PubMed Health⌕ Search

Biomedical subjects

G Harsten

Publications and source records attributed to G Harsten.

14 recordsLinked to original sources
PubMed2005

How we do it: radiofrequency-turbinectomy for nasal obstruction symptoms.

Radiofrequency energy has been reported to be effective to reduce nasal obstruction because of inferior turbinate hypertrophy. A total of 158 patients who had undergone such surgery are reported. Three to 30 months postoperatively 85% of the patients reported a marked decrease in nasal obstruction. This was irrespective of a short-term or a long-term follow-up, and was applicable to patients that had septal deviations in addition. Radiofrequency-turbinectomy is a simple and effective method for treatment of nasal obstruction as a result of hypertrophy of the inferior turbinates, even if combined with a moderate septal deviation.

Adolescent↗
PubMed1999

Laser-turbinectomy: long-term results.

Hypertrophy of the inferior turbinates is a common cause of nasal obstruction. Many cases respond to medical treatment with topical steroids or antihistamines. In some patients, however, this therapy is not sufficient and through the years many surgical procedures have been used to reduce the size of the inferior turbinates, but without any satisfactory long-term results. Furthermore, these procedures have often been painful to the patient and post-operative complications such as bleeding and crusting have not been uncommon. However, instead of conventional surgery of the turbinates, laser-surgery can be used to reduce their size. In order to investigate the long-term effect of such gross reduction of the turbinates we investigated the post-operative condition of 78 patients who had undergone CO2-laser-turbinectomy due to symptoms of nasal obstruction. Twenty-four to 36 months post-operatively three quarters of all the patients reported a marked decrease in nasal obstruction as well as a reduced frequency of nasal and sinus infections. No complications were reported and the procedure was without any discomfort to the patient. Thus, laser-turbinectomy seems to be an effective, simple and painless method for treatment of nasal obstruction due to hypertrophy of the inferior turbinates.

Adolescent↗
PubMed1993

Language development in children with recurrent acute otitis media during the first three years of life. Follow-up study from birth to seven years of age.

From a cohort of 113 children, followed prospectively from birth during the first three years of life regarding different aspects of acute otitis media (AOM), two study groups were selected for the present investigation: 13 children with recurrent AOM (rAOM, i.e. at least six episodes of AOM during a 12-month period), and 29 children without any AOM episode. The purpose of this study was to analyse the possible effects of early onset rAOM on language development as assessed at four and seven years of age at phoniatric and linguistic examinations performed blindly. There were no differences between the two groups on any of the linguistic analyses performed, although the rAOM group manifested a somewhat better performance on auditory discrimination tests at four years of age. The results of the present study show that rAOM during the first three years of life, in otherwise healthy children, does not cause a detectable delay of language development at four and seven years of age.

Acute Disease↗
PubMed1992

Middle ear problems in childhood.

No single factor is as yet known which could be used to predict the possible development of rAOM in infants and children. However, some circumstantial evidence can be seen. Thus, an AOM début before the age of six months in a child with a family history of recurrent otitis indicates a clear risk of multiple recurrent episodes. Other 'intrinsic factors' speaking in favour of rAOM are low concentrations of specific IgG antibodies against pneumococcus type 6A in cord serum and a presence of the hereditary HLA-antigen A2 on the surfaces of white blood cells. Extrinsic factors' such as type of day-care, passive exposure to smoking at home and poor housing seem to increase the risk but do probably not constitute the definite cause of rAOM.

Age Factors↗
PubMed1991

Serum antibodies against respiratory tract viruses in episodes of acute otitis media.

Although the findings of epidemiological studies have suggested viral respiratory tract infection (RTI) to be crucially involved in the development of acute otitis media (AOM), the relationship between AOM and viral RTI remains unclear. Serum samples, obtained in the acute and convalescent phases of 57 AOM episodes (in 35 children during the first three years of life) were analysed for IgG antibodies against influenza A viruses, influenza B viruses, parainfluenza virus type 1, respiratory syncytial virus and adenoviruses. One third of the AOM episodes (18/57) could be related to viral RTI, as evidenced by significant increases in viral serum antibody activity. Treatment failure occurred in four AOM episodes where increases in serum viral antibody activity were noted. In three of these failures, antibiotic treatment was unsuccessful despite the bacterial strains not being resistant to the drug used. This suggests that concomitant viral infection may be a determinant of treatment outcome in some AOM episodes.

Acute Disease↗
PubMed1990

Acute respiratory tract infections in children. A three-year follow-up from birth.

Respiratory tract infections (RTIs) in small children account for a considerable proportion of health care expenditure. In 113 children, followed for the first three years of life, we studied the frequency of acute RTI and its relationship to the factors: type of day-care, age, sex, family size, living conditions, allergic predisposition, family smoking habits, and season. To elucidate the influence of age, the frequency of acute RTI and its relationship to type of day-care was longitudinally studied on a quarterly basis. The frequency of acute RTI diagnosis increased gradually from birth culminating in a peak at the beginning of the second year. Besides age and season, type of day-care was the only factor studied to show any relationship with the frequency of acute RTI diagnosis. Up to the age of almost 2 1/2 years, children attending day-care centres accounted for more RTI diagnoses than did those in home care or family day-care, categories with comparable frequencies.

Acute Disease↗
PubMed1990

Responses to rubella, tetanus, and diphtheria vaccines in otitis-prone and non-otitis-prone children.

Delayed immunologic maturation--among other things based on a selective lack of antibodies against some acute purulent otitis media (AOM)-associated pneumococcal types--has been proposed in children with recurrent AOM (rAOM). To further elucidate the immunologic response in these children, we compared the antibody responses to diphtheria, tetanus, and rubella vaccinations in 13 children with rAOM and 29 children without AOM. The children took part in a prospective study from birth to the age of 3 years. The antibody response to the rubella vaccine was significantly lower in the children with rAOM. The responses to tetanus and to diphtheria did not differ between children with and without rAOM. Thus, the results indicate that in addition to the known lack of antibodies against pneumococcal polysaccharide antigens, a lower antibody response against at least one protein antigen may exist in otitis-prone children.

Antibody Formation↗
PubMed1989

Pneumococcal serum antibody concentrations during the first three years of life: a study of otitis-prone and non-otitis-prone children.

One hundred and thirteen children were followed prospectively from birth until the age of 3, serum being obtained from cord blood, and at the ages of 3, 6, 12, 18, 24, 30 and 36 months. Thirteen children developed recurrent acute otitis media (rAOM), 29 remained very healthy and the remaining children formed an intermediate group. Cord serum concentrations were determined of total IgG class, of IgG1 and IgG2 subclasses, as well as of specific IgG antibodies against the pneumococcal capsular types, 3, 6A and 19F. The specific pneumococcal IgG as well as IgA and IgM antibodies were also followed in the sequential serum samples up to the age of 3 in the rAOM and healthy children. Despite total IgG class and IgG1 and IgG2 subclass concentrations being of the same magnitude in cord serum of rAOM (median: 11.15, 7.48 and 2.16 g/l for IgG, IgG1 and IgG2, respectively) as in that of healthy children (median: 10.21, 8.16 and 2.16 g/l, respectively), both in cord serum and in most serum samples drawn during the first year of life, specific IgG antibodies against types 6A and 19F, but not against type 3, were significantly lower in the rAOM group than in the healthy children. In the intermediate group, cord serum concentrations of specific IgG antibodies to type 6A were of the same magnitude as in the healthy children. The only significant difference in specific IgM and IgA antibody concentrations against types 3, 6A and 19F between the two groups was noted for type 6A antibodies at 36 months of age where rAOM children exhibited lower values. The results indicate an association between pre-existing low specific IgG antibody levels against AOM-associated pneumococcal types and the development of rAOM.

Acute Disease↗
PubMed1989

Serum antibodies against respiratory tract viruses: a prospective three-year follow-up from birth.

Acute otitis media (AOM) has been epidemiologically related to viral respiratory tract infections, and viral antigens have also been detected in middle ear secretion in some AOM episodes. Successive serum samples from children followed prospectively for three years from birth were analysed for IgG antibodies against respiratory syncytial virus (RSV), adenoviruses and influenza A virus. Values from serum antibody activity gradually decreased during the first six months of life, followed by a gradual increase. Various relationships were found to obtain between age and the increases of antibody activity against the different viruses. Thus, three quarters of those tested had manifested increased antibody activity against RSV by 18 months of age, and against adenoviruses by 30 months of age. No increase of antibody activity against influenza A was noted before 12 months of age, and then only seen in two thirds of those tested during the entire three-year observation period. With regard to age, however, the proportion of children with increased antibody activity to RSV, adenoviruses or influenza A virus did not differ between otitis-prone and non-otitis-prone children. Thus, as compared to non-otitis-prone children, development of the ability to produce antibodies against these viruses was not found to be delayed in otitis-prone children.

Acute Disease↗
PubMed1989

C1q and C1 subcomponent complexes in otitis-prone and non-otitis-prone children. A prospective study of children during their first years of life.

Children with recurrent acute otitis media (rAOM) often show reduced C1q concentrations and an excess of (C1r-C1s)2 complexes. It is not known if such C1 aberrations precede development of rAOM or are a consequence of the infections. For this reason, serial investigation of C1q and C1 subcomponent complexes from birth until the age of three was performed in 113 children, 13 of whom developed rAOM. C1q concentrations at birth were found to be lower in the rAOM group than in children who did not experience acute otitis media, and were also correlated with age at the time of the first AOM episode. However, the wide variation of C1q within the groups precluded the use of C1q as a predictive marker. Excess (C1r-C1s)2 complexes were consistently absent at birth. High concentrations were found in children with established otitis media and the complexes persisted in association with recurrent disease. In conclusion, the C1 aberrations characteristic of rAOM were mainly acquired as a result of infection.

Acute Disease↗
PubMedDate not supplied

Treatment failure in acute otitis media. A clinical study of children during their first three years of life.

Although little is known about the occurrence of treatment failure in acute otitis media (AOM), available data suggest that it may be over-diagnosed. In the present study the frequency of treatment failure in AOM was determined in 113 children followed for 3 years from birth. Of 300 AOM episodes, 293 (in 70 children) were treated with oral antibiotics, and children under 10-11 months of age usually underwent myringotomy as well. During the observation period, there were 22 instances (in 16 children) of failure to respond to the primary antibiotic treatment of the AOM episodes. The annual frequency of treatment failure was 18.5%, 4.5% and 4.2% during the first, second and third years of life, respectively. The risk of failure to respond to antibiotic treatment was greater during the first year of life than during the following 2 years. The bacteria isolated and the choice of drug seemed to be of secondary importance.

Acute Disease↗
PubMedDate not supplied

Recurrent acute otitis media. A prospective study of children during the first three years of life.

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.

Acute Disease↗