The concept of pronicity in otitis media.
Explore the source record for details and available documents.
Child↗
Biomedical subjects
K Prellner
Publications and source records attributed to K Prellner.
Quantification of nasopharyngeal bacteria for diagnosis of respiratory tract infection in children.
Agreement between clinical signs of bacterial respiratory tract infections and quantities of respiratory tract pathogens in nasopharynx was studied in 77 children, aged 6-13 years. Specimens were obtained from 27 clinically bacterial and 51 clinically non-bacterial respiratory tract infections, and in 124 instances from healthy children. Viable counts of Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis, and beta-haemolytic streptococci were made from swab specimens suspended in saline before being plated on agar media. The frequency of these species in children with clinically bacterial, non-bacterial and no signs of respiratory tract infections were 85%, 47% and 26%, respectively. Bacterial counts greater than 10(4) colony-forming units (CFU)/ml of the pathogens occurred in 59% of clinically bacterial infections, as compared with 18% in clinically non-bacterial infections (p less than 0.001), the corresponding figures for counts greater than 10(3) CFU/ml being 85% and 41% (p less than 0.01), respectively. At neither level of bacterial count (i.e. greater than 10(4) or greater than 10(3], was there a significant difference between the healthy and those with a clinically non-bacterial infection. The quantification of bacteria in nasopharyngeal samples may thus be of clinical diagnostic value.
Bacteria↗
Complement activation by pneumococci associated with acute otitis media.
Pneumococci (types, I, III, VI, XIV, XVIII, XIX and XXIII) associated with acute otitis media were shown to activate complement in normal human serum by the classical as well as by the alternative pathway. In serum incubated with pneumococci classical pathway activation was demonstrated by decreased C4 values and the appearance of C1r-C1s-C1 IA complexes. Pneumococci caused C3 conversion in C2-deficient serum and in serum chelated with Mg++ EGTA showing activation of the alternative pathway without participation of the C42 convertase. Complement activation was more efficient when both pathways were intact. This was evident from a more pronounced C3 conversion and a greater reduction of the values for properdin and factor B in non-chelated serum as compared to Mg++ EGTA chelated serum.
Acute Disease↗
Purification of C-reactive protein on DEAE-cellulose by a simple two-step procedure utilizing the calcium-dependency of the protein.
A simple procedure for isolating C-reactive protein is presented. The method consists of two chromatographic separations on diethylaminoethyl (DEAE)-cellulose columns and utilized the difference between the binding of C-reactive protein to DEAE in the presence and absence of calcium. Electrophoretically pure C-reactive protein can be recovered from serum or ascitic fluid with a yield of approx. 50--60% within one day.
C-Reactive Protein↗
Respiratory tract infections in children with recurrent episodes as preschoolers.
The occurrence of respiratory tract infections (RTI) in 41 school-age children, who had recurrent RTIs treated with antibiotics as preschoolers, was followed prospectively for two years through diary reports by parents and medical consultations, and compared with that in 29 children of the same age and socio-economic background, who had few or no such infections as preschoolers. During the two-year follow-up, a greater number of episodes of RTI and a longer mean duration of such episodes were reported in the diaries concerning the children with recurrent bacterial RTIs as preschoolers compared with the controls (p less than 0.01). The annual incidence of bacterial RTI from birth onwards decreased with age among the children with recurrent episodes as preschoolers, unlike in the control group, where the incidence remained consistently low, the difference in incidence being significant up to the age of eight years (p less than 0.01). Acute otitis media was the predominant bacterial RTI in preschoolers, and acute tonsillitis in school-age children. There was a tendency toward a greater incidence of other types of disease and complications/sequelae of infections among the RTI-afflicted group than among the controls, both as preschoolers and as school children. Our findings suggest that certain children constitute a group with high morbidity, susceptible to RTIs and other illnesses over a rather long period of years.
Adolescent↗
Children with recurrent respiratory tract infections tend to belong to families with health problems.
Children (7-11 years of age) who had recurrent respiratory tract infections (RTI) treated with antibiotics as preschoolers (n = 41), and their families were compared with regard to medical and social factors to families with children of comparable age who had had no such infections as preschoolers, or only isolated episodes (controls; n = 29). All the children studied had attended day-care centres as preschoolers. The two groups of children did not differ with regard to socio-economic conditions or age at admission to day-care centres. There was a difference in the two groups with regard to signs noted at physical examination (p less than 0.05), eardrum changes being observed in 34% of the children with recurrent episodes of RTI as preschoolers and in none of the controls (p less than 0.001). Questionnaires answered by parents indicated diseases, particularly cardiovascular diseases, to be significantly more frequent in the families of the children with recurrent RTIs as preschoolers than in those of the controls (p less than 0.01). Parents of the controls were more often satisfied with their own health (p less than 0.05) and reported fewer symptoms of minor illness (p less than 0.05), as compared with parents of the children with recurrent RTIs as preschoolers. Thus, the results of the present study support the idea that children with recurrent bacterial RTIs as preschoolers tend to belong to families with health problems.
Anti-Bacterial Agents↗
Prevention of experimental acute otitis media with penicillin V.
The preventive effect of penicillin V (pcV) in pneumococcal otitis media in the rat has been studied. The pcV was administered either before bacterial challenge (prevention group) or after challenge but before the establishing of acute purulent otitis media (AOM) (early treatment group). In both cases a fulminant infection was avoided. Thus, in the prevention group no animal developed AOM and in the early treatment group the fulminant AOM was avoided in all cases. These results give further support to the idea of using long-term treatment with an antibiotic with a narrow spectrum to avoid recurrent AOM (rAOM). Furthermore the observation that early treatment might stop the development of fulminant AOM indicates another more restrictive possibility to use antibiotic as a prophylactic measure in otitis-prone children.
Acute Disease↗
Effect of gammaglobulin on pneumococcal otitis media in the rat.
Previously it has been found possible to induce pneumococcal AOM that closely resembles human infections, in the rat. In this study, the rat model has been used to study the possibilities to affect the infection by administration of gammaglobulin. The gammaglobulin was administered either systemically by intravenous injection of 0.2 g/kg bodyweight in 15 rats, or topically when 8 mg was instilled into the middle ear cavity of 18 rats. Although intravenous administration in this model failed to provide protection from AOM, topical administration simultaneously with the bacterial challenge was successful.
Administration, Topical↗
Colonization by Haemophilus influenzae and group A streptococci in recurrent acute tonsillitis and in tonsillar hypertrophy.
One hundred patients subjected to tonsillectomy because of recurrent acute tonsillitis or tonsillar hypertrophy were evaluated bacteriologically both with ordinary throat culturing and cultures from tonsillar cores. In 26% of the patients H. influenzae was isolated and in 20% beta-haemolytic group A streptococci. Growth of B. catarrhalis was obtained in 10% and group C-, group G streptococci or pneumococci in less than 5% each. None of the group A streptococcal strains proved tolerant to penicillin. A much higher isolation rate of H. influenzae was found in cultures obtained from tonsillar core tissue (23%) than from ordinary throat cultures (2%). This was also the fact, though to a lower extent, regarding group A streptococci. H. influenzae and group A streptococci were isolated as often in patients with tonsillar hypertrophy as in patients suffering from recurrent acute tonsillitis, suggesting a role of these bacteria in both conditions.
Adolescent↗
Treatment of sinus empyema in adults. A coordinated Nordic multicenter trial of cefixime vs. cefaclor.
In sinus empyema, H. influenzae is the most prevalent pathogen in some subpopulations and in case of therapeutic failure. Cefixime, the first oral cephalosporin of the 3rd generation, is highly potent in vitro against H. influenzae. To study the efficacy and safety of cefixime in adults with acute sinusitis, a coordinated, double-blind multicenter trial was designed for purulent cases, as confirmed by antral aspiration. A total of 364 patients were enrolled in the study with 125 cases randomized to the reference group, assigned to treatment with cefaclor. Evaluation was based on clinical outcome and on antral reaspiration (86% of the cases). No significant differences between the treatment groups were found, as regards short-term or long-term clinical outcome. However, the clinical examination overestimated the therapeutic results. Only 4% of the patients were considered as failures, but the re-aspiration demonstrated remaining suppuration in 14% of all cases (p less than 0.001). Based on re-aspiration, the failure rate among patients with initial growth of pathogens was lower for cefixime (8%) than for cefaclor (20%) (p less than 0.05). Such a difference was not found among patients with growth of H. influenzae. No serious adverse reactions were recorded, but loose stools and diarrhoea were significantly more frequent in the cefixime treatment group. Five patients (2%) in the cefixime treatment group discontinued their treatment due to adverse events.
Cefaclor↗