Otitis media

Casey, Janet R.; Pichichero, Michael E.

doi:10.1517/14656566.3.8.1073

Cited by 17 publications

(1 citation statement)

References 78 publications

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“…The burden of infectious disease is immense even in children with healthy immune systems. Recurrent otitis media is considered to be more than 4 episodes of acute otitis media during the past 12 months with complete resolution of the disease between episodes [13–15]. …”

Section: Methodsmentioning

confidence: 99%

Attending to Warning Signs of Primary Immunodeficiency Diseases Across the Range of Clinical Practice

et al. 2013

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PurposePatients with primary immunodeficiency diseases (PIDD) may present with recurrent infections affecting different organs, organ-specific inflammation/autoimmunity, and also increased cancer risk, particularly hematopoietic malignancies. The diversity of PIDD and the wide age range over which these clinical occurrences become apparent often make the identification of patients difficult for physicians other than immunologists. The aim of this report is to develop a tool for educative programs targeted to specialists and applied by clinical immunologists.MethodsConsidering the data from national surveys and clinical reports of experiences with specific PIDD patients, an evidence-based list of symptoms, signs, and corresponding laboratory tests were elaborated to help physicians other than immunologists look for PIDD.ResultsTables including main clinical manifestations, restricted immunological evaluation, and possible related diagnosis were organized for general practitioners and 5 specialties. Tables include information on specific warning signs of PIDD for pulmonologists, gastroenterologists, dermatologists, hematologists, and infectious disease specialists.ConclusionsThis report provides clinical immunologists with an instrument they can use to introduce specialists in other areas of medicine to the warning signs of PIDD and increase early diagnosis. Educational programs should be developed attending the needs of each specialty.

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Section: Methodsmentioning

confidence: 99%

Attending to Warning Signs of Primary Immunodeficiency Diseases Across the Range of Clinical Practice

et al. 2013

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The Genus Moraxella

Hays¹

2006

The Prokaryotes

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Lower nasopharyngeal epithelial cell repair and diminished innate inflammation responses contribute to the onset of acute otitis media in otitis-prone children

Verhoeven

Nesselbush

Pichichero

2013

Med Microbiol Immunol

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About 30% of young children experience excessive, frequent episodes of middle ear infection and are classified as acute otitis media prone (OP). Streptococcus pneumoniae (Spn) is a predominant otopathogen in OP and non-OP (NOP) children. The pathogenesis of middle ear infection involves otopathogen nasopharyngeal (NP) colonization followed by an upper respiratory viral infection that modifies the NP environment to allow a sufficient inoculum of bacteria to reflux via the Eustachian tube into the middle ear space. Here, we analyzed the NP mucosal repair response between age-matched OP and NOP children who progressed to middle ear infection caused by Spn. We found lower epidermal growth factor, epidermal growth factor receptor, and angiogenin cytokine concentrations in nasal washes of OP compared to NOP children. Despite higher expression of TLR2/4 transcript expression in nasal epithelium and in polymorphonuclear cells present in nasal secretions in OP children, OP children had lower expression of proinflammatory cytokines such as IL-6 and IL-8 in the NP. Chemotaxis associated cytokine expression at onset of AOM in OP children was also lower compared to NOP children, possibly indicating a lower capacity to signal the innate immune system. We conclude that lower epithelial cell repair responses during viral infection in the NP combined with diminished innate inflammatory responses potentiate Spn pathogenesis in the OP child.

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Otitis media

Cited by 17 publications

References 78 publications

Attending to Warning Signs of Primary Immunodeficiency Diseases Across the Range of Clinical Practice

Attending to Warning Signs of Primary Immunodeficiency Diseases Across the Range of Clinical Practice

The Genus Moraxella

Lower nasopharyngeal epithelial cell repair and diminished innate inflammation responses contribute to the onset of acute otitis media in otitis-prone children

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