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Query: UMLS:C0262471 (ENT)
5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After the review of the morphology, the identification and the pathogenic properties of H. influenzae, its occurrence in the different ENT infections is discussed. H. influenzae is found in chronic tonsillitis in 64% of the cases, in the deeper tissue of the tonsils, while its occurrence in the throat swabs is rare. In acute otitis media H. Influenzae is present in 10 to 150% of the cases, while in rhinitis and sinusitis its increasing occurrence until 1974 is noted (28% of all sinusitis cases showed H. Influenzae in that year); since 1974 its occurrence is somewhat decreasing: 18% in 1976. Susceptibility testing for antibiotics with the disc-method is unreliable; we have to use the tube or plate-dilution methods. The increasing occurrence of ampicilline resistant strains of H. influenzae is discussed.
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PMID:[Increasing importance of Haemophilus influenzae in nose, ear and throat infections]. 30 28

On the basis of our own experiences and the current literature, the following guidelines were established for the evaluation of scubadivers: 1. The ENT physical examination must include otoscopy and the valsalva manoeuver. The scubadiver should be able to promptly and symmetrically inflate his middle ear spaces. A central perforation is a relative contraindication, while a marginal ear drum perforation is an absolute contraindication for scubadiving. 2. Recommendations to the diver: Ear pressure equalibration should be performed continuously with increasing and decreasing water depth. Ear plugs should never be used. 3. Management of diving injuries: Barotitis should be treated in a manner similar to acute otitis media. Transient vertigo while ascending (alternobaric vertigo) without nystagmus or hearing impairment needs no further vestibular examination. A middle ear exploration is indicated when there is suspicion of a perilymphatic fistula.
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PMID:[Middle and inner ear barotrauma caused by scubadiving (author's transl)]. 52 29

The etiology of middle ear disease in Nijmegen, The Netherlands was studied on the basis of a data set collected in a prospective epidemiological study on otitis media with effusion (OME) in a cohort of 1439 preschool children. A factor analysis was used to evaluate two hypotheses: (1) that OME, acute otitis media (AOM), common cold and tonsillitis are manifestations of the same pathological entity, and (2) that a group of children can be distinguished who develop these conditions more frequently than average. The results only partly supported these hypotheses. The correlation between OME, AOM, common cold and tonsillitis was lower than expected from a review of the literature. Common cold appeared to be the ubiquitous ENT disease in childhood and, depending on the child's predisposition, could be accompanied by OME, AOM or tonsillitis. The course of middle ear and upper airway disease showed a gradual scale from "healthy" to "ill" with most of the children suffering from these conditions at an average frequency.
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PMID:An epidemiological approach to the etiology of middle ear disease in The Netherlands. 148 34

The combination of erythromycin ethylsuccinate and acetyl sulfafuroxazole (Pediazole = ES) is effective against Hemophilus influenzae, including beta-lactamase-producing strains, and against Streptococcus pneumoniae, including macrolide-resistant strains. In this study, mean daily dosage was 40-50 mg/kg for cefaclor and 50 mg/kg ES + 150 mg/kg sulfamide for Pediazole. Both products were given in three divided doses per day for ten days. Tolerance was evaluable in 106 children and effectiveness in 103 children including 52 in the ES group and 51 in the cefaclor group. Mean age was 23.5 months and both groups were comparable as concerns age, weight, previous ENT disease, and severity of the otitis media. Tolerance was satisfactory in both groups. Clinical results were as follows: failures before or at completion of the course, 5/52 in the ES group versus 13/51 in the cefaclor for the treatment of children with acute otitis media.
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PMID:[An open randomized trial, Pediazole versus cefaclor in the treatment of acute otitis media in children]. 202 23

During 1983-87, tympanostomy tubes were inserted in a total of 4952 ears of 2575 children remitted to the ENT Department of our hospital because of chronic or recurrent otitis media problems. The children were included in a prospective study and referred to one of three groups for comparison of findings. Group 1 included all 6- to 12-month-old infants undergoing primary tube treatment; group 2, all children 1 year or older who had their first ventilation tube(s) inserted in connection with adenoidectomy; and group 3, all children in whom tympanostomy had been performed one or more times previously. Middle ear effusion was aspirated from 2392 ears (48%); 67.6% of all ears were negative for bacteria and 22.1% of the ears with effusion grew pathogenic bacteria. S. pneumoniae was the most frequently cultured pathogen among the 6 to 12 month olds in group 1, but in groups 2 and 3 H. influenzae occurred more frequently than S. pneumoniae. Beta-lactamase-producing strains of pathogenic bacteria were formed in only 4% of all ears with effusion: H. influenzae in 1.2% and B. catarrhalis in 2.8%. Compared with figures from the United states, the frequency of beta-lactamase-producing strains is low in the present series. This is probably explained by differences in antimicrobial treatment practices; in Finland and the Scandinavian countries, penicillin V is the primary drug for acute otitis media. In light of present results, it seems well-suited for treatment of otitis media in young children.
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PMID:Bacterial findings in middle ear effusion in children. 211 35

The problem of otogenic intracranial complications is very important for medical practice. This paper presents data on the incidence, clinical development and outcome of intracranial complications of purulent otitis media. During 1979-1988 the ENT Department of the City First Aid Hospital treated 82 patients with otogenic intracranial complications, which developed often in the case of acute than chronic otitis media. The lethality rate caused by otogenic meningitis and meningoencephalitis was 0.95% in the patients with acute otitis media and 0.5% in the patients with chronic otitis media. In view of this, it is recommended to extend the list of indications for hospitalization of patients with acute otitis media. It is strongly recommended to admit to hospitals patients with acute otitis media caused by severe flu, pregnant women, patients with severe visceral pathologies, and old age patients.
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PMID:[Otogenic intracranial complications in an urban emergency service hospital]. 215 Jan 38

Over a period of 3 months a complete record was kept in 8 large medical institutions (in the Rostock county) of all children with acute otitis media and an analysis was made of the customary medical procedures followed by doctors for the diagnostics and treatment of these cases. Of the 761 patients (407 boys and 354 girls) 90% were babies and infants; more then 50% of these cases were suffering from otitis media serosa; 25% of the total did not receive antibiotics. A systemic antibiotic therapy was usually prescribed "blindly" and preference (83.7%) was given to penicillins and Berlocombin (a trimethoprim sulfonamide compound). In more than 2/3 of the cases the treatment was given by a paediatrician alone, in less than 10% of the cases only by the ENT specialist and the rest were treated by both departments. It would be advisable to start now to rethink the medical procedures related to initial bacteriological diagnostics as well as the local treatment of the auditory channel. In addition, there is an urgent need for a general "Recommendation on the diagnostics and therapy of otitis media acuta in children". This is now being prepared and should be approved by both specialist associations.
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PMID:[Diagnosis and treatment of acute otitis media in children. An analysis of the status in the Rostock district]. 262 41

To evaluate possible risk factors for developing recurrent acute otitis media (rAOM), 113 children were followed prospectively from birth to the age of 3 years. One of the aims was to determine whether such risk factors could be identified before the onset of the recurrences, so that optimal care and prophylactic measures could be made available at an early stage in such cases, on the basis of continuous follow-up by an ENT specialist. During the follow-up, 13 children developed rAOM, defined as six or more episodes of acute otitis media (AOM) during a 12-month period, 57 children had occasional episodes of AOM, and 43 children had no AOM at all. Of the children with onset of AOM before 6 months of age, 80% developed frequent episodes of AOM. The frequency of other respiratory tract infections and of family histories of otitis-proneness was higher among rAOM children than among the other children. The development of rAOM was unrelated to such factors as sex, familial history of allergy, duration of breast-feeding, or domestic environment. Nor could attendance at day-care centres be concluded as constituting a risk factor for the development of rAOM. An onset of AOM before 6 months of age was highly predictive of subsequent recurrent bouts of AOM, which emphasizes the importance of correct diagnosis in infants.
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PMID:Recurrent acute otitis media. A prospective study of children during the first three years of life. 292 8

The authors report the results of the study of 435 bacteriological samples taken in children presenting with acute otitis media, in the out-patient department of ENT at the hospital Bretonneau (Paris) and in Valognes (Manche) from October 1981 to September 1987. Three bacterial organisms prevailed: Haemophilus (37 and 22% respectively), S. pneumoniae (25 and 7%) and Staphylococcus (16 and 17%). Pseudomonas was fairly frequent in cases with otorrhea, even when recent. Comparison with other studies shows the clear progression of the incidence of Haemophilus in acute otitis media. The percentage of the strains secreting a beta-lactamase was 17% whether the children live in the country or in town. The frequency of S. pneumoniae was independent of age but was clearly lower in cases with prolonged or relapsing otitis. According to these results, the authors discuss the therapeutic strategy for acute otitis media. Amoxicillin still remains the antibiotic of choice. In case of persisting or relapsing otitis, the bacteriological examination will allow choosing the best adapted antibiotic: first generation cephalosporin, clavulanic acid and amoxicillin or trimethoprime and sulfamethoxazole.
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PMID:[Bacteriologic study of acute otitis media in hospitals and private practice]. 320 71

The aim of the present investigation was to determine to what extent beta-lactamase producing Haemophilus influenzae (H.i.) and Branhamella catarrhalis (B.c.) were isolated in cases of failure of treatment of acute otitis media (AOM) with phenoxymethylpenicillin. Among children with suspected therapeutic failure referred to an ENT specialist altogether 11, 15% of those referred, fulfilled the criteria of AOM. Three of them were on erythromycin, 1 on ampicillin and 7 on phenoxymethylpenicillin. In 5 of the children treated with phenoxymethylpenicillin H.i. was isolated from middle ear exudate and/or the nasopharynx. All H.i. isolates were non-capsulated and beta-lactamase negative. One beta-lactamase producing B.c. was isolated from the nasopharynx in a patient with pure culture of H.i. in the ear exudate. The present investigation did not support the suggestion that beta-lactamase producing H.i. or B.c. are major causative agents in therapeutic failures of AOM treated with phenoxymethylpenicillin and did not produce any evidence supporting a change from the recommended ampicillin esters/amoxycillin in therapeutic failures.
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PMID:Phenoxymethylpenicillin and therapeutic failure in acute otitis media. 393 32


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