1,721,006 research outputs found
Prevention of acute otitis media using currently available vaccines
No full textAcute otitis media (AOM) is common in infants and children. Although approximately two-thirds of cases are due to bacteria, almost all of the episodes are preceded by upper respiratory viral infection. Several viruses, among which respiratory syncytial virus is the most common, are involved in the determination of AOM. However, a significant number of AOM cases are associated with influenza infection, and influenza viruses are among the most frequently found respiratory viruses in the middle ear fluid during an acute episode of AOM. Consequently, influenza vaccination may have a favorable impact on the incidence and course of AOM. Moreover, as Streptococcus pneumoniae is one of the leading AOM bacterial pathogens and it is well known that influenza virus infection predisposes to pneumococcal infection, there is a further reason to suggest the use of influenza vaccine to reduce the risk of AOM. On the other hand, the administration of pneumococcal conjugate vaccine is considered per se a possible means of reducing the incidence of the disease. However, although a number of studies have measured the impact of both vaccines on AOM, it is still not known whether (and to what extent) they are really effective, nor what impact the more recently licensed vaccines may have. The aim of this review is to examine the clinical impact of vaccinations on AOM
Habitual use of push and pull plastic bottle caps is more prevalent among children with recurrent acute otitis media
No full textObjective: The use of a pacifier has been reported to be a causative factor of recurrent acute otitis media (RAOM) because the negative pressure which is generated during sucking may cause a negative intra-tympanic pressure and favour the reflux of nasopharyngeal secretions into the Eustachian tube. Push and pull (P&P) plastic bottle caps, recently marketed in Italy, might also induce negative nasopharyngeal pressure.This study was aimed to investigate if there is a difference in the prevalence of habitual use of P&P plastic bottle caps among children with a positive history of RAOM and healthy controls. Methods: A telephonic interview was performed in order to retrospectively evaluate the prevalence of habitual use of P&P plastic bottle cap among children with a history of RAOM and healthy controls, comparable to the former for environmental risk factors for RAOM. Results: Data were obtained from 57 Caucasian patients (males=36/57; 63.2%) with a median age of 59 (range=21-90) months, including 28 children with a history of RAOM and 29 healthy controls. Habitual use of P&P plastic bottle cap was significantly (p=0.047) more frequent in children with a history of RAOM (14/28; 50.0%) than in control group (7/29; 24.2%). Multivariate logistic regression analysis adjusted for age confirmed a significant association (p<0.01; Pseudo R2=0.2) between the use of P&P plastic bottle cap and a positive history of RAOM (adjusted OR=4.0; range=1.1-15.0). Conclusions: Our preliminary data show a significantly increased prevalence of P&P plastic cap bottle habitual users among children with a history or RAOM and support the need for larger studies to confirm the role of using P&P bottles as risk factor of RAOM and to identify the age groups at higher risk
Le terapie alternative e le infezioni respiratorie
Full text linkAttualmente, la più recente classifi cazione delle medicine e delle pratiche
non convenzionali è molto ampia e include molti tipi di medicine
e terapie estremamente diverse tra loro, dall’agopuntura alla medicina
ayurvedica/antroposofi ca, dalla fi toterapia alla medicina tradizionale cinese,
dall’omeopatia alla chiropratica.
In Italia il ricorso a terapie non convenzionali in età pediatrica (<14
anni), secondo un’indagine dell’ISTAT del 1999, non risulta elevato, attestandosi
in media intorno al 9%: da questa indagine è emerso che l’omeopatia e la
fi toterapia sono le terapie non convenzionali più seguite.
In realtà, nel nostro Paese esistono, comunque, grandi differenze loco regionali
nella pratica della medicina non convenzionale. Nella realtà del nostro ambulatorio,
tra il 2004 e il 2006, circa i 2/3 dei bambini giunti in osservazione per
infezioni delle alte vie respiratorie hanno ricevuto una o più terapie alternative,
sia di tipo medico (omeopatia, fi toterapia) che non medico (osteopatia, agopuntura)
Nasopharyngeal fiberendoscopy in children: a diagnostic challenge in current clinical practice: how we do it
No full textNasopharyngeal fiberendoscopy (NFE) is the gold standard diagnostic procedure in children with suspected adenoidal disease, but it is not always easily feasible in younger children, and there is no consensus on the optimal technical approach according to children's age or disease. This paper aims to report our experience with NFE performed during routine paediatric clinical examination, also with regards to tolerability and patients' satisfaction. METHODS:
NFE was performed in paediatric patients with suspected adenoidal obstruction by means of a 2.7mm-diameter flexible endoscope with the child seated in a chair or on parent's knees under outpatients basis and without administering local decongestants, anaesthetic agents, or sedatives. Relationship between possible confounders and patients' satisfaction, NFE tolerability, or needing for restraining was evaluated.
RESULTS:
NFE was successfully performed in all but one syndromic 2-year old patient. Analysis was conducted on 191 children (mean age=5.58; standard error, SE=2.52 years). Restraining was required more frequently (p<0.001) in younger children; NFE tolerability was good, as documented by mean visual analogue scale (VAS) values of 2.06 (SE=1.58), and a better NFE tolerance was reported more frequently (p<0.001) in older children. No significant relationship was found between needing for restraining or VAS and gender. No major or minor adverse events occurred.
CONCLUSIONS:
Our results support the feasibility and tolerability of flexible NFE performed by a skilled ENT specialist for nasopharyngeal evaluation in children aged more than 2 years with suspected adenoidal disease
No evidence for the effectiveness of systemic corticosteroids in acute pharyngitis, community-acquired pneumonia and acute otitis media
No full textCorticosteroids have been used to treat infectious diseases for more than 50 years but, although it has been shown that they are highly effective in improving the clinical course of some diseases, their effects have not been clearly defined in others. Nevertheless, they are still used by a considerable number of physicians. This review analyses the role of systemic corticosteroids in the treatment of acute pharyngitis (AP), community-acquired pneumonia (CAP) and acute otitis media (AOM). A number of trials involving patients with AP have been carried out, but most are marred by methodological flaws that do not allow any firm conclusions to be drawn. The number of trials involving CAP patients is even higher, and the data suggest that corticosteroids may reduce the risk of death only in patients with severe disease. There are very few data concerning AOM, and there is currently no reason for prescribing corticosteroids to treat it. Overall, the data showed that there is, currently, no indication for the universal use of systemic corticosteroids in any of the reviewed diseases and, further, high-quality studies of all of these respiratory tract infections are needed in order to identify the patients for whom the prescription of corticosteroids is rationally acceptabl
Implications of maternal vitamin D deficiency for the fetus, the neonate and the young infant
No full textIt has recently been demonstrated that vitamin D (VD) deficiency during pregnancy and lactation can give rise to problems in mothers and their childre
- …
