TÀI LIỆU THAM KHẢO HAY 3

http://www.ncbi.nlm.nih.gov/pubmed/11725622 Int J Circumpolar Health 2001;60 Suppl 2:1-54 Otitis media in Greenland Studies on historical, epidemiological, microbiological, and immunological aspects - vẻ, bề ngoài; diện mạo =to have a gentle aspect+ hiền lành - hướng =the house has a southern aspect+ nhà xoay hướng hướng nam - khía cạnh; mặt =to study every aspect of a question+ nghiên cứu khía cạnh vấn đề - (ngôn ngữ học) thể Homøe P Abstract This thesis describes the different aspects of otitis media (OM) in the population of Greenland viewed in a historical and modern clinical perspective Chapter outlines the addressed problems and aims while chapters and deal with historical studies and an evaluation of the present knowledge based on the literature Physical anthropological studies, using skeletal samples of adult Eskimo crania from before and after the colonization of Greenland in 1721 and information about modern living Eskimos (Inuit), have shown that OM sequelae of the temporal bones were significantly less common in pre-colonization Eskimos and that the mean area size of the pneumatized cell system in the temporal bone was significantly larger in pre-colonization Eskimos These findings indicated an increase in OM after the colonization most likely caused by the social, cultural, habitary, and dietary changes due to increased contact with the outside world Historical reports after the colonization confirm a high prevalence of OM especially in children Modern epidemiological studies from the 1960's to 1980's in the Arctic region of Alaska, Canada, and Greenland along with reports from visiting consultant otologists in Greenland almost uniformly mention prevalent OM problems in children as well as in adults The aim was therefore to further describe the epidemiological pattern of the different OM disease entities (acute OM (AOM), chronic OM (COM), COM with suppuration (CSOM), secretory OM (SOM), and cholesteatoma) and investigate the potentially associated risk factors in especially Greenlandic children because these diseases are primarily established and problematical in childhood Chapter describes the definitions used in the thesis and chapter describes the studies included Section 5.1 describes a study of cholesteatoma in Greenlanders The study revealed an almost similar incidence of hospital treated children with cholesteatoma (6.6 per 100,000) as seen in comparable studies from other parts of the world Furthermore, childhood cholesteatomas were the most aggressive The frequency of residuals or recurrences after otosurgical treatment was high with a trend for better results when using the extensive canal wall-down procedure It could be concluded that these patients urgently need close follow-up for at least five years postoperatively, if not lifelong Section 5.2 describes a hearing screening survey of 167 school children using school registration charts A high prevalence of hearing loss (HL) was found A total of 43% of the children had hearing thresholds exceeding 20 dB at one or more frequencies between 250-8000 Hz in one or both ears, and 19% had the same type of HL in the frequencies 500-2000 Hz HL was significantly associated with episodes of OM These findings were in accordance with reports from Alaska and Canada It is therefore concluded that a hearing screening programme of school children is important and that OM seems to have an impact on hearing in school children in Greenland In section 5.3 an epidemiological survey is described concerning the prevalence of the different OM disease entities The survey was carried out in Nuuk and Sisimiut and involved 740 children aged 3, 4, 5, and years A total of 591 children participated and selection bias was not found when controlling for age, sex, and episodes of AOM The survey revealed that 52% of children in Nuuk and 54% in Sisimiut had some kind of pathological affection of their middle ear COM and CSOM were found in 9%, but more prevalent among children in Sisimiut (12%) than in Nuuk (7%) Middle ear effusion (MEE) diagnosed by tympanometry was found in 23% in Nuuk and 28% in Sisimiut while simple tubal dysfunction (STD) was found in 13% and 8%, respectively MEE and STD were associated with young age Sequelae di chứng, di tật of OM was apparent in 11% in both towns When comparing the results with a 10-year-older, almost similar survey of 142 children, it was evident that the OM situation had not changed in the period between the studies The survey underlines the need for increased focus on the different OM entities in Greenlandic children Section 5.4 deals with microbiological aspects The nasopharyngeal microflora and ear discharge microflora of potential pathogens were evaluated in 54 children with AOM and in 201 control children without AOM Very high carriage rates expressed qualitatively and semiquantitatively of potentially pathogenio bacteria were found in the nasopharynx of children with AOM (98%) but also in that of the control children (91%) and even in children denoted as being very healthy (94%) However, the same bacterial species were cultured from the nasopharynx and ear discharge as in comparable studies world-wide Only S pneumoniae was carried significantly more often in the nasopharynx of AOM children compared with age matched control children Chlamydiae, M pneumoniae, adenovirus, respiratory syncytial virus, parainfluenza- type 1, 2, and virus, and influenza- type A and B virus were not major pathogens In contrast, enteroand rhinoviruses were detected significantly more frequent in nasopharyngeal specimens from AOM children (59%) compared with age matched controls (33%) and also in 29% of the examined ear discharge specimens It is therefore concluded that the potentially pathogenic bacterial load is early and massive This alone or in interplay with entero- and rhinovirus infection and occasionally with other viruses may play an important role in the high prevalence of OM among children in Greenland Section 5.5 deals with an examination of potential risk factors for AOM, recurrent AOM (rAOM), and COM in the same 591 children as studied in section 5.3 Early age at first AOM episode was associated with rAOM episodes (> or = episodes since birth) Thus, the relative risk of developing rAOM was eight times higher if the first episode of AOM occurred before months of age than after 24 months of age Furthermore, compared with studies elsewhere in the world, a high proportion (40%) of the children in this survey had their first AOM episode during their first year of life and 41% of these children developed rAOM It was also found that children had an increased risk of AOM, rAOM, or COM when both parents were born in Greenland, when parents also have had OM, when living in very crowded households, and when having experienced a long period of exclusive breast feeding, or when recalling of breast feeding was not possible Gender, type, and size of housing, insulation standard of housing, daycare, exposure to passive cigarette smoking, and dietary habits were not associated with AOM, rAOM, or COM in the surveyed children It is concluded that early onset of AOM occurs frequently in Greenlandic children and that a high proportion of these children develop rAOM The study confirms that AOM is a highly multifactorial disease determined by a number of genetic and environmental factors Finally, section 5.6 is a hypothesis generating study attempting to explain the high prevalence of early episodes of AOM in community-based children in Nuuk The hypothesis is based on a possible association between findings of mannose-binding lectin genotypes, early Epstein-Barr virus infections and episodes of AOM, rAOM, or nasopharyngeal colonization with potentially pathogenic bacteria However, the study does not support any of this hypothesis In chapter 6, future studies are suggested and chapter presents concluding remarks PMID: 11725622 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/11144704 Ann Pharmacother 2000 Dec;34(12):1452-68 treatment and prevention of otitis media Erramouspe J, Heyneman CA Source College of Pharmacy, Idaho State University, Pocatello 83209-8333, USA johnerra@otc.isu.edu Abstract OBJECTIVE: To review and summarize recent advances in the treatment and prevention of otitis media (OM) DATA SOURCES: A MEDLINE search (1996-March 2000) was performed to identify relevant primary and review articles References from these articles were also reviewed if deemed important STUDY SELECTION AND DATA EXTRACTION: English-language primary and review articles focusing on the treatment and prevention of acute otitis media (AOM) were included Studies focusing exclusively on OM with effusion or serous OM and chronic suppurative OM were excluded Information regarding prevention and drug therapy was reviewed, with an emphasis placed on advances made in the last two years DATA SYNTHESIS: Recently, an expert panel of the Centers for Disease Control and Prevention recommended use of only three of 16 systemic antibiotics approved by the Food and Drug Administration for treatment of AOM: amoxicillin, cefuroxime axetil, and ceftriaxone Controversy exists over the importance of key selection factors used by the expert panel in determining which antibiotics to recommend in a two-step treatment algorithm, that is, in vitro data, pharmacodynamic profiles, and necessity for coverage of drug-resistant Streptococcus pneumoniae at all steps of empiric treatment Additional antibiotic and patient selection factors useful for individualizing therapy include clinical efficacy, adverse effects, frequency and duration of administration, taste, cost, comorbid infections, and ramifications should bacterial resistance develop to the chosen antibiotic Presumed or past patient/caregiver adherence (especially when antibiotic failure has occurred) is also paramount in selecting antibiotic therapy A three-step treatment algorithm thuật toán for refractory AOM that employs amoxicillin, trimethoprim/sulfamethoxazole (TMP/SMX), or high-dose amoxicillin/clavulanate (depending on the prior dose of and adherence to amoxicillin therapy), and ceftriaxone or tympanocentesis at steps 1, 2, and 3, respectively, appears rational and cost-effective The recent upsurge in antimicrobial resistance is highlighted, and recommendations are presented for the treatment of AOM and prevention of recurrent otitis media (rAOM) CONCLUSIONS: Amoxicillin remains the antibiotic of choice for initial empiric treatment of AOM, although the traditional dosage should be increased in patients at risk for drug-resistant S pneumoniae In cases refractory to high-dose amoxicillin, TMP/SMX should be prescribed if adherence to prior therapy seemed good or complete, or high-dose amoxicillin/clavulanate if adherence was incomplete or questionable Ceftriaxone should be reserved as third-line treatment The increasing prevalence of drug-resistant S pneumoniae emphasizes the importance of alternative medical approaches for the prevention of OM, as well as judicious antibiotic use in established cases Removal of modifiable risk factors should be first-line therapy for prevention of rAOM We support the use of conjugate pneumococcal vaccine per guidelines for prevention of rAOM from the Advisory Committee on Immunization Practice of the Centers for Disease Control and Prevention, with consideration given to influenza vaccine for cases of rAOM that historically worsen during the flu season Sulfisoxazole prophylaxis should be reserved for children who are immunocompromised, have concurrent disease states exacerbated by AOM, or meet the criteria of rAOM despite conjugate pneumococcal and influenza vaccination Therapy should be intermittent, beginning at the first sign of an upper respiratory infection, and should continue for 10 days The invasive nature and risks of anesthesia relegate myringotomy, tympanostomy tubes, and adenoidectomy to last-line therapies for rAOM PMID: 11144704 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/9111441 Arch Pediatr Adolesc Med 1997 Apr;151(4):407-13 Utilization dùng, sử dụng of services for otitis media by children enrolled tuyển (quân )- kết nạp vào, ghi tên cho vào (hội )- (pháp lý) ghi vào (sổ sách án) in Medicaid Byrns PJ, Bondy J, Glazner JE, Berman S Source: Department of Medicine, University of Colorado Health Sciences Center, Denver, USA Abstract OBJECTIVE: To provide population-based information about the utilization of ambulatory visits, antibiotic prescriptions, and surgical procedures related to the diagnosis and management of otitis media DESIGN: A descriptive study in which utilization rates per child and per child-year were calculated Childyear rates stratified by age were calculated only for children having at least ambulatory visit with a diagnosis of otitis media SETTING: Administrative data from Colorado Medicaid for the 1991 and 1992 calendar years PATIENTS: All children enrolled in Medicaid who are younger than 13 years and not participating in a prepaid health care plan during the study years (n = 131,169 and n = 157,065) were included in the analysis RESULTS: Approximately 22% of children made at least ambulatory (y học) lại nằm (người bệnh) visit with a diagnosis of otitis media, with the peak prevalence (46.8%) occurring between ages and years Among all children younger than 13 years enrolled in Medicaid, there were 0.5 ambulatory visits for otitis media per child (0.7 ambulatory visits per child-year), with 70% occurring in a physician office setting, 14.8% in a hospital clinic or community health center, and 15.2% in a hospital emergency department For all children enrolled in Medicaid, the rate of antibiotic courses for otitis media was 0.34 per child (0.48/child-year) Each child with otitis media had an annual average of 1.55 antibiotic courses (1.82 antibiotic courses per childyear) The average ratio of antibiotic courses to ambulatory visits related to otitis media was 65% There was an annual rate of 12 surgical procedures related to otitis media per 1000 children (16.6/1000 child-years) The peak rate of ventilating tube insertion occurred in children ages to years and for adenoidectomy in children to years Mastoidectomy rates were low, 92% occurring in children older than years CONCLUSIONS: This study represents preliminary techniques to profile the care of children with otitis media Our findings support the need to measure volatility of enrollment in an insured population before calculating rates of utilization Additional research is needed to measure the effects of discontinuous eligibility, access to a regular source of primary care, site of treatment, and physician preferences on the quantity and quality of treatments for otitis media PMID:9111441[PubMed - indexed for MEDLINE] ... Pharmacother 2000 Dec ;34 (12):1452-68 treatment and prevention of otitis media Erramouspe J, Heyneman CA Source College of Pharmacy, Idaho State University, Pocatello 832 09- 833 3, USA johnerra@otc.isu.edu... effusion (MEE) diagnosed by tympanometry was found in 23% in Nuuk and 28% in Sisimiut while simple tubal dysfunction (STD) was found in 13% and 8%, respectively MEE and STD were associated with... frequent in nasopharyngeal specimens from AOM children (59%) compared with age matched controls (33 %) and also in 29% of the examined ear discharge specimens It is therefore concluded that the