Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a review and critical appraisal of the literature on antibiotic therapy for acute otitis media in children between 1939 and 1991, poor evidence supported the routine use of antibiotic therapy. Good evidence supported initial symptomatic treatment and institution of antibiotic therapy only in cases of an irregular course (fever or pain for more than 48 to 72 hours) in children 2 years and older. This approach cannot be recommended for children 2 years and younger because this age group has been excluded from most studies.
 ...
PMID:Acute otitis media in children. Role of antibiotic therapy. 821 63

Within a prospective group study of five practicing otorhinolaryngologists, conventional therapy of acute otitis media in children was compared with homeopathic treatments. Group A (103 children) was primarily treated with homeopathic single remedies (Aconitum napellus, Apis mellifica, Belladonna, Capsicum, Chamomilla, Kalium bichromicum, Lachesis, Lycopodium, Mercurius solubilis, Okoubaka, Pulsatilla, Silicea). Group B (28 children) was treated by decongestant nose-drops, antibiotics, secretolytics and/or antipyretics. Comparisons were done by symptoms, physical findings, duration of therapy and number of relapses. The children of the study were between 1 and 11 years of age. The difference in numbers was explained by the children with otitis media being primarily treated by pediatricians using conventional methods. The median duration of pain in group A was 2 days and in group B 3 days. Median therapy in group A lasted 4 days and in group B 10 days. Antibiotics were given over a period of 8-10 days, while homeopathic treatments were stopped after healing. In group A 70.7% of the patients were free of relapses within 1 years and 29.3% had a maximum of three relapses. Group B had 56.5% without relapses and 43.5% a maximum of six relapses. Five children in group A were given antibiotics and 98 responded solely to homeopathic treatments. No side effects of treatment were found in either group.
 ...
PMID:[Acute otitis media in children. Comparison between conventional and homeopathic therapy]. 880 13

Timmy, a two-year-old, has received two antibiotic courses (ampicillin, cefaclor) for acute otitis media during the past year. Today, his mom visits your pharmacy and mentions that they have just returned from an appointment with the boy's doctor. Timmy was diagnosed with otitis media with effusion, which the doctor described as fluid in the ears unaccompanied by fever or any signs of pain or discomfort. She is puzzled that the doctor did not prescribe any antibiotics this time. Worried about her son's recurrent ear problems, she asks your advice. Your review of Timmy's history reveals that he is otherwise healthy except for the two previous episodes of acute otitis media. Further discussion with Timmy's mom also reveals that his father is a heavy smoker.
 ...
PMID:Management of otitis media with effusion. 882 81

Two hundred and nineteen children (boys: 56%, girls: 44%) were included in a randomized, double-blind, multicentre (4 centres) controlled trial designed to assess the efficacy and safety of ibuprofen (IBU) in the treatment of 1 to 6 year-old children with otoscopically proven acute otitis media (AOM), either unilateral or bilateral. They randomly received 10 mg/kg IBU (n = 71), or acetaminophen (PARA) (n = 73) or placebo (PLA) (n = 75), orally, tid, for 48 hours. All received oral cefaclor (Alfatil, Lilly, France) for seven days. They were evaluated before (D0) and at the end of treatment (D2). The main criterion of response was the aspect (landmarks and color) of the tympanic membrane assessed on a semi-quantitative scale from 0 to 6. Other criteria, assessed on semi-quantitative scales, included relief of pain (0 or 1), rectal temperature (0 to 2), and overall evaluation by parents of the improvement of quality of life on three items: appetite (0 to 2), sleep (0 to 2), and playing activity (0 to 2). The results at D2 were as follows: there was no significant difference between treatment groups as to the main criterion, but only a trend for IBU and PARA to do better than PLA but not for IBU to do better than PARA. From these data there is no argument to emphasize the utility of non-steroidal anti-inflammatory drugs (NSAIDs) in treating the inflammatory signs of the tympanic membrane in otitis. There was a statistically significant difference between treatment groups at D2 for pain, IBU being superior to PLA (P < 0.01): 7%, 10% and 25% of the children were still suffering at D2 in the IBU, PARA and PLA treatment groups, respectively. The difference between PARA and PLA for pain was not statistically significant. There was no significant difference between treatment groups for the other criteria. All treatments were well and equally tolerated. Although no significant difference was found between the treatment groups on the aspect of the tympanic membrane, the efficacy of IBU was evidenced on the relief of pain, the symptom that most disturbs the child.
 ...
PMID:A randomized, double-blind, multicentre controlled trial of ibuprofen versus acetaminophen and placebo for symptoms of acute otitis media in children. 887 Nov 38

We undertook a retrospective study to examine our experience with acute mastoiditis over a 12-year period. Fifty-eight cases were identified in children aged 3 months to 15 years. Acute mastoiditis was the first evidence of otitis media in 54% of our patients. Pain and fever lasting for more than a median period of 4 days were most likely to be the harbingers of incipient acute mastoiditis. Streptococcus pneumoniae was the most common organism recovered from the cultures. All children were treated with intravenous antibiotics; 41 children were managed with an adjunctive drainage procedure. No statistically significant differences were observed between the cure rates and failure rates for children treated surgically with myringotomies with or without tubes and children managed more aggressively with mastoidectomies. One infant had bacterial meningitis. Cholesteatoma was diagnosed in two children. We conclude from our study that acute mastoiditis occurs mainly in young children and may be the first evidence of ear disease. Pain and fever that persist despite appropriate treatment for acute otitis media are the two most important symptoms. Intravenous antibiotics combined with myringotomy with or without tube insertion are as appropriate as intravenous antibiotics with mastoidectomy for initial management of acute mastoiditis in the absence of a subperiosteal abscess or central nervous system extension.
 ...
PMID:Acute mastoiditis in children: a 12-year retrospective study. 933 11

A recent analysis of the evidence suggests that, in Western countries the use of antibiotics as initial treatment for children with acute otitis media benefits one out of 20 children by reducing pain in the acute phase. There is no evident benefit for deafness, recurrent attacks or complications. This suggests that we should use antibiotics less readily.
 ...
PMID:Acute otitis media in children. Are antibiotics always appropriate? 950 13

Otalgia is a common symptom in the pediatric age group. The most common cause is acute otitis media, followed by otitis externa. In the majority of cases, the diagnosis can be established by a thorough history and a careful otologic examination. When the otologic findings are normal and the etiology is obscure, a thorough work-up to determine the source of referred pain is essential. Laboratory investigations are usually not necessary. Treatment should always be directed at the underlying cause.
 ...
PMID:Otalgia in children. 1140 97

(1) Ceftriaxone, a third-generation cephalosporin antibiotic, is now licensed in France for (intramuscular) treatment of acute otitis media in children, both as first-line therapy in children under 30 months, and after failure of a first antibiotic regimen. (2) The clinical file on first-line ceftriaxone treatment is relatively bulky. In contrast, only two non comparative trials of ceftriaxone after failure of initial treatment are available. (3) According to trials of first-line treatment, the efficacy of a single intramuscular dose of ceftriaxone is equivalent to that of the sulfamethoxazole + trimethoprim combination and the amoxicillin + clavulanic acid combination, and similar to that of amoxicillin (when all these reference antibiotics are given orally for 10 days). (4) Pain at the injection site is the main adverse effect of ceftriaxone, despite the local anaesthetic (lidocaine) contained in the solvent.
 ...
PMID:Ceftriaxone and otitis in children: new indication. Only in special circumstances. 1106 16

Preventing recurrent acute otitis media (AOM) is a goal of child health care. The objective is to reduce the frequency of pain and fever, shorten the duration of hearing loss, reduce the costs of physician visits, surgery and drugs, reduce parent anxiety, and prevent long term sequelae. Preventive approaches include understanding individual and familial risk factors, avoidance of environmental risk factors, antibiotic drug prophylaxis, polyvalent pneumococcal vaccination, myringotomy with tympanostomy tubes, and adenoidectomy. Earlier and more aggressive treatment can be provided to infants at increased risk. Antibiotic prophylaxis is challenged by a relatively small benefit and emerging resistant bacteria. Tympanostomy tubes are beneficial in chronic otitis media with effusion (OME), but of less value in recurrent AOM absent chronic OME. Adenoidectomy after tympanostomy tube failure is supported by at least one clinical trial.
 ...
PMID:Otitis media prevention: non-vaccine prophylaxis. 1116 76

Although mastoiditis can be a life threatening disease, clinicians often overlook it because it is uncommon. We reviewed the presentation and management of all children younger than 15 years of age with the discharge diagnosis of mastoiditis in our hospital from January 1994 through December 1999. Nineteen patients that fulfilled the case definition were included. The most common clinical presentation in this series was fever. More specific findings, such as otorrhea, postauricular pain, swelling, and redness of mastoid could be found in less than half of these patients. Only two patients had characteristic physical findings, and mastoiditis was diagnosed in only three patients upon admission. Plain radiographic evidence of mastoiditis was usually not apparent early in the course. In this series, the majority of patients were diagnosed by computed tomography (CT) scans. The present study demonstrates that mastoiditis most commonly presents without a clearly diagnostic set of physical examination and laboratory findings. Mastoiditis should be considered in patients with otitis media or with fever of unknown origin (FUO). The empirical antibiotic treatment should cover organisms commonly found in acute otitis media (AOM), including Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis.
 ...
PMID:Mastoiditis: a disease often overlooked by pediatricians. 1126 68


<< Previous 1 2 3 4 5 6 7 8 Next >>