Use of a Short Course of Prednisone for Treating Middle Ear Effusion

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 296-300 ◽  
Author(s):  
Richard H. Schwartz ◽  
Joseph Puglese ◽  
Daniel M. Schwartz
Keyword(s):  
Otitis Media With Effusion ◽  
Double Blind ◽  
Short Course ◽  
Prior Use ◽  
Unilateral Disease ◽  
History Of ◽  
Ventilating Tubes ◽  
Lactose Powder ◽  
The Relationship ◽  
Ear Effusion

This report presents findings of a double-blind crossover prospective study involving the use of a short course of prednisone for the treatment of otitis media with effusion (OME). Subjects were 41 children with persistent OME for three weeks or more despite the use of antimicrobial and/or decongestant therapy. Pulverized prednisone tablets (5 mg) or lactose powder (placebo) were packed in unmarked gelatin capsules and placed in identically coded vials. The dosage schedule was 1 mg/kg/day for the first two days in a divided dose; 0.75 mg/kg/day for the next two days; followed by 5–10 mg/kg/day as a single morning dose for the remaining three days. In addition, all children received concomitant sulfisoxazole suspension of 50 mg/kg/day twice daily. Results for 40 children treated with steroids either initially or following crossover revealed that 70% demonstrated resolution of OME via pneumo-otoscopy and 64% via tympanometry. In addition, we examined the relationship between the ability to resolve effusion with corticosteroids and six variables: 1) duration of OME prior to entry into study, 2) month of year at entry into study, 3) bilateral versus unilateral disease, 4) child's sex, 5) prior use of ventilating tubes, and 6) personal or family history of allergy. The results of these comparisons are discussed.

scholarly journals Interaction of Cannabis Use Disorder and Striatal Connectivity in Antipsychotic Treatment Response

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Melanie Blair Thies ◽  
Pamela DeRosse ◽  
Deepak K Sarpal ◽  
Miklos Argyelan ◽  
Christina L Fales ◽  
...  
Keyword(s):  
Treatment Response ◽  
Reward Processing ◽  
Cannabis Use ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Cannabis Use Disorder ◽  
Schizophrenia Spectrum Disorders ◽  
Double Blind ◽  
History Of ◽  
The Relationship

Abstract Antipsychotic (AP) medications are the mainstay for the treatment of schizophrenia spectrum disorders (SSD), but their efficacy is unpredictable and widely variable. Substantial efforts have been made to identify prognostic biomarkers that can be used to guide optimal prescription strategies for individual patients. Striatal regions involved in salience and reward processing are disrupted as a result of both SSD and cannabis use, and research demonstrates that striatal circuitry may be integral to response to AP drugs. In the present study, we used functional magnetic resonance imaging (fMRI) to investigate the relationship between a history of cannabis use disorder (CUD) and a striatal connectivity index (SCI), a previously developed neural biomarker for AP treatment response in SSD. Patients were part of a 12-week randomized, double-blind controlled treatment study of AP drugs. A sample of 48 first-episode SSD patients with no more than 2 weeks of lifetime exposure to AP medications, underwent a resting-state fMRI scan pretreatment. Treatment response was defined a priori as a binary (response/nonresponse) variable, and a SCI was calculated in each patient. We examined whether there was an interaction between lifetime CUD history and the SCI in relation to treatment response. We found that CUD history moderated the relationship between SCI and treatment response, such that it had little predictive value in SSD patients with a CUD history. In sum, our findings highlight that biomarker development can be critically impacted by patient behaviors that influence neurobiology, such as a history of CUD.

scholarly journals Perception of Voicing Cues by Children With Early Otitis Media With and Without Language Impairment

1996 ◽  
Vol 39 (1) ◽  
pp. 43-54 ◽  
Author(s):  
Paul Groenen ◽  
Thom Crul ◽  
Ben Maassen ◽  
Wim van Bon
Keyword(s):  
Otitis Media ◽  
Language Impairment ◽  
Auditory Processing ◽  
Otitis Media With Effusion ◽  
Discrimination Performance ◽  
Central Auditory Processing ◽  
Long Term Effects ◽  
History Of ◽  
The Relationship

Research on the relationship between early otitis media with effusion (OME), language impairment, and central auditory processing has been equivocal. Identification and discrimination tasks provide us with a sensitive method of assessing speech perception on both an auditory and a phonetic level. The present study examined identification and discrimination of initial bilabial stop consonants differing in voicing by 9-year-old children with a history of severe OME. The groups studied were controlled for language impairment. The ability of these children to perceive major and minor voicing cues was examined using multiple voicing cues. Long-term effects of OME were found for both identification and discrimination performance. Children with OME produced an overall inconsistency in categorization, which suggests poorer phonetic processing. Discrimination was measured by means of “just noticeable differences” (JND). Children with early OME experience demonstrated a greater mean JND than children without early OME experience. Finally, in cases of language impairment with early OME, there was no additional deterioration of auditory or phonetic processing. It appears that either early OME or language impairment can lead to poorer perception.

Otitis Media with Effusion: Results of Treatment with a Short Course of Oral Prednisone or Intranasal Beclomethasone Aerosol

1981 ◽  
Vol 89 (3) ◽  
pp. 386-391 ◽  
Author(s):  
Richard H. Schwartz
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Oral Prednisone ◽  
Pilot Project ◽  
Results Of Treatment ◽  
Short Course ◽  
Novel Method ◽  
Ear Effusion

A short course of prednisone suspension given in a decreasing dosage schedule for up to ten days was often effective (68%) in resolving mucoid otitis media with effusion (OME, middle ear effusion). No significant side effects were noted. Concommitant administration of sulfisoxazole suspension may have reduced the likelihood of activation of a quiescent infection of the middle ear. During an eight-month mean follow-up period, reaccumulation of the effusion was detected in 21% of the successfully treated children. Preliminary results of an unrelated, pilot project using intranasal beclomethasone dipropionate aerosol suggests that this novel method also may be efficacious in the treatment of OME.

Comparison of Cefaclor and Amoxicillin for Acute Otitis Media with Effusion

1981 ◽  
Vol 90 (3_suppl2) ◽  
pp. 48-52 ◽  
Author(s):  
Ellen M. Mandel ◽  
Charles D. Bluestone ◽  
S. Nasrin Ghorbanian ◽  
Erdem I. Cantekin ◽  
Howard E. Rockette
Keyword(s):  
Clinical Trial ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Middle Ear Effusion ◽  
Double Blind ◽  
Days Of Therapy ◽  
The Difference ◽  
Reasonable Choice ◽  
Ear Effusion

A double-blind randomized clinical trial was conducted comparing cefaclor and amoxicillin for the treatment of acute otitis media with effusion in 110 children (150 ears). Each child underwent unilateral or bilateral tympanocentesis and then randomly received a 14-day course of either amoxicillin or cefaclor. Of 57 children in the cefaclor group, only 3 children (5.3%) had persistent or recurrent symptoms during the 14-day course of treatment, as compared to 5 of 53 children (9.4 %) in the amoxicillin group, but this difference is not significant. After completion of the 14 days of therapy, 45 of 76 ears (59.2%) of the children in the cefaclor group were effusion-free, as compared to only 28 of 64 ears (43.7%) of the children in the amoxicillin group. When adjusted for age and race, this difference is statistically significant (p = .03). However, the difference between the effect of the two antimicrobials is not statistically significant in children. Cefaclor is a reasonable choice for antimicrobial therapy for acute otitis media with effusion, and from these study findings, it appears that cefaclor may be more effective than amoxicillin in resolving the middle ear effusion at the completion of 14-day therapy.

Pharmacologic Compliance with Antibiotic Therapy for Acute Otitis Media: Influence on Subsequent Middle Ear Effusion

PEDIATRICS ◽  
1981 ◽  
Vol 68 (5) ◽  
pp. 619-622
Author(s):  
Richard H. Schwartz ◽  
William J. Rodriquez ◽  
Kenneth M. Grundfast
Keyword(s):  
Otitis Media ◽  
Antibiotic Treatment ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Secretory Otitis Media ◽  
The Relationship ◽  
Serous Otitis Media ◽  
Positive Results ◽  
Urine Specimens ◽  
Ear Effusion

The frequency of otitis media with effusion (serous otitis media, secretory otitis media) detected after conventional antibiotic treatment of acute otitis media is approximately 50%. The relationship between pharmacologic compliance and the frequency of otitis media with effusion was studied. A Micrococcus lutea bioinhibition test was used to detect the presence of substances in the urine that inhibited the growth of this antibiotic-sensitive organism. On the fourth, seventh, and tenth days of antibiotic treatment for acute otitis media urine specimens were collected. Otitis media with effusion was detected in 53% of 66 children who had positive results for M lutea bioinhibition compliance tests for all three urine specimens. Electro-acoustic impedance measurements (tympanograms) confirmed the presence of effusion in all children in the effusion group tested by this method. The M lutea bioinhibition assay is a practical, in-office method to validate periodically, during treatment, pharmacologic compliance with antibiotics used for treatment of acute otitis media.

Effect of middle-ear effusion on otoacoustic emissions

2002 ◽  
Vol 116 (10) ◽  
pp. 794-799 ◽  
Author(s):  
Sang W. Yeo ◽  
Shi-Nae Park ◽  
Yong Soo Park ◽  
Byung Do Suh
Keyword(s):  
Middle Ear ◽  
Otoacoustic Emissions ◽  
Otitis Media With Effusion ◽  
Geometric Mean ◽  
Bone Conduction ◽  
Middle Ear Effusion ◽  
Spontaneous Otoacoustic Emissions ◽  
Distortion Product ◽  
The Relationship ◽  
Ear Effusion

Because otoacoustic emissions (OAEs) are transmitted from the cochlea to the ear canal via the middle ear, the transmission properties of the middle ear directly influence OAEs’ characteristics. In general, middle-ear effusion (MEE) reduces measured emission amplitudes and sometimes eliminates the response entirely. The purpose of this study was to establish the relationship between the conduction of the middle ear and OAEs’ properties and to elucidate the effect of middle-ear effusion on detecting OAEs’. Spontaneous otoacoustic emissions (SOAEs), transiently evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) were recorded from 44 normal ears and 32 ears with middle-ear effusion. DPOAEs were collected in two basic forms consisting of distortion product audiograms (DP grams) and input-output (I-O) functions, elicited by two primary tones F1 and F2 and varying geometric mean frequencies between 1–6 kHz. The results of air and bone conduction hearing levels in pure tone audiogram were also analysed. In 21 ears out of 32 otitis media with effusion (OME) ears, SOAEs were absent. In the 28 ears with middle-ear effusion, the response and wave reproducibility were diminished, and in the 17 ears with middle-ear effusion, the DP gram was diminished or eliminated. In particular, I-O function curves at 3 kH and 4 kHz were diminished by the primary tones of 45 and 55 dB under the condition of MEE. The SOAEs, TEOAEs and DPOAEs (DP gram and I-O function curve) are highly reliable and useful tests for monitoring changes in middle-ear condition in children with OME and in predicting the course of OME.

Effect of Naproxen, a Prostaglandin Inhibitor, on Acute Otitis Media and Persistence of Middle Ear Effusion in Children

1989 ◽  
Vol 98 (5) ◽  
pp. 389-392 ◽  
Author(s):  
Izhak B. Varsano ◽  
Benjamin M. Volovitz ◽  
Josef E. Grossman
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Acute Otitis Media ◽  
Middle Ear Effusion ◽  
Double Blind ◽  
Number Of Patients ◽  
Significant Difference ◽  
Prostaglandin Inhibitor ◽  
Ear Effusion

Prostaglandins are thought to be of importance in the pathophysiology of otitis media with effusion (OME), and the possibility of reducing the frequency and persistence of this condition by using prostaglandin inhibitors has been suggested. In a double blind manner, naproxen was administered to children with acute otitis media, in addition to amoxicillin, and its influence on the subsequent occurrence and persistence of middle ear effusion was evaluated. Eighty-one children participated in the study. No significant difference was found in the number of patients with tympanograms consistent with OME in the two groups. After 10 days of treatment, 63% in the naproxen and 58% in the placebo group, and after 30 days, 41% and 59%, respectively, had type B tympanograms. Similarly, there were no differences between the two groups with respect to other parameters studied (duration of otalgia, fever, otoscopic findings). No side effects related to naproxen were observed.

Otitis media with effusion: can erythromycin reduce the need for ventilating tubes?

1990 ◽  
Vol 104 (3) ◽  
pp. 200-202 ◽  
Author(s):  
Per Møller ◽  
Gjert Dingsør
Keyword(s):  
Otitis Media ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Outpatient Basis ◽  
Common Condition ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Double Blind ◽  
Ventilating Tubes ◽  
Conductive Hearing

AbstractOtitis media with effusion (OME) is a common condition among children and is characterized by nonpurulent fluid in the middle ear and fluctuating conductive hearing loss. Most children will spontaneously regain normal air-filled middle ears, but a certain number will have persistent problems. In our department we will treat annually about 500 children on an outpatient basis, with the insertion of ventilating tubes in the eardrum. The reason for this study was to evaluate the effect of erythromycin, instead of inserting a ventilation tube, in children with bilateral OME of longer duration than three months (double blind/placebo). The study comprises 147 children, 1–15 years of age, 83 boys and 64 girls, all with OME for more than three months. All the patients were candidates for tube insertion. In the group treated with erythromycin, 12 patients out of 69 had bilaterally air-filled middle ears after one month, as compared to 19 out of 72 in the group treated with the placebo. No difference was noted due to sex or age. The results support our indication and timing for ventilation tube insertion.

scholarly journals Evaluation of Caspase-1, Interleukin-1β, and Interleukin-18, in the Middle Ear Effusion in Children With Otitis Media With Effusion

2021 ◽  
Vol 9 ◽  
Author(s):  
Shanshan Liu ◽  
Lining Guo ◽  
Min Chen ◽  
Wei Liu ◽  
Yanhong Li ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Significant Negative Correlation ◽  
Enzyme Linked Immunosorbent Assay ◽  
Ventilation Tube ◽  
Middle Ear Effusion ◽  
Caspase 1 ◽  
History Of ◽  
Ear Effusion

Objectives: The present study aimed to assess the expression of caspase-1 and caspase-1-dependent processing of cytokines, such as interleukin (IL)-1β and IL-18, in the middle ear effusion of children with otitis media with effusion (OME) in order to identify the potential role of inflammasomes in OME.Methods: This study included 29 children scheduled for myringotomy with the insertion of tympanostomy tubes due to OME. Middle ear effusion (MEE) was collected during the surgery. Caspase-1, IL-1β, and IL-18 were assayed using enzyme-linked immunosorbent assay kits. The levels were compared between those with mucoid and serous MEE and those with and without a history of ventilation tube insertion.Results: Caspase-1, IL-1β, and IL-18 were detected in all samples. The caspase-1, IL-1β, and IL-18 levels did not significantly differ between mucoid samples and serous samples. No statistical significances were discovered in caspase-1, IL-1β, and IL-18 levels between with and without a history of ventilation tube groups. There was a significant negative correlation between IL-1β and IL-18 and the duration of OME (p < 0.05). However, no significant correlation was found between caspase-1 and disease duration.Conclusions: Inflammasomes may participate in the inflammatory process of OME. IL-1β and IL-18 levels in the MEE decreased over time.

Otitis Media with Effusion: An Approach to the Management of Persistent Symptoms and Signs in the Pediatric Patient

1983 ◽  
Vol 5 (4) ◽  
pp. 108-117
Author(s):  
Phillip H. Kaleida ◽  
Sylvan E. Stool
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Public Health Problem ◽  
Modern Medicine ◽  
Major Public Health Problem ◽  
Persistent Symptoms ◽  
Tympanostomy Tubes ◽  
History Of ◽  
Ear Effusion

Otitis media with effusion continues to be a major public health problem because of its prevalence and potential consequences. We know too little regarding its pathogenesis, management, and long-term consequences. These gaps in our knowledge make it difficult to formulate precise plans of management. Research, necessary at both the clinical and basic-science levels, often is especially difficult because of the large number of variables to be considered in this condition. It is important for the pediatrician to be aware of the variable natural history of otitis media, and of the variable hearing loss accompanying the middle-ear effusion. Pneumatic otoscopy is more sensitive in diagnosing OME than mere visualization of the tympanic membrane. Finally, tympanostomy tubes appear to be beneficial in most children for whom they are indicated; but vigilance is required to detect potential complications both of the disease and of the treatment(s). Feigin16 recently summarized the state of the art of otitis media with effusion: "One of the great paradoxes of modern medicine is that our knowledge is often most incomplete with respect to the disorders that afflict mankind with the greatest frequency. Such is the case with otitis media."

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