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1
Sánchez, Castañeda Luis Alberto. "Factores asociados en la recidiva de la otitis media crónica en pacientes reoperados en el Servicio de ORL, Hospital Nacional 2 de Mayo." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2004. https://hdl.handle.net/20.500.12672/2007.
Full textAbstract:
La OMC patología común en países subdesarrollados conlleva a elevar los gastos tanto de los sectores públicos como privados del sector salud, debido sobre todo a ser una patología con tratamiento quirúrgico. Así la reintervención quirúrgica en dichos pacientes por recidiva de la enfermedad, es decir nueva presencia de perforación timpánica elevaría en mayor medida el gasto tanto económico como social al comportarse como una enfermedad con un fondo discapacitante.
Por tal motivo la finalidad de la presente tesis es determinar los factores asociados a la recidiva de la OMC en pacientes reoperados, lo cual nos permitirá tenerlos en cuenta en futuras intervenciones quirúrgicas sobre todo a aquellos pacientes que se intervienen por primera vez, conllevando a una disminución en los costos hospitalarios y reincorporación del paciente al sector productivo.Tesis de segunda especialidad
2
Tasker, Andrea. "Otitis media with effusion : key factors." Thesis, University of Newcastle Upon Tyne, 2003. http://hdl.handle.net/10443/1075.
Full textAbstract:
Otitis media with effusion (OME) is a disease characterised by inflammation of the middle ear and changes in middle ear mucosa from a columnar to a more secretory type epithelium, with a proliferation of goblet cells and mucus glands. There is excessive production of mucus, resulting in the accumulation of a viscous effusion in the middle ear cleft. Various factors have been implicated in the aetiology of the disease including bacteria, Eustachian tube dysfunction, allergy and craniofacial abnormalities. It has been suggested that laryngopharyngeal reflux could be an inflammatory co-factor and possible cause of many upper respiratory disorders including OME. The aims of this thesis were to examine effusions for the presence of gastric juice and were also concerned with the biochemical and rheological characterisation of effusions. Acidic proteinase (pepsin) activity measured at pH2.2 using the N-terminal assay was detected in 29% of effusions and 91% of these samples contained pepsin/pepsinogen protein at elevated levels compared to serum (using an ELISA). As other serum protein levels in effusions were of the same order as serum reference levels, the source of the activity was unlikely to be from a transudate of plasma and rather due to the reflux of gastric contents into the middle ear. The data suggests that reflux may be a primary factor in the initiation of OME in children. Middle ear effusions are mucin-rich secretions that demonstrate a lack of degradation on storage. They contained at least two distinct mucin populations, MUC5B is the major mucin and MUC5AC is present at much lower levels. MUC5B had a significant correlation with effusion specific viscosity suggesting that it is responsible for the rheological properties of the effusion. Interleukin-8 (IL-8) levels in effusions had significant correlation with MUC5AC and it may be that MUC5AC is produced in response to IL-8 in the middle ear during the inflammatory process of glue ear. Neither IL-6 nor IL-8 levels correlated with MUC5B content. It is likely that a different stimulus or other cytokine is responsible for the regulation of MUCSB. There was a significant correlation between IL-6 and IL-8 levels in effusions demonstrating that one cytokine could stimulate the secretion of the other. Further studies developing from the work presented in this thesis would involve analysis of effusions for other components of gastric juice, such as gastric lipase and intrinsic factor, to confirm the role of reflux in OME. A study following children from the diagnosis stage through the disease course and grommet insertion for glue ear with awareness of signs and symptoms of reflux would assess the proportion of children with glue ear associated with reflux. An animal model for reflux could be set up, instilling gastric juice components into the middle ear via the nasopharynx/ET to see if an effusion develops. Effusions could be analysed for other cytokines (such as IL-10 or TNF-a) to see if levels correlate with MUC5B content.
3
Peer, Lindsay. "Dyslexia, multilingual speakers and otitis media." Thesis, University of Sheffield, 2003. http://etheses.whiterose.ac.uk/14728/.
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Current theories for the underlying causes of dyslexia highlight the role of phonological difficulties in the period of initial schooling. Both magnocellular and cerebellar deficit theories attempt to explain these difficulties in terms of abnormal brain function at birth. However, there is a dearth of evidence relating to the pre-school years. Intrigued by the difficulties of my own children, who had otitis media (OM) at an early age, I determined to assess the incidence and impact of OM in bilingual and multilingual children with reading difficulties. Over a period of eight years, data was collected for the first study on a sample of 1000 bi/multilingual children and adults who were referred for assessment due to identified difficulties along the dyslexia continuum. Of these, 703 had experienced serious bouts of OM and 297 had not. A 70% rate of occurrence is far beyond other incidence figures internationally - a highly significant finding. Having identified the existence of OM in the cohort, in the next two studies I investigated the impact of the condition. The studies were based on work with 63 of the 1000 families, and the teachers of their children. In no case was a connection made between hearing difficulties at a young age and later learning problems. This was echoed in conversation with those working in ENT who advised GPs on outcomes. There were several findings, which were highly significant for the OM group as opposed to those without OM considering the fact that the group, as a whole, was dyslexic. These were in areas of reading, writing, speed of processing, rote learning, lack of hearing in ax noisy background, anxiety and poor behaviour. It became evident from the results of the studies that there is a prospect of identifying needs of dyslexic children, if there is a background of OM. A fourth study was directed at 74 dyslexic adults from a bi/multilingual background and asked for their perspectives based on specific difficulties experienced by them in the learning process. The findings are novel in that they suggest that there is a potentially large group of dyslexic children who may not suffer from abnormal brain function at birth, but rather suffer from a phonological and speed disorder that is actually acquired in early childhood via OM. The' research has significant implications at theoretical, diagnostic and policy levels.
4
Ngo, Chinh Chung. "Microbiology and Immunology of Otitis Media." Thesis, Griffith University, 2016. http://hdl.handle.net/10072/365263.
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Background
Over 80% of children experience acute otitis media (AOM) at least once during childhood, with 10-30% of children experiencing recurrent episodes of AOM (RAOM) or persistence of fluid in the middle ear (ME) lasting greater than 3 months which is defined as chronic otitis media with effusion (COME). Microbial infection remains the main cause of AOM, however the causes of RAOM and COME are not fully understood. Heavy loads of microbial colonisation and bacterial/viral interaction in the upper respiratory tract (URT) contribute to OM pathogenesis. It is currently unclear whether compromised host immune system responses have a significant role in RAOM/COME. Bacterial biofilms within the ME may contribute to otopathogen persistence and recurrent infection and/or inflammation in these children.
Aims
This study identified the predominant bacterial and viral otopathogens within the URT and ME, of children undergoing ventilation tube insertion (VTI) for RAOM/COME. Bacterial persistence within the ME, in the form of biofilms was also examined. Bacteria and viruses which were identified within the URT of children with RAOM/COME were compared to a control group of children who were undergoing adenoidectomy for treatment of adenoidal hypertrophy (AH) and/or obstructive sleep apnoea (OSA).
Local (saliva, middle ear effusion (MEE)) and systemic (serum) innate and adaptive immune responses were examined in children with and without RAOM/COME. Specific antibody levels to bacterial proteins as well as cytokine levels were determined. Systemic immuno-gene expression was compared between children with RAOM/COME and AH/OSA.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medical Science
Griffith Health
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5
Gutiérrez, Elescano Willy Héctor. "Valoración preoperatoria como pronóstico en los pacientes con Otitis Media Crónica en el Servicio de Otorrinolaringología del Hospital Dos de Mayo." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2003. https://hdl.handle.net/20.500.12672/1932.
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DESCRIPCIÓN DEL PROBLEMA: El Servicio de Otorrinolaringología atiende en consulta externa alrededor de 60 a 70 pacientes diarios, de los cuales el 30% tiene Otitis Media Crónica. Generalmente el tiempo de enfermedad que presentan los pacientes están comprendidos entre 05 y 45 años. La mayoría de pacientes requieren intervención quirúrgica, por lo cual es importante la VALORACIÓN PREOPERATORIA como pronóstico en los pacientes que serán sometidos a SOP. Cabe destacar, que los pacientes que acuden al hospital son de condición económica baja y hacen el esfuerzo posible para operarse, sin embargo, los resultados postoperatorios no suelen ser óptimos dando como consecuencia abandono del paciente al tratamiento a seguir y probables complicaciones óticas.
Nosotros, como médicos tratantes, sufrimos decepciones en cuanto a los resultados postoperatorios alcanzados, al no poder solucionar el problema de salud como estaba planificado y eso indudablemente se debe a una serie de factores que debemos tener en cuenta al realizar la valoración preoperatoria como pronóstico de cada paciente.
HIPOTESIS: La adecuada valoración preoperatoria del paciente con Otitis Media Crónica en el Servicio de Otorrinolaringología del Hospital Nacional Dos de Mayo determinará el Pronóstico postoperatorio del paciente.
OBJETIVOS:
1.OBJETIVO GENERAL:
Determinar factores de mal pronóstico en pacientes postoperados de Otitis Media Crónica en el Servicio de Otorrinolaringología del Hospital Nacional Dos de Mayo.
2.OBJETIVOS ESPECIFICOS:
- Identificar los pacientes de Otitis Media Crónica.
- Identificar y describir signos y síntomas frecuentes de los pacientes que son sometidos a operación.
- Clasificar a los pacientes que serán sometidos a SOP según la clasificación de pronóstico de Bellucci.
- Comparar los criterios de valoración preoperatoria con resultados del postoperatorio.
- Analizar la congruencia de la valoración preoperatoria con resultados del postoperatorio.Tesis de segunda especialidad
6
Crompton, Michael. "Edison : a novel model of otitis media." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:1e13bb89-893e-434e-acc1-f39d0563d6cb.
Full textAbstract:
Otitis media (OM) is characterised by inflammation of the middle ear and is a common cause of conductive hearing impairment that places a substantial social, medical and economic burden on healthcare systems globally. Despite the importance of the disease, the aetiology of chronic middle ear inflammatory disease remains poorly understood. The development and persistence of chronic OM is multi-factorial with a significant genetic component. A new mouse model of chronic OM, edison, was generated by N-ethyl-N-nitrosourea (ENU) mutagenesis and discovered in a recessive screen at MRC Harwell. Homozygous edison mice have craniofacial abnormalities, an emphysema-like lung phenotype and spontaneously develop a conductive hearing loss at 28 days as measured by ABR. Histological analysis shows the hearing loss is associated with the development of chronic OM in the middle ear, characterised by mucosal inflammation and highly cellular ear exudates. Similar to the Jeff and Junbo mutants, edison shows raised levels of Vegfa, Tnfα and Il-1β in middle ear fluids. A putative functional mutation was identified, resulting in a missense Leu972Pro change in a relatively unknown gene, Nischarin (Nisch). The identification of additional ENU-induced Nisch alleles, and subsequent characterisation, validated Nisch as the causative gene in edison. NISCH selectively binds ITGA5, which is thought to have a role in modulating VEGF signalling through SRC and FAK kinases. A significant genetic interaction between Nisch and Itga5 exists and impacts upon development of chronic OM. Mice heterozygous for Itga5-null and homozygous for edison alleles show a significantly increased penetrance and severity of chronic OM. Analysis of downstream pathways suggests that the edison allele is impacting upon both RAC1 and TGF-β/SMAD signalling. I also explored the potential use of the edison mouse as a model for bacterial challenge with the human otopathogen, NTHi. Similar to the Junbo infection model at MRC Harwell, the edison mouse was identified as a robust OM model for bacterial NTHi infection. The edison mouse highlights a new candidate gene for susceptibility to chronic OM and will provide further insight into the genetic pathways and pathogenic processes involved in chronic OM.
7
Mulay, Apoorva. "The role of BPIFA1 in otitis media." Thesis, University of Sheffield, 2016. http://etheses.whiterose.ac.uk/15844/.
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Otitis Media (OM) is the most common paediatric disease and a leading cause of conductive hearing impairment. This multifactorial disease shows significant involvement of innate immunity genes and epithelial abnormalities are also commonly implicated. BPIFA1, a member of BPI fold containing family of putative innate defence proteins, is one of the most abundant secretory proteins in the upper airways and SNPs in BPIFA1 have been associated with OM susceptibility. Recent studies suggest that BPIFA1 plays a pleiotropic host defense role. This thesis describes experiments aimed at investigating the role of BPIFA1 in protection of the middle ear and in the development of OM. Bpifa1-/- mice do not spontaneously develop OM and do not demonstrate increased nasopharyngeal carriage of the human otopathogen, NTHi. However, deletion of Bpifa1 in Junbo (Evi1Jbo/+) mice, an established model of chronic OM, leads to significant exacerbation of OM severity and ME mucosal thickness. This thesis also describes the development of a novel in vitro model of the murine middle ear epithelium. Using a combination of transcriptional and proteomic approaches, I demonstrate that the model closely mimics the native middle ear epithelium and differentiates into ciliated cells, goblet cells and secretory cells and also supports infection by NTHi. Attempts were made to recapitulate the OM phenotype in vitro using this culture system. Overall, the data from this thesis indicate that BPIFA1 is involved in maintaining homeostasis within the middle ear under steady state conditions through nonspecific defence of the middle ear mucosa. Loss of BPIFA1 in presence of infection or inflammation increases the sensitivity of the epithelium and leads to an exacerbated host defence response and excessive epithelial remodelling. Furthermore, the novel in vitro culture system can be applied as an effective tool to study the interaction between the middle ear epithelium and various otopathogens.
8
Saleh, Nadeh S., and n/a. "Characterisation of the immune response in otitis media." University of Canberra. Applied Science, 2002. http://erl.canberra.edu.au./public/adt-AUC20061107.163007.
Full textAbstract:
Acute otitis media is the most common illness diagnosed during early childhood that
can cause significant morbidity (Brook, 1994) and sometimes can cause irreversible
sequelae such as a hearing defect and subsequent learning difficulties (Klein, 1994). The
aims of the research presented here were to study some aspects of the middle ear
defence mechanisms in both immune and non-immune rats following experimental
otitis media (OM) with two pathogens nontypeable Haemophilus influenzae (NTHi) and
Moraxella catarrhalis (M. catarrhalis). This study also aimed at developing a suitable
technique for preparing immunohistochemical staining of middle ear sections (chapter
2).
A previous study has shown that a regime where rats received an IPP immunisation
combined with an IT boost was effective in enhancing clearance of a middle ear
infection with the same strain of NTHi and also in the presence of a concomitant viral
infection (Moore et al, 2001). Results of this study have shown that for NTHi infection
a distinct cellular influx to the middle ear in the immune rats was accompanied by an
enhanced bacterial clearance compared to the non-immunised rats (chapter 3). This
cellular influx was responsible for the remarkable reduction in the bacterial number.
The sharp decline in PMNs numbers in the NTHi immunised rats that followed
complete bacterial clearance at 72h post infection (Table 3.1) indicate a more
effectively controlled down regulation of this cell infiltrate than the non-immunised rats.
For M. catarrhalis infection, there was no difference in cell infiltrate between immune
and non-immune rats, but enhanced clearance of the bacteria were observed for the
immune animals.
The histopathological changes in the middle ear mucosa of rats with experimentally
induced infection were studied to provide a better understanding about the distribution
of the inflammatory cells and changes in the mucosa during the first 24h post challenge
with NTHi and M. catarrhalis (Chapter 4). These changes have not been previously
studied for the two pathogens at 24h post challenge in rats. Induced infections with the
two pathogens were found to produce similar histopathological changes but more
inflammatory infiltration was observed within the infected mucosa with NTHi than that
seen with M. catarrhalis. The infections were characterized by increased thickness of
the middle ear mucosa, Eustachian tube mucosa, periosteum and tympanic membrane.
There was also an increase in the number and size of small blood vessels at all sites, and
these small blood vessels seem to be the source of the inflammatory infiltration into the
middle ear mucosa and middle ear cavity during the infection. These findings provided
an essential background to the immunohistochemical study.
The effect of mucosal immunisation on the distribution of CD4+T cells and CD8+T
cells has not been investigated previously. Results of the present study (Chapter 5) show
the pattern of distribution of these cells during the first 48h post infection with NTHi in
the rat. The number of CD4+and CD8+T cells peaked at 24h post infection in the nonimmunised
animal and were highest at 48h post-infection in the immunised rats. The
difference in response in the immunised rats may represent regulation of the
inflammatory response by the immune system. The inflammatory response regulation is
indicated by the difference in cellular influx into the immune rats and the response in
the immune rats that corresponds to enhanced bacterial clearance prior to a decrease in
numbers of inflammatory cells once the bacteria was no longer detected (Chapter 3).
This resolution of the inflammatory mass would reduce the opportunity for continued
damage to local tissue. These changes are also supported by the reduction in the
thickness of the middle ear mucosa of the immunised rats especially at 24h and 48h
post-infection (Chapter 5).
This study has shown that there are distinct differences in the rate of bacterial clearance
and cellular changes in the middle ear mucosa and tympanic bulla in immunised rats
during a middle ear infection. Future studies are still required to gain a better
understanding of differences in the inflammatory response for both pathogens, NTHi
and M. catarrhalis.
9
Wilson, Rachel. "The developmental consequences of otitis media with effusion." Thesis, University of Oxford, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273453.
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10
Lynn, Timothy Forest. "Otitis media and language development in late talkers." PDXScholar, 1990. https://pdxscholar.library.pdx.edu/open_access_etds/4100.
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While there is agreement in the literature that otitis media is an extremely prevalent disorder among young children, there is disagreement as to the effect that otitis media has on language development. The lack of definitive research attests to the complexity of the issue and to the need for continued research.
This study examined the relationship between an early history of otitis media and the language development of a group of "late talkers". The 28 toddlers in this group, while otherwise normal, were late to begin to speak. Each of the subjects was placed into one of two subgroups, depending upon their reported experience with otitis media. When the children were four years old, they were evaluated using the TOLD-P and a spontaneous speech sample. A similar group of 25 children who had a history of normal language development was also examined.
11
Kruse, Sigrid. "Otitis media bei Kindern : homöopathische Therapie versus konventionelle Therapie /." Stuttgart : Hippokrates-Verl, 1998. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=007947336&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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12
Larsson, Christina. "Stiffness changes of the tympanic membrane in otitis media /." Stockholm : [Karolinska institutets bibl.], 2002. http://diss.kib.ki.se/2002/91-7349-224-8/.
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13
Blomgren, Karin. "Diagnosis of acute maxillary sinusitis and acute otitis media." Helsinki : University of Helsinki, 2003. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/blomgren/.
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Bailey, Nancy J. "The experiences of latency age chldren with interminttent, fluctuating hearing problems." Click here for text online. The Institute of Clinical Social Work Dissertations website, 1995. http://www.icsw.edu/_dissertations/bailey_1995.pdf.
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Dissertation (Ph.D.) -- The Institute for Clinical Social Work, 1995.A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy.
15
Melhus, Åsa. "Haemophilus influenzae-induced acute otitis meida aspects of virulence and protection in an animal model /." Lund : Dept. of Medical Microbiology, Malmö General Hospital and the Dept. of Oto-Rhino-Laryngology, Lund University Hospital, Lund University, 1997. http://catalog.hathitrust.org/api/volumes/oclc/39676933.html.
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16
Bastos, Inga. "Otitis media and hearing loss among children in developing countries." Malmö : Oto-Rhino-Laryngology, Malmö General Hospital, 1994. http://books.google.com/books?id=U7psAAAAMAAJ.
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17
Gurr, André. "Ziliäre Schlagfrequenz der Mittelohrmukosa bei sekretorischer Otitis Media bei Kindern." [S.l. : s.n.], 1999. http://deposit.ddb.de/cgi-bin/dokserv?idn=959804102.
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Gündug, Ufuk. "Immunhistochemische Untersuchungen zum Knochenabbau im Rahmen der epitympanalen Otitis media." [S.l.] : [s.n.], 2001. http://deposit.ddb.de/cgi-bin/dokserv?idn=965034275.
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Koivunen, P. (Petri). "Otitis media in children:detection of effusion and influence on hearing." Doctoral thesis, University of Oulu, 1999. http://urn.fi/urn:isbn:9514252314.
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Abstract
This study was undertaken to improve the diagnosis of otitis media and to investigate possible hearing loss caused by middle ear effusion (MEE) in small children.
The accuracy of minitympanometry in detecting MEE was evaluated in 162 children. The finding was compared with the amount of effusion found in myringotomy. Minitympanometry proved to be an accurate method to detect MEE in young children, the sensitivity and specificity values being 79% and 93% in cooperative children but it had no value in non-cooperative children. Minitympanometric examination could be performed successfully with good cooperation in 87% of a total of 206 children in paediatric outpatient clinic.
Impaired mobility of the tympanic membrane (TM) was the best sign of MEE in pneumatic otoscopy of 76 children, with sensitivity and specificity values of 75% and 90%, respectively.
The influence of nitrous oxide (N2O) on MEE was tested by weighting the effusion found in myringotomy during general anaesthesia with and without N2O in 39 and 37 children, respectively. The mean weight of the effusion in the oxygen-air group did not differ from the weight in the N2O group, and thus peroperative findings in myringotomy are reliable.
Studies on symptomatology and the temporal development of acute otitis media (AOM) during upper respiratory tract infection (URI) were based on three-month follow-up of 857 children. Symptoms of URI only were compared with symptoms of URI complicated by AOM in the same child in 138 children. The most important symptom associated with AOM was earache, with a relative risk of 21.3. Sore throat, night restlessness and fever at days 3-6 were also significantly associated with AOM, with relative risks of 3.2, 2.6 and 1.8, respectively. In 44 children under two years of age, earache, conjunctival symptoms and cloudy rhinitis were significantly associated with AOM.
Temporal development of AOM was assessed from 250 episodes in 184 children. Sixty-three per cent of cases of AOM occurred during the first week after the onset of URI, peaking on days 2 to 5. The onset of AOM in children with a history of recurrent episodes of AOM did not differ from that in those who had experienced only a few episodes of AOM. No individual tendency was noticed among children suffering more than one AOM episode during follow-up.
To assess the influence of the quantity and quality of MEE on hearing in small children, transient evoked otoacoustic emission (TEOAE) was performed under general anaesthesia before myringotomy in 185 ears of 102 children. Reduced TEOAEs indicating hearing loss were found in 83% of the ears with mucoid effusion and in 56% of the ears with non-mucoid effusion, the difference being statistically significant (p < 0.01). A significant negative correlation between the reproducibility of TEOAE responses and the amount of effusion was found (Spearman rank correlation coefficient r = -0.589, p < 0.001). Findings in minitympanometry correlated with the responses of TEOAE.
Although parents are able to predict AOM quite reliably, various symptoms and the duration of URI seems to be of little value in helping the diagnosis of AOM. Detection of effusion in OM may be improven by minitympanometry in cooperative children. Any kind of effusion may cause hearing loss in small children, which must be considered when treating OM.
20
Bowman, Melissa Lynne. "Biochemical characterization of Moraxella catarrhalis strains associated with Otitis media." Thesis, Georgia Institute of Technology, 2001. http://hdl.handle.net/1853/25397.
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Thompson, Paula Louise. "Effect of antibiotics for otitis media on mastoiditis in children." Thesis, University College London (University of London), 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.509403.
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Macfadyen, Carolyn Anne. "Topical treatment for chronic suppurative otitis media in developing countries." Thesis, University of Liverpool, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.425437.
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Bhutta, Mahmood F. "Genetics of chronic otitis media : a mouse to man approach." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:3dacb68a-414c-4a79-bea4-c639cc01c0ff.
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Chronic otitis media (OM) is an archetypal complex disease, which is particularly prevalent in childhood. Epidemiological data suggest high heritability for disease susceptibility, but previous genetic association studies have had methodological flaws, and none have specifically focused on chronic OM phenotypes. Mouse models represent one way to ascertain candidate loci for human association testing. A number of mouse models of middle ear inflammation have been reported, but many susceptibility loci remain undiscovered. I demonstrate that oto-endoscopy is a robust and scalable phenotyping platform for OM in the mouse, and discuss its value in new model discovery. Chronic OM is also a feature of trisomy HSA21 (Down Syndrome). Through an interrogation of the mouse library of segmental trisomy models of Down Syndrome, I identify a critical trisomic region for chronic otitis media. This region may underlie OM susceptibility in Down Syndrome, but could also contribute to disease susceptibility in non-syndromic disease. Mouse models can also be used to interrogate disease mechanisms. Our previous work has shown that the chronically inflamed middle ear is hypoxic, and that hypoxia signalling is a potential therapeutic target. Exploiting the Junbo mouse model, I demonstrate that surgical ventilation of the Junbo ear improves inflammation, and that this is associated with loss of hypoxia signalling. I present preliminary results from transcript analyses of human middle ear effusions showing marked upregulation of hypoxia signalling. A systematic review of existing mouse models suggests that the loci FBXO11, EVI1, SMAD2, and TGIF1 are good candidates genes for human association testing. I detail recruitment and collection of DNA from families in the UK where a child is undergoing grommet insertion. Association testing using a variant of the transmission disequilibrium test shows susceptibility associated with polymorphisms at FBXO11, and possibly also SMAD2 and TGIF1.
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Asche, Carl V. "Magnitude and causes of small area variation in surgical rates of myringotomy with the insertion of ventilation tube in Ontario." Thesis, University of Surrey, 2000. http://epubs.surrey.ac.uk/755037/.
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Otitis media is often treated surgically through the use of a procedure termed myringotomy with insertion of a ventilation tube (MVT). From fiscal year 1992/3 to 1997/8, some 132,000 such operations were performed in Ontario, Canada, on young people < 20 years old. This study quantifies the small area variation (SAV) in MVT surgical rates across the 49 counties and 478 postal areas of Ontario; examines the rate variation as a function of variations in physician practice style, physician supply, physician demographic characteristics, urbanrural differences, and population socio-economic status; and identifies economic and policy-related implications of SA V. Physician practice style was assessed using responses from a comprehensive provincial survey of referring physicians (OPs and paediatricians) and specialists/surgeons concerning their opinions of the indications for, and treatment of, otitis media, with particular reference to MVT surgery. Other data were obtained from physician databases and Canada census statistics. The variation in age-gender standardized MVT rate across the counties is highly statistically significant, as demonstrated by Chi-square tests, and by comparison of simulated and observed values of variation statistics (the EQ, CV, and SCV) that show much higher inter-area variation than that expected by chance alone. Multivariate regression modelling of inter-county MVT rate variation across the counties showed six variables to be significant determinants of surgical rate. MVT rate is a positive function of physician propensity to refer patients to surgeons, the percentage of North American-trained referring physicians, and the supply of paediatricians; and a negative function of the supply of surgeons, and the median licence years of referring physicians and surgeons respectively. These variables explain 74 % of the SA V in MVT rate for the 35 counties for which the regression model applies. Over 40 % of the explained variation is accounted for by differences across the counties in the propensity of physicians to refer patients to surgeons. Socio-economic status (as measured by an index of deprivation) was not a significant predictor of inter-county MVT rate. When examined at the FSA (postal forward sortation area) level within counties, the effect of socio-economic status was small overall but locally significant for five counties. Urban counties, although better equipped with medical care resources, including the supply of physicians, generally maintain lower MVT rates than rural counties. This is interpreted as being due to inter-county referral flow from rural GPs and paediatricians to specialists operating in urban counties, particularly those counties containing teaching centres and training hospitals. In addition, the higher surgical rates in rural areas are also associated with a higher percentage of North American-trained referring physicians working in such areas. The large regional variations in MVT rates, and the determinants of such variations, have implications for health care providers and policymakers. Between 1992/3 and 1997/8, the welfare loss resulting from MVT surgical rate variation that was due to variation in physician variables (physician opinion, demographics, and supply) amounted to around $7.5 Million per year (or about three-quarters of the annual MVT surgical spend). More than 40 % of the welfare loss was attributable to inter-county variation in physician propensity to refer patients to surgeons. This welfare loss could in theory be reduced by the production and dissemination of information such as clinical guidelines, aimed at modifying physician behaviour and reducing variation in physician practice style (in particular, reducing variation in physician propensity to refer). However, published findings indicate that such change strategies are generally ineffective in modifying physician behaviour.
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Barnett, Catherine Margaret Eleanor. "Association of Single Nucleotide Polymorphisms in Surfactant Protein A and D with Otitis Media." The University of Waikato, 2007. http://hdl.handle.net/10289/2338.
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Otitis Media is one of the most common childhood diseases. Recurrent acute otitis media RAOM is characterized by repeated episodes of inflammation of the middle ear in conjunction with middle ear fluid, and often with an inflamed or bulging eardrum. Defective clearance by the Eustachian tube results in mucus build-up and is characteristic of otitis media with effusion (OME). Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, respiratory syncytial virus, and rhinovirus are the most common contributors to otitis media pathogenesis. In New Zealand, OME has been implicated with conductive hearing loss in childhood and has been shown to significantly impact on speech and language development. New Zealand Māori and Polynesian children have displayed significantly higher hearing test failure rates than European-Caucasian children. The collectins, Surfactant Protein (SP)-A and -D are encoded by three genes (SP-A1, SP-A2, and SP-D) and are host defense proteins present in the middle ear and Eustachian tube. Single nucleotide polymorphisms (SNPs) in SP-A1 and SP-A2 have been associated with increased or decreased susceptibility to otitis media, meningococcal disease, and range of respiratory diseases. Using allele-specific primers and real-time PCR with SYBR Green I melting curve analysis, four groups of individuals were genotyped for eleven SP-A1, SP-A2, and SP-D SNPs: European-Caucasian individuals with RAOM/OME; New Zealand Māori/Polynesian individuals with RAOM/OME; individuals with meningococcal disease; and a control group. The computer program, Haploview, was employed to perform χ2 analyses and identify statistically significant associations of alleles/haplotypes with RAOM/OME or meningococcal disease. In the European-Caucasian population, two SP-A1 alleles, one SP-A2 allele, and four haplotypes (CGAGC, 1A3, 1A9, and 1A10) were found to be associated with increased risk of RAOM/OME (P lt; 0.05). Conversely, haplotypes 6A2 and 1A2 were found to be protective against susceptibility to RAOM/OME (P lt; 0.05). In New Zealand Māori and Polynesian individuals, two SP-A1 alleles, three SP-A2 alleles, one SP-D allele, and four haplotypes (6A8, 6A10, 1A3, and 1A10) were found to be associated with increased risk of RAOM/OME (P lt; 0.05). An additional four haplotypes (6A2, 1A0, 1A2, and TA) were determined to be protective against susceptibility to RAOM/OME (P lt; 0.05). However, protective SPA1/SPA2/SPD haplotype 6A2-1A0-TA was significantly under-represented in the New Zealand Māori and Polynesian population (P lt; 0.05). A single allele and haplotype were associated with increased risk of meningococcal disease (P lt; 0.05). The findings of this study confirm that specific genetic variants of SP-A and SP-D are associated with either increased or decreased risk of developing RAOM and/or OME. Furthermore, it was demonstrated that New Zealand Māori and Polynesian individuals appear to exhibit more haplotypes susceptible to RAOM/OME. This may provide a partial explanation for the higher RAOM/OME-related failure rates of hearing tests in New Zealand Māori and Polynesian children. However, there are numerous socio-economic and environmental factors that also contribute to otitis media pathogenesis which were not considered in this study. The effects of the SP-A1, SP-A2, and SP-D alleles and haplotypes on the bacterial/viral binding efficiencies of SP-A and SP-D need to be investigated by further research, using a large population, to confirm the association with susceptibility or resistance with RAOM/OME.
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Matos, Ricardo Emanuel Castanheira de. "Computed tomography of clinical and subclinical middle ear disease in domestic rabbits (Oryctolagus cuniculus)." Master's thesis, Universidade de Lisboa. Faculdade de Medicina Veterinária, 2014. http://hdl.handle.net/10400.5/8128.
Full textAbstract:
Dissertação de Mestrado Integrado em Medicina VeterináriaOtitis media is commonly reported in rabbits. Proposed predisposing factors include upper respiratory infection and otitis externa/ear position. Otitis media can be difficult to diagnose, as affected rabbits are often asymptomatic unless it is associated with otitis externa or interna. Computed tomography (CT) is considered the “gold standard” for evaluation of the middle ear in dogs and cats. Medical records were searched for rabbits that had a head CT scan performed. Eighty eight cases met the inclusion criteria and were assigned to 2 groups based on reason for head CT (group 1: ear related clinical signs; group 2: non-ear related clinical signs). The prevalence of clinical and subclinical middle ear disease was 57% and 27% respectively as defined by increased attenuation within the tympanic cavity. Lysis of the tympanic bulla was associated with clinical disease and weakly associated with clinical progression of subclinical middle ear disease to clinical disease. Upon follow up of rabbits with subclinical middle ear disease, most cases remained subclinical after CT exam. A strong correlation was found between otitis media and lop-ear position and otitis externa. No correlation was found between middle ear disease and upper respiratory disease.
RESUMO - A otite média ocorre frequentemente em coelhos domésticos. Os factores de risco para a ocorrência da doença em coelhos inclui doença do trato respiratório superior e otite externa/posição da orelha. A otite média nos coelhos é normalmente assintomática e difícil de diagnosticar, excepto quando associada com otite externa ou interna. A tomografia computorizada (TC) é considerada a modalidade de imagiologia de referência para o diagnóstico de otite média em animais domésticos. Para o estudo retrospectivo, foram utilizados registos clínicos de coelhos com história clínica compatível com otite média ou outros problemas na cabeça mas não relacionados com o ouvido e que incluíam TC da cabeça. Os animais foram distribuídos em dois grupos consoante a indicação clínica para realização de TC da cabeça (grupo 1: problemas que sugerem presença de otite; grupo 2: problemas na região da cabeça mas não relacionados com o ouvido). A prevalência de otite média clínica no grupo 1 foi de 57% e de otite média sub-clínica no grupo 2 foi de 27%. O sinal mais comum na TC do ouvido médio foi aumento da densidade na cavidade tímpânica . Nos casos de otite média clínica ocorreu com mais frequência o sinal de lesão lítica da bolha timpânica comparativamente com os casos de otite média sub-clínica. Nos animais do grupo 2 com alterações do ouvido médio na TC, foi realizado acompanhamento clínico para determinar a progressão da otite média sub-clínica. Na maioria dos casos, o animal não desenvolveu sinais clínicos sugestivos de otite média. Os resultados do estudo confirmaram que existe uma relação significativa entre otite média e otite externa e posição da orelha para baixo, mas não entre otite média e doença do trato respiratório superior.
27
Westman, Eva. "Experimental acute otitis media : aspects on treatment, protection and structural changes." Doctoral thesis, Umeå : Univ, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-162.
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Sobol, Steven E. "Th2 cytokine expression in atopic children with otitis media with effusion." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33031.
Full textAbstract:
Background. Otitis media with effusion (OME) is more common in atopic children. Few studies have looked for the presence of inflammatory mediators in the middle ear effusions of this population.Objectives. We hypothesize that atopic children with OME have a different inflammatory cell and cytokine profile than non-atopic children with the disease.
Methods. The atopic status of 26 children with OME was determined. Using immunocytochemistry, fluid specimens were assessed for T lymphocytes, eosinophils, neutrophils, mast cells, and basophils. The expression of IL-4, II.-5, and IFN-gamma mRNA was assessed using in-situ hybridization.
Results. There is a higher percentage of eosinophils, T lymphocytes and cells expressing IL-4 and IL-5 mRNA in atopic children (n = 8) compared to non-atopic controls (n = 18) (p < 0.01).
Conclusion. The predominance of eosinophils, T lymphocytes and Th2 mediators in the middle ear effusions of atopic children provides strong evidence that atopy plays a role in the pathogenesis of this condition.
29
Quach-Thanh, Caroline. "Acute otitis media in Quebec's children : antibiotic prescribing patterns and outcomes." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=19456.
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Acute otitis media ( AOM) is one of the most common indications for antibiotic use in children. We used the Régie de l'assurance maladie du Québec databases to better understand the prescribing patterns of physicians and to assess the effectiveness of different antibiotics in the treatment of AOM. We selected a cohort of 60,513 children aged < 6 years with a first episode of AOM between June 1999 and June 2002. Failure was defined as either a new dispensation of antibiotic or a hospitalization or outpatient visit for complications related to AOM in the following 30 days. The antibiotic most widely used was amoxicillin (42.8%). Failure occurred in 12,693 (21%) children. Overall, azithromycin was the only antibiotic that was less associated with failure when compared to amoxicillin (odds ratio 0.88; 95% confidence interval 0.82, 0.94). In the first 3 days of treatment, a 50% increased risk of failure was seen when macrolides were initially given. However, azithromycin was associated with a 20% decrease in the risk of failure occurring > 14 days after the beginning of treatment. Other risk factors associated with treatment failure were age < 24 months, antibiotics or hospitalization in the preceding month, and otitis-prone conditions. Considering the results of the effectiveness study, the importance of macrolides resistance among pneumococci, and because there is no single factor or combination of factors that predict with certainty which child will develop early or late failure, amoxicillin should remain the first-line drug of choice.
30
Thorp, Marc A. "Aluminium acetate solution in the treatment of chronic suppurative otitis media." Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/2905.
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Novotny, Laura A. "Design and assessment of pre-clinical vaccine candidates against otitis media due to nontypeable Haemophilus influenzae and the development of a non-invasive vaccine delivery strategy." Thesis, Griffith University, 2019. http://hdl.handle.net/10072/390034.
Full textAbstract:
Otitis media (OM) is one of the most common bacterial diseases of childhood and include both acute and chronic forms of disease (1). Whereas acute OM (AOM) is a disease with rapid onset and is short in duration, chronic forms of OM can persist for weeks to months. The most severe form, chronic suppurative OM (CSOM) occurs upon OM with tympanic membrane rupture and is characterized by purulent drainage from the middle ear space that persists for at least 2 weeks or longer. There are 709 million cases of acute OM and 65 million to 330 million episodes of chronic suppurative OM (CSOM) occurring each year, worldwide (2, 3). Complications of CSOM result in the deaths of at least 50,000 children under 5 years of age in resource-poor regions across the world (4, 5) and morbidity associated with OM is significant for all children worldwide. Hearing loss due to OM is associated with developmental delays in behavior, language acquisition and education, all factors with profound influence that last well into adulthood (6-8). Significantly, prevention of the first incidence of OM curb extensive antibiotic prescription and surgical intervention in young children and is projected to reduce subsequent episodes, limiting the disease-related sequellae (9).
Nontypeable Haemophilus influenzae (NTHI) is a primary causative agent of OM, in addition to multiple upper and lower respiratory tract diseases (10). In children, NTHI is the predominant bacterium implicated in chronic OM, recurrent OM and OM for which treatment has failed (11-14). Moreover, whereas Streptococcus pneumoniae was the primary pathogen in OM prior to the use of pneumococcal conjugate vaccines, NTHI now also predominates during acute OM (15-17). NTHI, a typically benign commensal inhabitant of the human nasopharynx, possesses numerous determinants that facilitate its persistence, including outer membrane adhesive proteins and lipooligosaccharide (18). Perturbation of innate and/or physical immune defenses can result in disease distally, for example within the middle ear during OM, sinuses in rhinosinusitis, lungs in chronic cough and during episodes of exacerbations of chronic obstructive pulmonary disease (COPD) and cystic fibrosis (19). Moreover, the ability of this bacterium to rapidly form a biofilm, a community of bacteria that is frequently polymicrobial and is highly recalcitrant to the action of antibiotics and resistant to clearance by host immune effectors (20) promotes disease chronicity.
This compilation of my research, presented for consideration herein, describes the pre-clinical development of vaccines against NTHI-induced OM with a focus on two critical adhesive proteins expressed by NTHI, outer membrane protein P5 (OMP P5) and the Type IV pilus (Tfp), selected from my research performed over the past 22 years. Adhesin OMP P5 binds to mucin, intercellular adhesin molecule- 1 (ICAM1) and carcinoembryonic antigen-related adhesion molecule-1 (CEACAM1) (21-25), and I identified that NTHI Tfp engages ICAM1 (26). Furthermore, NTHI Tfp performs multiple biological functions which include competence, twitching motility and biofilm formation (27-31). I show that antibodies directed against the majority protein subunit of NTHI Tfp, PilA, induces active dispersal of NTHI from established biofilms, an outcome that is dependent on and coordinated with expression of the quorum signaling molecule, LuxS (29). Toward development of NTHI OMP P5 and Tfp-directed vaccine immunogens, I performed epitope mapping studies that revealed minimal immunodominant and immunoprotective domains within each native protein (32-34). These data guided the subsequent design of a novel chimeric immunogen, as a multi-component vaccine may be necessary to provide maximal protection against this heterogeneous bacterial species (35). I validated pre-clinical efficacy of each immunogen in chinchilla models of NTHI-induced experimental OM (29, 34-36).
Although immunisation via intramuscular or subcutaneous injection is wellestablished and proven to be one of the most effective strategies for disease prevention, non-invasive delivery methods have the potential to promote greater compliance, reduce costs associated with production and administration and extend the reach of vaccines to underserved regions (37). To explore this premise, I considered transcutaneous immunisation (TCI). My first efforts involved rubbing vaccine formulations on to the pinnae (or outer ears) of chinchillas (38, 39), a strategy that was later refined to utilize a small circular bandaid applied to the postauricular region behind the ear as a delivery device and administration route (40, 41). I examined the influence of adjuvantation, skin hydration and homing of antigenpresenting cell to local lymphoid tissues as essential factors toward induction of protective immunity. I characterised the durability of immunity induced by skin vaccination and validated TCI as a highly effective strategy to induce protective immune responses in experimental models of NTHI-induced OM (38-41). Improving vaccination methodologies for young children, particularly those in resource-poor regions of the world, was a key consideration in TCI conceptualization and refinement. Collectively, these data demonstrate the simplicity of bandaid immunisation which, combined with highly effective antigens, that target two critical NTHI adhesive proteins admixed with a potent adjuvant, has tremendous potential to enable greater reach of vaccines against NTHI and diseases of the respiratory tract, including OM.Thesis (Professional Doctorate)
Doctor of Philosophy by Publication (PhD)
School of Medicine
Griffith Health
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Tay, Khoon-Yen Elisa. "A Wait-and-See Prescription for the Treatment of Acute Otitis Media: A Randomized, Controlled Trial." Yale University, 2006. http://ymtdl.med.yale.edu/theses/available/etd-06282006-144523/.
Full textAbstract:
Acute otitis media (AOM) is the most common diagnosis for which antibiotics are prescribed for children in the United States. Previous trials evaluating an optional antibiotic prescription are limited and have significant limitations. None have evaluated an optional prescription in the urgent care setting. We conducted a randomized, controlled trial in an urban emergency department in which children aged 6 months to 12 years diagnosed with AOM were randomly assigned a "wait-and-see prescription" (WASP) or a "standard treatment prescription" (STP). Structured phone interviews were conducted 4-6, 11-14, and 30-40 days after enrollment to determine the proportion of each group that filled the antibiotic prescription and outcomes related to the clinical course. Substantially more parents in the WASP group (N=138) did not fill the antibiotic prescription compared to the STP group (N=145) (62% vs. 13%; P<0.001). There were no statistically significant differences between the groups in the frequency of subsequent fever, otalgia or unscheduled visits for medical care. Within the WASP group, both fever (OR = 4.0, 95% confidence interval, 1.7-9.5) and otalgia (OR = 4.5, 95% confidence interval, 1.7-11.5) were associated with filling the prescription. The WASP approach substantially reduced unnecessary use of antibiotics in children and is a reasonable alternative to routine use of antimicrobials for treatment of AOM.
33
Tapiainen, T. (Terhi). "Microbiological effects and clinical use of xylitol in preventing acute otitis media." Doctoral thesis, University of Oulu, 2002. http://urn.fi/urn:isbn:9514267796.
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Abstract
The purpose was to evaluate the microbiological mechanism of action of xylitol and to assess its use
in clinical practice for preventing acute otitis media (AOM).
To test whether the effect of xylitol on S. pneumoniae is inhibited by fructose,
a total of 20 strains of S. pneumoniae were exposed to xylitol in the presence of
fructose and other carbon sources. Addition of 5% xylitol to the media resulted in marked growth inhibition,
an effect which was totally eliminated in the presence of 1%, 2.5% or 5% fructose but not in the presence of
1% or 5% glucose, 1% galactose or 1% sucrose. The inhibition of pneumococcal growth is probably mediated via
a fructose phosphotransferase system in a similar manner to that seen in mutans streptococci. Sorbitol alone
did not affect the growth of pneumococci, and thus sorbitol is unlikely to provide any clinical benefit in
the prevention of AOM.
To evaluate the effect of xylitol on the ultrastructure of S. pneumoniae and
Haemophilus influenzae (H. influenzae) and on the pneumococcal
phenotype, five strains of S. pneumoniae and one strain of H.
influenzae were examined by electron microscopy after xylitol exposure. Xylitol damaged the
ultrastructure of the pneumococci. Some of the bacteria were lysed and the cell wall of the remaining ones
became more diffuse and the polysaccharide capsule was ragged. The resulting morphology was identical to
that of the transparent pneumococcal phenotypic variant. The properties of the transparent variants of
pneumococci could explain the clinical efficacy of xylitol in preventing AOM despite the lack of effect on
the nasopharyngeal carriage of pneumococci. The cell wall of H. influenzae became
slightly thicker, but the morphology remained otherwise unchanged.
To evaluate the pharmacokinetics of xylitol locally in the nasopharynx, xylitol concentrations were
measured in the saliva of 65 children by enzymatic assay after giving them xylitol chewing gum or syrup at
doses equal to those used in clinical trials. Concentrations high enough to have an antimicrobial effect
were attained, but the xylitol disappeared from the saliva within 15 minutes, which indicates that high peak
concentrations may be more important for efficacy than the time for which the concentration exceeds the level needed for an antimicrobial effect.
To find a more convenient dosing regime for xylitol prophylaxis, xylitol was administered to 1277
children only during an acute respiratory infection (ARI) in a randomised placebo-controlled trial. The
occurrence of AOM during ARI was 34/166 (20.5%) in the xylitol mixture group as compared with 32/157 (20.4%)
among the children receiving the control mixture. Among older children receiving control chewing gum,
xylitol chewing gum or xylitol lozenges, AOM was experienced by 24/218 (11.0%), 31/220 (14.1%) and 34/219
(15.5%) respectively. None of the differences between the groups was statistically significant. Xylitol
should be used continuously in AOM prophylaxis, as it proved ineffective when used only during URI.
34
Timmerman, Angelique Antonius. "'How to describe the functional health status of children with otitis media'." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=9648.
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Sundberg, Mikael. "Optical Methods for Tympanic Membrane Characterisation : Towards Objective Otoscopy in Otitis Media." Doctoral thesis, Linköping : Linköping University, Department of Biomedical Engineering, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-11246.
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Nguyen, Ha-Nam Phan 1975. "Evidence linking allergic otitis media with effusion to the United airways concept." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=80341.
Full textAbstract:
Otitis media with effusion (OME) is a chronic inflammatory disease of the middle ear space characterized by the accumulation of fluid. Previous investigations have found the composition of the inflammatory substrate in effusions of allergy-associated otitis media to be is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in asthma and in allergic rhinitis. In addition, there is evidence suggesting that diseases of the upper and lower airways may represent different clinical manifestations of a single inflammatory airway syndrome, or the United Airway Concept. The objective of this research is to determine if the middle ear compartment may be a component of the United Airways in allergic disease. Middle ear fluid, torus tubaris (Eustachian tube mucosa at the nasopharyngeal orifice) and adenoidal tissue biopsies were obtained from 45 patients undergoing simultaneous tympanostomy tube placement for OME and adenoidectomy for adenoid hypertrophy. The cellular and cytokine profiles of each site were investigated using immunocytochemistry (elastase, CD3, MBP) and in-situ hybridization (IL-4, IL-5, IFN-gamma mRNA). Atopic status was determined for each patient using skin-prick testing. Eleven of the 45 patients with OME (24%) were atopic. The MEE of atopics had significantly higher levels of eosinophils, T lymphocytes, IL-4 and IL-5 mRNA +cells (p < 0.01), and significantly lower levels of neutrophils and IFN-gamma mRNA +cells (p < 0.01) when compared to non-atopics. The nasopharyngeal tissue biopsies also revealed similar cellular and cytokine profiles. Therefore, the allergic inflammation in atopic patients with OME occurs on both sides of the Eustachian tube, both in the middle ear and in the nasopharynx. The results of this study support the concept that the middle ear may be part of the United Airway in atopic individuals.
37
Stephenson, Helen. "Sequelae in adults of childhood otitis media : binaural hearing and acoustic reflexes." Thesis, University of Nottingham, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.240433.
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Lohr-Flanders, Marla. "The effect of otitis media on articulation in expressive language-delayed children." PDXScholar, 1992. https://pdxscholar.library.pdx.edu/open_access_etds/4365.
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Researchers have long been concerned with the effects of otitis media on speech and language acquisition because of the high correlation of a mild to moderate hearing loss during the time period that fluid (effusion) may be in the middle ear. Middle-ear effusion would prevent many of the auditory messages from accurately reaching the nervous system (Zinkus, 1986). Deprived of the ability to discern the subtle acoustic differences that provide information for phonetic contrasts, a child's speech acquisition may differ from children who do not experience such losses.
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Aynali, Giray Yarıktaş Murat. "Deneysel efüzyonlu otitis mediada metilprednizolon, montelukast ve indometazin'in antienflamatuar etkilerinin karşılaştırılması /." Isparta: SDÜ Tıp Fakültesi, 2006. http://tez.sdu.edu.tr/Tezler/TT00274.pdf.
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Affeld, Cristiane Nehring. "Video Head Impulse Test : resultados em crianças, adolescentes e adultos portadores de otite média crônica não colesteatomatosa." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2016. http://hdl.handle.net/10183/143349.
Full textAbstract:
Objetivos: analisar a associação entre otite média crônica não colesteatomatosa (OMCNC) e os resultados obtidos no video head impulse test (vHIT). Delineamento: tipo transversal. Métodos: a amostra foi selecionada em ambulatório especializado de um hospital universitário. A inclusão dos pacientes neste estudo obedeceu aos seguintes critérios: idade entre 7 e 59 anos; diagnóstico de OMCNC unilateral, com orelha contralateral normal; não ter realizado cirurgia otológica prévia; não ter comprometimentos cognitivos e/ou neurológicos e/ou motores registrados nos prontuários. Os critérios de exclusão foram: impossibilidade de retirada de maquiagem nos olhos (impossibilita a execução do exame); não compreensão ou dificuldade na execução das ordens do exame. Os pacientes foram divididos em Grupo A (7 a 19 anos) e Grupo B (20 a 59 anos). Todos foram avaliados por meio de exame otorrinolaringológico padrão do ambulatório, anamnese e vHIT. Os exames com valor de ganho superior a 0,8 foram considerados normais. Os canais com valores de ganho entre 0,6 e 0,8 foram classificados, nesta pesquisa, como limítrofe. Nos casos considerados limítrofes, foi analisado o valor da assimetria para diagnóstico, que foi considerada anormal acima de 20%. Para o cálculo amostral evidenciou que o número mínimo de indivíduos avaliados seria de, 10 sujeitos no grupo A e 20 sujeitos no grupo B. Resultados: a amostra total foi composta por 32 indivíduos. O grupo A foi formado por 11 indivíduos, com idade média de 12,7 ± 3,9 anos e o grupo B por 21 indivíduos, com idade média de 46,3 ± 11,1 anos. A análise dos resultados do vHIT revelou que não houve diferença significativa entre o lado considerado normal e o lado considerado afetado, considerando-se a análise intragrupo e entre grupos. Conclusão: a pesquisa evidenciou que, na amostra estudada, não houve diferença nos resultados obtidos no vHIT entre os lados afetados e não afetados pela OMCNC.Objectives: To analyze the association between chronic otitis media (COM) without cholesteatoma and results in the video head impulse test (vHIT). Design: Cross sectional. Methods: The sample was selected in a specialized clinic of a university hospital. Patient inclusion in this study obeyed the following criteria: age between 7 and 59 years; diagnosis of unilateral COM without cholesteatoma with normal contralateral ear; not having done previous ear surgery; not having cognitive impairment and / or neurological and / or motor recorded in the medical records. The exclusion criteria were: patients with eye makeup, which cannot be removed (makes it impossible to perform the exam); patients who did not understand the operation of the test and therefore could not accomplish it. Patients were divided in group A (7 to 19) and group B (20 to 59) years of age. Both groups performed standard outpatient otolaryngology evaluation, clinical history and video head impulse test. Exams with a gain above 0.8 were considered normal. Canals gain values between 0.6 and 0.8 were classified in this study as borderline. In borderline cases considered, we analyzed the value of asymmetry for diagnosis, which was considered abnormal over 20%. For sample size calculation showed that the minimum number of individuals assessed was of 10 subjects in group A and 20 subjects in group B. Results: The total sample consisted of 32 individuals. Group A consisted of 11 subjects mean with an average age of 12.7 ± 3.9 years and the group B of 21 subjects with an average age of 46.3 ± 11.1 years. Analysis of the vHIT results showed no significant difference between the side considered normal and the side considered affected, considering the intra-group and between groups analysis. Conclusion: The research showed that, in our sample, there was no difference in the results obtained in vHIT between the affected side and the not affected by COM without cholesteatoma.
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Oliveira, Lis Christina de. "Otite MÃdia e Externa Bilateral em CÃes. Estudo Comparativo do Perfil MicrobiolÃgico e Susceptibilidade a Antimicrobianos das EspecÃeis Prevalentes." Universidade Federal do CearÃ, 2004. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=215.
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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorA otite resulta da inflamaÃÃo do conduto auditivo e representa 8-15% dos casos na prÃtica veterinÃria. Com o objetivo de delinear e comparar o perfil de isolamento de microrganismos a partir dos ouvidos mÃdio e externo de cÃes com otite foi realizado este estudo. No perÃodo de agosto/2003 a marÃo/2004 foram analisados 64 cÃes com otite externa e mÃdia associados e 50 cÃes com conduto auditivo hÃgido. A coleta de amostras foi realizada no Centro de Controle de Zoonoses de Fortaleza-CE e a anÃlise microbiolÃgica no Setor de Microbiologia do Depto. de Patologia e Medicina Legal/UFC. As amostras do ouvido externo foram coletadas com auxÃlio de swab estÃril eas de ouvido mÃdio atravÃs da tÃcnica de osteotomia da bula timpÃnica. A cultura e identificaÃÃo de microrganismos foram realizadas segundo metodologia estabelecida e os testes de susceptibilidade atravÃs do mÃtodo de difusÃo em Ãgar gel (NCCLS). Em cÃes otopatas as alteraÃÃes mais frequentes foram: escoriaÃÃes no pavilhÃo auricular (72%), otalgia (12%) e alteraÃÃo no posicionamento do pavilhÃo (12%). Em 62% dos animais a membrana timpÃnica se encontrava Ãntegra, embora mostrasse alguma alteraÃÃo estrutural. A cultura foi positiva em 48% das amostras de ouvido mÃdio e os agentes isolados com maior frequÃncia foram: Estafilococos coagulase-positiva (62,5%), bacilos Gram-negativos nÃo fermentadores (10%), enterobactÃrias (5%) e Candida albicans (5%). Foi verificada diferenÃa no nÃmero e variedade de espÃcies isoladas do ouvido externo quando comparado ao ouvido mÃdio, onde predominaram: Bacillus sp. (27,1%), M. pachydermatis (23,4%) e S. intermedius (21,8%). Os agentes mais isolados nos ouvidos externos de cÃes com otite bilateral foram: Bacillus sp. (27,9% e 31%), M. pachydermatis (25,9% e 24%), S. intermedius (23,8% e 24,6%) e EnterobactÃrias (6% e 6,1%). Observou-se diferenÃa significativa (p<0,0001) na forma como os agentes se associam, revelando a individualidade de cada conduto auditivo nesses quadros. A presenÃa de bactÃrias anaerÃbias estritas nÃo foi observada. Cepas de S. intermedius (n=83) mostraram resistÃncia intermediÃria à maioria dos antimicrobianos testados e altos nÃveis de resistÃncia a: penicilina (36,1%), ampicilina (27,7%), tetraciclina (27,7%), eritromicina (14,5%) e clindamicina (12%). Os resultados obtidos descrevem a variedade de agentes bacterianos e fÃngicos associados aos quadros de otite canina e sugerem a necessidade de se adotar procedimentos sistemÃticos e direcionados para o diagnÃstico e tratamento de otopatias em cÃes.
Otitis results from auricular inflammation and represents 8-15% of all cases received in the veterinarian practices. This study was done to outline and compare the isolation profile in external and middle ears from dogs with otitis. Between August/2003 and March/2004, 64 dogs with both otitis externa and media and 50 dogs with bilateral otitis externa were studied. Fifty dogs with healthy ears were used as control group. The collection was done ate the Zoonosis Control Center in Fortaleza-CE and the microbiological analysis at the Microbiological Center - Department of Pathology and Legal Medicine-UFC. Samples from the external ears were collected with sterile swabs and the ones from the middle ears by osteotomy of the tympanic bulla. The microrganisms were cultured and identified according to methods previously described and susceptibility tested by agar diffusion method (NCCLS). In otitic dogs the most frequent alterations were: lesions of the pinna (72%), local pain (12%) and alteration of the pinna position (12%). Sixty-two per cent of the dogs showed entire tympanic membrane with some structural alteration. Microbiogical growth was seen in 48% of the samples fromdogss with otitis media, and the most frequent isolates were: Estafilococos positive-coagulase (62.5%), non-fermentative Gram-negative (10%), Enterobacteriaceae (5%) and Candida albicans (5%). It was observed that there was an increased number and variety of species isolated in external ears comparaed to middle ears. In samples from external ears, the following predominated: Bacillus sp. (27.1%), M. pachydermatis (23.4%) e S. intermedius (21.8%). The most frequent species isolated in dogs with bilateral otitis externa were: Bacillus sp. (27.9% e 31%), M. pachydermatis (25.9% e 24%), S. intermedius (23.8% e 24.6%) e EnterobactÃrias (6% e 6.1%). There was a significative difference (p<0.0001) in the way the isolates were associated, which showed the individuality from each ear in bilateral otitis externa. In this study, no anaerobic microrganisms were isolated. S. intermedius strains (n=83) showed intermediate resistance to most of the cntimicrobials tested and high resistance to penicillin (36.1%), ampicillin (27.7%), tetracyclin (27.7%), erythromycin (14.5%) and clindamycin (12.0%). These results describe tha variety of bacterial and fungal isolates associated with canine otitis and reveal the need to adopt systematic procedures for the diagnosis and treatment of dogs with otitis.
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Beers, Alison Nicole. "Wideband reflectance in normal school-aged children and in children with otitis media." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/32076.
Full textAbstract:
In addition to the high prevalence of otitis media with effusion (OME), researchers
are motivated to develop methods for early and accurate OME diagnosis because of the
financial strain on the health care system associated with its diagnosis and management, and
the medical and developmental consequences that may manifest if OME is left untreated.
Standard (226 Hz) and high frequency (1000 Hz) tympanometry have traditionally been used
clinically to assess middle ear status in children. A relatively new advanced middle ear
analysis technique is Wideband reflectance (WBR). WBR has the potential to provide more
information regarding the status of the middle ear than the methods currently being used
clinically. This technique provides frequency-specific information about sound conduction
through the peripheral auditory system. As a result of its recent introduction as an analysis
method there is limited normative data available for this measurement system for pediatric
populations and for those with middle ear pathology. Development of normative pediatric
WBR data may render this technique a highly useful diagnostic tool for assessing the
mechano-acoustical properties of middle ear function and for differentiating between healthy
and pathological middle ears.
WBR patterns from 55 subjects (102 ears) with normal middle ear status and 39
subjects (57 ears) with varying degrees of middle ear pathology were measured. The mean
and the 5t h and 95t h percentile ranges were graphically presented. Repeated measures
analysis of variance was performed with frequency as the within subjects factor and age
(child versus adult), middle ear condition (normal, mild negative pressure, severe negative
pressure or effusion), race (Caucasian versus Chinese) and/or gender as the between subjects
factors. Frequency-specific significant WBR pattern differences existed for reactance-based and impedance-based measures, between pediatric and adult groups, Caucasian children and
Chinese children, and all four middle ear conditions. Wideband reflectance must be further
explored within a pediatric population before results can be generalized, but this
measurement technique shows promise of providing a better understanding of the
mechanico-acoustic properties of the middle ear and the changes to the system's functioning
with middle ear pathology.Medicine, Faculty of
Audiology and Speech Sciences, School of
Graduate
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Hogan, Sarah Cecilia Mary. "The development of hearing in children : some effects of otitis media with effusion." Thesis, University of Oxford, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301869.
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Guo, Li. "Studies into mucin and its regulation in pathogenesis of otitis media with effusion." Thesis, University of Nottingham, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517658.
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Viswanathan, Harishnath. "Mucin Gene Expression and GastricReflux in Chronic Rhinosinusitis and Otitis Media with Effusion." Thesis, University of Newcastle Upon Tyne, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499336.
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Johnson, Ian J. M. "Otitis Media with Effusion - investigation into aspects of rheology biochemistry and inflammatory mediators." Thesis, University of Newcastle Upon Tyne, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287845.
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Ogbonna, Judith C. "Risk of Maternal Smoking on Breastfed Infants and the Development of Otitis Media." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2857.
Full textAbstract:
Despite advances in health promotion through efforts to reduce tobacco smoking, tobacco-related health conditions have continued to be significant. Exposure to secondhand smoke has been identified as a health risk also in addition to infant health risks related to maternal smoking. In contrast, breastfeeding has been found to promote infant health and is strongly encouraged. Despite literature supporting both of these statements, the combined effects of both breastfeeding and maternal smoking on infant wellbeing have not been delineated. Otitis media represents a common health problem among infants and young children. Tobacco exposure has been shown to increase its incidence while breastfeeding has been shown to reduce its occurrence. In the current study, a consecutive sample of all infants less than 5 years of age with otitis media and breastfed for at least 6 months was collected from a busy urban clinic for analysis. A survey tool was administered to those meeting study criteria. Primary analysis examined the odds ratio of developing otitis media among breastfed infants between those whose mothers smoked tobacco and those whose mothers did not. As a result, the association between the protective effects of breastfeeding and the detrimental effects of maternal smoking was evaluated in relation to the development of otitis media. Secondary variables including demographics, family history, past medical and birth history, and secondhand smoke exposure were also assessed. Results failed to demonstrate a significant difference in otitis media between the 2 cohorts in this study, and of the secondary variables, only cranio-facial deformities and/or a family history of these conditions resulted in higher otitis media occurrence. Further study with larger populations with higher tobacco use rates may offer additional insights into this matter.
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Heald, Melinda Merle 1962. "The use of pressure-equalization (PE) tubes in the treatment of otitis media: A national survey of otolaryngologists." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/276664.
Full textAbstract:
This study was designed to describe those indicators for the surgical insertion of pressure-equalization (PE) tubes given highest priority in clinical practice by board-certified otolaryngologists. A questionnaire was mailed to 1000 otolaryngologists practicing in the United States. The respondents rated the importance of 22 items on a six-point scale. These items were grouped into four categories: medical history, physical examination, audiologic evaluation, and related factors. The return rate was 52.7%. The five items receiving the highest ratings were "persistence of fluid for 3 or more months per episode," "presence of speech-language delay," "bilateral conductive hearing loss of 20 dB or more," "total number of episodes of otitis media," and "lack of response to suppressive antibiotic therapy."
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Weckwerth, Paulo Henrique. "Etiologia e susceptibilidade à drogas de microrganismos relacionados com a otite média crônica supurativa em pacientes portadores de fissura palatal /." Botucatu : [s.n.], 2002. http://hdl.handle.net/11449/89976.
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Orientador: Carlos Alberto de Magalhães LopesResumo: A otite média crônica supurativa (OMCS) é uma condição comum em pacientes portadores de fissura palatal e lábio-palatal não reparada. Devido a uma anormalidade muscular, existe disfunção da tuba auditiva que, por sua vez, não equilibra a pressão diferencial do ar entre o ouvido médio e a nasofaringe, ocasionando acúmulo de fluidos na cavidade do ouvido médio. Amostras efusivas de OMCS de 40 pacientes portadores de fissura lábiopalatal matriculados no Hospital de Reabilitação de Anomalias Craniofaciais (HRAC) - USP - Bauru - SP, foram analisadas através de culturas bacteriológicas, e as bactérias isoladas submetidas ao padrão de susceptibilidade in vitro frente a drogas de uso clínico. Culturas positivas foram obtidas em 100% dos casos estudados. Das 57 linhagens obtidas, foram isoladas com maior freqüência as bactérias Pseudomonas aeruginosa (35%), Staphylococcus aureus (15,5%), Enterococcus faecalis (14%) e Proteus mirabilis (12%). A freqüência de bacilos Gram negativos (enterobactérias e não fermentadores da glicose) isolados foi de 67%. Frente à ciprofloxacina, a Pseudomonas aeruginosa apresentou melhor sensibilidade. Frente à gentamicina, as enterobactérias apresentaram melhor sensibilidade. As linhagens de Staphylococcus aureus e de Enterococcus faecalis mostraram melhor sensibilidade frente ao imipenem e sulfazotrim, respectivamente. Acreditamos que nossos dados possam contribuir para a escolha apropriada de antibióticos quando for considerado o tratamento não cirúrgico da OMCS em pacientes portadores de fissura lábio palatal.
Abstract: Chronic suppurative otitis media (CSOM) is a common condition in patients with unrepaired cleft palate and cleft lip palate. The muscular abnormality leads to auditive tube malfunction which it will not equilibrate the differential air pressure between the middle ear and the nasopharynx. Consequently, it increases the fluid in the middle ear cavity. Effusive samples of CSOM from 40 patients with clef palate and cleft lippalate of the HRAC-USP-Bauru-SP, were studied. After bacterial cultures, the bacteria were isolated and submitted, "in vitro", at standard susceptibility to drugs of clinical use. Positive cultures were obtained in 100% of studied cases. Pseudomonas aeruginosa (35%), Staphylococcus aureus (15,5%), Enterococcus faecalis (14%) e Proteus mirabilis (12%) were the most frequent bacteria in 57 strains. Gram negative bacilli (enteric Gram negative bacilli and nonfermentative bacilli) were observed in 67% of the samples. Pseudomonas aeruginosa shown better sensitivity to ciprofloxacin, and the enteric Gram negative baciili to gentamicin. Moreover, the S. aureus and also the E. faecalis shown hight sensitivity to imipenem and trimethoprim/sulfamethoxazole, respectively. This data will contribute to the correct choice of the antibiotic in CSOM patients with cleft palate or clef lip-palate, which the nonsurgical management is the main therapy.
Mestre
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Eriksson, Per Olof. "Developing otitis media : experimental studies in particular regarding inflammatory changes in the tympanic membrane." Doctoral thesis, Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-180.
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