Adverse food reactions in dogs due to antibiotic residues in pet food: a preliminary study.

In the last decades, adverse food reactions have increased considerably in dogs and cats. In this study we report on the possible onset of food intolerances symptoms, including otitis, diarrhoea, generalised anxiety, and dermatitis in a cohort of 8 dogs consuming commercial diets. All dogs received an organic chicken-based diet for 15 days. We performed analysis of blood biochemical parameters, kibble composition, and oxytetracycline (OTC) serum concentration before and after 15 days of organic chicken-based diet supplementation. We hypothesised that a chronic intake of contaminated food enhanced by the presence of nanoparticle aggregates might be at the base of the onset of pharmacologic or idiopathic food intolerances. At the end of the evaluation period, an overall significant reduction of otitis, diarrhoea, generalised anxiety, and dermatitis was observed. Biochemical analyses indicate a significant increase in the alkaline phosphatase, from 41 to 52.5 U/L, after 15 days (••p <0.01), while a significant decrease in Gamma-glutamyl transferase and urea, from 9.37 to 6.25 U/L and from 32.13 ± 8.72 to 22.13 ± 7.8 mg/dL, respectively, was observed (•p <0.05). A significant decrease, from 0.22 to 0.02 µg/mL, in mean OTC serum concentration was also observed (••p <0.01). Composition analysis revealed the presence of OTC, calcium, aluminium, silicon, and phosphorous nanoparticle aggregates. Further research on a wider sample size would help to confirm the hypothesis proposed here.

[The assessment of the clinical effectiveness of fenspiride for the treatment of acute obstruction of the Eustachian tube].

The objective of the present study was to estimate the clinical effectiveness of fenspiride used to correct the obstruction of the Eustachian tube in 80 patients presenting with acute tubootitis and exudative otitis media. The algorithm of the examination included the evaluation of the severity of subjective clinical symptoms based on the relevant analog-visual scale, results of tonal audiometry, and tympanometry. The control group was comprised of 34 patients treated with antibacterial preparations, topical decongestants, and transtubal administration of glucocorticoids. The study group included 46 patients who received fenspiride at a dose of 80 mg thrice daily in addition to the above pharmacotherapy. The severity of clinical symptoms in the patients treated with fenspiride decreased faster than in the control subjects. The frequency analysis of dynamics of the air-bone gaps on the audiometric curves revealed the significantly more intensive recovery of the hearing function in the patients treated by basal pharmacotherapy in the combination with fenspiride. Type A tympanograms predominated on day 7 after the onset of the conservative treatment with the use of fenspiride whereas type C tympanograms continued to predominate in the patients of the control group. It is concluded that the introduction of fenspiride into combined therapy of acute tubootitis and exudative otitis media promotes the normalization of the ventilation and drainage functions and relieves the severity of subjective clinical symptoms.

Handheld tympanometer measurements in conscious dogs for the evaluation of the middle ear and auditory tube.

BACKGROUND: Otitis externa is frequently accompanied by otitis media, yet it can be difficult to evaluate the tympanum, middle ear and auditory tube without the use of advanced radiographic imaging. HYPOTHESIS/OBJECTIVES: The objective was to develop techniques for tympanometry testing in conscious dogs and to present normative data for clinical use of this equipment to enable assessment of the tympanum, middle ear and auditory tube. ANIMALS: Sixteen hounds (14 female) from a school teaching colony. METHODS: Dogs were gently restrained in a standing position. After cleaning of the ear canal, a tympanometer probe tip extension was placed in the vertical canal and automated testing performed using a handheld device. Both ears were tested in all dogs. RESULTS: Acceptable recordings were obtained from both ears of 13 dogs, from one ear in each of two dogs and from neither ear of one dog, resulting in data from 28 of 32 (88%) ears. Otoscopic examination confirmed the absence of inflammation or any other obvious explanation for the noncompliant dogs. No significant differences were seen between ears for any measure. Normative data are reported for peak compliance, peak compliance pressure, gradient and ear canal volume. CONCLUSIONS AND CLINICAL IMPORTANCE: Tympanograms can be recorded in conscious dogs to assist in the evaluation of the middle ear structures.

Cyclo(His-Pro) exerts anti-inflammatory effects by modulating NF-κB and Nrf2 signalling.

Cyclo(His-Pro) is an endogenous cyclic dipeptide that exerts oxidative damage protection by selectively activating the transcription factor Nrf2 signalling pathway. Given the existence of a tight interplay of the Nrf2/NF-κB systems and that the pro-inflammatory response is governed by transcription factor NF-κB, here we sought to investigate whether and how cyclo(His-Pro) interferes with the cross-talk between the antioxidant Nrf2/heme oxygenase-1 and the pro-inflammatory NF-κB pathways. By knocking down the Nrf2 gene, we confirmed that cyclo(His-Pro) inhibits NF-κB nuclear accumulation induced by paraquat in rat pheochromocytoma PC12 cells via the Nrf2/heme oxygenase-1 pathway. The protection required functional heme oxygenase-1 activity, since zinc protoporphyrin IX, a heme oxygenase-1 inhibitor, prevented NF-κB inhibition, and the presence of exogenous carbon monoxide and bilirubin afforded cytoprotection against paraquat-induced toxicity by preventing NF-κB activation. Cyclooxygenase-2 and matrix metalloproteinase 3, two gene products governed by NF-κB, were down-regulated by cyclo(His-Pro) and up-regulated in heme oxygenase-1 knock-down cells. We validated the general mechanism underlying the anti-inflammatory effects by treating PC12 and murine microglial BV2 cells with different pro-inflammatory agents. Finally, cyclo(His-Pro) reduced 12-otetradecanoylphorbol-13-acetate-induced oedema in mouse ear inflammation model. Results, by showing that cyclo(His-pro) suppresses the pro-inflammatory NF-κB signalling via the Nrf2-mediated heme oxygenase-1 activation, contribute to the understanding of essential cellular pathways and allow the proposal of cyclo(His-Pro) as an in vivo anti-inflammatory compound.

Risk of spontaneous preterm delivery in a low-risk population: the impact of maternal febrile episodes, urinary tract infection, pneumonia and ear-nose-throat infections.

OBJECTIVE: To assess the associations between maternal infections during pregnancy (i.e. ear-nose-throat infection, pneumonia, urinary tract infection, febrile episodes and influenza-like infection) and spontaneous preterm delivery (SPTD). STUDY DESIGN: Prospective questionnaire data from the Norwegian Mother and Child Cohort (MoBa) study, including more than 100000 pregnancies and, collected during 1999-2008, were used. Linked data from the Medical Birth Registry of Norway were added. SPTD occurring between gestational weeks 22+0 days and 36+6 days was the main outcome. Data were analysed in two steps because questionnaires (including information about occurrence of the various infections so far) were completed at different stages of pregnancy. Hazard ratios (HR) were obtained using Cox regression. RESULTS: The SPTD proportion was low in this cohort: 2.9% and 2.7% at the two analysis steps, respectively. After exclusions, 67310 and 60689 pregnancies, respectively, remained for the analyses. Ear-nose-throat infections occurring before week 17 were associated with an increased risk of SPTD in the first (HR: 1.27, 95% CI: 1.08-1.50) and second (HR: 1.26, 95% CI: 1.04-1.52) step of the analysis, but not if occurring later in pregnancy. None of the other maternal infections were associated with an increased risk of SPTD. CONCLUSION: In this low-risk population, ear-nose-throat infection in early pregnancy was associated with an increased risk of SPTD. However, infectious morbidity in later pregnancy was not. Thus, the link between maternal infection and preterm delivery may vary in different populations and health care settings.

[Combined approaches to diagnostics and treatment of traumatic otitis].

A total of 216 patients with the injured tympanic membrane were examined and treated during the last 5 years. 198 (91.6%) patients presenting with traumatic otitis were found to have pathological changes in the nose and paranasal sinuses. In patients who applied for medical aid soon (within 1-2 weeks) after injury to the tympanic membrane, the resulting perforation was closed with the use of hen's egg amniotic membrane. Audiological examination demonstrated that 84.7% of traumatic tympanic membrane ruptures were associated with acute sensorinerual loss of hearing.

[Video endoscopic analysis of eustachian tube function in children with middle ear pathology]. / Wideoendoskopowa ocena funkcji gardlowego ujscia trabki sluchowej u dzieci z chorobami ucha srodkowego.

Eustachian tube (ET) dysfunction play an important role in the development, persistence and recurrence of otitis media with effusion (OME) and chronic otitis. Evaluation of the type of obstruction in the cartilaginous portion of ET is important for decision concerning methods of treatment and prognosis of surgical outcome. The aim of this study was to identify characteristics of dynamic function of the pharyngeal orifice of ET in children with OME and chronic otitis by video endoscopy. Transnasal endoscopic examination of the nasopharyngeal opening of ET during swallowing was performed on 21 children - 13 with OME, 8 with chronic otitis. Video recording were made for dynamic slow-motion analysis of ET dilation and closing processes. Most cases of ET dysfunction in children were obstrucive (81%), associated with mucosal oedema and hyperplasia. Dynamic type of dysfunction is caused by the reduced movement of the tensor veli palatini. Dynamic video analysis is useful in the identify type of ET dysfunction in children. Obstructive dysfuntion need diagnostic procedures for chronic infection, nasopharyngeal reflux and alergic diseases.

Ototoxicity of topical moxifloxacin in a chinchilla animal model.

OBJECTIVE: Ciprofloxacin is currently the only proven nonototoxic topical antibiotic. However, its widespread use has resulted in the emergence of antimicrobial resistance. There are also concerns that there is currently no safe alternative to ciprofloxacin for patients with a nonintact eardrum. We thus wished to evaluate whether a moxifloxacin solution is ototoxic when used topically in chinchilla ears in the presence of a pressure-equalizing tube (PET). STUDY DESIGN: A prospective, randomized, controlled trial was conducted in an animal model. METHODS: Twenty chinchillas were included in this study. After bilateral insertion of PETs, four drops of a moxifloxacin solution were delivered twice daily for 7 days in the randomly assigned experimental ear. The control ear received an equal amount of a solution of Ringer's lactate. Distortion product otoacoustic emissions (DPOAE) were recorded at baseline (after PET insertion) and at days 1, 3, 7, 14, and 28 after treatment initiation. RESULTS: When baseline DPOAE measurements were compared with the final measurements at day 28, moxifloxacin caused a statistically significant (P < .05) hearing loss (HL) in the experimental ears for the frequencies between 3.7 and 15 kHz. There was no significant change in hearing in the control ears. CONCLUSION: This represents the first study on the ototoxicity of topical moxifloxacin. Our results demonstrate that moxifloxacin causes HL when used with a nonintact tympanic membrane in a chinchilla animal model.

[Dynamics of paranasal sinus and tympanic membrane changes in prolongely intubated patients].

67 prolongely intubated patients from intensive care unit were under our observation. Were performed ultrasound examination and CT scan of paranasal sinuses in prolongely intubated patients. In the same patients it was performed the examination of tympanic cavity by acoustic impendansometry. Also was performed bacteriologic examination of nasal discharge in prolongely intubated patients. Our investigations showed, that in prolongely intubated patients there is a high risk of development of polysinusitis and evstachitis, which can lead to so called fever of unknown origin and even to chronic sepsis. According to the authors, sanitation of nasal cavity must be performed every day at least 1 time, and if there is the shade--at least 2 times every day. To create the negative pressure, it is rational to use iamic--catheter and, through which activation of mucocilliary transport is performed. Changing of nasogastral probe is rational after one day by turns in each nasal pass. It is rational to cleanse places of pressing of these probes with the antiseptic solutions.

Análise retrospectiva da toxicidade de gotas otológicas, medicamentos tópicos nasais e orofaríngeos registrada na Grande São Paulo / Retrospective analysis of toxicity of eardrops, topical nasal and oropharyngeal medicines, documented in São Paulo, Brazil

OBJETIVO: Análise retrospectiva dos registros de toxicidade em humanos envolvendo medicamentos tópicos para tratamento de doenças das vias aéreas superiores (gotas otológicas; medicamentos tópicos nasais; colutórios, pastilhas e aerossóis para afecções da orofaringe). MÉTODOS: Foram selecionadas: 34 marcas comerciais de gotas otológicas, 48 de medicamentos tópicos nasais e 22 de pastilhas, colutórios e aerossóis para afecções orofaríngeas, totalizando 104 medicamentos disponíveis no Brasil. Analisamos os registros do banco de dados eletrônico do Centro de Controle de Intoxicações (CCI-Jabaquara) da Grande São Paulo, no período de janeiro de 1996 a dezembro de 2000 e compilamos os casos relacionados aos fármacos escolhidos. RESULTADOS: Foram relatados ao CCI-Jabaquara, voluntariamente, 10.823 casos de toxicidade de medicamentos em humanos. Remédios tópicos para tratamento de afecções das vias aéreas superiores corresponderam a 291 casos (2,68 por cento), dos quais 240 (82,5 por cento) foram intoxicações; 12 (4,1 por cento) envolveram gotas otológicas; 268 (92 por cento), medicamentos tópicos nasais e 11 (3,9 por cento), medicamentos de uso tópico orofaríngeo. Na categoria dos tópicos nasais, predominaram vasoconstritores (233 casos). Dentre os tópicos para afecções orofaríngeas prevaleceu a tetracaína (quatro casos). Na distribuição por idade, houve preponderância de casos em crianças de um a quatro anos (p=0,0003). As principais circunstâncias da toxicidade foram: ingestão acidental (43 por cento) e erro de administração dos medicamentos (14,8 por cento). Os sintomas mais freqüentes de toxicidade foram hiperreflexia e vômitos. CONCLUSÕES: Houve incidência significativa de toxicidade sistêmica por gotas otológicas, medicamentos tópicos nasais e orofaríngeos em crianças de um a quatro anos de idade, cuja principal causa foi ingestão acidental destes remédios.

[Retrospective analysis of toxicity of eardrops, topical nasal and oropharyngeal medicines, documented in São Paulo, Brazil]. / Análise retrospectiva da toxicidade de gotas otológicas, medicamentos tópicos nasais e orofaríngeos registrada na Grande São Paulo.

BACKGROUND: Retrospective analysis of human toxicity files involving topical medicines for treatment of upper airways diseases (eardrops, topical nasal medicines, lozenges, drops and sprays for oropharyngeal affections). METHODS: Thirty-four brands of eardrops, 48 of topical nasal medicines and 22 of tablets, lozenges and sprays for oropharyngeal affections were selected, from a total of 104 products available in Brazil. We analyzed the registries in the electronic database from the Poison Control Centre of São Paulo (CCI-Jabaquara), Brazil, for the period from January 1996 through December 2000. The cases related to selected pharmaceuticals were collected. RESULTS: 10,823 cases of human toxicity caused by medicines were voluntarily reported to CCI-Jabaquara. Topical medicines for treatment of upper airways diseases accounted for 291 cases (2.68%), from which 240 (82.5%) represented poisoning; 12 (4.1%) involved ear drops, 268 (92%), topical nasal medicines and 11 (3.9%), topical medicines for oropharyngeal affections. Among topical nasal medicines, vasoconstrictors predominated (233 cases), and among medicines for oropharyngeal affections, it was tetracaine (four cases). Considering age distribution, toxicity predominated significantly in children aged from 1 to 4 years (p=0.0003). The main causes of toxicity were: accidental intake of medicines (43%) and error in drug administration (14.8%). Hypereflexia and vomiting were the most frequent symptoms related to toxicity. CONCLUSIONS: There was significant incidence of systemic toxicity due to eardrops, topical nasal and oropharyngeal medicines in children 1 to 4 years-old, whose main cause was accidental intake of these medicines.

Avaliação audiológica em crianças nascidas de mães soropositivas para o vírus da imunodeficiência humana / Audiological Evaluation in Children Born to HIV Positive Mothers

Presente trabalho teve como objetivo avaliar audiologicamente crianças nascidas de mães soropositivas para o HIV, verificando a ocorrência de alterações auditivas. Material e método: A população estudada constou de 143 crianças, 82 do sexo masculino e 61 do sexo feminino, na faixa etária entre um mês a dois anos e seis meses de idade. As crianças foram divididas em três grupos, de acordo com o Sistema de Classificação Revisado 16 para a infecção pelo HIV em crianças menores de 13 anos de idade, sendo estes denominados: infectado (I), sororrevertido (SR) e exposto (E). Os procedimentos empregados na avaliação audiológica foram a audiometria de observação comportamental, audiometria com reforço visual e medidas de imitância acústica. Analisando a amostra avaliada segundo as variáveis duração da gestação e peso ao nascimento, pôde ser observado um número maior de crianças nascidas a termo e com peso adequado para a idade gestacional. No estudo da ocorrência de alterações auditivas, foram utilizados os resultados da última avaliação audiológica obtidos nas 143 crianças da amostra. Resultados: A análise estatística revelou presença de alterações auditivas significantemente maior nas crianças infectadas. Nos grupos sororrevertido e exposto ocorreu exatamente o oposto, ou seja, houve predominância de ausência de alterações auditivas. Conclusão: O tipo de alteração auditiva mais freqüentemente encontrado no grupo infectado foi a sugestiva de alteração auditiva central, e nos demais grupos ocorreu similaridade entre as alterações de orelha média e as sugestivas de alterações auditivas centrais.

The aim of the present study was the audiological evaluation of children born to mothers serologically positive for HIV, in order to verify the occurrence of auditory disorders. Material and method: The population studied included 143 children - 82 males and 61 females - ranging in age from one month to two years and six months. The children were divided into three groups, following the revised classification systemt1 for human immunodeficiency virus infection in children less than 13 years of age, as infected (1), seroreverter (SR) or exposed (E). The audiological evaluation procedures employed were behavioral observation audiometry, visual reinforcement audiometry and acoustic immittance measurements. Analysis of the sample population for duration of gestation and birth weight showed that the majority of the children were born at term with a suitable weight for gestational age. For studying the incidence of auditory disorders, the results of the latest audiological examinations on the 143 children were used. Results: Statistical analysis showed a significantly higher incidence of auditory disorder in the infected children. Among the seroreverter and exposed children the inverse was the case, with the majority of the children showing no auditory disorder. Conclusion: Results suggesting central auditory disorders were predominant in the infected group, whereas the incidences of central and middle ear disorders were similar in the other two groups.

Effects of otitis on hearing in dogs characterised by brainstem auditory evoked response testing.

Hearing function was measured in normal dogs and in dogs with otitis using brainstem auditory evoked response testing. Data were obtained from 86 normal ears and from 105 ears with otitis, categorised into four degrees of severity. The data were analysed to illustrate the differences between the hearing function in the normal and abnormal ears and to estimate the degree of impairment associated with differing degrees of pathology. While severe hearing loss seemed to be present in the dogs with more severe otitis, only two individuals were identified as being totally deaf in the affected ears and no dogs were identified in which the cleaning and examination processes had caused damage to hearing function. Cleaning the ear canal produced measurable improvements in hearing in several dogs, indicating the profound effect of physical obstruction of the external ear canal by debris. It is concluded that most dogs with chronic otitis externa are not totally deaf and that the hearing impairment that does occur has the characteristics of conductive hearing loss.

A canalplasty technique for the surgical treatment of chronic otitis externa.

This article describes a surgical technique for the treatment of chronic stenosing otitis externa. A retrospective survey of the post-operative course in eight patients (10 ears) showed this to be a satisfactory treatment with no recurrence of symptoms.

Significance of Haemophilus spp. and Branhamella catarrhalis in upper respiratory tract infections.

Haemophilus influenzae and Branhamella catarrhalis can be considered inhabitants of the upper respiratory tract in humans. Although the pathogenetic role of H. influenzae cannot be discussed, the Authors report the mechanisms of pathogenicity of this microorganism; furthermore, they discuss the direct or indirect pathogenicity of B. catarrhalis in respiratory tract diseases and the ability of both microorganisms to produce beta-lactamases. H. influenzae and B. catarrhalis, together with S. pneumoniae, are the most common bacteria responsible for upper respiratory tract infections, namely otitis and sinusitis. The activity of these bacteria in the onset of otitis and sinusitis is reported.

Deflation opening pressure of the eustachian tube.

Measurements derived from tests of the performance of the eustachian tube (ET) under a variety of normal and pathologic conditions are widely diffuse and overlap considerably. In this survey, the deflation opening pressure (DOP) of the ET was tested in 31 patients suffering either from recurrent otitis (these patients had ventilating tubes inserted) or from chronic otitis media. Oxygen was deflated from the external ear canal, through the middle ear to the pharyngeal end of the ET. The DOP was the pressure needed for the passing of the oxygen. This pressure was usually between 100 to 200 mm H2O. No difference was found in the DOP between infants and adults or between discharging ears and dry ones. A second measurement was obtained through measuring the deflation flow pressure (DFP) required for the continuous passage of oxygen through the ET. The DFP was less than the DOP by approximately 20 to 60 mm H2O, and again no difference was noted between age groups or between infected and noninfected ears. It was concluded that DOP and DFP measurements of the ET are similar in a variety of conditions and therefore cannot indicate whether the ET is normally or abnormally functioning. The existence of a linear connection between the health of the ET and its performance is not proven; hence the role of the ET in predicting the likely outcome of tympanoplasty should be assessed within a different context.

Ear infections.

Infections of the ear are among the most frequent causes for patients to seek care in the ED. Although most infections are fairly simple to diagnose and treat, the anatomic complexity of the ear, its shared innervation with other body structures, its proximity to other body systems, and the risk of serious complications necessitate an orderly approach to the care of these problems. This article outlines an approach to the history, physical examination, diagnosis, and management of these infections. Adherence to such an approach should maximize the likelihood of attaining relief and obliteration of pain, prevention of acute and chronic sequelae, and ultimately, patient satisfaction.