Diagnosis, Microbial Epidemiology, and Antibiotic Treatment of Acute Otitis Media in Children

Coker, Tumaini R.; Chan, Linda S.; Newberry, Sydne J; Limbos, Mary Ann; Suttorp, Marika J; Shekelle, Paul G; Takata, Glenn

doi:10.1001/jama.2010.1651

Cited by 248 publications

(186 citation statements)

References 62 publications

(60 reference statements)

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“…It is conceivable that even minor alterations in tendonmediated force transmission during synchronous muscle contractions in Scx-null mice could produce extraesophageal reflux into the nasopharynx and Eustachian tube, predisposing the animal to middle ear infection. Extraesophageal reflux is a proposed mechanism by which children develop otitis media (Hall-Stoodley et al 2006;O'Reilly et al 2008), the most common infection in children for which antibiotics are prescribed (Coker et al 2010). Alternatively, the musculature responsible for active dilation of the Eustachian tube (the tensor veli palatini and levator veli palatini) may not exert sufficient force to modulate the ductal valve to equalize middle ear pressures and allow fluid drainage from the middle ear mucosa to the nasopharynx.…”

Section: Discussionmentioning

confidence: 99%

Scleraxis is Required for Differentiation of the Stapedius and Tensor Tympani Tendons of the Middle Ear

Wang

Bresee

Jiang

et al. 2011

JARO

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Scleraxis (Scx) is a basic helix-loop-helix transcription factor expressed in tendon and ligament progenitor cells and the differentiated cells within these connective tissues in the axial and appendicular skeleton. Unexpectedly, we found expression of the Scx transgenic reporter mouse, Scx-GFP, in interdental cells, sensory hair cells, and cochlear supporting cells at embryonic day 18.5 (E18.5). We evaluated Scx-null mice to gain insight into the function of Scx in the inner ear. Paradoxical hearing loss was detected in Scx-nulls, with 50% of the mutants presenting elevated auditory thresholds. However, Scx-null mice have no obvious, gross alterations in cochlear morphology or cellular patterning. Moreover, we show that the elevated auditory thresholds correlate with middle ear infection. Laser interferometric measurement of sound-induced malleal movements in the infected Scx-nulls demonstrates increased impedance of the middle ear that accounts for the hearing loss observed. The vertebrate middle ear transmits vibrations of the tympanic membrane to the cochlea. The tensor tympani and stapedius muscles insert into the malleus and stapes via distinct tendons and mediate the middle ear muscle reflex that in part protects the inner ear from noise-induced damage. Nothing, however, is known about the development and function of these tendons. Scx is expressed in tendon progenitors at E14.5 and differentiated tenocytes of the stapedius and tensor tympani tendons at E16.5-18.5. Scx-nulls have dramatically shorter stapedius and tensor tympani tendons with altered extracellular matrix consistent with abnormal differentiation in which condensed tendon progenitors are inefficiently incorporated into the elongating tendons. Scx-GFP is the first transgenic reporter that identifies middle ear tendon lineages from the time of their formation through complete tendon maturation. Scx-null is the first genetically defined mouse model for abnormal middle ear tendon differentiation. Scx mouse models will facilitate studies of tendon and muscle formation and function in the middle ear.

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Section: Discussionmentioning

confidence: 99%

Scleraxis is Required for Differentiation of the Stapedius and Tensor Tympani Tendons of the Middle Ear

Wang

Bresee

Jiang

et al. 2011

JARO

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“…The AAP again partnered with AHRQ and the Southern California Evidence-Based Practice Center to develop the evidence report, which served as a major source of data for these practice guideline recommendations. 20,21 New key questions were determined by a technical expert panel. The scope of the new report went beyond the 2001 AHRQ report to include recurrent AOM.…”

Section: Methodsmentioning

confidence: 99%

The Diagnosis and Management of Acute Otitis Media

Tunkel

Rosenfeld²,

Sevilla³

et al. 2013

Pediatrics

1,087

832

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This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM.In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations.The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships.The practice guideline underwent comprehensive peer review before formal approval by the AAP.This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem. Pediatrics 2013;131:e964-e999

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“…Acute OM is characterized by middle ear inflammation with signs of middle ear effusion and acute symptoms of infection including middle ear pain and fever (Coker et al 2010;Toll and Nunez 2012). A minority of children who suffer from acute OM will develop either chronic otitis media with effusion (COME) or recurrent otitis media (ROM).…”

Section: Introductionmentioning

confidence: 99%

A Genome-Wide Association Study of Chronic Otitis Media with Effusion and Recurrent Otitis Media Identifies a Novel Susceptibility Locus on Chromosome 2

Allen

Chen

Weeks

et al. 2013

JARO

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Chronic otitis media with effusion (COME) and recurrent otitis media (ROM) have been shown to be heritable, but candidate gene and linkage studies to date have been equivocal. Our aim was to identify genetic susceptibility factors using a genome-wide association study (GWAS). We genotyped 602 subjects from 143 families with 373 COME/ROM subjects using the Illumina Human CNV370-Duo DNA Bead Chip (324,748 SNPs). We carried out the GWAS scan and imputed SNPs at the regions with the most significant associations. Replication genotyping in an independent family-based sample was conducted for 53 SNPs: the 41 most significant SNPs with PG10 −4 and 12 imputed SNPs with PG10 −4 on chromosome 15 (near the strongest signal). We replicated the association of rs10497394 (GWAS discovery P= 1.30×10 −5 ) on chromosome 2 in the independent otitis media population (P=4.7×10 −5 ; meta-analysis P= 1.52×10 −8 ). Three additional SNPs had replication PvaluesG0.10. Two were on chromosome 15q26.1 including rs1110060, the strongest association with COME/ROM in the primary GWAS (P=3.4×10 −7 ) in KIF7 intron 7 (P=0.072), and rs10775247, a nonsynonymous SNP in TICRR exon 2 (P=0.075). The third SNP rs386057 was on chromosome 5 in TPPP intron 1 (P=0.045). We have performed the first GWAS of COME/ROM and have identified a SNP rs10497394 on chromosome 2 is significantly associated with COME/ROM susceptibility. This SNP is within a 537 kb intergenic region, bordered by CDCA7 and SP3. The genomic and functional significance of this newly identified locus in COME/ROM pathogenesis requires additional investigation.

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Diagnosis, Microbial Epidemiology, and Antibiotic Treatment of Acute Otitis Media in Children

Cited by 248 publications

References 62 publications

Scleraxis is Required for Differentiation of the Stapedius and Tensor Tympani Tendons of the Middle Ear

Scleraxis is Required for Differentiation of the Stapedius and Tensor Tympani Tendons of the Middle Ear

The Diagnosis and Management of Acute Otitis Media

A Genome-Wide Association Study of Chronic Otitis Media with Effusion and Recurrent Otitis Media Identifies a Novel Susceptibility Locus on Chromosome 2

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