcus pneumoniae strains lacking capsular polysaccharide have been increasingly reported in carriage and disease contexts. Since most cases of otitis media involve more than one bacterial species, we aimed to determine the capacity of a nonencapsulated S. pneumoniae clinical isolate to induce disease in the context of a single-species infection and as a polymicrobial infection with nontypeable Haemophilus influenzae. Using the chinchilla model of otitis media, we found that nonencapsulated S. pneumoniae colonizes the nasopharynx following intranasal inoculation, but does not readily ascend into the middle ear. However, when we inoculated nonencapsulated S. pneumoniae directly into the middle ear, the bacteria persisted for two weeks post-inoculation and induced symptoms consistent with chronic otitis media. During coinfection with nontypeable H. influenzae, both species persisted for one week and induced polymicrobial otitis media. We also observed that nontypeable H. influenzae conferred passive protection from killing by amoxicillin upon S. pneumoniae from within polymicrobial biofilms in vitro. Therefore, based on these results, we conclude that nonencapsulated pneumococci are a potential causative agent of chronic/recurrent otitis media, and can also cause mutualistic infection with other opportunists, which could complicate treatment outcomes. © FEMS 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Bacterial strain changes during chronic otitis media surgery.

Science.gov (United States)

Kim, G J; Yoo, S; Han, S; Bu, J; Hong, Y; Kim, D-K

2017-09-01

Cultures obtained from pre-operative middle-ear swabs from patients with chronic otitis media have traditionally been used to guide antibiotic selection. This study investigated changes in the bacterial strains of the middle ear during chronic otitis media surgery. Pre-operative bacterial cultures of otorrhoea, and peri-operative cultures of the granulation tissue in either the middle ear or mastoid cavity, were obtained. Post-operative cultures were selectively obtained when otorrhoea developed after surgery. Bacterial growth was observed in 45.5 per cent of pre-operative cultures, 13.5 per cent of peri-operative cultures and 4.5 per cent of post-operative cultures. Methicillin-resistant Staphylococcus aureus was identified as the most common bacteria in all pre-operative (32.4 per cent), peri-operative (52.4 per cent) and post-operative (71.4 per cent) tests, and the percentage of Methicillin-resistant S aureus increased from the pre- to the post-operative period. The bacterial culture results for post-operative otorrhoea showed low agreement with those for pre-operative or peri-operative culture, and strain re-identification was required.

Cinética de la deshidratación osmótica de piña con alcohol etílico como osmodeshidratante

OpenAIRE

Zapata Montoya, José Edgar; Castro Quintero, Gilberto

1999-01-01

La deshidratación Osmótica es un método no térmico de deshidratación, que permite obtener productos de humedad intermedia, con una muy buena calidad organoléptica. Se basa en la utilización de una solución de alta presión osmótica, que al entrar en contacto con un producto le extrae el agua, debido a que esta sale para tratar de solubilizar el soluto presente en la solución externa. Muchos solutos se han ensayado como osmodeshidratantes, pero la mayoría de ellos son poco o no volátiles, por l...

Evaluación externa del desempeño en el tamizaje de bancos de sangre en Argentina: resultados y estrategias para mejorarlo

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Oknaian Sebastián

2003-01-01

Full Text Available OBJETIVOS: Debido a la falta de un programa para la evaluación externa de la calidad del tamizaje de infecciones transmisibles por transfusión (ITT en los bancos de sangre, el Servicio de Hemoterapia del Hospital Garrahan, de Buenos Aires, Argentina, inició en 1999 un programa continuo con el apoyo de la Organización Panamericana de la Salud (OPS y la Asociación Argentina de Hemoterapia e Inmunohematología (AAHI. MÉTODOS: Se distribuyó un panel de 12 muestras con reactividad para todos los marcadores tamizados en los bancos de sangre argentinos. El panel se entregó a 52, 102 y 118 laboratorios en 1999, 2000 y 2001, respectivamente. Los laboratorios participantes se clasificaron según su desempeño en: A: menos de 2 resultados positivos falsos (RPF; B: de 2 a 3 PF; C: más de 3 RPF; y D: algún resultado negativo falso. Se efectuaron talleres con los participantes para analizar conjuntamente los resultados. RESULTADOS: Los porcentajes de respuesta de cada año fueron 92,3, 92,2 y 83,9, respectivamente; estos porcentajes de respuesta indican interés en las actividades de evaluación. Sin embargo, el promedio de los laboratorios con clasificación D resultó muy alto (30%, lo que evidencia la presencia de problemas en el desempeño del tamizaje de las ITT. Esto podría asociarse con la dificultad de tomar medidas correctoras en todo el sistema, dado el elevado número de laboratorios involucrados. CONCLUSIONES: Se deben incluir evaluaciones de este tipo en el Programa Nacional de Sangre para el diagnóstico continuo de la situación, la toma de decisiones y el seguimiento de la calidad del tamizaje.

Propiedades psicométricas de la versión española de la Escala Temporal de Satisfacción con la Vida (Temporal Satisfaction With Life Scale, TSLS: Un estudio en mayores que acuden a programas universitarios

Directory of Open Access Journals (Sweden)

Laura Galiana

2015-12-01

Full Text Available Para la operacionalización del bienestar se han desarrollado un gran número de medidas, destacando la Escala de Satisfacción con la Vida (SWLS. Para paliar algunos de sus problemas, se desarrolló la Escala Temporal de Satisfacción con la Vida (TSLS. El objetivo de este estudio es la presentación y primera validación de la TSLS en su versión española, en una muestra de personas mayores que acuden a programas universitarios. La muestra estaba formada por 737 personas mayores. Además de la TSLS, se empleó un indicador de satisfacción general con la vida y la SF-8. Los análisis incluyeron estudio de la validez factorial, estimaciones de la fiabilidad y de validez externa. Los resultados del análisis factorial confirmatorio fueron adecuados: χ2 (87 = 454.593 (p < .001, CFI = .973; RMSEA = .085, mostrando la adecuación del modelo de tres dimensiones propuesto. La consistencia interna de las tres dimensiones fue alta: alfas de .83 para la satisfacción con la vida pasada, .81 para la presente y .86 para la futura. También los resultados de validez externa fueron los esperados. La TSLS incorpora el eje temporal en la medida de la satisfacción con la vida, con garantías psicométricas. Sus utilidades se comentan en la discusión.

Manejo de conductos radiculares con curvatura marcada

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Jorge Mario Nuñez Duran

2013-10-01

Full Text Available Las variaciones anatómicas en dientes con conductos que poseen dilaceraciones hacen del tratamiento de endodonciaun reto o una complicación relativa, en donde el clínico debe desarrollar toda su habilidad y el uso de instrumentosespeciales que faciliten u optimicen la terapia de conductos radiculares. La toma de radiografías previas con diferentesangulaciones y el estudio minucioso de ellas, darán una ayuda fundamental para conocer más detalladamente estacomplicación anatómica, que en algunos casos es muy frecuente. El uso de instrumental más flexible y resistentepermite llegar con mayor precisión y seguridad a la parte apical sin que se corra el riesgo de fracturar los instrumentos,limpiándolos y modelándolos en toda su extensión para poder obturarlos de una manera correcta.El uso de limas de menor calibre, precurvadas, permite acceder a la porción dilacerada de la raíz. Este es un métodoeficaz para prevenir la perdida de longitud de trabajo y evitar así las perforaciones de las raíces durante la preparación.Dentro de los errores más comunes durante la instrumentación de los conductos está la perdida de longitud detrabajo, junto con la transportación del foramen apical, ya sea de manera externa o interna. En el presente artículose menciona el uso de nuevas y mejores técnicas usadas para poder evitar este tipo de errores y se muestra un casoclínico del manejo de un molar superior con una curvatura de 40 grados que fue preparado y obturado exitosamentecon el sistema Protaper (Dentsply- maillefer.

Long-term Tympanic Membrane Pathology Dynamics and Spontaneous Healing in Chronic Suppurative Otitis Media

DEFF Research Database (Denmark)

Jensen, Ramon Gordon; Koch, Anders; Homøe, Preben

2012-01-01

BACKGROUND:: Children in the developing parts of the world have a high prevalence of chronic suppurative otitis media (CSOM). It is estimated that 65 to 330 million people worldwide have CSOM, yet very little is known about the natural course of the disease. The Inuit population of the Arctic......-based cohort of 591 children originally examined during 1993 to 1994 at 3 to 8 years of age. Follow-up was attempted among 348 individuals still living in the areas. Video otoscopy and tympanometry were used. Data on otologic disease, ear surgery, and antibiotic use for otitis media were collected from medical...... of spontaneous healing was not influenced by the age at which CSOM was diagnosed in the initial study. Thirty-nine individuals (17%) had CSOM in either the initial study or at follow-up. Of these, 2 had never received antibiotic treatment for otitis media, and 15 had been treated less than 3 times. Eighty...

Complications of otitis media - The importance of early recognition

NARCIS (Netherlands)

Albers, FWJ

Objective: The purpose of this study was to determine the factors that are important for the early diagnosis of intracranial and intratemporal complications of otitis media. Study design: The study design was a retrospective follow-up study. Setting: The study took place at a tertiary referral

Mucin production and mucous cell metaplasia in otitis media

DEFF Research Database (Denmark)

Lin, Jizhen; Caye-Thomasen, Per; Tono, Tetsuya

2012-01-01

Otitis media (OM) with mucoid effusion, characterized by mucous cell metaplasia/hyperplasia in the middle ear cleft and thick fluid accumulation in the middle ear cavity, is a subtype of OM which frequently leads to chronic OM in young children. Multiple factors are involved in the developmental...

Microbiology of chronic suppurative otitis media at Queen Elizabeth ...

African Journals Online (AJOL)

Background Chronic suppurative otitis media (CSOM) is still a significant health problem in developing countries. Therefore, it was pertinent to determine the local Malawian microbiology in order to guide adequate treatment, avoid complications, and provide records for future reference. Aim The study sought to determine ...

Microbiology of chronic suppurative otitis media at Queen Elizabeth ...

African Journals Online (AJOL)

Background. Chronic suppurative otitis media (CSOM) is still a significant health problem in developing countries. Therefore, it was pertinent to determine the local Malawian microbiology in order to guide adequate treatment, avoid complications, and provide records for future reference. Aim. The study sought to determine ...

[The observation and analysis the function and morphology of the eustachian tube in secretory otitis media and chronic rhinosinusitis in children].

Science.gov (United States)

Xia, Zhongfang; Wang, Zhinan; Xu, Zhongxiang; Cui, Long; Wei, Cuifen; Liu, Yan; Huang, Fang

2014-07-01

To observe and analyze the function and morphology of pharyngeal ostium of the eustachian tubes in secretory otitis media and chronic rhinosinusitis in children under direct vision,in order to provide an objective basis for clinical treatments. Fifty cases of secretory otitis media,50 cases of chronic rhinosinusitis and a control group of 50 cases with hoarseness were examined under video laryngoscope to observe the pharyngeal ostium morphological changes of the eustachian tubes, and their functional statuses were tested by using acoustic impedance instrument. All the data were analyzed by statistical methods. (1) In the secretory otitis group, the abnomal rate of the pharyngeal ostium of the eustachian tubes was 94% while the chronic rhinosinusitis group was 80%,and between them there was no significant differences (P > 0.05). But both of them had significant differences with the control group (P otitis group, the rate of the eustachian tube dysfunction was 70% while the chronic rhinosinusitis group was 26%, and between them there was significant differences (P otitis media and chronic rhinosinusitis in children. Eustachian tube dysfunction played a dominant role in the pathogenesis of secretory otitis media in children rather than the morphological change did compared to the chronic rhinosinusitis in children.

Perfil dos atendimentos a crianças e adolescentes vítimas de causas externas de morbimortalidade, 2000-2006 Perfil de la atención a los niños y adolescentes víctimas de causas externas de morbilidad y mortalidad, 2000-2006 Profile of care delivered to children and adolescents victims of external causes of morbidity and mortality, 2000-2006

Directory of Open Access Journals (Sweden)

Marta Angélica Iossi Silva

2010-06-01

Full Text Available As causas externas constituem importantes fatores de morbimortalidade infantil e de incapacitações permanentes em todo o mundo. Estudo descritivo, de natureza quantitativa que objetivou caracterizar os atendimentos a crianças e adolescentes, na faixa etária de zero a 19 anos, vítimas de causas externas de morbimortalidade em um hospital universitário do interior de São Paulo, Brasil, no período de 2000 a 2006. Constatou-se no período estudado 6.302 atendimentos, sendo que a maioria dos casos registrados ocorreu entre adolescentes de 15 a 19 anos, no sexo masculino, entre sábado e segunda-feira e das 19 à zero hora. O principal diagnóstico de causa externa foram os acidentes de transporte, seguidos das agressões. Conclui-se que é de fundamental importância o papel da enfermagem na atenção aos acidentes, violências e agressões junto às famílias e comunidade, contribuindo para o planejamento e desenvolvimentos de ações preventivas e assistenciais.Las causas externas se constituyen en importantes factores de morbilidad, mortalidad y discapacidad permanente en todo el mundo. Estudio cuantitativo, descriptivo y transversal, tuvo como objetivo caracterizar la atención de emergencia para niños y adolescentes con edades de cero a 19 años, víctimas de las causas externas de morbilidad y mortalidad en un hospital universitario en el interior del estado de Sao Paulo, Brasil, desde 2000 hasta 2006. Se observó durante el período de estudio 6302 de los casos, y que la mayoría de los casos notificados ocurrieron entre los adolescentes de 15 a 19 años, varones, entre el sábado y el lunes y de 19 a 00 horas. El principal diagnóstico de causa externa fueron los accidentes de transporte, seguido por agresiones. Así, es de importancia fundamental el papel de la atención de enfermería a los accidentes, la violencia y la agresión entre las familias y la comunidad, contribuyendo a la planificación y desarrollo de acciones

Tympanic membrane changes in experimental acute otitis media and myringotomy

DEFF Research Database (Denmark)

Alzbutiene, G.; Hermansson, A.; Caye-Thomasen, P.

2008-01-01

OBJECTIVE: The present experimental study explored pathomorphological changes and calcium depositions in the tympanic membrane during experimental acute otitis media caused by nontypeable Haemophilus influenzae in myringotomized and nonmyringotomized ears. MATERIAL AND METHODS: A rat model of exp...

Deleterious sucking habits and atypical swallowing in children with otitis media with effusion.

Science.gov (United States)

Ralli, Giovanni; Ruoppolo, Giovanni; Mora, Renzo; Guastini, Luca

2011-10-01

The aim of this study was to investigate the possible correlation between otitis media with effusion, bad sucking habits and atypical swallowing in children affected by otitis media with effusion. 65 children, aged from 7 to 12 years, observed in the ENT Department of the "La Sapienza" University of Rome, were enrolled in the study group (group A). All children were affected by otitis media with effusion for more than 3 months. As control group, 60 healthy children, aged from 7 to 12 years were identified (group B). All the children underwent medical history, with evaluation of the sucking habits, ENT examination, tympanometry, orthodontic examination and evaluation of swallowing. In the orthodontic examination the variables analyzed were: maximum mouth opening, right and left mandibular lateral movements and mandibular protrusion. Atypical swallowing was considered to occur when lip activity produced strong tension in the perioral musculature, and/or the tip of the tongue was placed or pushed against the anterior teeth during swallowing. In the group A, atypical swallowing was found in 33/65 subjects out of the 65 children (50.7%). In the control group (group B) 16/60 children (26.6%) showed atypical swallowing. Compared with group B, deleterious sucking habits were significantly higher (phabits were present in almost all children with atypical swallowing (28/33 in group A and 12/16 in group B). Our data suggest a correlation between otitis media with effusion, deleterious sucking habits and prevalence of atypical swallowing. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Endoscopy-Assisted Ear Surgery for Treatment of Chronic Otitis Media With Cholesteatoma, Adhesion, or Retraction Pockets.

Science.gov (United States)

Ulku, Cagatay Han

2017-06-01

The objective of this study was to analyze the results of endoscopy-assisted ear surgery for the treatment of chronic otitis media with cholesteatoma, adhesion, or retraction pockets.Fifty-one patients who underwent oto-endoscopy-assisted canal wall up tympanomastoid surgery and/or limited anterior atticotomy with tympanoplasty for chronic otitis media with cholesteatoma, adhesion, or retraction pocket from 2006 to 2013 have been included in this study. Eradication of the disease from the middle ear and mastoid air cells was achieved by combination of the oto-microscobic and oto-endoscopic approaches. Second look surgery was performed 18 months later from the initial surgery in selected patients. Age, gender, pre-/postoperative otoscopy findings/audiograms, type of the used prostheses, and follow-up time were obtained from the patient's file. Anatomic integrity rates of the tympanic membrane, the mean gains of air bone gap, on pure-tone audiogram at 4 frequencies and existence of the residual disease were reviewed parameters. Functional evaluation was made in patients with intact tympanic membrane.Of the 51 patients, the ratios of the chronic otitis media with cholesteatoma and isolated adhesive otitis or retraction pocket cases were 74.5% (38/51) and 25.5% (13/51), respectively. Ossicular chain reconstruction was made with PORP in 27 patients and TORP in 20 patients, whereas the ossicular chain was intact in 4 patients. Anatomic integrity rates of the tympanic membrane were 90.2% (46/51). The overall (n = 46) pre-/postoperative mean ABG obtained at 4 frequencies were 28.3 ± 12.26 and 9.18 ± 5.68 dB (P otitis media with cholesteatoma patients. However, there was no recurrence or new cholesteatoma formation in isolated retraction pockets or adhesive otitis patients.Oto-endoscopic eradication of the cholesteatoma or epithelial tissue from hidden area after the all visible cholesteatoma removal by oto-microscope improves the quality of surgery

Política Externa Independente: origem, desenvolvimento e colapso sob a perspectiva teórica- histórica da relação entre a política externa e a opinião pública

Directory of Open Access Journals (Sweden)

Tânia Maria P. G. Manzur

2014-12-01

Full Text Available Este artigo tem como objetivo abordar, em perspectiva histórica e teórica, a Política Externa Independente (PEI, que teve lugar no Brasil entre os anos de 1961 e 1964 e a significativa interação que se deu, na vigência da PEI, entre a opinião pública nacional e os direcionamentos da política externa. Naqueles anos, evidenciou-se uma estratégia de inserção internacional que procurou a independência e no Brasil em relação aos blocos antagônicos da Guerra Fria, tentando ampliar o leque de oportunidades para o comércio internacional e as relações políticas; o País quis se projetar como um interlocutor privilegiado entre o Norte e defendeu a existência de um sistema internacional mais justo.Naquele momento, a opinião pública movimentou-se dramaticamente em face dos temas da inserção internacional do Brasil. A relação entre a opinião pública e política externa na vigência da PEI tomou força como um dos elementos essenciais para a mudança estrutural do regime político ocorrida no Brasil em 1964.

Violencia externa en el trabajo en el sector servicios: Consideraciones generales, notificación y protocolos de actuación External violence at work in the service sector general considerations: Notification and action protocol

Directory of Open Access Journals (Sweden)

María Luisa Rodríguez de la Pinta

2011-01-01

Full Text Available La violencia en el lugar de trabajo es un fenómeno emergente que afecta a todos los sectores y categorías laborales. Su prevención y manejo exige una actuación coordinada de todas las instituciones implicadas. Partiendo de la normativa legal existente, se crea la necesidad de poner en marcha las medidas preventivas dirigidas a eliminar o minimizar el riesgo, para conseguir este objetivo se deben elaborar procedimientos de trabajo que establezcan las actuaciones a seguir ante situaciones de violencia externa, estos procedimientos son de aplicación a todos los trabajadores y tienen que ser difundidos a todos los estamentos de la empresa. La información y formación de los trabajadores en relación con este tema es otra de las medidas preventivas que hay que poner en marcha, para que estos adquieran las habilidades necesarias con el fin de evitar la violencia externa. Para conocer la dimensión exacta del problema es preciso disponer de los datos referidos a las situaciones de violencia externa que suceden en nuestra organización, por lo que es imprescindible elaborar un plan de notificación y registro.Violence in the workplace is a new problem that affects all types of sectors and professional categories. Its prevention and management requires coordinated action by all institutions involved. According to current legislation, we need to implement preventive measures to remove or minimize this risk. To achieve this goal, we must develop working procedures establishing actions to be taken in situations of external violence. These procedures should be applied to all workers and distributed to all levels in the company. The information and training of workers in relation to this subject is another of the preventive measures which have to be carried out, so that they acquire the necessary skills to avoid external violence. To know the real dimension of the problem it is necessary to record accurately all external violence situations which occur

The effect of ventilating tubes in Young children with recurrent acute otitis media

DEFF Research Database (Denmark)

Heidemann, Christian Hamilton; Homøe, Preben; Lous, Jørgen

2017-01-01

Purpose of Review. Ventilating tube treatment (VT) is a common surgical procedure in preschool children. Twenty to fifty percent of children treated with VT suffer from recurrent acute otitis media (RAOM). The aim of this review is to update current knowledge on the topic. Recent Findings. Therre...... is still controversy regarding the use of VT for children with RAOM. So far, only six randomized trials have been published. From the limited data pool, it seems that children with RAOM treated with VT experienced less time with acute otitis media and experienced less recurrence compared to controls...

A case of a temporal bone meningioma presenting as a serous otitis media

International Nuclear Information System (INIS)

Nicolay, Simon; De Foer, Bert; Bernaerts, Anja; Van Dinther, Joost; Parizel, Paul M

2014-01-01

We report the imaging features of a case of a temporal bone meningioma extending into the middle ear cavity and clinically presenting as a serous otitis media. Temporal bone meningioma extending in the mastoid or the middle ear cavity, however, is very rare. In case of unexplained or therapy-resistant serous otitis media and a nasopharyngeal tumor being ruled out, a temporal bone computed tomography (CT) should be performed. If CT findings are suggestive of a temporal bone meningioma, a magnetic resonance imaging (MRI) examination with gadolinium will confirm diagnosis and show the exact extension of the lesion

Depletion of mucosal substance P in acute otitis media

DEFF Research Database (Denmark)

Cayé-Thomasen, Per; Schmidt, Peter Thelin; Hermansson, Ann

2004-01-01

OBJECTIVE: The neuropeptide substance P (SP) is an inducer of neurogenic inflammation and bone resorption in the middle ear. Resorption of the bone tissue structures surrounding the middle ear cavity is a distinct feature of the initial stage of acute otitis media (AOM), which may be due to nerve...

Otitis Media and Learning Disabilities: More Than a Relationship?

Science.gov (United States)

Quick, Carol; Mandell, Colleen

The relationship between recurrent otitis media (middle ear infection characterized by the presence of middle ear fluid and possibly leading to a temporary conductive hearing loss) and learning disabilities (LD) is examined. Traditional treatment approaches (antibiotic medication and surgery) are reviewed. The definition of LD is presented and the…

Microbiology of chronic suppurative otitis media at Queen Elizabeth ...

African Journals Online (AJOL)

Abstract. Background. Chronic suppurative otitis media (CSOM) is still a significant health problem in developing countries. Therefore, it was pertinent to determine ..... CSOM was most prevalent in children and young adults than in older participants. This is similar to studies reported by others in India and Pakistan9,10.

Reconsidering management for otitis media with effusion in children ...

African Journals Online (AJOL)

Recent research findings have led to a more conservative approach to treatment of otitis media with effusion as opposed to previous recommendations for prompt insertion of tympanostomy tubes to avoid suspected developmental delays due to the mild conductive hearing loss. A large scale longitudinal clinical trial has ...

Otitis complicated by Jacod's syndrome with unusal facial nerve involvement: Case report and review of literature.

Science.gov (United States)

Abdulkadir, Kocer; Buket, Sanlisoy; Dilek, Agircan; Munevver, Okay; Ayse, Aralasmak

2015-04-01

Otitis media is a well-known condition and its infra-temporal and intracranial complications are extremely rare because of the widespread usage of antibiotic treatment. We report a case of 63-year-old female with complaints of right-sided facial pain and diplopia. She had a history of acute otitis media before 4 months of admission to our neurology unit. Neurological examination showed that total ophthalmoplegia with ptosis, mydriasis, decreased vision and loss of pupil reflex on the right side. In addition, there was involvement of 5th and 7th cranial nerves. Neurological and radiological follow-up examinations demonstrated Jacod's Syndrome with unusual facial nerve damage and infection in aetiology. Sinusitis is the most common aetiology, but there are a few cases reported Jacod's Syndrome originating from otitis media.

Perfil de vítimas e tratamento de lesões por causas externas segundo atendimento pelo Centro de Reabilitação Municipal de Uberlândia, MG – Causas externas e fisioterapia

Directory of Open Access Journals (Sweden)

Carla Andréa Gondim Lemos

2013-06-01

Full Text Available No Brasil, as causas externas são responsáveis por grande número de incapacidades. A maioria das pesquisas tem dado ênfase à mortalidade e à demanda de atendimentos hospitalares, pouco se sabendo sobre a evolução das vítimas não fatais. O objetivo do presente estudo foi conhecer o perfil das vítimas e as características das lesões por causas externas, o tratamento fisioterapêutico e a evolução funcional de pacientes atendidos em um centro público de reabilitação. Os dados foram colhidos, prospectivamente, por entrevistas com os pacientes que ingressaram no Centro de Reabilitação Municipal (CEREM de Uberlândia, de janeiro a julho de 2005. A maioria dos pacientes era do sexo masculino e predominaram aqueles de 20 a 59 anos, com baixas renda e escolaridade; as principais causas das lesões foram as quedas e os acidentes de trânsito; quase a metade dos eventos ocorreram em vias públicas e as fraturas foram comuns, principalmente em membros superiores. Os recursos fisioterapêuticos mais utilizados foram a cinesioterapia, a eletroterapia e a termoterapia por adição, e a maioria dos tratamentos iniciados foi concluída. O perfil dos pacientes que procuram o CEREM devido a lesões por causas externas parece refletir, sobretudo, aquele das pessoas que sofrem tais lesões. Recursos fisioterapêuticos relativamente simples mostraram-se suficientes para uma boa evolução dos pacientes.

AVALIAÇÕES CITOLÓGICAS EM OTITES CANINAS POR MALASSEZIA SPP.: ESTUDO RETROSPECTIVO

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Alessandra Melchert

2011-12-01

Full Text Available Otitis externa is a condition frequently observed in dogs at the small animal clinics. Malassezia spp. is the most frequently isolated microorganism in the ears of dogs, which is one of the major etiologic agents of ear infections. Identification of this agent may be based on fungal culture or cytology, and the first method is longer and more expensive. The aim of this study was to conduct a retrospective study of the incidence of Malassezia spp. in cases of canine otitis by cytology, in a period of five years. Ear cytology samples from 249 dogs with suspected otitis were evaluated, and were observed positive samples for Malassezia spp. in 44 cases (17.67%, among these 35 dogs (79.5% with positive cytology in both ears, and 9 dogs (20.5% were positive for Malassezia in only one ear. In conclusion, dogs with suspected otitis present high incidence of positive Malassezia spp. cytology counts. Cytology revealed to be a useful tool for diagnosis of canine ear infections involving this pathogen, representing diagnostic alternative in cases where the culture is not feasible. However, one must consider that there is no national standard cytological counting yeast cells/field set for cases of canine otitis, which may represent possible misdiagnosis.

Xylitol Syrup for the Prevention of Acute Otitis Media

Science.gov (United States)

Corwin, Michael J.; Vezina, Richard M.; Pelton, Steven I.; Feldman, Henry A.; Coyne-Beasley, Tamera; Mitchell, Allen A.

2014-01-01

BACKGROUND: Acute otitis media (AOM) is a common childhood illness and the leading indication for antibiotic prescriptions for US children. Xylitol, a naturally occurring sugar alcohol, can reduce AOM when given 5 times per day as a gum or syrup, but a more convenient dosing regimen is needed for widespread adoption. METHODS: We designed a pragmatic practice-based randomized controlled trial to determine if viscous xylitol solution at a dose of 5 g 3 times per day could reduce the occurrence of clinically diagnosed AOM among otitis-prone children 6 months through 5 years of age. RESULTS: A total of 326 subjects were enrolled, with 160 allocated to xylitol and 166 to placebo. In the primary analysis of time to first clinically diagnosed AOM episode, the hazard ratio for xylitol versus placebo recipients was 0.88 (95% confidence interval [CI] 0.61 to 1.3). In secondary analyses, the incidence of AOM was 0.53 episodes per 90 days in the xylitol group versus 0.59 in the placebo group (difference 0.06; 95% CI –0.25 to 0.13); total antibiotic use was 6.8 days per 90 days in the xylitol group versus 6.4 in the placebo group (difference 0.4; 95% CI –1.8 to 2.7). The lack of effectiveness was not explained by nonadherence to treatment, as the hazard ratio for those taking nearly all assigned xylitol compared with those taking none was 0.93 (95% CI 0.56 to 1.57). CONCLUSIONS: Viscous xylitol solution in a dose of 5 g 3 times per day was ineffective in reducing clinically diagnosed AOM among otitis-prone children. PMID:24394686

Chronic otitis media sequelae in skeletal material from medieval Denmark

DEFF Research Database (Denmark)

Qvist, M; Grøntved, A M

2001-01-01

OBJECTIVES: Chronic otitis media sequelae (COMS) have been identified in archaeological skeletal materials from various ages. COMS reflecting episodes of upper respiratory tract infection may be used as a paleopathological indicator of general health. Estimation of the frequency of COMS may...

Auditory Deprivation and Early Conductive Hearing Loss from Otitis Media.

Science.gov (United States)

Gunnarson, Adele D.; And Others

1990-01-01

This article reviews auditory deprivation effects on anatomy, physiology, and behavior in animals and discusses the sequelae of otitis media with effusion (OME) in children. Focused on are central auditory processing disorders associated with early fluctuating hearing loss from OME. (DB)

Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate: Cumulative Incidence and Outcome of the Management.

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Ungkanont, Kitirat; Boonyabut, Panrasee; Komoltri, Chulaluk; Tanphaichitr, Archwin; Vathanophas, Vannipa

2018-04-01

To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate. Retrospective cohort study in the tertiary care center. Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies. Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes. Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%). Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.

Eosinophilic Otitis Media: the Aftermath of Eosinophil Extracellular Trap Cell Death.

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Ueki, Shigeharu; Ohta, Nobuo; Takeda, Masahide; Konno, Yasunori; Hirokawa, Makoto

2017-05-01

Eosinophilic otitis media (EOM) is a refractory disease characterized by the accumulation of eosinophils in middle ear effusion and mucosa. We summarize current knowledge regarding the clinical characteristics and management of EOM. Although eosinophil activation in inflamed foci is involved in the pathogenesis of EOM, little is known about the fate of the eosinophils and aftermath of their cell death. We discuss the possibility that eosinophils undergo non-apoptotic cell death that worsens tissue damage and increases effusion viscosity. Unlike chronic otitis media, EOM is strongly associated with an allergic background. Corticosteroids are currently the only effective pharmacological treatment, and surgical intervention is often required. Mucosal eosinophils infiltrate extensively into the middle ear cavity where they are stimulated by locally produced activators including interleukin-5 and eotaxin. The eosinophils undergo cytolysis in the effusion, which represents a major fate of activated eosinophils in vivo. Recent data revealed cytolysis could be renamed as extracellular trap cell death (ETosis). ETosis represents suicidal cell death involving total cell degranulation and development of sticky chromatin structures (extracellular traps (ETs)). The characteristics of eosinophil- and neutrophil-derived ET polymers might contribute to the difference in viscosity of secretions between EOM and common chronic otitis media. The extracellular products remaining after eosinophil ETosis are an important aspect of EOM pathology. The concept of ETosis also has novel implications for potential therapeutic modalities in various eosinophilic disorders.

Causas externas e mortalidade materna: proposta de classificacao

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Mercia Maria Rodrigues Alves

2013-06-01

Full Text Available OBJETIVO: Analisar os óbitos por causas externas e causas mal definidas em mulheres em idade fértil ocorridos na gravidez e no puerpério precoce. MÉTODOS: Foram estudados 399 óbitos de mulheres em idade fértil de Recife, PE, de 2004 a 2006. A pesquisa utilizou o método Reproductive Age Mortality Survey e um conjunto de instrumentos de investigação padronizados. Foram usados como fontes de dados laudos do Instituto Médico Legal, prontuários hospitalares e da Estratégia Saúde da Família e entrevistas com os familiares das mulheres falecidas. Óbitos por causa externa na gravidez foram classificados de acordo com a circunstância da morte usando-se o código O93 e calculadas as razões de mortalidade materna antes e depois da classificação. RESULTADOS: Foram identificados 18 óbitos na presença de gravidez. A maioria das mulheres tinha entre 20 e 29 anos, de quatro a sete anos de estudo, eram negras, solteiras. Quinze óbitos foram classificados com o código O93 como morte relacionada à gravidez (13 por homicídio - O93.7; dois por suicídio - O93.6 e três mortes maternas obstétricas indiretas (uma homicídio - O93.7 e duas por suicídio - O93.6. Houve incremento médio de 35,0% nas razões de mortalidade materna após classificação. CONCLUSÕES: Os óbitos por causas mal definidas e no puerpério precoce não ocorrem por acaso e sua exclusão dos cálculos dos indicadores de mortalidade materna aumentam os níveis de subinformação.

[Quality of Life of Children with Otitis Media and Impact of Insertion of Transtympanic Ventilation Tubes in a Portuguese Population].

Science.gov (United States)

Lameiras, Ana Rita; Silva, Deodato; O Neill, Assunção; Escada, Pedro

2018-01-31

Quality of life is an important measure for health-outcome evaluation. Although otitis media is one of the most common childhood diseases, its impact on Portuguese children's quality of life is unknown. The aim of this study is to determine the quality of life of Portuguese children with chronic otitis media with effusion and/or recurrent acute otitis media and the short-term impact of transtympanic ventilation tubes, using the Portuguese version of the OM-6 questionnaire, a valid, reliable and sensitive instrument to evaluate the health-related quality of life in children with otitis media. This study was conducted in a tertiary referral center, to where children are referred from primary care and hospital pediatric consultations. The Portuguese version of the OM-6 questionnaire was applied to children with chronic otitis media with effusion and/or recurrent acute otitis media. The instrument was re-administered at two months postoperatively to a group of children who underwent tympanostomy tube placement, to evaluate the change in quality of life with the surgical procedure. The study involved a sample of 169 children, aged between 6 months and 12 years (mean: 4.20 ± 2.05 years). The average score in the survey was 3.3 ± 1.47, of a maximum of 7 (worst quality of life). The domains 'caregiver concerns', 'hearing loss' and 'physical suffering' had the highest scores. The domain 'hearing loss' was correlated with the domain 'speech impairment' (rs = 0.41; p Portuguese children quality of life. Tympanostomy tubes improve quality of life related to the middle ear in most children. The application of validated disease-specific questionnaires allows an enhanced understanding of the impact of otitis media on Portuguese children quality of life and of the success of therapeutic measures.

Comparative prevalence of otitis media in children living in urban slums, non-slum urban and rural areas of Delhi.

Science.gov (United States)

Chadha, Shelly K; Gulati, Kriti; Garg, Suneela; Agarwal, Arun K

2014-12-01

The study aimed to determine the prevalence and profile of otitis media in different parts of a city, i.e. non-slum urban areas, urban slums and rural areas. A door to door survey was conducted in identified areas of Delhi. A total of 3000 children (0-15 years) were randomly selected and examined for presence of otitis media. These children were equally distributed in the three areas under consideration. Data was analyzed to establish the prevalence of different types of otitis media. Chi-square test was then applied to compare disease prevalence among the three areas. 7.1% of the study population was identified with otitis media, which includes CSOM (4.26%), OME (2.5%) and ASOM (0.4%). In the non-slum urban parts of the city, 4.6% children had otitis media. This was significantly lower compared to 7% children in rural parts of Delhi and 9.9% in urban slums of the city. The prevalence of CSOM was considerably higher in slum areas (7.2%) as compared with rural (3%) and non-slum urban areas (2.6%). Ear infections are significantly more common in urban slums as compared to non-slum city areas and rural parts of Delhi. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Reduced Memory CD4+ T-Cell Generation in the Circulation of Young Children May Contribute to the Otitis-Prone Condition

Science.gov (United States)

Sharma, Sharad K.; Casey, Janet R.

2011-01-01

Background. An explanation for the immunologic dysfunction that causes children to be prone to repeated episodes of acute otitis media (AOM) has long been sought. Poor antibody response has been associated with the otitis-prone condition; however, there is no precise mechanistic explanation for this condition. Methods. Non–otitis-prone and otitis-prone children with AOM or nasopharyngeal (NP) colonization caused by either Streptococcus pneumoniae or Haemophilus influenzae were compared for pathogen-specific CD4+ T-helper memory responses by stimulating peripheral blood mononuclear cells using 6 vaccine candidate S. pneumoniae and 3 H. influenzae protein antigens. Samples were analyzed by multi-parameter flow cytometry. Results. Significantly reduced percentages of functional CD45RALow memory CD4+ T cells producing specific cytokines (interferon γ, interleukin [IL]–2, IL-4 and IL-17a) were observed in otitis-prone children following AOM and NP colonization with either S. pneumoniae or H. influenzae. Immunoglobulin (Ig) G responses to the studied protein antigens were reduced, which suggests that antigen-specific B-cell function may be compromised as a result of poor T-cell help. Staphylococcal enterotoxin B stimulated similar cytokine patterns in memory CD4+T cells in both groups of children. Conclusions. Otitis-prone children have suboptimal circulating functional T-helper memory and reduced IgG responses to S. pneumoniae or H. influenzae after colonization and after AOM; this immune dysfunction causes susceptibility to recurrent AOM infections. PMID:21791667

Retrospective results of radiation therapy of the Eustachian tube in chronic otitis media; Retrospektive Ergebnisse der perkutanen Strahlentherapie der Tuba Eustachii bei chronischer Otitis media

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Schultze, J.; Reinke, C.; Kimmig, B. [Klinik fuer Strahlentherapie (Radioonkologie), Universitaetsklinikum Kiel (Germany); Frese, K.A. [Klinik fuer Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitaetsklinikum Kiel (Germany)

2003-01-01

Background: The treatment results of symptomatic radiation therapy of the Eustachian tube in chronic otitis media had to be evaluated retrospectively. Patients and Methods: Between 1980 and 1997, 66 patients were referred for therapy. The median age was 58 years. In the clinical presentation, all the patients had a hearing impairment, 35 patients complained of pain, 21 had otorrhea. In their history, 20 patients indicated chronic recurrent infections. The complaints lasted for 4.7 years in the median, primary conservative (adstringentia, antibiotics) and surgical treatment (paracentesis, tympanic tubule, tympanoplastic) did not lead to lasting cure. In 40 of 66 patients, finally radiation therapy was done of both Eustachian tubes. With opposed fields and cobalt-60 photons a total dose of 6 Gy at single doses of 1 Gy, three times a week, was applied. Under the causes for exclusion of radiation therapy were non-acceptance of the patients (nine), prior radiation therapies (six) or spontaneous improvement after initial presentation in our department. The treatment results were evaluated by interviews of the patients and regular otorhinolaryngological examinations. Results: There were no side effects noticed. 28 of 40 (70%) patients reported a significant improvement that could be verified by objective otorhinolaryngological examinations. In the group of 26 nonirradiated patients, 22 could be interviewed indicating in 16 cases (72%) that the complaints were unchanged and chronic otitis media was lasting. In a subgroup analysis concerning the duration of otitis media radiation therapy proved more effective in an acute and subacute stadium of disease of up to 5 years duration, while the patients resistant to radiation therapy were entirely in a chronic stage of disease exceeding 5 years duration. (orig.) [German] Hintergrund: Die Behandlungsergebnisse der symptomatischen Radiotherapie bei chronischer Otitis media sollten retrospektiv evaluiert werden. Patienten und

Paediatric chronic suppurative otitis media in the Free State ...

African Journals Online (AJOL)

Background. Chronic suppurative otitis media (CSOM) is a chronic infection of the middle ear cleft. In sub-Saharan Africa >50% of cases occur in children <10 years of age. Objectives. To describe the otological, audiological and bacteriological findings in children with CSOM. Methods. We conducted a prospective study at ...

Ballondilatation af det eustakiske rør er ny behandling til kronisk otitis media

DEFF Research Database (Denmark)

Møller, Martin Nue; Wanscher, Jens; Larsen, Per Leganger

2014-01-01

Balloon dilation of Eustachian tube is a novel method for managing chronic ventilatory dysfunction in patients with chronic otitis media, as an alternative to classic grommet insertion. Although few retrospective studies have been conducted the method seems to be rapid, simple and safe with promi......Balloon dilation of Eustachian tube is a novel method for managing chronic ventilatory dysfunction in patients with chronic otitis media, as an alternative to classic grommet insertion. Although few retrospective studies have been conducted the method seems to be rapid, simple and safe...

Morphological evidence of biofilm formation in Greenlanders with chronic suppurative otitis media

DEFF Research Database (Denmark)

Homøe, Preben; Bjarnsholt, Thomas; Wessman, Marcus

2009-01-01

Biofilm may explain the recurrences and recalcitrant episodes of otorrhea in chronic suppurative otitis media (CSOM). This study investigates bacterial biofilm in Greenlanders with CSOM and chronic otitis media with effusion (COME). The study is partly blinded, prospective and retrospective. Six...... were analyzed with microscopy and peptide nucleic acid fluorescence in situ hybridization (PNA-FISH). Biofilm was confirmed in 83% of CSOM smears but in none of the COME smears. Mucosal biofilm was confirmed in 80% of the biopsies from adults with CSOM. This study provides direct morphological evidence...... of biofilm in samples from human CSOM. This may help to explain the microbiological mechanisms of the disease and alter the treatment strategy in the future....

Mortalidade por causas externas no estado do Rio de Janeiro no período de 1976 a 1980

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Célia Landmann Szwarcwald

1986-03-01

Full Text Available O presente trabalho teve por objetivo o de determinar as tendências da mortalidade por causas externas no período de 1976 a 1980, no Estado do Rio de Janeiro. Foram estudadas as principais causas externas de óbito e sua distribuição temporal e espacial. Os acidentes de trânsito de veículo a motor se revelaram como a principal causa externa de morte e, entre eles, os atropelamentos mostraram-se de real gravidade, sobretudo entre as crianças em idade escolar (5 a 14 anos. O estudo revelou um aumento de 70% na taxa de homicídios nos 5 anos pesquisados, e estes já se constituem no principal f ator de mortalidade entre os adultos jovens de 20 a 29 anos. Evidenciou-se, também, grande número de óbitos classificados como "lesões ignoradas se acidental ou intencionalmente infligidas", apontando para falhas no sistema de classificação dos óbitos por causas externas no Estado do Rio de Janeiro.Deaths due to accident and violent causes were studied in Rio de Janeiro, Brasil from 1976 to 1980. Spatial and time distributions of the main causes of death were analysed. Motor vehicle traffic accidents had shown to be the first cause of death, mainly among school age children (5-14 years old. An increase of 70% in homicide rates was observed and homicides are actually the first cause of death among young adults (20-29 years old. A substantial proportion of misclassifications was found, as indicated by the great number of deaths classified as ''other violences".

Association of cytokine gene polymorphisms and risk factors with otitis media proneness in children.

Science.gov (United States)

Miljanović, Olivera; Cikota-Aleksić, Bojana; Likić, Dragan; Vojvodić, Danilo; Jovićević, Ognjen; Magić, Zvonko

2016-06-01

In order to assess the association between gene polymorphisms and otitis media (OM) proneness, tumor necrosis factor alpha (TNFA) -308, interleukin (IL) 10-1082 and -3575, IL6 -597, IL2 -330, and CD14 -159 genotyping was performed in 58 OM-prone children and 85 controls who were exposed to similar number and frequency of environmental and host risk factors. The frequencies of genotypes (wild type vs. genotypes containing at least one polymorphic allele) were not significantly different between groups, except for IL10 -1082. Polymorphic genotypes IL10 -1082 GA and GG were more frequent in OM-prone children than in control group (RR 1.145, 95 % CI 1.011-1.298; p = 0.047). However, logistic regression did not confirm IL10 -1082 polymorphic genotypes as an independent risk factor for OM proneness. The present study indicates that high-producing IL10 -1082 GA/GG genotypes may increase the risk for OM proneness in its carriers when exposed to other environmental/host risk factors (day care attendance, passive smoking, male sex, respiratory infections, and atopic manifestations). This study revealed no significant independent genetic association, but the lack of breastfeeding in infancy was found to be the only independent risk factor for development of OM-prone phenotype, implying that breastfeeding had a protective role in development of susceptibility to OM. • The pathogenesis of OM is of multifactorial nature, dependent on infection, environmental factors, and immune response of the child. • Cytokines and CD14 play an important role in the presentation and clinical course of otitis media, but a clear link with otitis media proneness was not established. What is new: • This is the first clinical and genetic study on Montenegrin children with the otitis media-prone phenotype. • The study revealed that high-producing IL10 -1082 genotypes may influence otitis media proneness in children exposed to other environmental/host risk factors.

Aerobic bacteria in safe type chronic suppurative otitis media in ...

African Journals Online (AJOL)

... cefuroxime, cefaclor and ceftriaxone. Ciprofloxacin and gentamicin appear to be the best choices for empiric therapy in patients with CSOM. In contrast, the use of amoxyclav, cotrimoxazole, cefuroxime, cefaclor and ceftriaxone should be discouraged. Keywords: Aerobic bacteria, Chronic suppurative otitis media, Gezira ...

Long-term hearing outcomes after recurrent acute otitis media during early childhood.

Science.gov (United States)

Krakau, Mattias; Dagöö, Britta Rynnel; Hellström, Sten; Granath, Anna

2017-12-01

To survey long-term hearing outcomes and middle ear pathology in a 30-year follow-up in individuals with onset of recurrent acute otitis media (rAOM) before three years of age. 28 adults, aged 30.1-31.8 years, who originally - at the age of 12-32 months - participated in a study on rAOM between 1979 and 1983, were re-examined regarding self-reported ear problems, current tympanic membrane changes and audiology. Thirteen subjects had suffered from rAOM during early childhood and 15 subjects served as a control group. Recurrent acute otitis media subjects reported hearing problems comparable to those of the controls. Pure tone audiometry, at 125-8000 Hz, did not differ between groups. The rAOM group had a trend for impaired high-frequency (9000-14,000 Hz) threshold levels (9000-14,000 Hz); implying that their cochlear function seemed to have deteriorated. Adults, who suffered from recurrent acute otitis media as infants, did not show any clinically significant hearing loss for pure tone audiometry when compared to controls, but there was a trend for impaired results regarding extended high frequency audiometry (9-14 kHz). Children suffering from rAOM will be at low risk of developing hearing loss and severe middle ear disease.

Trends in broad-spectrum antibiotic prescribing for children with acute otitis media in the United States, 1998–2004

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Gambler Angela S

2009-06-01

Full Text Available Abstract Background Overuse of broad-spectrum antibiotics is associated with antibiotic resistance. Acute otitis media (AOM is responsible for a large proportion of antibiotics prescribed for US children. Rates of broad-spectrum antibiotic prescribing for AOM are unknown. Methods Analysis of the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1998 to 2004 (N = 6,878. Setting is office-based physicians, hospital outpatient departments, and emergency departments. Patients are children aged 12 years and younger prescribed antibiotics for acute otitis media. Main outcome measure is percentage of broad-spectrum antibiotics, defined as amoxicillin/clavulanate, macrolides, cephalosporins and quinolones. Results Broad-spectrum prescribing for acute otitis media increased from 34% of visits in 1998 to 45% of visits in 2004 (P Conclusion Prescribing of broad-spectrum antibiotics for acute otitis media has steadily increased from 1998 to 2004. Associations with non-clinical factors suggest potential for improvement in prescribing practice.

Fijación torácica externa con varillas metálicas en el tórax batiente

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Jean Le'Clerc Nicolás

1998-08-01

Full Text Available La terapéutica del tórax batiente en la actualidad se basa en la atención de las alteraciones ventilatorias que ocasiona la contusión pulmonar, y en la estabilización de la pared torácica. Con este último objetivo se utilizaron alambres de acero de tipo Steiman, y éstos a su vez se fijaron en bloque con unos pistones o émbolos de los que contienen los sets de fijadores externos, para constituir esto una novedad hasta donde se tiene conocimiento en el tratamiento del tórax batiente. Se trata de un método sencillo en el que se destaca entre sus ventajas el que se pueda realizar al pie de la cama del enfermo, con escaso instrumental y que se logre de inmediato corregir las alteraciones de la mecánica respiratoria, lo cual resultaría imposible el deslizamiento de los alambres con el uso del aditamento utilizadoThe therapy for flail chest is presently based on the care of respiratory disorders causing pulmonary contusion, and on the stabilization of the chest wall. To solve this last problem; Steinman-type steel wires are used and they are secured in block by pistons similar to those of external fixator sets. As far as it is known, this treatment technique of flail chest is a novelty. This is a simple method with such advantages as: it may be used bedside, requires few surgical implements and inmediately eliminates respiratory disorders. The used fitting makes the steel wire sliding impossible

Otitis Media and Speech/Language Development in Late-Talkers.

Science.gov (United States)

Paul, Rhea; And Others

This study examines otitis media as a possible factor associated with increased risk for communicative handicap in a group of children with a possible vulnerability for language delay: "late-talkers." Speech and language outcomes at ages 3 and 4 were examined in 28 late talkers and 24 children with normal language development. Late…

Human Immunodeficiency virus and invasive external otitis- A case ...

African Journals Online (AJOL)

Acute invasive external otitis is an uncommon life-threatening infection of the exteernal auditory canal (EAC), most often affecting the elderly diabetic patients. Although few reports have been made in HIV-positive/Aids patients among the caucasians. We present here a 25 year old nursing mother with a month history of ...

Occurrence and identification of yeasts in dogs external ear canal with and without otitis

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Elidiana de Bona

2012-08-01

Full Text Available Objective. To analyze the presence of yeast in the external ear canal of 116 dogs with and without a diagnosis of otitis from veterinary clinic in the Chapecó city, Santa Catarina, Brazil, and to examine the secretion of the proteinase in isolates. Materials and methods. Were collected cerumen of conduct hearing of dogs of 16 different races 71% with pendular ear type, 5% of semi-pendular and 24% of the erect type. All dogs were previously evaluated by otoscopy and grouped in dogs with and without otitis. Results. Yeasts were isolated in 44 samples (approximately 36%, where Malassezia pachydermatis was identified in 95% of samples where were observed growth of yeasts. On 20 samples the proteinase enzyme showed strong activity in 31% isolates, were 21% of the dogs with otitis tested showed high proteolytic activity. Conclusions. We observed a variation of strains of M. pachydermatis-producing enzymes. The variation in production of these enzymes is probably more associated with different response to the action of the immune system of the animal in the tissue injury.

Attention to Language in Day Care Attending Children: A Mediating Factor in the Developmental Effects of Otitis Media.

Science.gov (United States)

Feagans, Lynne V.; And Others

Three ways in which otitis media may affect development of hearing are explored. First, developmental effects may be due to illness in general; second, otitis media may cause fluctuating hearing loss which may lead to deficits in language in many areas; and, third, fluctuating hearing loss may have only a temporary effect on the acquisition of…

Pathogenic agents of chronic suppurative otitis media in Ilorin, Nigeria

African Journals Online (AJOL)

Conclusion: Chronic suppurative otitis media is still highly prevalent in our environment, affecting mainly children. The antibiotic susceptibility pattern of pathogenic isolates is different from those of other regions of Nigeria with increasing resistance recorded for some organisms. Hence, where possible and available, ...

Democratas na Presidência: qual a política externa inicial?

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Virgílio Caixeta Arraes

2009-01-01

Full Text Available

o artigo trata da política externa do Presidente

Barack Obama na Ásia. Desta forma, aborda se ela

representará uma mudança ou continuidade com

relação ao governo anterior.

A política externa cubana nos anos 90: condicionantes internos e inserção internacional

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Marcos Antonio da Silva

2014-03-01

Full Text Available O presente trabalho analisa a política externa cubana nos anos 90, depois do colapso do bloco soviético, que conduziu o país a mais grave crise econômica de sua história recente e a um relativo isolamento internacional, elementos que foram determinantes para sua reinserção internacional. A partir disto aponta que sua reinserção internacional se fundamenta na afirmação da soberania nacional, na ampliação dos atores envolvidos na formulação e execução de tal política, na busca de novos parceiros que conduziu a uma inserção pendular no cenário internacional e no desenvolvimento da diplomacia social. A pesquisa foi realizada através de levantamento e análise bibliográfica, bem como de dados indicativos da situação econômica do país e de sua inserção internacional, combinando elementos de análise quantitaviva com a qualitativa. A hipótese inicial fundamenta-se na reorientação da política externa cubana, com o fim do bloco soviético, e na sua reinserção, embora tensa, no cenário internacional determinadas pela crise interna e pelo novo contexto internacional. O levantamento de dados foi possível através de pesquisas in loco e em portais e publicações de organismos como a CEPAL (Comissão Econômica para a América Latina e ONEI (Oficina Nacional de Estadistica y Informaciones, assim como de autores dedicados ao tema. Através de análise crítica e comparativa de tais dados e informações estabelece as variáveis fundamentais e os elementos que permitem a compreensão da política externa cubana no período mencionado. Tal trabalho demonstra que a política externa cubana foi resultado da interação entre os fatores domésticos, a crise econômica e social que o país enfrentou, e de fatores internacionais. Além disto, aponta que ocorreu uma reorientação da política externa cubana com o desenvolvimento de novas estratégias e parcerias para sua reinserção internacional. Finalmente, demonstra que tal

Gradenigo's Syndrome in a Patient with Chronic Suppurative Otitis Media, Petrous Apicitis, and Meningitis.

Science.gov (United States)

Taklalsingh, Nicholas; Falcone, Franco; Velayudhan, Vinodkumar

2017-09-28

BACKGROUND Gradenigo's syndrome includes the triad of suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve. Gradenigo's syndrome is rare, and the diagnosis is easily overlooked. This case is the first to report Gradenigo's syndrome presenting with meningitis on a background of chronic suppurative otitis media (CSOM) and petrous apicitis (apical petrositis). CASE REPORT A 58-year-old male African American presented with headaches and confusion. Magnetic resonance imaging (MRI) of the head showed petrous apicitis with mastoiditis and abscess formation in the cerebellomedullary cistern (cisterna magna). The case was complicated by the development of palsy of the fourth (trochlear) cranial nerve, fifth (trigeminal) cranial nerve, and sixth (abducens) cranial nerve, with radiological changes indicating infection involving the seventh (facial) cranial nerve, and eighth (vestibulocochlear) cranial nerve. Cerebrospinal fluid (CSF) culture results were positive for Klebsiella pneumoniae, sensitive to ceftriaxone. The patient improved with surgery that included a left mastoidectomy and debridement of the petrous apex, followed by a ten-week course of antibiotics. Follow-up MRI showed resolution of the infection. CONCLUSIONS This report is of an atypical case of Gradenigo's syndrome. It is important to recognize that the classical triad of Gradenigo's syndrome, suppurative otitis media, ipsilateral sixth (abducens) cranial nerve palsy and facial pain in the distribution of the fifth (trigeminal) cranial nerve, may also involve chronic suppurative otitis media (CSOM), which may lead to involvement of other cranial nerves, petrous apicitis (apical petrositis), and bacterial meningitis.

Violencia laboral externa en el ámbito de urgencias generales del Hospital Universitario Virgen del Rocío de Sevilla

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Tatiana Chagoyen Barroso

Full Text Available Introducción: En los últimos años se ha incrementado la violencia laboral, y un sector de los más afectados es el sanitario. En la actualidad, está cobrando importancia la violencia laboral en el personal de urgencias. Las agresiones suelen ser por parte de los usuarios y, en ocasiones de sus familiares, a los profesionales de la Salud. Objetivos: Conocer si los trabajadores de Urgencias Generales del Hospital Universitario Virgen del Rocío (HUVR saben de la existencia de un plan de prevención y atención de agresiones para los profesionales del sistema público de Andalucía. Conocer agresiones no registradas hacia el personal de urgencias en HUVR. Material y métodos: Se trata de un estudio observacional, descriptivo con 221 trabajadores (68 varones y 153 mujeres, a los que se les entrega un cuestionario sobre la Violencia Laboral Externa (VLE percibida durante los 2 últimos años; se realiza un estudio descriptivo con análisis de frecuencias. Y posteriormente, se realizará test de Chi Cuadrado o prueba exacta de Fisher para ver si existe relación entre variables categóricas. Resultados: De 221 trabajadores que realizaron la encuesta, solo 26 conocen el plan de agresiones de HUVR. De 127 agresiones en los 2 últimos años, solo se registraron 13 (no existe significación estadística con sexo, edad o categoría profesional. Conclusiones: Existe infradeclaración de agresiones y un claro desconocimiento del plan de agresiones en el Hospital Universitario Virgen del Rocío.

Indicadores de vulnerabilidad al estrés en directivos y su relación con factores de estrés organizacional

OpenAIRE

Hernández Estrada, Anaisel; Díaz Rojas, Amelis

2012-01-01

El estrés es uno de los factores de riesgo más importantes para la mayoría de las enfermedades, provoca una respuesta del organismo a condiciones externas que perturban el equilibrio emocional de la persona. Sus consecuencias afectan la vida del individuo, dentro de ella, su esfera laboral, con su influencia en la efectividad productiva de los directivos de forma destacada, entorpeciendo suscapacidades para la toma de decisiones, el pensamiento flexible, la creatividad, motivación y la salud....

Cellular Immune Response in Young Children Accounts for Recurrent Acute Otitis Media

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Sharma, Sharad K.; Pichichero, Michael E.

2013-01-01

Acute otitis media (AOM) is a common disease in young children. Streptococcus pneumoniae(Spn) and Haemophilus influenzae (NTHi) are the two most common pathogens that cause AOM. Over the past 5 years our group has been studying the immunologic profile of children that experience repeated AOM infections despite tympanocentesis drainage of middle ear fluid and individualized antibiotic treatment; we call these children stringently-defined otitis-prone (sOP). Although protection against AOM is primarily mediated by ototpathogen-specific antibody, our recent studies suggest that suboptimal memory B-& T- cell responses and an immaturity in antigen presenting cells may play a significant role in the propensity to recurrent AOM infections. This review focuses on the studies performed to define immunologic dysfunction in sOP children. PMID:24022464

The Incidence of Exudative Otitis Media in HIV Infected Children

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Nuriddin U. Narzullaev, PhD

2012-09-01

Full Text Available Diseases of the ENT organs are among the commonly prevalent and dangerous pathologies of childhood, occurring as a complication of respiratory, bacterial diseases and HIV infection. One of the serious complications of HIV infection in children is the lesion of ENT organs. In HIV infected children, in addition to suppurative diseases occur middle ear diseases with nonsuppurative origin. A total of 79 HIV infected children aged 3-14 years with different pathologies of the nasal cavity, nasopharynx and paranasal sinuses were included into the current study. The control group included 20 healthy children of comparable age and sex. The survey was conducted in the ENT department of the Children’s Multi-Medical Center, in Bukhara region. Children with a diagnosis of suppurative otitis media and/or history of suppurative otitis media were not included into the study. All HIV infected children, along with physical examination, were performed ENT examination, finger study, X-ray examination of the paranasal sinuses, audiological research and impedancemetry.

Otitis media with effusion in children with in Down syndrome.

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Austeng, Marit Erna; Akre, Harriet; Øverland, Britt; Abdelnoor, Michael; Falkenberg, Eva-Signe; Kværner, Kari Jorunn

2013-08-01

To determine the prevalence of otitis media with effusion (OME) in children with Down syndrome (DS), and the associated to hearing loss at the age of 8 years. A national population based clinical study of all children with DS born in Norway in 2002. OME was found in 20 out of 52 (38%) children. Those with OME had a significant lower hearing level with a mean pure tone average (PTA) of 33.4 dB HL compared to children with no OME whose mean PTA was 21.7 dB HL (p children with DS as current otitis media was found in one of three. This reduced hearing ability in children with DS due to OME at age of 8 strongly emphasizes the need for optimal treatment and follow up to optimize hearing rehabilitation. The findings are further supported by the population based study design, the focus on the narrow age band and the high response rate. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Quality of life of children with otitis media - a cohort study

DEFF Research Database (Denmark)

Ryborg, Christina T; Søndergaard, Jens; Lous, Jørgen

2014-01-01

BACKGROUND: Studies about health-related quality of life (HRQOL) in children with otitis media have primarily focused on short-term effects of the disease, and how treatment with insertion of ventilation tubes (VTs) affects the HRQOL. More knowledge is needed about how long-term HRQOL is associated...... with different factors like insertion of VT and use of antibiotics. OBJECTIVE: We aimed to analyse HRQOL in children with otitis media 1 year after inclusion and to what extent insertion of VT, use of antibiotics, diagnoses, symptoms in the children, day-care attention, parental absence from work and parental...... was significantly improved after 13 months. The improvement of HRQOL was significantly lower for children with sleep problems compared with children without sleep problems. The improvement in HRQOL was significantly lower in children whose parents had been absent from work during the preceding 3 months due...

IgG responses to Pneumococcal and Haemophilus influenzae protein antigens are not impaired in children with a history of recurrent acute otitis media.

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Wiertsema, Selma P; Corscadden, Karli J; Mowe, Eva N; Zhang, Guicheng; Vijayasekaran, Shyan; Coates, Harvey L; Mitchell, Timothy J; Thomas, Wayne R; Richmond, Peter C; Kirkham, Lea-Ann S

2012-01-01

Vaccines including conserved antigens from Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) have the potential to reduce the burden of acute otitis media. Little is known about the antibody response to such antigens in young children with recurrent acute otitis media, however, it has been suggested antibody production may be impaired in these children. We measured serum IgG levels against 4 pneumococcal (PspA1, PspA 2, CbpA and Ply) and 3 NTHi (P4, P6 and PD) proteins in a cross-sectional study of 172 children under 3 years of age with a history of recurrent acute otitis media (median 7 episodes, requiring ventilation tube insertion) and 63 healthy age-matched controls, using a newly developed multiplex bead assay. Children with a history of recurrent acute otitis media had significantly higher geometric mean serum IgG levels against NTHi proteins P4, P6 and PD compared with healthy controls, whereas there was no difference in antibody levels against pneumococcal protein antigens. In both children with and without a history of acute otitis media, antibody levels increased with age and were significantly higher in children colonised with S. pneumoniae or NTHi compared with children that were not colonised. Proteins from S. pneumoniae and NTHi induce serum IgG in children with a history of acute otitis media. The mechanisms in which proteins induce immunity and potential protection requires further investigation but the dogma of impaired antibody responses in children with recurrent acute otitis media should be reconsidered.

IgG responses to Pneumococcal and Haemophilus influenzae protein antigens are not impaired in children with a history of recurrent acute otitis media.

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Selma P Wiertsema

Full Text Available BACKGROUND: Vaccines including conserved antigens from Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi have the potential to reduce the burden of acute otitis media. Little is known about the antibody response to such antigens in young children with recurrent acute otitis media, however, it has been suggested antibody production may be impaired in these children. METHODS: We measured serum IgG levels against 4 pneumococcal (PspA1, PspA 2, CbpA and Ply and 3 NTHi (P4, P6 and PD proteins in a cross-sectional study of 172 children under 3 years of age with a history of recurrent acute otitis media (median 7 episodes, requiring ventilation tube insertion and 63 healthy age-matched controls, using a newly developed multiplex bead assay. RESULTS: Children with a history of recurrent acute otitis media had significantly higher geometric mean serum IgG levels against NTHi proteins P4, P6 and PD compared with healthy controls, whereas there was no difference in antibody levels against pneumococcal protein antigens. In both children with and without a history of acute otitis media, antibody levels increased with age and were significantly higher in children colonised with S. pneumoniae or NTHi compared with children that were not colonised. CONCLUSIONS: Proteins from S. pneumoniae and NTHi induce serum IgG in children with a history of acute otitis media. The mechanisms in which proteins induce immunity and potential protection requires further investigation but the dogma of impaired antibody responses in children with recurrent acute otitis media should be reconsidered.

Caracterización proteómica de vesículas de membrana externa extraídas de Shigella sonnei

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María de los A Padrón-Collaz

2017-12-01

Full Text Available Las vacunas compuestas por vesículas de membrana externa (VMEs previenen de manera exitosa la enfermedad meningocócica del serogrupo B. Esta plataforma tecnológica de obtención puede ser aplicada para otros patógenos bacterianos Gram negativos. Una vacuna de VMEs desarrollada contra Shigella sonnei fue obtenida a través de una extracción de componentes celulares y su caracterización por electroforesis en geles de poliacrilamida unidimensional (1D. Se estudiaron las mejores condiciones de solubilización de las muestras, separación electroforética e identificación a través de espectrometría de masas acoplada a cromatografía de alta presión después del corte de las bandas y su tratamiento enzimático con tripsina. En esta etapa se identificaron un total de 57 proteínas en 23 bandas (2,5 proteínas por banda escindida, 47 de las proteínas no repetidas. Las proteínas inmunogénicas presentes en VMEs de S. sonnei fueron cuantificadas en cuanto a masa molecular por 1D-Western blotting en membranas de nitrocelulosa con anticuerpos obtenidos a partir de ratones inmunizados con las VMEs. Como que las bandas electroforéticas 1D contenían más de una proteína, se estudiaron las mejores condiciones de separación por el método de electroforesis bidimensional (2D para el establecimiento del mapa proteico; tal que el incremento del tamaño de las tiras, el tiempo de focalización y la aplicación catódica garantizaron la mayor resolución.

Otitis Media in Young Children: Medical, Developmental, and Educational Considerations.

Science.gov (United States)

Roberts, Joanne E., Ed.; Wallace, Ina F., Ed.; Henderson, Frederick W., Ed.

The 12 chapters of this book provide a synthesis of what is currently known about otitis media and its sequelae on aspects of child development. Chapters are grouped into four sections: definition, prevalence, and diagnosis; auditory, language, and learning sequelae; medical and surgical management; and international perspectives and future…

A mouse model of otitis media identifies HB-EGF as a mediator of inflammation-induced mucosal proliferation.

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Keigo Suzukawa

Full Text Available Otitis media is one of the most common pediatric infections. While it is usually treated without difficulty, up to 20% of children may progress to long-term complications that include hearing loss, impaired speech and language development, academic underachievement, and irreversible disease. Hyperplasia of middle ear mucosa contributes to the sequelae of acute otitis media and is of important clinical significance. Understanding the role of growth factors in the mediation of mucosal hyperplasia could lead to the development of new therapeutic interventions for this disease and its sequelae.From a whole genome gene array analysis of mRNA expression during acute otitis media, we identified growth factors with expression kinetics temporally related to hyperplasia. We then tested these factors for their ability to stimulate mucosal epithelial growth in vitro, and determined protein levels and histological distribution in vivo for active factors.From the gene array, we identified seven candidate growth factors with upregulation of mRNA expression kinetics related to mucosal hyperplasia. Of the seven, only HB-EGF (heparin-binding-epidermal growth factor induced significant mucosal epithelial hyperplasia in vitro. Subsequent quantification of HB-EGF protein expression in vivo via Western blot analysis confirmed that the protein is highly expressed from 6 hours to 24 hours after bacterial inoculation, while immunohistochemistry revealed production by middle ear epithelial cells and infiltrating lymphocytes.Our data suggest an active role for HB-EGF in the hyperplasia of the middle ear mucosal epithelium during otitis media. These results imply that therapies targeting HB-EGF could ameliorate mucosal growth during otitis media, and thereby reduce detrimental sequelae of this childhood disease.

Manejo clinicoquirúrgico de la otitis media crónica colesteatomatosa en el niño Clinical and surgical management of cholesteatomatous chronic otitis media in children

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Julianis Loraine Quintero Noa

2007-12-01

Full Text Available El tratamiento de la otitis media crónica colesteatomatosa en los niños es controversial y difícil. Nos propusimos caracterizar a pacientes pediátricos con colesteatomas extensos e infección activa, así como identificar hallazgos otoscópicos y quirúrgicos, complicaciones, microbiología, eficacia del tratamiento antimicrobiano y afectaciones funcionales auditivas. Se realizó un estudio descriptivo prospectivo con 12 pacientes, en edades entre 4 y 15 años, operados mediante técnica abierta combinada con timpanoplastia y osiculoplastia entre el 2001 y el 2004. La evolución de los pacientes fue seguida hasta los 3 años después de la cirugía. Los hallazgos más frecuentes fueron la perforación epitimpánica posterior marginal (41,6 %, lesión osicular total (50 %, facial timpánico dehiscente y erosión del canal semicircular horizontal (45,4 %. Las complicaciones intratemporales fueron las más frecuentes (50 %. Se realizó reconstrucción tímpano-osicular a 8 pacientes y los resultados auditivos fueron satisfactorios en el 66,6 %, mientras que la respuesta al antimicrobiano utilizado fue eficaz en el 100 %. El uso de la técnica quirúrgica abierta unida a una correcta estrategia antibiótica es lo indicado en los niños con colesteatomas extensos y con infección activa.The treatment of in children is controversial and difficult. We proposed ourselves to characterize pediatric patients with extensive cholesteatomas and active infection, as well as to identify otoscopic and surgical findings, complications, microbiology, efficiency of the antimicrobial treatment and functional auditive affections. A descriptive and prospective study was conducted among 12 patients aged 4-15 that were operated on by open technique combined with tympanoplasty and ossiculoplasty from 2001 to 2004. The evolution of the patients was followed during 3 years after surgery. The most common findings were posterior marginal epytimpanic perforation (41

Evaluación clínicoinmunológica de la otitis media crónica en niños

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Miriam Zaldívar Ochoa

2003-10-01

Full Text Available Se estudiaron las alteraciones clínicas inmunológicas en niños que presentan otitis media crónica (OMC, cuyo síntoma fundamental es la otorrea persistente, uni o bilateral, que tuvo sus comienzos en la mayoría de los casos en sus primeros años de vida. Se aplicaron métodos coherentes de investigación, lo que permitió llegar a algunos resultados como que el 52 % del universo estudiado presentaban déficit inmunológico, y de ellos el 76,9 % correspondió a inmunidad de tipo humoral. Estos resultados se utilizaron para orientar la acción terapéutica, y se encontraron diferencias significativas entre aquellos pacientes a los que se les aplicó tratamiento de su déficit inmunológico con alta respuesta satisfactoria, y a los que no, se les fue modificado su trastorno inmunológico.Clinical and immunological disturbances in children with chronic otitis media, whose fundamental symptom is persistent bilateral or unilateral otorrhea that mostly occured in the first years of life, were studied. Coherent research methods were implemented; this allowed achieving some results such as 52% of the studied universe had immunological deficit and 76,9% presented with humoral immunology. These results served to guide the therapeutical action. Significant differences between patients who had been applied treatment for their immune deficit with highly satisfactory response and those with immune disorder that was not solved.

Evaluación antropométrica de pacientes con fibrosis quística asociada a mutaciones genéticas

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Mirtha Rondón Peña

2014-08-01

Full Text Available Se realizó un estudio observacional y descriptivo, de corte transversal, de 19 pacientes con fibrosis quística, atendidos en consultas externas del Hospital Pediátrico Docente Provincial "Hermanos Cordové" en Manzanillo, Granma, durante el semestre de julio-diciembre del 2012, con vistas a identificar el estado nutricional de estos a partir de una evaluación antropométrica -- para lo cual se calculó el índice de Waterlow --, y luego relacionarlo con las mutaciones genéticas. Entre los resultados de la serie sobresalió que 73,7 % de los pacientes poseía peso y talla adecuados para la edad, mientras que 31,5 % fue evaluado como desnutrido. De igual modo, existió relación entre el estado nutricional y la mutación genética, y se concluyó que la mayoría de los afectados presentaba una evaluación nutricional adecuada, como consecuencia de una correcta atención multidisciplinaria

Chronic suppurative otitis media, middle ear pathology and corresponding hearing loss in a cohort of Greenlandic children

DEFF Research Database (Denmark)

Avnstorp, Magnus Balslev; Homøe, Preben; Bjerregaard, Peter

2016-01-01

BACKGROUND: Otitis media (OM) has been observed at elevated prevalence rates in Greenlandic children. OM associated hearing loss (HL) may compromise the children's linguistic skills, social development and educational achievements. OBJECTIVES: We investigated the prevalence of chronic suppurative...... otitis media (CSOM), otitis media with effusion (OME) and tympanic membrane sequelae of OM, and compared the corresponding hearing thresholds. METHODS: In 2010 we examined a cohort of 223 Greenlandic children aged 4-10 years by video otoscopy, tympanometry and tested hearing thresholds for the low......-frequencies: 500, 1000 and 2000Hz and the high-frequencies: 4000 and 6000Hz. HL was categorized according to the worst hearing ear and was compared within the groups: CSOM, OME, tympanic membrane sequelae of OM and normal. RESULTS: Of 207 children, 5.8% had CSOM, 13.9% had OME and 55.6% had tympanic membrane...

Papel de las imágenes en el enfoque diagnóstico del paciente con ictericia

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Claudia Jimena Ortiz Liévano

2012-08-01

Full Text Available La ictericia es un signo que describe la coloración amarillenta de piel, escleras y mucosas por acumulación de bilirrubina. Es causa frecuente de consulta en los servicios de urgencias y de consulta externa; de hecho, es muy frecuente en el periodo neonatal. La ictericia no es una entidad aislada sino es el reflejo de una enfermedad específica. Por tal motivo, luego de una adecuada evaluación clínica y teniendo los paraclínicos pertinentes, se inicia el estudio del cuadro por imágenes con una ecografía; según los hallazgos se continua el estudio tomografía abdominal con medio de contraste para evaluar el tracto biliar, resonancia magnética u otros métodos no invasivos según el estado del paciente y su disponibilidad. Dependiendo de los resultados es necesario continuar con colangiopancreatografía retrógrada endoscópica como método diagnóstico, terapéutico o ambos.

Molecular characterization of Malassezia sympodialis and Malassezia furfur from cattle with and without otitis Caracterização molecular de isolados de Malassezia sympodialis e Malassezia furfur provenientes de bovinos com e sem otite externa

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E.R. Duarte

2008-08-01

Full Text Available A molecular study of Malassezia strains isolated from cattle with or without otitis was carried out by random amplified polymorphic DNA analysis (RAPD. DNA was extracted and purified from nine strains of Malassezia sympodialis and fourteen of Malassezia furfur. These microorganisms were collected from eight different bovine herds in Minas Gerais state, Brazil. The RAPD analysis and phenograms did not show the formation of genetically distinct groups among the strain isolated from cattle with or without otitis raised in the same herds. Genetic heterogeneity was observed among Malassezia strains from different geographic origins. These data suggest that genetically similar M. sympodialis and M. furfur strains found as members of the normal ear microbiota could become opportunistically active in the inflammatory process in cattle.A caracterização molecular de amostras de Malassezia spp., isoladas de bovinos com e sem otite, foi realizada por meio da técnica do DNA polimórfico amplificado ao acaso (RAPD. DNAs de nove amostras de Malassezia sympodialis e quatorze de M. furfur foram extraídos e purificados. Essas amostras foram provenientes de oito diferentes rebanhos bovinos no estado de Minas Gerais, Brasil. A análise de RAPD e os fenogramas não revelaram a formação de grupos geneticamente distintos entre amostras isoladas de bovinos, criados no mesmo rebanho, com ou sem otite. Heterogeneidade genética foi observada entre amostras de diferentes origens geográficas. Os dados sugerem que isolados geneticamente semelhantes e membros da microbiota normal do ouvido podem participar, como oportunistas, no processo inflamatório do conduto auditivo externo de bovinos.

Prescripción de antibióticos en consulta externa pediátrica de un hospital de Lima, Perú

OpenAIRE

Llanos-Zavalaga, Fernando; Facultad de Salud Pública y Administración "Carlos Vidal Layseca". Universidad Peruana Cayetano Heredia, Lima, Perú.; Silva T, Enrique; Facultad de Salud Pública y Administración "Carlos Vidal Layseca". Universidad Peruana Cayetano Heredia, Lima, Perú.; Velásquez H, José; Facultad de Medicina #Alberto Hurtado". Universidad Peruana Cayetano Heredia, Lima, Perú.; Reyes L, Roberto; Facultad de Salud Pública y Administración "Carlos Vidal Layseca". Universidad Peruana Cayetano Heredia, Lima, Perú.; Mayza P, Julio; Facultad de Salud Pública y Administración "Carlos Vidal Layseca". Universidad Peruana Cayetano Heredia, Lima, Perú.

2004-01-01

Objetivo: Evaluar la proporción y calidad de la prescripción antibiótica en consulta externa del Departamento de Pediatría del Hospital Nacional Cayetano Heredia de Lima, Perú. Métodos: Se realizó un estudio transversal descriptivo entre agosto y setiembre del año 2002. La población estuvo formada por la totalidad de personas que acudieron a consulta externa. Para determinar la calidad de la prescripción se obtuvo una muestra por saturación de 164 personas. La informa- ción fue revisada y cal...

Experiencia con la fístula arteriovenosa interna para hemodiálisis periódica

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Andrés Rebollo

1971-04-01

Full Text Available Dos y medio años después de experiencia con 600 diálisis en 8 pacientes han demostrado que el uso de fístula anteriovenosa descrita por brescia es en el momento el mejor método para el acceso repetido a los vasos sanquíneos durante el tratamiento de la hemodiálisis periódica suprimiendo algunos de los inconvenientes a la cánula externa de teflón y sylastic, trombosis, embolismo pulmonar y septicemia son complicaciones previsibles en si mayor parte y debidas a fallas, mal manejo y omiciones de asepsia elemental durante las punciones.

Obtención de extractos de membrana externa de Vibrio cholerae O1, mediante el uso de diferentes detergentes

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José Luis Pérez

2006-04-01

Full Text Available En la actualidad existen dos variantes principales de vacunas orales contra el cólera: una basada en células inactivadas de diferentes biotipos y serotipos y otra basada en la administración de cepas vivas genéticamente atenuadas. Una vacuna por subunidades pudiera ser una variante muy atractiva. Este trabajo describe la purificación parcial y caracterización preliminar de extractos de proteínas de membrana externa-lipopolisacárido (PME-LPS, obtenidos a partir de Vibrio cholerae O1, con el interés de seleccionar un proteoliposoma que posteriormente será estructurado en forma de cocleatos para su uso por vía oral en humanos. Las preparaciones fueron obtenidas a través del uso de diferentes detergentes. La cantidad de LPS en cada preparación fue estimada mediante la determinación de las unidades endotóxicas en el ensayo del Limulus (LAL. La composición de cada muestra fue evaluada mediante SDS-PAGE y Dot Blot. La inoculación intranasal (IN en ratones Balb/c se utilizó para la evaluación de la inmunogenicidad de las preparaciones, y la respuesta inmune fue determinada por ELISA y el título de anticuerpos vibriocidas. El tamaño molecular de la preparación con mejores resultados en inmunogenicidad se estimó mediante la cromatografía en Sephacryl S-1000. Se obtuvieron diferentes perfiles electroforéticos de acuerdo con el tipo de detergente utilizado. El LPS fue identificado en todas las preparaciones y aquella obtenida con el SDS al 15% mostró la más baja relación proteínas/LPS y los mejores resultados en los ensayos de inmunogenicidad. Adicionalmente se comprobó que su tamaño molecular es similar al observado en el proteoliposoma de VAMENGOC- BC. La preparación obtenida con el SDS al 15% constituye un proteoliposoma, con capacidad para estimular altos niveles de anticuerpos IgG anti-LPS y altos títulos de anticuerpos vibriocidas, luego de su administración por vía intranasal en ratones. Estos resultados constituyen

Skull Base Osteomyelitis from Otitis Media Presenting as the Collet-Sicard Syndrome

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Wong-Kein Low

2018-01-01

Full Text Available Skull base osteomyelitis can involve the jugular foramen and its associated cranial nerves resulting in specific clinical syndromes. The Collet-Sicard syndrome describes the clinical manifestations of palsies involving cranial nerves IX, X, XI, and XII. We present a rare atypical case of skull base osteomyelitis originating from infection of the middle ear and causing the Collet-Sicard syndrome. Caused by Pseudomonas aeruginosa and Klebsiella pneumoniae, this occurred in an elderly diabetic man subsequent to retention of a cotton swab in an ear with chronic suppurative otitis media. This case report illustrates the possibility of retained cotton swabs contributing to the development of otitis media, skull base osteomyelitis, and ultimately the Collet-Sicard syndrome in the ears of immune-compromised patients with chronically perforated eardrums.

Otitis media aguda: nuevo enfoque terapéutico

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Ileana Alvarez Lam

2004-03-01

Full Text Available La otitis media aguda continúa siendo una de las enfermedades infecciosas más frecuentes en la infancia. Se hace una revisión del tema haciendo énfasis en la conducta terapéutica actual luego del surgimiento de complejos mecanismos de resistencia bacteriana creados por los microorganismos causantes de la enfermedad. Como toda enfermedad infecciosa las esperanzas están cifradas en el surgimiento de una vacuna que impacte de forma positiva en nuestra población infantil. En tal sentido se hace una reflexión sobre el uso de la vacuna antineumocócica de 7 valencias (Prevnar y su repercusión sobre esta enfermedad.Acute otitis media is still one of the most common infectious diseases among children. A review of the topic is made giving emphasis to the present therapeutic conduct after the appearance of complex mechanisms of bacterial resistance created by the microorganisms causing the disease. As in every infectious disease, we place our hopes on the emergence of a vaccine with a positive impact on our infantile population. In this sense, a reflection is made on the use of the heptavalent antipneumococcic vaccine (Prevnar and its repercussion on this disease.

La Gestión de la Comunicación Externa Online con los Visitantes en los Museos y Centros de Arte en Málaga / The Online External Communication Management with the Visiting Public in Museums and Art Centers in Málaga

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Ana Soler Humanes

2013-12-01

Full Text Available La siguiente investigación analiza la gestión de la comunicación externa online con el público visitante en los museos y centros de arte malagueños, centrándose en el uso de páginas web y plataformas 2.0 para cumplir sus objetivos. La muestra abarca a los tres museos más visitados de Málaga: Museo Picasso, Museo Carmen Thyssen y Centro de Arte Contemporáneo (CAC. Los resultados obtenidos prueban que la comunicación de los museos en internet continúa manteniendo un carácter tradicional, si bien se observan claros avances en la adaptación al entorno digital. / The following research analyses the management of the online external communication with the visiting public in museums and art centers in Málaga, focusing on the use of web pages and 2.0 platforms to attain their objectives. The sample includes the three most visited museums in Málaga: Picasso Museum, Carmen Thyssen Museum and the Contemporary Art Center (CAC. The results show that communication online of the museums keeps being traditional, although there is a clear progress in adapting to the digital environment.