Otitis Media: Inflammation of the MIDDLE EAR including the AUDITORY OSSICLES and the EUSTACHIAN TUBE.Otitis Media with Effusion: Inflammation of the middle ear with a clear pale yellow-colored transudate.Pleural Effusion: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself.Otitis Media, Suppurative: Inflammation of the middle ear with purulent discharge.Ear, Middle: The space and structures directly internal to the TYMPANIC MEMBRANE and external to the inner ear (LABYRINTH). Its major components include the AUDITORY OSSICLES and the EUSTACHIAN TUBE that connects the cavity of middle ear (tympanic cavity) to the upper part of the throat.Otitis Externa: Inflammation of the OUTER EAR including the external EAR CANAL, cartilages of the auricle (EAR CARTILAGE), and the TYMPANIC MEMBRANE.Pericardial Effusion: Fluid accumulation within the PERICARDIUM. Serous effusions are associated with pericardial diseases. Hemopericardium is associated with trauma. Lipid-containing effusion (chylopericardium) results from leakage of THORACIC DUCT. Severe cases can lead to CARDIAC TAMPONADE.Pleural Effusion, Malignant: Presence of fluid in the PLEURAL CAVITY as a complication of malignant disease. Malignant pleural effusions often contain actual malignant cells.Middle Ear Ventilation: Ventilation of the middle ear in the treatment of secretory (serous) OTITIS MEDIA, usually by placement of tubes or grommets which pierce the TYMPANIC MEMBRANE.Chinchilla: A genus of the family Chinchillidae which consists of three species: C. brevicaudata, C. lanigera, and C. villidera. They are used extensively in biomedical research.Eustachian Tube: A narrow passageway that connects the upper part of the throat to the TYMPANIC CAVITY.Otitis: Inflammation of the ear, which may be marked by pain (EARACHE), fever, HEARING DISORDERS, and VERTIGO. Inflammation of the external ear is OTITIS EXTERNA; of the middle ear, OTITIS MEDIA; of the inner ear, LABYRINTHITIS.Otoscopy: Examination of the EAR CANAL and eardrum with an OTOSCOPE.Haemophilus influenzae: A species of HAEMOPHILUS found on the mucous membranes of humans and a variety of animals. The species is further divided into biotypes I through VIII.Culture Media: Any liquid or solid preparation made specifically for the growth, storage, or transport of microorganisms or other types of cells. The variety of media that exist allow for the culturing of specific microorganisms and cell types, such as differential media, selective media, test media, and defined media. Solid media consist of liquid media that have been solidified with an agent such as AGAR or GELATIN.Mastoiditis: Inflammation of the honeycomb-like MASTOID BONE in the skull just behind the ear. It is usually a complication of OTITIS MEDIA.Acoustic Impedance Tests: Objective tests of middle ear function based on the difficulty (impedance) or ease (admittance) of sound flow through the middle ear. These include static impedance and dynamic impedance (i.e., tympanometry and impedance tests in conjunction with intra-aural muscle reflex elicitation). This term is used also for various components of impedance and admittance (e.g., compliance, conductance, reactance, resistance, susceptance).Haemophilus Infections: Infections with bacteria of the genus HAEMOPHILUS.Pneumococcal Infections: Infections with bacteria of the species STREPTOCOCCUS PNEUMONIAE.Acute Disease: Disease having a short and relatively severe course.Tympanic Membrane: An oval semitransparent membrane separating the external EAR CANAL from the tympanic cavity (EAR, MIDDLE). It contains three layers: the skin of the external ear canal; the core of radially and circularly arranged collagen fibers; and the MUCOSA of the middle ear.Exudates and Transudates: Exudates are fluids, CELLS, or other cellular substances that are slowly discharged from BLOOD VESSELS usually from inflamed tissues. Transudates are fluids that pass through a membrane or squeeze through tissue or into the EXTRACELLULAR SPACE of TISSUES. Transudates are thin and watery and contain few cells or PROTEINS.Tympanic Membrane Perforation: A temporary or persistent opening in the eardrum (TYMPANIC MEMBRANE). Clinical signs depend on the size, location, and associated pathological condition.Moraxellaceae Infections: Infections with bacteria of the family MORAXELLACEAE.Labyrinthitis: Inflammation of the inner ear (LABYRINTH).Streptococcus pneumoniae: A gram-positive organism found in the upper respiratory tract, inflammatory exudates, and various body fluids of normal and/or diseased humans and, rarely, domestic animals.Moraxella (Branhamella) catarrhalis: Gram-negative aerobic cocci of low virulence that colonize the nasopharynx and occasionally cause MENINGITIS; BACTEREMIA; EMPYEMA; PERICARDITIS; and PNEUMONIA.Nasopharynx: The top portion of the pharynx situated posterior to the nose and superior to the SOFT PALATE. The nasopharynx is the posterior extension of the nasal cavities and has a respiratory function.Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat.Amoxicillin-Potassium Clavulanate Combination: A fixed-ratio combination of amoxicillin trihydrate and potassium clavulanate.Cholesteatoma, Middle Ear: A mass of KERATIN-producing squamous EPITHELIUM that resembles an inverted (suck-in) bag of skin in the MIDDLE EAR. It arises from the eardrum (TYMPANIC MEMBRANE) and grows into the MIDDLE EAR causing erosion of EAR OSSICLES and MASTOID that contains the INNER EAR.Tuberculosis, Pleural: Tuberculosis of the serous membrane lining the thoracic cavity and surrounding the lungs.Lymphoma, Primary Effusion: A rare neoplasm of large B-cells usually presenting as serious effusions without detectable tumor masses. The most common sites of involvement are the pleural, pericardial, and peritoneal cavities. It is associated with HUMAN HERPESVIRUS 8, most often occurring in the setting of immunodeficiency.Adenoids: A collection of lymphoid nodules on the posterior wall and roof of the NASOPHARYNX.Ear Diseases: Pathological processes of the ear, the hearing, and the equilibrium system of the body.Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to AMPICILLIN except that its resistance to gastric acid permits higher serum levels with oral administration.Tympanoplasty: Surgical reconstruction of the hearing mechanism of the middle ear, with restoration of the drum membrane to protect the round window from sound pressure, and establishment of ossicular continuity between the tympanic membrane and the oval window. (Dorland, 28th ed.)Otoscopes: Instruments designed to inspect or auscultate the ear. They are designed primarily to examine the outer ear canal and tympanic membrane by means of light and air under moderate pressure, as with a pneumatic otoscope. (UMDNS, 1999)Mastoid: The posterior part of the temporal bone. It is a projection of the petrous bone.Hearing Loss: A general term for the complete or partial loss of the ability to hear from one or both ears.Respiratory Tract Infections: Invasion of the host RESPIRATORY SYSTEM by microorganisms, usually leading to pathological processes or diseases.Sulfisoxazole: A short-acting sulfonamide antibacterial with activity against a wide range of gram- negative and gram-positive organisms.Diagnostic Techniques, Otological: Methods and procedures for the diagnosis of diseases of the ear or of hearing disorders or demonstration of hearing acuity or loss.Earache: Pain in the ear.Adenoidectomy: Excision of the adenoids. (Dorland, 28th ed)Recurrence: The return of a sign, symptom, or disease after a remission.Ear Canal: The narrow passage way that conducts the sound collected by the EAR AURICLE to the TYMPANIC MEMBRANE.Pericardiocentesis: Puncture and aspiration of fluid from the PERICARDIUM.Cardiac Tamponade: Compression of the heart by accumulated fluid (PERICARDIAL EFFUSION) or blood (HEMOPERICARDIUM) in the PERICARDIUM surrounding the heart. The affected cardiac functions and CARDIAC OUTPUT can range from minimal to total hemodynamic collapse.Pneumococcal Vaccines: Vaccines or candidate vaccines used to prevent infections with STREPTOCOCCUS PNEUMONIAE.Neisseriaceae Infections: Infections with bacteria of the family NEISSERIACEAE.Anti-Bacterial Agents: Substances that reduce the growth or reproduction of BACTERIA.Pleura: The thin serous membrane enveloping the lungs (LUNG) and lining the THORACIC CAVITY. Pleura consist of two layers, the inner visceral pleura lying next to the pulmonary parenchyma and the outer parietal pleura. Between the two layers is the PLEURAL CAVITY which contains a thin film of liquid.Vaccines, Conjugate: Semisynthetic vaccines consisting of polysaccharide antigens from microorganisms attached to protein carrier molecules. The carrier protein is recognized by macrophages and T-cells thus enhancing immunity. Conjugate vaccines induce antibody formation in people not responsive to polysaccharide alone, induce higher levels of antibody, and show a booster response on repeated injection.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Hearing Tests: Part of an ear examination that measures the ability of sound to reach the brain.Child Day Care Centers: Facilities which provide care for pre-school and school-age children.Empyema, Pleural: Suppurative inflammation of the pleural space.Sinusitis: Inflammation of the NASAL MUCOSA in one or more of the PARANASAL SINUSES.Subdural Effusion: Leakage and accumulation of CEREBROSPINAL FLUID in the subdural space which may be associated with an infectious process; CRANIOCEREBRAL TRAUMA; BRAIN NEOPLASMS; INTRACRANIAL HYPOTENSION; and other conditions.Azithromycin: A semi-synthetic macrolide antibiotic structurally related to ERYTHROMYCIN. It has been used in the treatment of Mycobacterium avium intracellulare infections, toxoplasmosis, and cryptosporidiosis.Cefaclor: Semisynthetic, broad-spectrum antibiotic derivative of CEPHALEXIN.Mucous Membrane: An EPITHELIUM with MUCUS-secreting cells, such as GOBLET CELLS. It forms the lining of many body cavities, such as the DIGESTIVE TRACT, the RESPIRATORY TRACT, and the reproductive tract. Mucosa, rich in blood and lymph vessels, comprises an inner epithelium, a middle layer (lamina propria) of loose CONNECTIVE TISSUE, and an outer layer (muscularis mucosae) of SMOOTH MUSCLE CELLS that separates the mucosa from submucosa.Hearing Loss, Conductive: Hearing loss due to interference with the mechanical reception or amplification of sound to the COCHLEA. The interference is in the outer or middle ear involving the EAR CANAL; TYMPANIC MEMBRANE; or EAR OSSICLES.Pleurodesis: The production of adhesions between the parietal and visceral pleura. The procedure is used in the treatment of bronchopleural fistulas, malignant pleural effusions, and pneumothorax and often involves instillation of chemicals or other agents into the pleural space causing, in effect, a pleuritis that seals the air leak. (From Fishman, Pulmonary Diseases, 2d ed, p2233 & Dorland, 27th ed)Disease Models, Animal: Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.Audiometry: The testing of the acuity of the sense of hearing to determine the thresholds of the lowest intensity levels at which an individual can hear a set of tones. The frequencies between 125 and 8000 Hz are used to test air conduction thresholds and the frequencies between 250 and 4000 Hz are used to test bone conduction thresholds.Bacterial Infections: Infections by bacteria, general or unspecified.Xylitol: A five-carbon sugar alcohol derived from XYLOSE by reduction of the carbonyl group. It is as sweet as sucrose and used as a noncariogenic sweetener.Nasopharyngeal Diseases: Pathological processes involving the NASOPHARYNX.Ascitic Fluid: The serous fluid of ASCITES, the accumulation of fluids in the PERITONEAL CAVITY.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Mass Media: Instruments or technological means of communication that reach large numbers of people with a common message: press, radio, television, etc.Otologic Surgical Procedures: Surgery performed on the external, middle, or internal ear.Pleural Cavity: Paired but separate cavity within the THORACIC CAVITY. It consists of the space between the parietal and visceral PLEURA and normally contains a capillary layer of serous fluid that lubricates the pleural surfaces.Hydrothorax: A collection of watery fluid in the pleural cavity. (Dorland, 27th ed)Drainage: The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.Myringoplasty: Surgical restoration of a perforated tympanic membrane by grafting. (Dorland, 28th ed.)Paracentesis: A procedure in which fluid is withdrawn from a body cavity or organ via a trocar and cannula, needle, or other hollow instrument.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Antibodies, Bacterial: Immunoglobulins produced in a response to BACTERIAL ANTIGENS.Pericarditis: Inflammation of the PERICARDIUM from various origins, such as infection, neoplasm, autoimmune process, injuries, or drug-induced. Pericarditis usually leads to PERICARDIAL EFFUSION, or CONSTRICTIVE PERICARDITIS.Ear Ossicles: A mobile chain of three small bones (INCUS; MALLEUS; STAPES) in the TYMPANIC CAVITY between the TYMPANIC MEMBRANE and the oval window on the wall of INNER EAR. Sound waves are converted to vibration by the tympanic membrane then transmitted via these ear ossicles to the inner ear.Streptolysins: Exotoxins produced by certain strains of streptococci, particularly those of group A (STREPTOCOCCUS PYOGENES), that cause HEMOLYSIS.Chylothorax: The presence of chyle in the thoracic cavity. (Dorland, 27th ed)Cefuroxime: Broad-spectrum cephalosporin antibiotic resistant to beta-lactamase. It has been proposed for infections with gram-negative and gram-positive organisms, GONORRHEA, and HAEMOPHILUS.Infant, Newborn: An infant during the first month after birth.Facial Paralysis: Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. FACIAL NERVE DISEASES generally results in generalized hemifacial weakness. NEUROMUSCULAR JUNCTION DISEASES and MUSCULAR DISEASES may also cause facial paralysis or paresis.Haemophilus Vaccines: Vaccines or candidate vaccines containing antigenic polysaccharides from Haemophilus influenzae and designed to prevent infection. The vaccine can contain the polysaccharides alone or more frequently polysaccharides conjugated to carrier molecules. It is also seen as a combined vaccine with diphtheria-tetanus-pertussis vaccine.Human bocavirus: A member of the family PARVOVIRIDAE, subfamily PARVOVIRINAE, originally isolated from human nasopharyngeal aspirates in patients with respiratory disease.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Cerumen: The yellow or brown waxy secretions produced by vestigial apocrine sweat glands in the external ear canal.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Herpesvirus 8, Human: A species in the genus RHADINOVIRUS, subfamily GAMMAHERPESVIRINAE, isolated from patients with AIDS-related and "classical" Kaposi sarcoma.Culture Media, Conditioned: Culture media containing biologically active components obtained from previously cultured cells or tissues that have released into the media substances affecting certain cell functions (e.g., growth, lysis).Ascites: Accumulation or retention of free fluid within the peritoneal cavity.

Middle ear fluid cytokine and inflammatory cell kinetics in the chinchilla otitis media model. (1/256)

Streptococcus pneumoniae is the most frequent microbe causing middle ear infection. The pathophysiology of pneumococcal otitis media has been characterized by measurement of local inflammatory mediators such as inflammatory cells, lysozyme, oxidative metabolic products, and inflammatory cytokines. The role of cytokines in bacterial infection has been elucidated with animal models, and interleukin (IL)-1beta, IL-6, and IL-8 and tumor necrosis factor alpha (TNF-alpha) are recognized as being important local mediators in acute inflammation. We characterized middle ear inflammatory responses in the chinchilla otitis media model after injecting a very small number of viable pneumococci into the middle ear, similar to the natural course of infection. Middle ear fluid (MEF) concentrations of IL-1beta, IL-6, IL-8, and TNF-alpha were measured by using anti-human cytokine enzyme-linked immunosorbent assay reagents. IL-1beta showed the earliest peak, at 6 h after inoculation, whereas IL-6, IL-8, and TNF-alpha concentrations were increasing 72 h after pneumococcal inoculation. IL-6, IL-8, and TNF-alpha but not IL-1beta concentrations correlated significantly with total inflammatory cell numbers in MEF, and all four cytokines correlated significantly with MEF neutrophil concentration. Several intercytokine correlations were significant. Cytokines, therefore, participate in the early middle ear inflammatory response to S. pneumoniae.  (+info)

Pneumococcus activation of the 5-lipoxygenase pathway and production of glycoproteins in the middle ear of rats. (2/256)

Pneumococcal otitis media is associated with the production of potent inflammatory mediators (leukotrienes), but the mechanism by which pneumococcus induces production of leukotrienes in the middle ear is poorly understood. In this study, up-regulation of 2 genes that govern the lipoxygenase pathway, cPLA2 and 5-LOX, was observed in rats following inoculation of pneumococcus into the middle ear cavity. Expression of cPLA2 was low, and 5-LOX gene expression was not detected in control animals. Up-regulation of cPLA2 and 5-LOX in middle ear epithelial cells was accompanied by an increase of high-molecular-weight glycoproteins in middle ear fluid and cells. These findings suggest that pneumococcus activates the lipoxygenase pathway by up-regulating expression of the cPLA2 and 5-LOX genes. This, in turn, may stimulate synthesis and secretion of high-molecular-weight glycoproteins that facilitate production of fluid in the middle ear cleft.  (+info)

Interpretation of middle ear fluid concentrations of antibiotics: comparison between ceftibuten, cefixime and azithromycin. (3/256)

AIMS: The aim of this study was to determine the potential influence of variables such as the cell content in the fluid, and serum levels, on the concentrations of ceftibuten, cefixime and azithromycin in the middle ear fluid of patients suffering from acute otitis media. METHODS: This randomized, open study compared the penetration of ceftibuten (9 mg kg(-1) 18 patients), cefixime (8 mg kg(-1), 16 patients) and azithromycin (10 mg kg(-1) 16 patients) into the intracellular and extracellular compartments of middle ear fluid of 50 paediatric patients (aged 8-14 years) with acute otitis media. Middle ear fluid was extracted by tympanocentesis 4, 12 and 24 h after dosing and divided into two fractions: with cells (as collected) (C+) and cell-free (C-). Antibiotics were assayed in C+ and C- samples by h.p.l.c. RESULTS: Ceftibuten achieved greater penetration into middle ear fluid than cefixime and azithromycin. Higher concentrations of ceftibuten (CTB) and cefixime (CFX) were found in the C- fraction (CTB: 4h 13.3+/-1.86; 12h 4.7+/-1.18; 24h 0.5+/-0.2. CFX: 4h 3.2+/-1.4; 12h 1.5+/-0.5; 24h>(0.1 mgl(-1)) than in the C+ fraction (CTB:4 h 8.4+/-4.3; 12 h 2.88+/-1.19; 24 h 0.3+/-0.27. CFX: 4 h 1.2+/-0.6; 12 h 0.8+/-0.2; 24 h>0.1 mg l(-1)) at the each time point, while the opposite was true for azithromycin (C-: 4 h 0.11+/-0.04; 12 h 0.12+/-0.08; 24 h 0.23+/-0.12. C+: 4 h 0.38+/-0.24; 12 h 0.9+/-0.03; 24 h 1.05+/-0.3 mg l(-1)). CONCLUSIONS: This study demonstrates that the penetration of antibiotics into the middle ear fluid is influenced by its serum concentrations as well as by the cell content in the fluid. Ceftibuten achieved higher middle ear fluid concentrations than cefixime in C+ and C- fractions at all time points. Both ceftibuten and cefixime concentrations are negatively influenced by the cell content in the fluid. In contrast the concentration of azithromycin to the middle ear fluid is positively influenced by the cell content in the fluid.  (+info)

Protection against development of otitis media induced by nontypeable Haemophilus influenzae by both active and passive immunization in a chinchilla model of virus-bacterium superinfection. (4/256)

Three separate studies, two involving active-immunization regimens and one involving a passive-transfer protocol, were conducted to initially screen and ultimately more fully assess several nontypeable Haemophilus influenzae outer membrane proteins or their derivatives for their relative protective efficacy in chinchilla models of otitis media. Initial screening of these antigens (P5-fimbrin, lipoprotein D, and P6), delivered singly or in combination with either Freund's adjuvant or alum, indicated that augmented bacterial clearance from the nasopharynx, the middle ears, or both anatomical sites could be induced by parenteral immunization with P5-fimbrin combined with lipoprotein D, lipoprotein D alone, or the synthetic chimeric peptide LB1 (derived from P5-fimbrin), respectively. Data from a second study, wherein chinchillas were immunized with LB1 or lipoprotein D, each delivered with alum, again indicated that clearance of nontypeable H. influenzae could be augmented by immunization with either of these immunogens; however, when this adjuvant was used, both antibody titers in serum and efficacy were reduced. A third study was performed to investigate passive delivery of antisera directed against either LB1, lipoprotein D, nonacylated lipoprotein D, or a unique recombinant peptide designated LPD-LB1(f)2,1,3. The last three antiserum pools were generated by using the combined adjuvant of alum plus monophosphoryl lipid A. Passive transfer of sera specific for LB1 or LPD-LB1(f)2,1,3 to adenovirus-compromised chinchillas, prior to intranasal challenge with nontypeable H. influenzae, significantly reduced the severity of signs and incidence of otitis media which developed (P +info)

Complement activation and expression of membrane regulators in the middle ear mucosa in otitis media with effusion. (5/256)

The aetiopathogenesis of chronic otitis media with effusion (OME) in children is not yet fully understood. OME is characterized by metaplasia of the epithelium and accumulation of sticky, glue-like effusion in the middle ear containing different mediators of inflammation, including activation fragments of the complement system. Here we examined whether the fluid phase complement activation is reflected in the middle ear mucosa and how the mucosa is protected against the cytolytic activity of complement. Mucosal biopsies from 18 middle ears of children with a history of chronic OME were taken. The biopsies were analysed by immunofluorescence microscopy after staining for complement fragments iC3b/C3c, C3d and C9, and regulators membrane cofactor protein (MCP; CD46), decay-accelerating factor (DAF; CD55) and protectin (CD59). There was a strong staining for iC3b/C3c, and a weaker one for C3d and C9 on the surface of the middle ear epithelial cells of OME patients but not in controls without OME. MCP was expressed on the hyperplastic three to four outer cell layers of the epithelium, while CD59 was expressed throughout the middle ear mucosa. The results suggest a strong ongoing complement activation and consequent inflammation in the middle ear cavity. Unrestricted complement damage of the epithelial lining is prevented by the strong expression of MCP and CD59.  (+info)

Accumulation of factors influencing children's middle ear disease: risk factor modelling on a large population cohort. (6/256)

STUDY OBJECTIVES: Data were analysed from a large national birth cohort to examine cumulative and interactive prediction from various risk factors for childhood middle ear disease, and to resolve conflicting evidence arising from small and incompletely controlled studies. The large sample size permitted appropriate covariate adjustment to give generality, and permit demographic breakdown of the risk factors. SETTING: A large multi-purpose longitudinal birth cohort study of all births in the UK in one week in 1970, with multiple questionnaire sweeps. PARTICIPANTS: Over 13,000 children were entered into the original cohort. Data on over 12,000 children were available at the five year follow up. MAIN OUTCOME MEASURES: For children at 5 years, parent reported data were available on health and social factors including data on two markers for middle ear disease: the occurrence of purulent (nonwax) ear discharge and suspected or confirmed hearing difficulty. MAIN RESULTS: In those children who had ever had reported hearing difficulty (suspected or confirmed), after control for socioeconomic status, three of the classic factors (male sex, mother's smoking habits since birth, and attending day care) were significantly more frequent. In those who had ever had ear discharge reported, only mother's smoking habit since birth was significantly more frequent. However, it showed an orderly dose response relation. In addition, a derived general child health score was found to be significantly associated with both the middle ear disease markers. Control for this variable in the analysis of those having reported hearing difficulty reduced the effect size of mother's smoking habit, but it remained statistically significant. For reported ear discharge, even after control for the general health score and social index, mother's smoking habits and day care attendance were both significant predictors. Mother's (but not father's) smoking habits and day care attendance were found to be significant risk factors for middle ear disease. Breast feeding effects were weak and did not generally survive statistical control. CONCLUSIONS: A child having all three risk factors (attends day care, a mother who smokes, and male sex) is 3.4 times more likely to have problems with hearing than a child who has none, based on cumulative risk. Further studies should focus on preventative risk modification and well specified intervention.  (+info)

Antimicrobial treatment of an experimental otitis media caused by a beta-lactamase positive isolate of Haemophilus influenzae. (7/256)

A gerbil model of otitis media induced by a beta-lactamase producing and non-serotypeable isolate of Haemophilus influenzae was used to assess the in-vivo efficacy of co-amoxiclav and cefuroxime at low (5 mg/kg) and high (20 mg/kg) doses. The MIC of the antibiotics tested against the pathogen was 1 mg/L (1/0.5 mg/L for co-amoxiclav). The organism was inoculated (+/-10(6) cfu) by transbullar challenge directly in the middle ear and antibiotic treatment was commenced 2 h post-inoculation and continued at 8 h intervals for three doses. Only high dose co-amoxiclav significantly reduced the number of culture-positive specimens as compared with untreated animals or with other treatment groups (91.7% as compared with 36.7% for high dose cefuroxime). The results obtained in any treatment group were related to middle ear antibiotic level/MIC. Antibiotic concentrations in the middle ear 90 min after administration were about 10% of serum levels at 15 min, probably related to a slight inflammatory response. Only after high dose co-amoxiclav did the concentration in the middle ear exceed the MIC by a factor of four. In otitis media with effusion, if indicated, antibiotics active in vitro should be administered in high doses and, to avoid side effects, probably in short courses.  (+info)

Middle ear effusion: rate and risk factors in Australian children attending day care. (8/256)

There have been no previous longitudinal studies of otitis media conducted in non-Aboriginal Australian children. This paper describes the rate and risk factors for middle ear effusion (MEE) in children attending day care in Darwin, Australia. A prospective cohort study of 252 children under 4 years was conducted in 9 day care centres over 12 fortnights between 24 March and 15 September 1997. Tympanometry was conducted fortnightly and multivariate analysis used to determine risk factors predicting MEE. The outcome of interest was the rate of type B tympanograms per child detected in either ear at fortnightly examinations. After adjusting for clustering by child, MEE was detected on average 4.4 times in 12 fortnights (37% of all examinations conducted). Risk factors associated with presence of effusion were younger age, a family history of ear infection, previous grommets (tympanostomy tubes), ethnicity and the day care centre attended. A history of wheeze appeared protective. These effects were modest (RR 0.57-1.70). Middle ear effusion is very common in children attending day care in Darwin. This has clinical importance, since MEE during early childhood may affect optimal hearing, learning and speech development. There is little scope for modification for many of the risk factors for MEE predicted by this model. Further study of the day care environment is warranted.  (+info)

  • A1 - Bernstein,J M, PY - 1993/9/1/pubmed PY - 1993/9/1/medline PY - 1993/9/1/entrez SP - 611 EP - 20 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 109 IS - 3 Pt 2 N2 - Otitis media with effusion is the most common cause of hearing loss in children today. (unboundmedicine.com)
  • In this study, researchers also discovered that various of inflammatory mediators such as histamine have been detected in middle ear effusions of the children who had OME [Arch Otolaryngol Head Neck Surg 1988;114:1131- (pachaworld.org)
  • For acute otitis externa, administer OTIPRIO as a single 0.2 mL (12 mg) administration to the external ear canal of each affected ear of patients aged 6 months and older. (drugs.com)
  • Figure 1: Preparation and dosing directions for Acute Otitis Externa and for Otitis Media with Effusion. (drugs.com)
  • In a single randomized, sham controlled Phase 3 clinical trial, 259 pediatric and adult patients with acute otitis externa were treated with OTIPRIO or sham administered by a healthcare professional to the external ear canal as a single dose (0.2 mL to each affected ear). (drugs.com)
  • The diagnosis of acute otitis media (AOM) should be made in children who present with moderate to severe bulging of the tympanic membrane (TM) or new onset of ottorhea not due to acute otitis externa or mild bulging of the TM and recent (less than 48 hours) onset of ear pain or intense erythema of the TM. (aafp.org)
  • The safety and effectiveness of OTIPRIO in infants below six months of age have not been established for the treatment of pediatric patients with bilateral otitis media with effusion undergoing tympanostomy tube placement and acute otitis externa. (otiprio.com)
  • An open, pragmatic, randomized trial by Williamson et al also supported the efficacy of autoinflation, finding that in children with otitis media with effusion, it cleared effusions and improved symptoms. (medscape.com)
  • Children with otitis media with effusion will be treated with osteopatic cranial techniques or with a placebo treatment. (clinicaltrials.gov)
  • To identify subgroups of children with otitis media with effusion (OME) that might benefit more than others from treatment with ventilation tubes. (bmj.com)
  • It aims to improve hearing and quality of life in children with otitis media. (nice.org.uk)
  • Abdelshafy IA, Atalla AT, AbdELAziz AE, Shehata WM, Gendy OAE (2015) Pepsinogen Assay as a Marker of Reflux in Children with Otitis Media with Effusion. (medcraveonline.com)
  • abstract = "Although previous studies have shown that prostaglandins (PGs), leukotrienes (LTs), and other arachidonic acid (AA) metabolites play an important role in the pathogenesis of otitis media with effusion (OME), the exact role of each AA metabolite in OME is still unknown. (elsevier.com)
  • A. Prevalence, features of the clinical course and effectiveness of the surgical treatment of otitis media with effusion in children: Abstract of PhD Thesis. (ijbm.org)
  • Abstract Introduction Otitis media with effusion (OME) is a leading cause of hearing impairment in children . (bvsalud.org)
  • Neither the affected children nor their parents describe reports referable to a middle ear effusion in 40-50% of documented cases of otitis media with effusion. (medscape.com)
  • Objective: To investigate, in cases of otitis media with effusion (OME), the correlation of the TM color changes with the presence and viscosity of the effusion in the middle ear. (bezmialem.edu.tr)
  • Pharmacologic management of otitis media with effusion (OME) includes administration of antimicrobial agents, steroids, antihistamines and decongestants, and mucolytics. (medscape.com)
  • The guideline, The Diagnosis and Management of Otitis Media , was developed by the American Academy of Pediatrics and endorsed by the American Academy of Family Physicians. (aafp.org)
  • Objectives The objective of this research is to assess the efficacy of intratympanic (IT) steroids injection for management of otitis media with effusion (OME). (bvsalud.org)
  • Erdivanli OC, Coskun ZO, Kazikdas KC, Demirci M. Prevalence of Otitis Media with Effusion among Primary School Children in Eastern Black Sea, in Turkey and the Effect of Smoking in the Development of Otitis Media with Effusion. (medscape.com)
  • This report examines the role of immunoglobulin E-mediated hypersensitivity in the development of otitis media with effusion. (unboundmedicine.com)
  • Objectives: To study whether cyclooxygenase 2 (COX-2) plays a role in the development of otitis media with effusion (OME). (elsevier.com)
  • Age plays a factor in the development of otitis media. (sfsu.edu)
  • Skeletal changes play an important part in the development of otitis media. (sfsu.edu)
  • The guideline, Otitis Media with Effusion , was updated by the American Academy of Otolaryngology-Head and Neck Surgeons and endorsed by the American Academy of Family Physicians. (aafp.org)
  • The surgical insertion of Ventilation Tubes (VTs) for the management of persistent bilateral Otitis Media with Effusion (OME) in children remains a contentious issue due to the varying opinions regarding the risks and benefits of this procedure. (biomedcentral.com)
  • The treatment of pediatric patients with bilateral otitis media with effusion undergoing tympanostomy tube placement. (drugs.com)
  • For bilateral otitis media with effusion, administer OTIPRIO as a single intratympanic administration of one 0.1 mL (6 mg) dose into each affected ear of pediatric patients (6 months of age and older), following suctioning of middle ear effusion. (drugs.com)
  • In two randomized, sham-controlled Phase 3 clinical trials, 530 pediatric patients with bilateral otitis media with effusion undergoing tympanostomy tube placement were treated with OTIPRIO or sham administered intratympanically as a single dose. (drugs.com)
  • Examination revealed dehydration, bilateral otitis media, and normal respiratory function. (cdc.gov)
  • The purpose of this study is to identify the relation between the types of immune cells in otitis media with effusion (OME) and tympanostomy tube otorrhea (TTO) in children. (bvsalud.org)
  • Similar to isolates from acute otitis media, the most common are S. pneumoniae, H. influenzae, and M. catarrhalis, but the latter two organisms are more commonly isolated than pneumococcus.4 Resistance rates of these organisms are similar to rates found when these bacteria cause acute otitis media. (mussenhealth.us)
  • Several investigators have reported mixed results when attempting to determine if autoinflation, compared with no intervention, improves effusion clearance rates. (medscape.com)
  • To assess the effectiveness of autoinflation compared with no treatment in children and adults with otitis media with effusion. (edu.au)
  • However, because of the low cost and absence of adverse effects it is reasonable to consider autoinflation whilst awaiting natural resolution of otitis media with effusion. (edu.au)
  • Forty three patients with congenital nasolacrimal duct obstruction were examined by an E.N.T. specialist in Prince Ali Hospital for presence or absence of otitis media with effusion to investigate the association, if any, between otitis media with effusion and congenital nasolacrimal duct obstruction along with its impact on prognosis. (iasj.net)
  • OME is more common than AOM (acute otitis media), and may be caused by viral upper respiratory infections, allergies, or exposure to irritants (such as cigarette smoke). (sharecare.com)
  • Clinical research is providing evidence that children who inhale secondhand smoke may have a higher incidence of health problems such as upper respiratory infections, otitis media, tonsillitis, aggravation of chronic respiratory conditions, and sudden infant death syndrome. (bmj.com)
  • OSTRICH is a randomised controlled trial for otitis media with effusion (OME) in children, to determine the clinical and cost effectiveness of a short course of oral steroids. (biomedcentral.com)
  • Adults with otitis media with effusion report aural fullness and/or pressure, an ear being plugged, or decreased hearing. (medscape.com)
  • Adenoids and tonsils can be removed if they cause chronic otitis media, which is more common in children than in adults. (hse.ie)