The Experts below are selected from a list of 27351 Experts worldwide ranked by ideXlab platform
Yukiko Iino - One of the best experts on this subject based on the ideXlab platform.
-
pathogenesis and diagnosis of Otitis Media with anca associated vasculitis
Allergology International, 2014Co-Authors: Naohiro Yoshida, Yukiko IinoAbstract:Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is histologically characterized by systemic necrotizing vasculitis and is clinically classified into two phases, systemic or localized. Recently, otological symptoms such as Otitis Media and hearing loss, not previously often associated with AAV, have been reported in AAV cases. In these cases we propose a diagnosis of Otitis Media with AAV (OMAAV). The ANCA titer is important for the diagnosis of OMAAV, and in most cases rapid progressive hearing loss is observed as localized AAV. Peripheral facial nerve palsy or hypertrophic pachymeningitis are coupled with 25% of cases and 18% of cases respectively. Proteinase 3-ANCA (PR3-ANCA) positive Otitis Media causes granulomatous formation or middle ear effusion in the middle ear, on the other hand myeloperoxidase-ANCA (MPO-ANCA) positive Otitis Media predominantly presents as Otitis Media with effusion. The early diagnosed case and the sensorineural hearing loss not progressed deaf could be recovered by the immunosuppressive therapy. Delayed diagnosis of AAV occasionally leads to progression to the irreversible phase; therefore, diagnosis at the early-localized stage is important for treating AAV. In this review, we discuss the current understanding of this newly proposed concept of OMAAV.
-
diagnostic criteria of eosinophilic Otitis Media a newly recognized middle ear disease
Auris Nasus Larynx, 2011Co-Authors: Yukiko Iino, Sachiko Tomiokamatsutani, Atsushi Matsubara, Takashi Nakagawa, Manabu NonakaAbstract:Abstract Objective Eosinophilic Otitis Media (EOM) is a newly recognized intractable middle ear disease, characterised by the accumulation of eosinophils in middle ear effusion and middle ear mucosa. Since EOM patients show gradual or sudden deterioration of hearing, it is important to properly diagnose EOM and to start adequate treatment for EOM. We aimed to investigate the clinical risk factors of EOM and to establish the diagnostic criteria of EOM. Patients and methods We reviewed 138 patients with EOM and 134 age-matched patients with the common type of Otitis Media with effusion or chronic Otitis Media as controls. We analyzed the incidence of the following clinical variables in both groups: bilaterality of Otitis Media, viscosity of middle ear effusion, formation of granulation tissue in the middle ear, response to the treatment for Otitis Media, deterioration of bone conduction hearing level, and association with other diseases such as bronchial asthma, chronic rhinosinusitis, nasal polyposis, and allergic rhinitis. Results A high odds ratio was obtained from an association with bronchial asthma (584.5), resistance to conventional treatment for Otitis Media (232.2), viscous middle ear effusion (201.6), association with nasal polyposis (42.17), association with chronic rhinosinusitis (26.49), bilaterality (12.93), and granulation tissue formation (12.62). The percentage of patients with EOM who were positive for two or more among the highest four items was 98.55%. Conclusion A patient who shows Otitis Media with effusion or chronic Otitis Media with eosinophil-dominant effusion (major criterion) and with two or more among the highest four items (minor criteria), can be diagnosed as having EOM. Patients with ear symptoms should have the proper diagnosis of EOM using the proposed diagnostic criteria, and then can receive adequate treatment, resulting in prevention of deterioration of hearing and quality of life.
-
diagnostic criteria of eosinophilic Otitis Media a newly recognized middle ear disease
Auris Nasus Larynx, 2011Co-Authors: Yukiko Iino, Sachiko Tomiokamatsutani, Atsushi Matsubara, Takashi Nakagawa, Manabu NonakaAbstract:OBJECTIVE: Eosinophilic Otitis Media (EOM) is a newly recognized intractable middle ear disease, characterised by the accumulation of eosinophils in middle ear effusion and middle ear mucosa. Since EOM patients show gradual or sudden deterioration of hearing, it is important to properly diagnose EOM and to start adequate treatment for EOM. We aimed to investigate the clinical risk factors of EOM and to establish the diagnostic criteria of EOM. PATIENTS AND METHODS: We reviewed 138 patients with EOM and 134 age-matched patients with the common type of Otitis Media with effusion or chronic Otitis Media as controls. We analyzed the incidence of the following clinical variables in both groups: bilaterality of Otitis Media, viscosity of middle ear effusion, formation of granulation tissue in the middle ear, response to the treatment for Otitis Media, deterioration of bone conduction hearing level, and association with other diseases such as bronchial asthma, chronic rhinosinusitis, nasal polyposis, and allergic rhinitis. RESULTS: A high odds ratio was obtained from an association with bronchial asthma (584.5), resistance to conventional treatment for Otitis Media (232.2), viscous middle ear effusion (201.6), association with nasal polyposis (42.17), association with chronic rhinosinusitis (26.49), bilaterality (12.93), and granulation tissue formation (12.62). The percentage of patients with EOM who were positive for two or more among the highest four items was 98.55%. CONCLUSION: A patient who shows Otitis Media with effusion or chronic Otitis Media with eosinophil-dominant effusion (major criterion) and with two or more among the highest four items (minor criteria), can be diagnosed as having EOM. Patients with ear symptoms should have the proper diagnosis of EOM using the proposed diagnostic criteria, and then can receive adequate treatment, resulting in prevention of deterioration of hearing and quality of life.
-
eosinophilic Otitis Media a new middle ear disease entity
Current Allergy and Asthma Reports, 2008Co-Authors: Yukiko IinoAbstract:Eosinophilic Otitis Media (EOM) is intractable Otitis Media characterized by the presence of a highly viscous yellow effusion containing eosinophils. It occurs mainly in patients with bronchial asthma and is resistant to conventional treatments for Otitis Media. Here we discuss the clinical features, pathogenesis, and management of EOM. EOM predominantly affects women and presents most often in patients in their 50s. The clinical features of the middle ear in EOM are roughly divided into the Otitis Media with effusion type and chronic Otitis Media type. The latter is further divided into two subtypes: simple perforation and granulation tissue formation. EOM is often complicated by rhinosinusitis (eosinophilic sinusitis). High-tone loss is more frequently found and more severe in EOM patients than in chronic Otitis Media control patients, and EOM patients sometimes become deaf suddenly. Systemic or topical steroid administration is the most effective treatment for patients with EOM. The instillation of triamcinolone acetonide, a suspension of steroids, into the middle ear is very effective for controlling eosinophilic inflammation. It is very important to explain to patients with EOM that the disease may last for a long period and that progressive and sudden hearing loss may occur.
Ellen R Wald - One of the best experts on this subject based on the ideXlab platform.
-
antibiotic recommendations for acute Otitis Media and acute bacterial sinusitis conundrum no more
Pediatric Infectious Disease Journal, 2018Co-Authors: Ellen R Wald, Gregory P. DemuriAbstract:There has been a substantial change in the prevalence and microbiologic characteristics of cases of acute Otitis Media secondary to the widespread use of pneumococcal conjugate vaccines. Current trends in nasopharyngeal colonization and the microbiology of acute Otitis Media support a change in the recommendation for antibiotic management of acute Otitis Media and acute bacterial sinusitis in children.
-
Acute Otitis Media and Acute Bacterial Sinusitis
2016Co-Authors: Ellen R WaldAbstract:Acute Otitis Media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute Otitis Media in 37% of cases. Currently, precise microbiologic diagnosis of acute Otitis Media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future. Acute Otitis Media (AOM) is the most common in-dication for the use of antimicrobial agents in children [1]. Acute bacterial sinusitis is the fifth most common indication for antibiotics [2]. Together, they are re
-
acute Otitis Media and acute bacterial sinusitis
Clinical Infectious Diseases, 2011Co-Authors: Ellen R WaldAbstract:Acute Otitis Media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute Otitis Media in 37% of cases. Currently, precise microbiologic diagnosis of acute Otitis Media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.
Lynn M Taussig - One of the best experts on this subject based on the ideXlab platform.
-
exclusive breast feeding for at least 4 months protects against Otitis Media
Obstetrical & Gynecological Survey, 1993Co-Authors: Burris Duncan, Catharine J Holberg, Anne L Wright, Fernando D Martinez, Lynn M TaussigAbstract:Objective. This study was designed to assess the relation of exclusive breast-feeding, indepen- dent of recognized risk factors, to acute and recurrent Otitis Media in the first 12 months of life. Methods. Records of 1220 infants who used a health maintenance organization and who were followed dur- ing their first year of life as part of the Tucson Children's Respiratory Study were reviewed. Detailed prospective information about the duration and exclusiveness of breast-feeding was obtained, as was information relative to potential risk factors (socioeconomic status, gender, number of siblings, use of day care, maternal smoking, and family history of allergy). Acute Otitis Media and recurrent Otitis Media, defined as three or more episodes of acute Otitis Media in a 6-month period or four episodes in 12 months, were the outcome variables. Results. Of the 1013 infants followed for their entire first year, 476 (47%) had at least one episode of Otitis and 169 (17%) had recurrent Otitis Media. Infants exclusively
-
exclusive breast feeding for at least 4 months protects against Otitis Media
Pediatrics, 1993Co-Authors: Burris Duncan, Catharine J Holberg, Anne L Wright, Fernando D Martinez, Lynn M TaussigAbstract:Objective. This study was designed to assess the relation of exclusive breast-feeding, independent of recognized risk factors, to acute and recurrent Otitis Media in the first 12 months of life. Methods. Records of 1220 infants who used a health maintenance organization and who were followed during their first year of life as part of the Tucson Children9s Respiratory Study were reviewed. Detailed prospective information about the duration and exclusiveness of breast-feeding was obtained, as was information relative to potential risk factors (socioeconomic status, gender, number of siblings, use of day care, maternal smoking, and family history of allergy). Acute Otitis Media and recurrent Otitis Media, defined as three or more episodes of acute Otitis Media in a 6-month period or four episodes in 12 months, were the outcome variables. Results. Of the 1013 infants followed for their entire first year, 476 (47%) had at least one episode of Otitis and 169 (17%) had recurrent Otitis Media. Infants exclusively breast-fed for 4 or more months had half the mean number of acute Otitis Media episodes as did those not breast-fed at all and 40% less than those infants whose diets were supplemented with other foods prior to 4 months. The recurrent Otitis Media rate in infants exclusively breast-fed for 6 months or more was 10% and was 20.5% in those infants who breast-fed for less than 4 months. This protection was independent of the risk factors considered. Conclusion. These findings suggest that exclusive breast-feeding of 4 or more months protected infants from single and recurrent episodes of Otitis Media.
Melinda M Pettigrew - One of the best experts on this subject based on the ideXlab platform.
-
viral bacterial interactions and risk of acute Otitis Media complicating upper respiratory tract infection
Journal of Clinical Microbiology, 2011Co-Authors: Melinda M Pettigrew, Janneane F Gent, Richard B Pyles, Aaron L Miller, Johanna Noksokoivisto, Tasnee ChonmaitreeAbstract:Acute Otitis Media (AOM) is a common complication of upper respiratory tract infection whose pathogenesis involves both viruses and bacteria. We examined risks of acute Otitis Media associated with specific combinations of respiratory viruses and acute Otitis Media bacterial pathogens. Data were from a prospective study of children ages 6 to 36 months and included viral and bacterial culture and quantitative PCR for respiratory syncytial virus (RSV), human bocavirus, and human metapneumovirus. Repeated-measure logistic regression was used to assess the relationship between specific viruses, bacteria, and the risk of acute Otitis Media complicating upper respiratory tract infection. In unadjusted analyses of data from 194 children, adenovirus, bocavirus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were significantly associated with AOM (P < 0.05 by χ(2) test). Children with high respiratory syncytial virus loads (≥3.16 × 10(7) copies/ml) experienced increased acute Otitis Media risk. Higher viral loads of bocavirus and metapneumovirus were not significantly associated with acute Otitis Media. In adjusted models controlling for the presence of key viruses, bacteria, and acute Otitis Media risk factors, acute Otitis Media risk was independently associated with high RSV viral load with Streptococcus pneumoniae (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.90 and 10.19) and Haemophilus influenzae (OR, 2.04; 95% CI, 1.38 and 3.02). The risk was higher for the presence of bocavirus and H. influenzae together (OR, 3.61; 95% CI, 1.90 and 6.86). Acute Otitis Media risk differs by the specific viruses and bacteria involved. Acute Otitis Media prevention efforts should consider methods for reducing infections caused by respiratory syncytial virus, bocavirus, and adenovirus in addition to acute Otitis Media bacterial pathogens.
-
microbial communities of the upper respiratory tract and Otitis Media in children
Mbio, 2011Co-Authors: Alison S Laufer, Janneane F Gent, Joshua P Metlay, Kristopher P Fennie, Yong Kong, Melinda M PettigrewAbstract:ABSTRACT Streptococcus pneumoniae asymptomatically colonizes the upper respiratory tract of children and is a frequent cause of Otitis Media. Patterns of microbial colonization likely influence S. pneumoniae colonization and Otitis Media susceptibility. This study compared microbial communities in children with and without Otitis Media. Nasal swabs and clinical and demographic data were collected in a cross-sectional study of Philadelphia, PA, children (6 to 78 months) (n = 108) during the 2008-2009 winter respiratory virus season. Swabs were cultured for S. pneumoniae. DNA was extracted from the swabs; 16S rRNA gene hypervariable regions (V1 and V2) were PCR amplified and sequenced by Roche/454 Life Sciences pyrosequencing. Microbial communities were described using the Shannon diversity and evenness indices. Principal component analysis (PCA) was used to group microbial community taxa into four factors representing correlated taxa. Of 108 children, 47 (44%) were colonized by S. pneumoniae, and 25 (23%) were diagnosed with Otitis Media. Microbial communities with S. pneumoniae were significantly less diverse and less even. Two PCA factors were associated with a decreased risk of pneumococcal colonization and Otitis Media, as follows: one factor included potentially protective flora (Corynebacterium and Dolosigranulum), and the other factor included Propionibacterium, Lactococcus, and Staphylococcus. The remaining two PCA factors were associated with an increased risk of Otitis Media. One factor included Haemophilus, and the final factor included Actinomyces, Rothia, Neisseria, and Veillonella. Generally, these taxa are not considered Otitis Media pathogens but may be important in the causal pathway. Increased understanding of upper respiratory tract microbial communities will contribute to the development of Otitis Media treatment and prevention strategies. IMPORTANCE Otitis Media (middle ear infection) is the most common reason for pediatric sick visits in the United States. Streptococcus pneumoniae is a leading Otitis Media pathogen. S. pneumoniae must colonize the upper respiratory tract and compete with a complex community of nonpathogenic bacteria before infecting the middle ear. We compared microbial communities in the upper respiratory tract of children who had Otitis Media and those who did not. Members of the normal flora, i.e., Corynebacterium and Dolosigranulum, were protective for S. pneumoniae colonization and Otitis Media. As expected, the genera Haemophilus was associated with Otitis Media. Surprisingly, Actinomyces, Rothia, Neisseria, and Veillonella were associated with an increased risk of Otitis Media. These bacteria are not Otitis Media pathogens but may be associated with antibiotic use or involved in the causal pathway to disease. Increased understanding of upper respiratory tract microbial communities will lead to new ways to prevent middle ear infections, including probiotics.
Tasnee Chonmaitree - One of the best experts on this subject based on the ideXlab platform.
-
viral bacterial interactions and risk of acute Otitis Media complicating upper respiratory tract infection
Journal of Clinical Microbiology, 2011Co-Authors: Melinda M Pettigrew, Janneane F Gent, Richard B Pyles, Aaron L Miller, Johanna Noksokoivisto, Tasnee ChonmaitreeAbstract:Acute Otitis Media (AOM) is a common complication of upper respiratory tract infection whose pathogenesis involves both viruses and bacteria. We examined risks of acute Otitis Media associated with specific combinations of respiratory viruses and acute Otitis Media bacterial pathogens. Data were from a prospective study of children ages 6 to 36 months and included viral and bacterial culture and quantitative PCR for respiratory syncytial virus (RSV), human bocavirus, and human metapneumovirus. Repeated-measure logistic regression was used to assess the relationship between specific viruses, bacteria, and the risk of acute Otitis Media complicating upper respiratory tract infection. In unadjusted analyses of data from 194 children, adenovirus, bocavirus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were significantly associated with AOM (P < 0.05 by χ(2) test). Children with high respiratory syncytial virus loads (≥3.16 × 10(7) copies/ml) experienced increased acute Otitis Media risk. Higher viral loads of bocavirus and metapneumovirus were not significantly associated with acute Otitis Media. In adjusted models controlling for the presence of key viruses, bacteria, and acute Otitis Media risk factors, acute Otitis Media risk was independently associated with high RSV viral load with Streptococcus pneumoniae (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.90 and 10.19) and Haemophilus influenzae (OR, 2.04; 95% CI, 1.38 and 3.02). The risk was higher for the presence of bocavirus and H. influenzae together (OR, 3.61; 95% CI, 1.90 and 6.86). Acute Otitis Media risk differs by the specific viruses and bacteria involved. Acute Otitis Media prevention efforts should consider methods for reducing infections caused by respiratory syncytial virus, bocavirus, and adenovirus in addition to acute Otitis Media bacterial pathogens.
-
importance of respiratory viruses in acute Otitis Media
Clinical Microbiology Reviews, 2003Co-Authors: Terho Heikkinen, Tasnee ChonmaitreeAbstract:Acute Otitis Media is usually considered a simple bacterial infection that is treated with antibiotics. However, ample evidence derived from studies ranging from animal experiments to extensive clinical trials supports a crucial role for respiratory viruses in the etiology and pathogenesis of acute Otitis Media. Viral infection of the upper respiratory mucosa initiates the whole cascade of events that finally leads to the development of acute Otitis Media as a complication. The pathogenesis of acute Otitis Media involves a complex interplay between viruses, bacteria, and the host’s inflammatory response. In a substantial number of children, viruses can be found in the middle-ear fluid either alone or together with bacteria, and recent studies indicate that at least some viruses actively invade the middle ear. Viruses appear to enhance the inflammatory process in the middle ear, and they may significantly impair the resolution of Otitis Media. Prevention of the predisposing viral infection by vaccination against the major viruses would probably be the most effective way to prevent acute Otitis Media. Alternatively, early treatment of the viral infection with specific antiviral agents would also be effective in reducing the occurrence of acute Otitis Media.
