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Arto A Palmu - One of the best experts on this subject based on the ideXlab platform.
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impact of national ten valent pneumococcal conjugate vaccine program on reducing antimicrobial use and Tympanostomy Tube placements in finland
Pediatric Infectious Disease Journal, 2017Co-Authors: Arto A Palmu, Hanna Rintakokko, Hanna Nohynek, Pekka J Nuorti, Jukka JokinenAbstract:Background:Otitis media in young children is associated with major resource use including antimicrobial consumption and Tympanostomy Tube placements (TTPs). We evaluated the impact of 10-valent pneumococcal conjugate vaccine (PCV10) introduction into the Finnish National Vaccination Programme (NVP)
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effectiveness of the ten valent pneumococcal conjugate vaccine against Tympanostomy Tube placements in a cluster randomized trial
Pediatric Infectious Disease Journal, 2015Co-Authors: Arto A Palmu, Jukka Jokinen, Heta Nieminen, Hanna Rintakokko, Esa Ruokokoski, Taneli Puumalainen, Magali Traskine, Marta Moreira, Dorota Borys, Lode SchuermanAbstract:Background:We evaluated the impact of the new pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10, GSK Vaccines) on Tympanostomy Tube placements (TTPs).Methods:Finnish Invasive Pneumococcal disease vaccine trial was a nationwide phase III/IV cluster-randomized, double-blind tr
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long term effect of pneumococcal conjugate vaccines on Tympanostomy Tube placements
Pediatric Infectious Disease Journal, 2013Co-Authors: Ilona D Sarasoja, Jukka Jokinen, Mika Lahdenkari, Terhi Kilpi, Arto A PalmuAbstract:Background: We have previously shown that the 7-valent pneumococcal conjugate vaccine (PncCRM) given in infancy is effective in reducing Tympanostomy Tube placements up to 4 to 5 years of age. This study aimed to assess the effectiveness of pneumococcal conjugate vaccines PncCRM and PncOMPC from 2 up to 13 years of age. Methods: Altogether 2497 children participated in the Finnish Otitis Media Vaccine trial conducted in 1995 to 1999 and were vaccinated at 2, 4, 6 and 12 months of age with PncCRM or PncOMPC or hepatitis B vaccine as controls. The data for Tympanostomy Tube placements were collected from health registers including hospital and private office operations. Vaccine efficacy was estimated by comparing incidences of tympanostomies from 2 to 12–13 years of age in each of the pneumococcal vaccine groups with the control group. Results: Register data were searched for 2474 subjects. A total of 535 Tympanostomy Tube placements were identified in the health registers from 1998 through 2008 with a cumulative incidence of 14.6% from 2 to 13 years of age in the control group. The vaccine impact was age-dependent: from 2 through 5 years of age the vaccine effectiveness was 34% (95% confidence interval: 1% to 52%) for PncCRM and 6% (–28 to 31) for the PncOMPC vaccine. For the age group of 6 to 12–13 years the vaccine effectiveness estimates for the PncCRM and PncOMPC groups were –13% (–137 to 46) and –2% (–123 to 54), respectively. Conclusions: PncCRM vaccine reduced the Tympanostomy Tube placements up to 5 years of age. No impact on new surgical procedures could be demonstrated after that but the benefit achieved was sustained.
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the seven valent pneumococcal conjugate vaccine reduces Tympanostomy Tube placement in children
Pediatric Infectious Disease Journal, 2004Co-Authors: Arto A Palmu, Jukka Jokinen, Jouko Verho, Pekka Karma, Terhi KilpiAbstract:Background:The novel pneumococcal conjugate vaccine, PncCRM, has been shown to prevent acute otitis media caused by vaccine serotypes and to reduce otitis surgery. Our aim was to assess long term efficacy of the vaccine on Tympanostomy Tube placements.Methods:Children with complete follow-up in the
Jukka Jokinen - One of the best experts on this subject based on the ideXlab platform.
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impact of national ten valent pneumococcal conjugate vaccine program on reducing antimicrobial use and Tympanostomy Tube placements in finland
Pediatric Infectious Disease Journal, 2017Co-Authors: Arto A Palmu, Hanna Rintakokko, Hanna Nohynek, Pekka J Nuorti, Jukka JokinenAbstract:Background:Otitis media in young children is associated with major resource use including antimicrobial consumption and Tympanostomy Tube placements (TTPs). We evaluated the impact of 10-valent pneumococcal conjugate vaccine (PCV10) introduction into the Finnish National Vaccination Programme (NVP)
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effectiveness of the ten valent pneumococcal conjugate vaccine against Tympanostomy Tube placements in a cluster randomized trial
Pediatric Infectious Disease Journal, 2015Co-Authors: Arto A Palmu, Jukka Jokinen, Heta Nieminen, Hanna Rintakokko, Esa Ruokokoski, Taneli Puumalainen, Magali Traskine, Marta Moreira, Dorota Borys, Lode SchuermanAbstract:Background:We evaluated the impact of the new pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10, GSK Vaccines) on Tympanostomy Tube placements (TTPs).Methods:Finnish Invasive Pneumococcal disease vaccine trial was a nationwide phase III/IV cluster-randomized, double-blind tr
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long term effect of pneumococcal conjugate vaccines on Tympanostomy Tube placements
Pediatric Infectious Disease Journal, 2013Co-Authors: Ilona D Sarasoja, Jukka Jokinen, Mika Lahdenkari, Terhi Kilpi, Arto A PalmuAbstract:Background: We have previously shown that the 7-valent pneumococcal conjugate vaccine (PncCRM) given in infancy is effective in reducing Tympanostomy Tube placements up to 4 to 5 years of age. This study aimed to assess the effectiveness of pneumococcal conjugate vaccines PncCRM and PncOMPC from 2 up to 13 years of age. Methods: Altogether 2497 children participated in the Finnish Otitis Media Vaccine trial conducted in 1995 to 1999 and were vaccinated at 2, 4, 6 and 12 months of age with PncCRM or PncOMPC or hepatitis B vaccine as controls. The data for Tympanostomy Tube placements were collected from health registers including hospital and private office operations. Vaccine efficacy was estimated by comparing incidences of tympanostomies from 2 to 12–13 years of age in each of the pneumococcal vaccine groups with the control group. Results: Register data were searched for 2474 subjects. A total of 535 Tympanostomy Tube placements were identified in the health registers from 1998 through 2008 with a cumulative incidence of 14.6% from 2 to 13 years of age in the control group. The vaccine impact was age-dependent: from 2 through 5 years of age the vaccine effectiveness was 34% (95% confidence interval: 1% to 52%) for PncCRM and 6% (–28 to 31) for the PncOMPC vaccine. For the age group of 6 to 12–13 years the vaccine effectiveness estimates for the PncCRM and PncOMPC groups were –13% (–137 to 46) and –2% (–123 to 54), respectively. Conclusions: PncCRM vaccine reduced the Tympanostomy Tube placements up to 5 years of age. No impact on new surgical procedures could be demonstrated after that but the benefit achieved was sustained.
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the seven valent pneumococcal conjugate vaccine reduces Tympanostomy Tube placement in children
Pediatric Infectious Disease Journal, 2004Co-Authors: Arto A Palmu, Jukka Jokinen, Jouko Verho, Pekka Karma, Terhi KilpiAbstract:Background:The novel pneumococcal conjugate vaccine, PncCRM, has been shown to prevent acute otitis media caused by vaccine serotypes and to reduce otitis surgery. Our aim was to assess long term efficacy of the vaccine on Tympanostomy Tube placements.Methods:Children with complete follow-up in the
Patrick J. Antonelli - One of the best experts on this subject based on the ideXlab platform.
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randomized clinical trial of a sustained exposure ciprofloxacin for intratympanic injection during Tympanostomy Tube surgery
Annals of Otology Rhinology and Laryngology, 2016Co-Authors: Eric A Mair, Patrick J. Antonelli, Jonathan R Moss, Joseph E Dohar, Moraye Bear, Carl LebelAbstract:Objective:This exploratory clinical trial evaluated the safety and clinical activity of a novel, sustained-exposure formulation of ciprofloxacin microparticulates in poloxamer (OTO-201) administered during Tympanostomy Tube placement in children.Methods:Double-blind, randomized, prospective, placebo- and sham-controlled, multicenter Phase 1b trial in children (6 months to 12 years) with bilateral middle ear effusion requiring Tympanostomy Tube placement. Patients were randomized to intraoperative OTO-201 (4 mg or 12 mg), placebo, or sham (2:1:1 ratio).Results:Eighty-three patients (52 male/31 female; mean age, 2.80 years) were followed for safety (otoscopic exams, cultures, audiometry, and tympanometry) and clinical activity, defined as treatment failure (physician-documented otorrhea and/or otic or systemic antibiotic use ≥3 days post surgery). At baseline, 14.3% to 36.8% of children showed positive cultures of middle ear effusion samples in at least 1 ear. Through day 15, treatment failures accounted fo...
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effect of Tympanostomy Tube surface on occlusion
International Journal of Pediatric Otorhinolaryngology, 2012Co-Authors: Nimish A Patel, Ethan G Sherman, Patrick J. AntonelliAbstract:Abstract Objective Premature Tympanostomy Tube (TT) occlusion frequently leads to TT replacement surgery. TT surface preparations have been suggested as a means of reducing TT occlusion. The purpose of this study is to determine if commercial TT compositions or surface preparations impact the rate of TT occlusion using an in vitro model. Methods Commercial TTs composed of titanium, fluoroplastic, and silicone, as well as human serum albumin coated titanium, phosphorylcholine coated fluoroplastic, and polyvinylpyrrolidone coated silicone TTs, were tested for occlusion development in a previously validated in vitro model that simulates middle ear air and mucus flow. Results Time to occlusion was longer with all coated TTs relative to all uncoated TTs (p = 0.038). Polyvinylpyrrolidone coated silicone TTs had the lowest rate of occlusion and improvement relative to silicone (36% vs. 70%). Time to occlusion was longer in all coated TTs, but individually, none reached statistical significance. Conclusion TT composition and surface preparations do not dramatically impact the development of TT occlusion. All tested surface coatings seem to delay TT occlusion in this in vitro model. In vivo testing will be necessary to validate these findings.
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topical antibiotic treatment reduces Tympanostomy Tube biofilm formation
Laryngoscope, 2011Co-Authors: Robert G Thomas, Carolyn P Ojanodirain, Patrick J. AntonelliAbstract:Objectives: Single doses of different ototopical antibiotic preparations (OAPs) have been shown to have an unequal reduction of post Tympanostomy Tube otorrhea (PTTO). Microbial biofilm formation on the Tympanostomy Tube (TT) has been implicated as one cause of PTTO. The goal of this study was to determine if TT exposure to a single dose of OAP reduces biofilm formation by Pseudomonas aeruginosa. Study Design: Prospective and controlled. Methods: Fluoroplastic TTs were briefly exposed to plasma, followed by one of three OAPs (ofloxacin, neomycin/polymyxin B/hydrocortisone, or ciprofloxacin/dexamethasone) or saline (20 TT per group). TTs were placed in growth media with P. aeruginosa and incubated for 4 days, during which total bacterial growth was monitored by media turbidity. At 4 days, planktonic organisms were killed and biofilm development was measured with microbial counts. Results: Bacterial growth was significantly delayed by OAPs, with the least growth seen with ciprofloxacin/dexamethasone followed by ofloxacin and neomycin/polymyxin B/hydrocortisone (P ≤ .0001). At day 4, bacterial growth was less with ciprofloxacin/dexamethasone than ofloxacin and neomycin/polymyxin B/hydrocortisone (P .05). Conclusions: Treatment of TTs with ototopical antibiotic preparations reduces P. aeruginosa growth and biofilm formation in vitro. This may, in part, explain the reduction of PTTO rates observed with single doses of OAPs.
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Effect of blood and mucus on Tympanostomy Tube biofilm formation.
Laryngoscope, 2008Co-Authors: John Malaty, Patrick J. AntonelliAbstract:Objectives/Hypothesis: Tympanostomy Tube (TT) biofilm formation may lead to refractory otorrhea and occlusion. The aim of this study was to determine whether TT biofilm formation may be promoted by mucus or blood exposure. Study Design: In vitro, controlled. Methods: Fluoroplastic TTs were exposed to blood, mucoid effusion, or saline. Half were allowed to dry. TTs were cultured with Pseudomonas aeruginosa. After 4 days, gentamicin was added to kill planktonic bacteria. Biofilm formation was assessed by quantitative bacterial counts and scanning electron microscopy. Results: Mucus pretreatment (dry and wet) did not increase biofilm formation. Both dry and wet blood exposure increased biofilm formation by bacterial counts (P < .0001). Biofilm formation was demonstrated by electron microscopy in all groups. Conclusions:P. aeruginosa biofilm formation on fluoroplastic TTs is enhanced by blood exposure. Care should be taken to minimize bleeding with TT placement to reduce the risk of biofilm formation.
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Defining Tympanostomy Tube plugs.
The Laryngoscope, 2002Co-Authors: John G. Westine, Carla M. Giannoni, Patrick J. AntonelliAbstract:Objectives: To define the composition of Tympanostomy Tube plugs because selecting or developing effective solvents depends on such knowledge. Study Design: Prospective, in vitro laboratory study. Methods: Luminal contents of 105 plugged, microscopically removed Tympanostomy Tubes were expressed, pooled, acid hydrolyzed, and passed through a high-performance liquid chromatography column. Retention times were compared with high-performance liquid chromatography standards to develop free amino acid and monosaccharide profiles. Cerumen, blood, and chronic mucoid effusion (collected during myringotomy) were pooled and subjected to the same analysis. The elution profiles of each substance were compared to determine which substance most closely matched the plugs. Results: High-performance liquid chromatography amino acid and monosaccharide analysis demonstrated greatest similarity between Tympanostomy Tube plugs and mucoid effusion. Conclusions: Tympanostomy Tube plug composition is more similar to mucoid effusion than to blood or cerumen. Solvents to open plugged Tympanostomy Tubes should be directed against the components of mucoid effusion.
Terhi Kilpi - One of the best experts on this subject based on the ideXlab platform.
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long term effect of pneumococcal conjugate vaccines on Tympanostomy Tube placements
Pediatric Infectious Disease Journal, 2013Co-Authors: Ilona D Sarasoja, Jukka Jokinen, Mika Lahdenkari, Terhi Kilpi, Arto A PalmuAbstract:Background: We have previously shown that the 7-valent pneumococcal conjugate vaccine (PncCRM) given in infancy is effective in reducing Tympanostomy Tube placements up to 4 to 5 years of age. This study aimed to assess the effectiveness of pneumococcal conjugate vaccines PncCRM and PncOMPC from 2 up to 13 years of age. Methods: Altogether 2497 children participated in the Finnish Otitis Media Vaccine trial conducted in 1995 to 1999 and were vaccinated at 2, 4, 6 and 12 months of age with PncCRM or PncOMPC or hepatitis B vaccine as controls. The data for Tympanostomy Tube placements were collected from health registers including hospital and private office operations. Vaccine efficacy was estimated by comparing incidences of tympanostomies from 2 to 12–13 years of age in each of the pneumococcal vaccine groups with the control group. Results: Register data were searched for 2474 subjects. A total of 535 Tympanostomy Tube placements were identified in the health registers from 1998 through 2008 with a cumulative incidence of 14.6% from 2 to 13 years of age in the control group. The vaccine impact was age-dependent: from 2 through 5 years of age the vaccine effectiveness was 34% (95% confidence interval: 1% to 52%) for PncCRM and 6% (–28 to 31) for the PncOMPC vaccine. For the age group of 6 to 12–13 years the vaccine effectiveness estimates for the PncCRM and PncOMPC groups were –13% (–137 to 46) and –2% (–123 to 54), respectively. Conclusions: PncCRM vaccine reduced the Tympanostomy Tube placements up to 5 years of age. No impact on new surgical procedures could be demonstrated after that but the benefit achieved was sustained.
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the seven valent pneumococcal conjugate vaccine reduces Tympanostomy Tube placement in children
Pediatric Infectious Disease Journal, 2004Co-Authors: Arto A Palmu, Jukka Jokinen, Jouko Verho, Pekka Karma, Terhi KilpiAbstract:Background:The novel pneumococcal conjugate vaccine, PncCRM, has been shown to prevent acute otitis media caused by vaccine serotypes and to reduce otitis surgery. Our aim was to assess long term efficacy of the vaccine on Tympanostomy Tube placements.Methods:Children with complete follow-up in the
Hanna Rintakokko - One of the best experts on this subject based on the ideXlab platform.
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impact of national ten valent pneumococcal conjugate vaccine program on reducing antimicrobial use and Tympanostomy Tube placements in finland
Pediatric Infectious Disease Journal, 2017Co-Authors: Arto A Palmu, Hanna Rintakokko, Hanna Nohynek, Pekka J Nuorti, Jukka JokinenAbstract:Background:Otitis media in young children is associated with major resource use including antimicrobial consumption and Tympanostomy Tube placements (TTPs). We evaluated the impact of 10-valent pneumococcal conjugate vaccine (PCV10) introduction into the Finnish National Vaccination Programme (NVP)
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effectiveness of the ten valent pneumococcal conjugate vaccine against Tympanostomy Tube placements in a cluster randomized trial
Pediatric Infectious Disease Journal, 2015Co-Authors: Arto A Palmu, Jukka Jokinen, Heta Nieminen, Hanna Rintakokko, Esa Ruokokoski, Taneli Puumalainen, Magali Traskine, Marta Moreira, Dorota Borys, Lode SchuermanAbstract:Background:We evaluated the impact of the new pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10, GSK Vaccines) on Tympanostomy Tube placements (TTPs).Methods:Finnish Invasive Pneumococcal disease vaccine trial was a nationwide phase III/IV cluster-randomized, double-blind tr
