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[PMID]:28498895
[Au] Autor:Arnold BF; Schiff KC; Ercumen A; Benjamin-Chung J; Steele JA; Griffith JF; Steinberg SJ; Smith P; McGee CD; Wilson R; Nelsen C; Weisberg SB; Colford JM
[Ti] Título:Acute Illness Among Surfers After Exposure to Seawater in Dry- and Wet-Weather Conditions.
[So] Source:Am J Epidemiol;186(7):866-875, 2017 Oct 01.
[Is] ISSN:1476-6256
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Rainstorms increase levels of fecal indicator bacteria in urban coastal waters, but it is unknown whether exposure to seawater after rainstorms increases rates of acute illness. Our objective was to provide the first estimates of rates of acute illness after seawater exposure during both dry- and wet-weather periods and to determine the relationship between levels of indicator bacteria and illness among surfers, a population with a high potential for exposure after rain. We enrolled 654 surfers in San Diego, California, and followed them longitudinally during the 2013-2014 and 2014-2015 winters (33,377 days of observation, 10,081 surf sessions). We measured daily surf activities and illness symptoms (gastrointestinal illness, sinus infections, ear infections, infected wounds). Compared with no exposure, exposure to seawater during dry weather increased incidence rates of all outcomes (e.g., for earache or infection, adjusted incidence rate ratio (IRR) = 1.86, 95% confidence interval (CI): 1.27, 2.71; for infected wounds, IRR = 3.04, 95% CI: 1.54, 5.98); exposure during wet weather further increased rates (e.g., for earache or infection, IRR = 3.28, 95% CI: 1.95, 5.51; for infected wounds, IRR = 4.96, 95% CI: 2.18, 11.29). Fecal indicator bacteria measured in seawater (Enterococcus species, fecal coliforms, total coliforms) were strongly associated with incident illness only during wet weather. Urban coastal seawater exposure increases the incidence rates of many acute illnesses among surfers, with higher incidence rates after rainstorms.
[Mh] Termos MeSH primário: Enterococcus/isolamento & purificação
Gastroenteropatias/epidemiologia
Infecção/epidemiologia
Água do Mar/microbiologia
Esportes
Tempo (Meteorologia)
[Mh] Termos MeSH secundário: Adulto
California/epidemiologia
Dor de Orelha/epidemiologia
Enterobacteriaceae/isolamento & purificação
Monitoramento Ambiental
Fezes/microbiologia
Feminino
Seres Humanos
Incidência
Estudos Longitudinais
Masculino
Meia-Idade
Chuvas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170513
[St] Status:MEDLINE
[do] DOI:10.1093/aje/kwx019


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[PMID]:28489124
[Au] Autor:Paiva ALC; Araujo JLV; Lovato RM; Teixeira JAR; Miura FK; Guirado VMP; Veiga JCE
[Ad] Endereço:Neurosurgery Resident at Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.
[Ti] Título:Retroauricular pain caused by Eagle syndrome: A rare presentation due to compression by styloid process elongation.
[So] Source:Rev Assoc Med Bras (1992);63(3):213-214, 2017 Mar.
[Is] ISSN:1806-9282
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Eagle syndrome is a rare condition presenting with retroauricular pain (usually as main symptom) associated with dysphagia, headache, neck pain on rotation and, much rarelier, stroke. This occurs due to styloid process elongation. Sometimes, there is also styloid ligament calcification, which can cause compression of nerves and arteries and the symptoms above. Treatment can be conservative with pain modulators (e.g. pregabalin) or infiltrations (steroids or anesthetics drugs). In refractory cases, surgical approach aiming to reduce the size of the styloid process can be performed. We present a rare case of Eagle syndrome (documented by computed tomography) with good response to clinical treatment.
[Mh] Termos MeSH primário: Dor de Orelha/etiologia
Dor de Orelha/fisiopatologia
Ossificação Heterotópica/complicações
Ossificação Heterotópica/fisiopatologia
Osso Temporal/anormalidades
[Mh] Termos MeSH secundário: Analgésicos/uso terapêutico
Dor de Orelha/tratamento farmacológico
Feminino
Seres Humanos
Imagem Tridimensional
Meia-Idade
Pregabalina/uso terapêutico
Osso Temporal/fisiopatologia
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS
[Nm] Nome de substância:
0 (Analgesics); 55JG375S6M (Pregabalin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE


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[PMID]:28316289
[Au] Autor:Watts E; Powell HRF; Saeed SR; Irving RM
[Ad] Endereço:ENT Department,Queen Elizabeth Hospital Birmingham,UK.
[Ti] Título:Post-stapedectomy granuloma: a devastating complication.
[So] Source:J Laryngol Otol;131(6):557-560, 2017 Jun.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This paper reports three cases of severe post-stapedectomy granuloma, emphasising the variable presentation of this devastating complication and the challenges of its management. METHODS: A retrospective review was conducted of three cases of post-stapedectomy granuloma requiring surgical debulking between 2010 and 2015. Clinical symptoms, serial imaging, histopathology and post-operative outcomes were considered. RESULTS: Intra-operatively, extensive granulation tissue with erosion of the otic capsule was found. There was spread along the VIIth and VIIIth cranial nerves to the cochlear nucleus in one patient. Post-operative clinical improvement was demonstrable, corroborated by diminution of contrast enhancement on serial magnetic resonance imaging. Facial nerve function recovered, tinnitus amelioration was variable and some otalgia persisted. Post-operative complications included grade IV facial weakness and late Pseudomonas aeruginosa meningitis, which all resolved. CONCLUSION: To the authors' knowledge, this paper reports the only case of post-stapedectomy granuloma tracking to the brainstem. Otalgia was present in all our cases, and may be deemed a red flag symptom of progressive bony destruction and otic capsule involvement. Although granuloma remains rare, it should be considered in any patient with worsening otological symptoms following stapes surgery.
[Mh] Termos MeSH primário: Encefalopatias/etiologia
Granuloma/etiologia
Complicações Pós-Operatórias/etiologia
Cirurgia do Estribo/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Encefalopatias/patologia
Encefalopatias/cirurgia
Tronco Encefálico/patologia
Tronco Encefálico/cirurgia
Dor de Orelha/etiologia
Paralisia Facial/etiologia
Feminino
Tecido de Granulação/patologia
Tecido de Granulação/cirurgia
Granuloma/patologia
Granuloma/cirurgia
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias/patologia
Complicações Pós-Operatórias/cirurgia
Estudos Retrospectivos
Zumbido/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170321
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117000627


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[PMID]:28274897
[Au] Autor:Ho KY; Huang TY; Tsai SM; Wang HM; Chien CY; Chang NC
[Ad] Endereço:Department of Otolaryngology, Kaohsiung Medical University Hospital, Taiwan; Department of Otolaryngology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan. hmwang@kmu.edu.tw.
[Ti] Título:Surgical Treatment of External Auditory Canal Cholesteatoma - Ten Years of Clinical Experience.
[So] Source:J Int Adv Otol;13(1):9-13, 2017 Apr.
[Is] ISSN:1308-7649
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe the clinical manifestations of external auditory canal (EAC) cholesteatoma and evaluate the surgical outcomes of reconstruction using an inferior pedicled soft-tissue periosteum flap. MATERIALS AND METHODS: A total of 28 patients were enrolled in this retrospective study conducted at Kaohsiung Medical University Hospital in Taiwan between January 2004 and December 2013. EAC cholesteatoma was classified according to the disease extent. The surgery was performed to reconstruct a smooth contour of EAC. RESULTS: The average age of the 28 patients (9 males and 19 females: 30 surgical ears) was 53.7 years. The most common clinical manifestations were unilateral otalgia (63.3%) and otorrhea (46.7%), and the most frequent locations of EAC cholesteatoma with bony invasion were the posterior-inferior (40%), inferior (30%), posterior (20%), and posterior-inferior-anterior (10%) aspects. Based on Naim's staging systems of EAC cholesteatoma, 26 ears (86.7%) were classified as stage III and 4 ears (13.3%) as stage IV. All patients received surgical management via a postauricular approach, and the average length of postoperative follow-up was 61.5 months (range 8-131 months). One patient had recurrence after surgery for 1 year 3 months. CONCLUSION: Bony canaloplasty and obliteration with an inferior pedicled soft-tissue periosteum flap is a reliable procedure for EAC cholesteatoma.
[Mh] Termos MeSH primário: Colesteatoma da Orelha Média/diagnóstico
Colesteatoma da Orelha Média/cirurgia
Meato Acústico Externo/cirurgia
Retalhos Cirúrgicos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Colesteatoma da Orelha Média/complicações
Dor de Orelha/etiologia
Feminino
Seguimentos
Hospitais de Ensino
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Otológicos/métodos
Procedimentos Cirúrgicos Reconstrutivos
Recidiva
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.5152/iao.2017.2342


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[PMID]:28189351
[Au] Autor:Espenel S; Garcia MA; Guy JB; Vallard A; Ben Mrad M; Langrand-Escure J; El Meddeb Hamrouni A; Trone JC; Xia Y; Rancoule C; Magné N
[Ad] Endereço:Département de radiothérapie, institut de cancérologie Lucien-Neuwirth, 108 bis, avenue Albert-Raimond, BP60008, 42271 Saint-Priest-en-Jarez cedex, France.
[Ti] Título:[Ototoxicity in head and neck cancers after radiotherapy and chemoradiotherapy: From primary prevention to tertiary prevention].
[Ti] Título:Ototoxicité radio-induite et chimio-induite dans les cancers ORL : de la prévention primaire à la prévention tertiaire..
[So] Source:Cancer Radiother;21(1):77-83, 2017 Feb.
[Is] ISSN:1769-6658
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Each year, 15,000 head and neck cancer are treated in France. Prognosis is steadily improving. Consequently, limitation of late toxicities becomes essential. Ototoxicity is common, disabling and undervalued. We aimed to inventory primary, secondary and tertiary prevention measures to reduce ototoxicity induced by radiotherapy and chemotherapy, as well as its impact on quality of life of patients treated for head and neck cancer. External radiation therapy induced 30 to 40% of ototoxicity, including irreversible sensorineural hearing loss. Primary prevention of this risk is based on limiting the dose to the cochlea: 40Gy in case of radiotherapy alone, 10Gy during concomitant chemoradiotherapy with cisplatin. Dose gradients allowed by intensity-modulated radiotherapy help respecting these limits. Concurrent chemotherapy with high dose cisplatin (100mg/m ) also causes hearing loss by cochlear damages. Prescription of carboplatin-5-fluorouracil combination or cetuximab should be preferred in case of high risk of ototoxicity. This risk must be precisely evaluated before treatment. Ototoxicity monitoring during treatment allows early management, and lower long-term impact. Radiosensitivity predictive tests and research of genetic factors predisposing to chemo-induced ototoxicity should enable optimization of therapeutic choices and monitoring.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Neoplasias de Cabeça e Pescoço/terapia
Perda Auditiva Condutiva/prevenção & controle
Perda Auditiva Neurossensorial/prevenção & controle
Lesões por Radiação/prevenção & controle
Radioterapia de Intensidade Modulada/efeitos adversos
[Mh] Termos MeSH secundário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Quimiorradioterapia/efeitos adversos
Quimiorradioterapia/métodos
Cisplatino/administração & dosagem
Cisplatino/efeitos adversos
Cóclea/efeitos dos fármacos
Cóclea/efeitos da radiação
Terapia Combinada
Dor de Orelha/induzido quimicamente
Dor de Orelha/etiologia
Neoplasias de Cabeça e Pescoço/radioterapia
Perda Auditiva Condutiva/etiologia
Perda Auditiva Neurossensorial/induzido quimicamente
Perda Auditiva Neurossensorial/etiologia
Seres Humanos
Órgãos em Risco
Otite/induzido quimicamente
Otite/etiologia
Prevenção Primária/métodos
Qualidade de Vida
Lesões por Radiação/etiologia
Tolerância a Radiação
Dosagem Radioterapêutica
Prevenção Secundária/métodos
Prevenção Terciária/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
Q20Q21Q62J (Cisplatin)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170425
[Lr] Data última revisão:
170425
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170213
[St] Status:MEDLINE


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[PMID]:28173896
[Au] Autor:Mulazimoglu S; Flury R; Kapila S; Linder T
[Ad] Endereço:Department of Otorhinolaryngology,Head and Neck Surgery,Luzerner Kantonsspital,Luzern,Switzerland.
[Ti] Título:Effects of a sensory branch to the posterior external ear canal: coughing, pain, Ramsay Hunt's syndrome and Hitselberger's sign.
[So] Source:J Laryngol Otol;131(4):329-333, 2017 Apr.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A distinct nerve innervating the external auditory canal can often be identified in close relation to the facial nerve when gradually thinning the posterior canal wall. This nerve has been attributed to coughing during cerumen removal, neuralgic pain, Hitselberger's sign and vesicular eruptions described in Ramsay Hunt's syndrome. This study aimed to demonstrate the origin and clinical impact of this nerve. METHODS AND RESULTS: In patients with intractable otalgia or severe coughing whilst inserting a hearing aid, who responded temporarily to local anaesthesia, the symptoms could be resolved by sectioning a sensory branch to the posterior canal. In a temporal bone specimen, it was revealed that this nerve is predominantly a continuation of Arnold's nerve, also receiving fibres from the glossopharyngeal nerve and facial nerve. Histologically, the communicating branch from the facial nerve was confirmed. CONCLUSION: Surgeons should be aware of the posterior auricular sensory branch and its clinical implications.
[Mh] Termos MeSH primário: Tosse/fisiopatologia
Meato Acústico Externo/inervação
Dor de Orelha/fisiopatologia
Herpes Zoster da Orelha Externa/fisiopatologia
Neuralgia/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Tosse/etiologia
Tosse/cirurgia
Pavilhão Auricular/inervação
Pavilhão Auricular/cirurgia
Meato Acústico Externo/cirurgia
Dor de Orelha/etiologia
Dor de Orelha/cirurgia
Nervo Facial/fisiopatologia
Nervo Facial/cirurgia
Feminino
Nervo Glossofaríngeo/fisiopatologia
Nervo Glossofaríngeo/cirurgia
Herpes Zoster da Orelha Externa/complicações
Herpes Zoster da Orelha Externa/cirurgia
Seres Humanos
Masculino
Meia-Idade
Neuralgia/etiologia
Neuralgia/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170321
[Lr] Data última revisão:
170321
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170209
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117000160


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[PMID]:28122101
[Au] Autor:Sataloff RT; Pavlick ML; McCaffrey JD; Davis JM; Stewart SM
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, 219 N. Broad St., 10th floor, Philadelphia, PA 19107, USA. rtsataloff@phillyent.com.
[Ti] Título:Simultaneous binaural bithermal caloric testing: Clinical value.
[So] Source:Ear Nose Throat J;96(1):29-31, 2017 Jan.
[Is] ISSN:1942-7522
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this retrospective review was to determine the clinical value of simultaneous binaural bithermal caloric testing (SBT) versus alternate binaural bithermal caloric testing (ABB) in the setting of a tertiary care neurotology clinic. Charts of 131 adults who had presented with otologic complaints and had undergone both SBT and ABB examinations were included in the study. The main outcome measure was the identification of peripheral hypofunction. One hundred two patients had a normal ABB caloric examination; 86 of those 102 patients (84.3%) had normal ABB examinations but abnormal SBT results. We conclude that SBT is a more sensitive measure of peripheral pathology than the traditional ABB examination. If peripheral pathology is suspected but not confirmed by ABB, SBT appears useful for detecting mildly reduced vestibular response.
[Mh] Termos MeSH primário: Testes Calóricos/métodos
Doenças Vestibulares/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Tontura/etiologia
Dor de Orelha/etiologia
Feminino
Perda Auditiva/etiologia
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Zumbido/etiologia
Vertigem/etiologia
Doenças Vestibulares/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170614
[Lr] Data última revisão:
170614
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE


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[PMID]:28061926
[Au] Autor:Govindaraju R; Adaikappan M; Rajagopalan R
[Ti] Título:Baro-otolagia Secondary to Cholesteatoma.
[So] Source:Aerosp Med Hum Perform;88(1):65-67, 2017 Jan 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Baro-otalgia is a common complaint among passengers in an aircraft, in particular those who had a recent upper respiratory tract infection. The underlying pathophysiology is secondary to unequal aeration of the middle ear cleft with the surrounding atmosphere and it can be explained using Boyle's Law. We describe an unusual presentation of baro-otalgia in a pilot secondary to cholesteatoma obstructing the aditus despite normal middle ear pressure equalization provided by a grommet in the ear. CASE REPORT: A 26-yr-old pilot with a presenting complaint of conductive hearing loss was diagnosed and treated for congenital cholesteatoma. His hearing improved, but 4 yr later he developed ear pain during the cruising phase of flight at an altitude of 9144 m (30,000 ft) above sea level. This pain persisted until descent to 4876 m (16,000 ft). Despite insertion of a middle ear ventilating tube, he remained symptomatic, requiring further investigation. This led to the diagnosis of recurrent cholesteatoma obstructing the aditus to the mastoid cavity. Upon surgical removal of the cholesteatoma, symptoms resolved. DISCUSSION: We hypothesize that the recurrent cholesteatoma caused obstruction to normal aeration of the mastoid air cells during the changing atmospheric air pressure, thus producing pain. This is akin to sinus barotrauma instead of the usual pathophysiology underlying barotitis.Govindaraju R, Adaikappan M, Rajagopalan R. Baro-otolagia secondary to cholesteatoma. Aerosp Med Hum Perform. 2017; 88(1):65-67.
[Mh] Termos MeSH primário: Medicina Aeroespacial
Barotrauma/etiologia
Colesteatoma da Orelha Média/complicações
Dor de Orelha/etiologia
Pilotos
Pressão
[Mh] Termos MeSH secundário: Adulto
Altitude
Colesteatoma/congênito
Colesteatoma/cirurgia
Colesteatoma da Orelha Média/diagnóstico por imagem
Seres Humanos
Masculino
Processo Mastoide/diagnóstico por imagem
Recidiva
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170221
[Lr] Data última revisão:
170221
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170108
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4688.2017


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[PMID]:28059446
[Au] Autor:Hirsch SD; Reiter ER; DiNardo LJ; Wan W; Schuman TA
[Ad] Endereço:Virginia Commonwealth University School of Medicine, Richmond, Virginia, U.S.A.
[Ti] Título:Elimination of pain improves specificity of clinical diagnostic criteria for adult chronic rhinosinusitis.
[So] Source:Laryngoscope;127(5):1011-1016, 2017 May.
[Is] ISSN:1531-4995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Determine whether the elimination of pain improves accuracy of clinical diagnostic criteria for adult chronic rhinosinusitis. STUDY DESIGN: Retrospective cohort study. METHODS: History, symptoms, nasal endoscopy, and computed tomography (CT) results were analyzed for 1,186 adults referred to an academic otolaryngology clinic with presumptive diagnosis of chronic rhinosinusitis. Clinical diagnosis was rendered using the 1997 Rhinosinusitis Taskforce (RSTF) Guidelines and a modified version eliminating facial pain, ear pain, dental pain, and headache. RESULTS: Four hundred seventy-nine subjects (40%) met inclusion criteria. Among subjects positive by RSTF guidelines, 45% lacked objective evidence of sinonasal inflammation by CT, 48% by endoscopy, and 34% by either modality. Applying modified RSTF diagnostic criteria, 39% lacked sinonasal inflammation by CT, 38% by endoscopy, and 24% by either modality. Using either abnormal CT or endoscopy as the reference standard, modified diagnostic criteria yielded a statistically significant increase in specificity from 37.1% to 65.1%, with a nonsignificant decrease in sensitivity from 79.2% to 70.3%. Analysis of comorbidities revealed temporomandibular joint disorder, chronic cervical pain, depression/anxiety, and psychiatric medication use to be negatively associated with objective inflammation on CT or endoscopy. CONCLUSION: Clinical diagnostic criteria overestimate the prevalence of chronic rhinosinusitis. Removing facial pain, ear pain, dental pain, and headache increased specificity without a concordant loss in sensitivity. Given the high prevalence of sinusitis, improved clinical diagnostic criteria may assist primary care providers in more accurately predicting the presence of inflammation, thereby reducing inappropriate antibiotic use or delayed referral for evaluation of primary headache syndromes. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1011-1016, 2017.
[Mh] Termos MeSH primário: Dor de Orelha/diagnóstico
Dor Facial/diagnóstico
Cefaleia/diagnóstico
Rinite/diagnóstico
Sinusite/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Doença Crônica
Comorbidade
Diagnóstico Diferencial
Endoscopia
Seres Humanos
Meia-Idade
Medição da Dor
Prevalência
Estudos Retrospectivos
Sensibilidade e Especificidade
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170428
[Lr] Data última revisão:
170428
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE
[do] DOI:10.1002/lary.26442


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[PMID]:28012530
[Au] Autor:Garcia C; Salgueiro AB; Luís C; Correia P; Brito MJ
[Ad] Endereço:Department of Pediatrics, Hospital Prof. Doutor Fernando Fonseca, EPE, Estrada IC-19, 2720-276, Amadora, Portugal. Electronic address: catarinasmgarcia@gmail.com.
[Ti] Título:Acute mastoiditis in children: Middle ear cultures may help in reducing use of broad spectrum antibiotics.
[So] Source:Int J Pediatr Otorhinolaryngol;92:32-37, 2017 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Acute mastoiditis (AM) is a suppurative infection of the mastoid air cells, representing the most frequent complication of acute otitis media. AM remains an important entity in children due to its potential complications and sequelae. We aim to describe the cases of AM admitted at our department, identify risk factors potentially associated with complications and analyse the changes in clinical approach of AM over time. METHODS: Case review of clinical files of children admitted with acute mastoiditis from June 1996 to May 2013 at a Lisbon metropolitan area hospital. Data was divided into two groups (prior and after May 2005) in order to evaluate changes in AM approach over the years. RESULTS: 135 AM episodes were included. The median age was 3.8 years and 42% children were less than 24 months of age. Symptoms at presentation included fever (69%), ear pain (56%) and otorrhea (40%). Complications occurred in 22% patients and were more common in children under 24 months (33% vs 15%, p ≤ 0.01). Leukocyte count was significantly higher in children with complications (16.7 vs 14.5 × 10 /µL, p ≤ 0.05) as was C-Reactive Protein value (13 vs 6.3 mg/dL, p ≤ 0.001). There was a significant association between the development of complications and C-Reactive Protein value at admission (OR 1.892; IC95%: 1.018-2.493, p ≤ 0.01). The optimal cut-off value was 7.21 mg/dL. Over time there was a significant increase in middle ear cultures obtained by tympanocentesis during surgery (2% vs 16%, p ≤ 0,01) and also a decrease in the use of broad spectrum antibiotherapy as initial treatment (52% vs 25%,p ≤ 0,001). CONCLUSIONS: Children under 24 months, with high leukocyte count or with high C-Reactive Protein value should be monitored closely since complications tend to be more frequent. A CRP value of 7.21 mg/dL at admission seems to be a good cut-off to monitor children for potential complications. Throughout the period analysed more cultures were performed allowing identification of the pathogens and implementation of appropriate antibiotic therapy.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Orelha Média/microbiologia
Mastoidite/tratamento farmacológico
Mastoidite/microbiologia
[Mh] Termos MeSH secundário: Doença Aguda
Adolescente
Proteína C-Reativa/metabolismo
Criança
Pré-Escolar
Dor de Orelha/etiologia
Feminino
Febre/etiologia
Hospitalização
Seres Humanos
Lactente
Contagem de Leucócitos
Masculino
Mastoidite/sangue
Mastoidite/complicações
Estudos Retrospectivos
Timpanocentese
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161226
[St] Status:MEDLINE



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