Development of Microchip Isotachophoresis Coupled with Ion Mobility Spectrometry and Evaluation of Its Potential for the Analysis of Food, Biological and Pharmaceutical Samples

An online coupling of microchip isotachophoresis (µITP) with ion mobility spectrometry (IMS) using thermal evaporation interface is reported for the first time. This combination integrates preconcentration power of the µITP followed by unambiguous identification of trace compounds in complex samples by IMS. Short-chain carboxylic acids, chosen as model analytes, were first separated by the µITP in a discontinuous electrolyte system at pH 5–6, and subsequently evaporated at 130 °C during their transfer to the IMS analyzer. Various parameters, affecting the transfer of the separated sample components through the evaporation system, were optimized to minimize dispersion and loss of the analytes as well as to improve sensitivity. The following analytical attributes were obtained for carboxylic acids in the standard solutions: 0.1–0.3 mg L−1 detection limits, 0.4–0.9 mg L−1 quantitation limits, linear calibration range from the quantitation limit to 75 mg L−1, 0.2–0.3% RSD of the IMS response and 98–102% accuracy. The analytical potential of the developed µITP-IMS combination was demonstrated on the analysis of various food, pharmaceutical and biological samples, in which the studied acids are naturally present. These include: apple vinegar, wine, fish sauce, saliva and ear drops. In the real samples, 0.3–0.6% RSD of the IMS response and 93–109% accuracy were obtained.

Biannual Differences in Interest Peaks for Web Inquiries Into Ear Pain and Ear Drops: Infodemiology Study

Background The data retrieved with the online search engine, Google Trends, can summarize internet inquiries into specified search terms. This engine may be used for analyzing inquiry peaks for different medical conditions and symptoms. Objective The aim of this study was to analyze World Wide Web interest peaks for “ear pain,” “ear infection,” and “ear drops.” Methods We used Google Trends to assess the public online interest for search terms “ear pain,” “ear infection,” and “ear drops” in 5 English and non–English-speaking countries from both hemispheres based on time series data. We performed our analysis for the time frame between January 1, 2004, and December 31, 2019. First, we assessed whether our search terms were most relevant to the topics of ear pain, ear infection, and ear drops. We then tested the reliability of Google Trends time series data using the intraclass correlation coefficient. In a second step, we computed univariate time series plots to depict peaks in web-based interest. In the last step, we used the cosinor analysis to test the statistical significance of seasonal interest peaks. Results In the first part of the study, it was revealed that “ear infection,” “ear pain,” and “ear drops” were the most relevant search terms in the noted time frame. Next, the intraclass correlation analysis showed a moderate to excellent reliability for all 5 countries’ 3 primary search terms. The subsequent analysis revealed winter interest peaks for “ear infection” and “ear pain”. On the other hand, the World Wide Web search for “ear drops” peaked annually during the summer months. All peaks were statistically significant as revealed by the cosinor model (all P values <.001). Conclusions It can be concluded that individuals affected by otitis media or externa, possibly the majority, look for medical information online. Therefore, there is a need for accurate and easily accessible information on these conditions in the World Wide Web, particularly on differentiating signs and therapy options. Meeting this need may facilitate timely diagnosis, proper therapy, and eventual circumvention of potentially life-threatening complications.

Ways to increase compliance in patients with acute otitis externa

Topicality: The problem of diagnosis and treatment of otitis externa (OE) has been posed to doctors for a long time, and until the discovery of antibiotics (AB) and antifungal drugs (AFD) remained unresolved. OE can affect up to 10% of people at different periods of their lives, manifesting itself in the form of acute OE (AOE) in 95% of cases after the age of 2 years. There is a reduction in the number of patients admittance to the ENT specialist with the onset of the COVID-19 pandemic while maintaining the structure of the pathology, where AOE - in the top three of frequency. At the same time, there are a reports of an increasing amount of AOE cases in patients with COVID-19. Aim: To evaluate the dynamics of pain, the need for additional analgesia, systemic antibacterial therapy (ABT) or topical antifungal therapy (TAT), the level of compliance in patients with AOE in empirical treatment with a complex drug «Candibiotic» in comparison with protocol treatment. Material and methods: The study included adults and children from 2 years of age with a diagnosis of AOE: 30 patients in the main (17 adults, 13 children) and 25 patients in the control (15 adults, 10 children) groups. Patients in the main group as a basic treatment received topical ear drops «Candibiotic». Patients in the control group received protocol treatment. If necessary, patients were additionally prescribed analgesic therapy (ibuprofen in the appropriate dose), systemic ABT or TAT. For subjective pain asses, a visual analog scale (VAS) was used. Compliance was assessed using the Morisky-Green questionnaire. The obtained results were processed by common statistical methods. Results and discussion: In the main group of patients receiving «Candibiotic», there were fewer needs for additional systemic analgesia, systemic ABT, no one needed additional TAT. Comparison of the obtained results (percentage) in the form of arbitrary tables using the chi-squared test established that the relationship between factor and performance traits is not statistically significant (p>0.05). The mean compliance score between the two study groups differed significantly as a whole and separately between the groups of adults and children (p<0.05). Conclusion: In patients of adult and pediatric age with a diagnosis of AOE at the initial empirical appointment of the drug «Candibiotic» there was less need for additional analgesia, the appointment of systemic ABT and AFT. Such results did not differ statistically significantly from the results in adult and pediatric patients who were prescribed protocol treatment of AOE. Patients with «Candibiotic» monotherapy had a significantly higher average compliance score compared with the control group, especially among parents of children with AOE. The complex composition of ear drops «Candibiotic» contributes to a high adherence to treatment in patients, and the lack of an absolute analogue makes it the means of choice for the initial empirical treatment of AOE in adults and children over 2 years.

Pain Relief by Analgesic Eardrops: Paradigm Shift in the Treatment of Acute Otitis Media?

Acute otitis media is a common middle ear infection in children with the predominant symptoms of hearing impairment and pain. If antibiotics are given, they need time to have an effect on the inflammation, so the focus is on pain control. For pain management local anesthetics have the advantage of lesser systemic side effects but are still subject to scrutiny. In this review the literature between 2000 and 2020 was systematically searched for investigating studies and recommendation in guidelines against the background of the mode of action. 11 clinical studies, 2 guidelines and 5 reports resp. reviews could be identified. Contraindications and side effects were not found in these studies. The analgesic ear drops showed in placebo-controlled studies a relatively short duration of action when applied once but rapid onset of action. There is evidence that analgesic ear drops could provide a first-line analgesia in otitis media without systemic adverse effects such as gastrointestinal disturbance and nausea and could support an antibiotic-saving wait-and-see attitude. The review shows a change in attitude towards the recommendation to include local anesthetics ear drops in otitis media but still there is a lack in treatment protocols which go beyond a single administration. The results do not yet show a significant paradigm shift. The reviews revealed indications that a more adapted galenic preparation could give more effectiveness. Pharmaceutical research in this field should be intensified to exploit the analgesic potential of local anesthetic ear drops in acute otitis media.

Laporan Kasus: Gingivostomatitis dan Infeksi Ektoparasit Parasite Otodectes Ccynotis pada Kuping Kucing Lokal

Feline chronic gingivostomatitis (FCGS) merupakan inflamasi yang menimbulkan rasa nyeri dan sering terjadi pada rongga mulut kucing. Hewan kasus adalah seekor kucing ras lokal, jenis kelamin jantan, berumur empat tahun, bobot berat badan 5,5 kg, dan rambut berwarna kuning putih. Pemilik datang dengan keluhan kucing mengalami penurunan nafsu makan dan minum, dan satu minggu sebelumnya kucing sempat memuntahkan makanan ketika diberi pakan kering serta kucing terlihat kesulitan mengunyah makanannya. Pada pemeriksaan klinis rongga mulut teramati terdapat peradangan pada gusi dari bagian kranial hingga kaudal. Peradangan pada mukosa mulut terjadi bilateral dan terlihat jelas adanya ulserasi, kemerahan, kebengkakan dan ketidak nyamanan kucing saat dilakukan pembukaan rongga mulut. Kucing kasus didiagnosis sebagai gingivostomatitis dengan prognosis fausta. Disamping itu pPada rongga telinga bagian dalam terlihat kotoran serumen kering berwarna coklat kehitaman. Pemeriksaan mikroskopis atas kotoran kering ditemukan tungau parasit Otodectes cynotis. Pengobatan terhadap gingivostomatitis dilakukan dengan pemberian dexamethasone 0,50 mg/kg BB (satu kali sehari) selama lima hari injeksi, cefotaxime 330 mg/kg BB (dua kali sehari) selama tujuh hari injeksi, infus RL selama tujuh hari, dan multivitamin hematodin 0,2 mL/kg BB (sekali sehari) selama tiga hari injeksi. Satu minggu pasca pengobatan, hewan kasus berangsur pulih dan terjadi kesembuhan. Terhadap infestasi infeksi O. cynotis diberikan pengobatan tetes telinga illium ear drops (dua kali sehari) selama satu minggu. Pada pemeriksaan serumen kotoran telinga setelah seminggu, tungau O. cynotis tidak ditemukan. Pengobatan yang diberikan terhadap gingivostomatitis hanya bersifat simtomatis tetapi tidak pada agen penyebab infeksi secara kausatif sehingga kasus berulang pada tujuh hari setelah pengobatan dilakukan sehingga dianjurkan untuk dilakukan cabut/ekstraksi gigi.

A survey on the health status of Dutch scuba diving instructors

Introduction: As the diving population is ageing, so are the diving instructors. Health issues and the use of prescribed medications are more common when ageing. The death of two diving instructors during one weekend in 2017 in the Netherlands, most likely due to cardiovascular disease, motivated investigation of the prevalence of relevant comorbidities in Dutch diving instructors. Methods: All Dutch Underwater Federation diving instructors were invited to complete an online questionnaire. Questions addressed diving experience and current and past medical history including the use of medications. Results: A response rate of 27% yielded 497 questionnaires (87% male, average age 57.3 years [SD 8.5]). Older instructors were over-represented among responders (82% of males and 75% of females > 50 years versus 66% of males and 51% of females among the invited cohort). Forty-six percent of respondents reported no current medical condition. Hypertension was the most commonly reported condition followed by hay fever and problems equalising ears and sinuses. Thirty-two percent reported no past medical condition. Problems of equalising ears and sinuses was the most common past medical condition, followed by hypertension, joint problems or surgery, and hay fever. Fifty-nine percent used non-prescription medication; predominantly analgesics and nose or ear drops. Forty-nine percent used prescription medicine, mostly cardiovascular and respiratory drugs. Body mass index (BMI) was > 25 kg·m-2 in 66% of males and 38% of females. All instructors with any type of cardiovascular disease were overweight. Conclusions: Nineteen percent of responding diving instructors suffered from cardiovascular disease with above-normal BMI and almost 60% used prescribed or non-prescribed medication. Some dived while suffering from medical issues or taking medications, which could lead to medical problems during emergency situations with their students.