Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0017168 (gastroesophageal reflux disease)
11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

OBJECTIVE: Otitis media is the most frequently diagnosed infection in the pediatric office. Ninety per cent of the children present at least one episode of otitis media before the fifth birthday. We reviewed the literature in order to update information regarding the current definitions of acute otitis media, recurrent otitis media and otitis media with effusion, analyzing the predisposing factors, microbiology, clinical manifestations, diagnostic criteria and methods of treatment for these entities, and the relationship between otitis media and language development and learning disabilities.DATA SOURCE: Bibliographic review of an eighteen- year period (1980-1998) using Index Medicus and Medline.RESULTS AND CONCLUSIONS: More than 25 million diagnoses per year of middle ear infections are made in the United States, being responsible for rising costs of treatment. The role of many predisposing factors is presently well recognized and we should be capable of defining interventions related to some of them as is the case of early institution of day-care, short duration of breast feeding and difficulties in the identification and treatment of gastroesophageal reflux. Changes in the microbiology of the middle ear infections and the emergence of multiresistant bacteria leads to modifications in antibiotic therapy and the duration of its use. Antibacterial agents should be prescribed only in the presence of a well-defined diagnosis and chemoprophylaxis should be avoided. Recurrent otitis media and otitis media with effusion in infants may be associated to speech disorders and learning disabilities. The development of a conjugated vaccine against S. pneumoniae and the experiments with a vaccine against non-typeable H. influenzae represent a big step in the prevention of infections of the middle ear for the near future.
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PMID:[Acute and secretory otitis media] 1468 71

Streptococcus pneumoniae is the most frequent pathogen in young children's acute otitis media. It also plays a significant role in nosocomial ear infection in children, while it causes pneumonia with or without bacteremia in hospitalized elderly people. Multiple antibiotic resistant strains are prevalent among S. pneumoniae isolates from the respiratory tract of hospitalized patients in Hungary. This fact makes therapeutic reconsiderations concerning the use of oral beta-lactams mandatory. In this retrospective study two nosocomial outbreaks caused by multiresistant S. pneumoniae in two pediatric hospitals are described. The patients admitted with a chronic underlying disease (milk intolerance and gastro-oesophageal reflux were predominant) or respiratory tract infection acquired acute otitis media. Therapy with oral beta-lactams (first and second generation cephalosporins and amoxicillin), macrolides and co-trimoxazole was ineffective in most of the cases or resulted in transient improvement. In some cases acute otitis media resolved with the improvement of the underlying condition, in two cases administration of cefotaxime resulted in recovery and in one case mastoidectomy became necessary.
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PMID:Nosocomial Streptococcus pneumoniae infection causing children's acute otitis media. 1861 82

Otitis media (OM) is one of the most common pediatric infections worldwide, but the complex microbiology associated with OM is poorly understood. Previous studies have shown an association between OM and gastroesophageal reflux (GER) in children. Therefore, in order to bridge the gap in our current understanding of the interaction between GER and OM, we investigated the nasopharyngeal and middle ear microbiota of children suffering from GER-associated OM and OM only, using culture-independent 16S rRNA gene sequencing. Middle ear fluid, nasopharyngeal swabs, and clinical data were collected as part of a prospective pilot study conducted at the Department of Otorhinolaryngology of the Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. A total of 30 children up to 12 years of age who suffered from recurrent acute otitis media (AOM) (5), chronic otitis media with effusion (OME) (23), or both (2), and who were listed for tympanostomy tube placement, were included in the study. Nine children were included in the GER-associated OM cohort and 21 in the OM-only cohort. We found no obvious effect of GER on the nasopharyngeal and middle ear microbiota between the two groups of children. However, our results highlight the need to assess the true role of Alloiococcus spp. and Turicella spp. in children presenting with a high prevalence of recurrent AOM and chronic OME.
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PMID:Characterization of the nasopharyngeal and middle ear microbiota in gastroesophageal reflux-prone versus gastroesophageal reflux non-prone children. 2940 36

International consensus on the treatment of pediatric otitis media with effusion and current status of treatment in China Summary Otitis media with effusion (OME) is a non-suppurative inflammatory disease of the middle ear characterized by middle ear effusion and hearing loss, which is common in children.The main impact of OME in children is hearing loss and cooccurring recurrent acute otitis media, which would affect speech language development. Thus OME should be highly vigilant and prompt treatment is necessary. There have been many guidelines and evidence-based medicine research on the diagnosis and treatment of OME in children. But there is still no unified conclusion. International Federation of Otorhinolaryngological Societies Congress(IFOS) published an international consensus on the diagnosis and treatment of OME in children in 2017 to promote the standardized diagnosis and treatment of the disease. The guidelines suggest that gastroesophageal reflux and allergy should be routinely evaluated in children with OME. Children should be routinely evaluated by hearing tests. Steroids, antibiotics, and decongestants are not recommended because they have no evidence of definite efficacy and could cause side effects. Patients with ineffective conservative treatment should undergo myringotomy, and children over 4 years old should also consider adenoidectomy.
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PMID:[International consensus on the treatment of pediatric otitis media with effusion and current status of treatment in China]. 3040 Jun 96