Antibiotic use in infancy and the risk of asthma in Mexican American children.

OBJECTIVE: This study examined the associations of antibiotic use in infancy with lifetime doctor-diagnosed asthma and current wheeze among Mexican American children. METHODS: In a population-based, cross-sectional investigation, parents of 2023 children 4-18 years of age completed a questionnaire/interview addressing respiratory conditions, antibiotic use, and covariates. RESULTS: In adjusted analyses, among children without history of ear infections in infancy, children who used antibiotics ≥3 times and 1-2 times were more likely to report doctor-diagnosed asthma compared with their peers who did not use antibiotics in infancy [adjusted odds ratio (aOR) = 5.14, 95% confidence interval (CI): 2.88-9.17, and aOR = 2.15, 95% CI: 1.26-3.69, respectively, p trend < 0.0001]. The respective aORs for current wheeze were 3.67 (95% CI: 1.95-6.89) and 1.63 (95% CI: 0.91-2.95). Antibiotic use in infancy was not associated with asthma or current wheeze in children who had ear infections in infancy. In additional analyses, antibiotic use in infancy was associated with asthma in children without parental history of asthma or allergies (aOR = 2.73, 95% CI: 1.70-4.39) but not in those with parental history of asthma or allergies. Among Mexico-born participants born in rural areas, antibiotic use in infancy was associated with a seven-fold increase in risk of asthma (aOR = 7.21, 95% CI: 1.46-35.65), while the association was non-significant in Mexico-born children born in urban areas in Mexico. CONCLUSIONS: Antibiotic use in infancy may increase the risk of asthma and wheezing, but these associations were limited to subgroups of children.

Self-reported aural symptoms, headache and temporomandibular disorders in Japanese young adults.

BACKGROUND: To investigate the associations of aural symptoms, headache and depression with the presence of temporomandibular disorder (TMD) symptoms in a young adult population in Japan. METHODS: A personal interview survey was conducted on first-year university students (n = 1,930) regarding symptoms of TMD, aural problems, headache, shoulder pain and depression. Logistic regression was applied to assess the associations of these problems with the presence of TMD symptoms after controlling for age and gender. RESULTS: Among the 1,930 students, 543 students exhibited TMD symptoms and were classified into 7 groups: clicking only (Group I, n = 319), pain in the TMJ only (Group II, n = 21), difficulty in mouth opening only (Group III, n = 18), clicking and pain (Group IV, n = 29), clicking and difficulty in mouth opening (Group V, n = 48), difficulty in mouth opening and pain (Group VI, n = 11), and combination of three symptoms (Group VII, n = 97). The control group (n = 1,387) were subjects without any TMD symptoms. After adjusting for age and gender, a strong association was observed between TMD symptoms (Group II and IV) and tinnitus (OR = 12.1 and 13.2, respectively). TMD symptoms (Group I, II and III) were also associated with vertigo and headache. Otalgia and depression were significantly associated with the presence of clicking only. CONCLUSIONS: TMD symptoms were significantly correlated to aural symptoms and headache. A functional evaluation of the stomatognathic system should be considered in subjects with unexplained aural symptoms and headache.

Racial Disparity in Tympanostomy Tube Placement in Inpatient Pediatric Admissions.

This study aims to evaluate if race and ethnicity affect rates of tympanostomy tube (TT) placement during inpatient pediatric admissions in children with otologic conditions. A review of the 2016 Kids' Inpatient Database was conducted based on the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) codes for common otologic conditions. Among 85 827 weighted pediatric inpatient discharges with ICD-10-CM codes for common otologic conditions, 213 underwent TT placement. Odds ratios (ORs) for children of Hispanic ethnicity and Asian or Pacific Islander race undergoing TT placement when compared to other ethnicities and races were 0.60 (P = .011) and 0.21 (P = .040), respectively. Multiple logistic regression showed Hispanic ethnicity was associated with lower rates of TT placement when compared to non-Hispanic white children (OR = 0.62; 95% confidence interval = 0.40-0.96). Future studies should assess why these differences exist and if these differences are associated with racial/ethnic bias or attributed to patient/family preference.

Complexities of revision mastoid surgery in a migratory population cohort.

We present a review of patients from Eastern Europe who have recently immigrated to Ireland with complicated otological disease. We carried out a retrospective chart review of these patients. These are a complicated cohort of 7 patients, 5 (71.4%) of whom had previous ear surgery, none had old notes and there was often a need for interpreters (3 or 42.8%) and challenging surgery. Follow up was also problematic with many of the patients. In summary this is a case series to highlight a relatively new group of patients to emphasize the need for pre-operative CT scans, facial nerve monitoring and the difficult nature of revision surgery with no old notes.

Ear nose and throat diseases in the Bedouin of the South Sinai Desert: a cross-sectional survey and discussion of healthcare needs.

In the summer of 2000, a team of medical and affiliated workers visited the South Sinai Desert to assess the medical problems and needs of the Bedouin population. This paper reports on the ENT diseases of this population, and discusses their healthcare needs.

Auricular pseudocyst in the tropics: a multi-racial Singapore experience.

Endochondral pseudocyst of the auricle is an uncommon condition that affects predominantly Chinese males, with many reports studying this condition in homogenous Chinese populations. There have been few large-scale reports describing the features of this disease among the other Asian groups. In one of the largest series described to date, we report the epidemiological features, clinico-pathologic characteristics, and success of surgical treatment in 40 patients of different Asian groups presenting with pseudocyst of the auricle. Results showed a Chinese predominance (90 per cent), followed by Malays (five per cent) and Eurasians (five per cent). All had unilateral presentations apart from one patient. Most (55 per cent) presented within two weeks of auricular swelling. Few (10 per cent) had a history of trauma. The pseudocysts predominantly affected the concha (61 per cent). Surgery comprised excision of the anterior wall followed by local pressure application. Only 2.5 per cent had recurrence after surgery. These findings confirm earlier understood features of this disease while revealing some notable variations.

[Population characteristics of chronic ENT diseases prevalence in adults living in the North of the Eastern Siberia]. / Populiatsionnye osobennosti rasprosstranennosti khronicheskoi LOR-patologii u vzroslykh zhitelei vysokikh shirot Vostochnoi Sibiri.

Characteristics of chronic ENT diseases in European migrants and native Mongoloid population of the East Siberian North have been analysed epidemiologically. Epidemiological differences and similarities between the above populations are explained by their immunogenetic peculiarities.

Isolated otosclerosis of the incus in a Korean woman.

We report an isolated otosclerosis of the incus that was removed using a transcanal approach and the ossicular chain was reconstructed using a total ossicular replacement prosthesis due to a tilted stapes.

Characteristics of Chinese patients with Wegener's granulomatosis with anti-myeloperoxidase autoantibodies.

BACKGROUND: Cytoplasmic antineutrophil cytoplasmic autoantibodies (cANCA)/proteinase-3(PR3)-ANCA was considered the serologic diagnostic marker for Wegener's granulomatosis (WG). However, Chinese patients with MPO-ANCA positive WG were frequently diagnosed. We now analyze the characteristics of patients with MPO-ANCA positive WG and investigate the difference between patients with MPO-ANCA and PR3-ANCA. METHODS: Patients with WG were selected according to both Chapel Hill Consensus Conference definition and American College of Rheumatology (ACR) classification criteria in 500 Chinese patients with ANCA-associated systemic vasculitides. The clinical manifestions were compared between patients with MPO-ANCA and with PR3-ANCA. RESULTS: Eight-nine patients fulfilled the diagnostic criteria of WG: 54/89(60.7%) were MPO-ANCA positive, 34/89(38.2%) were PR3-ANCA positive. Patients with MPO-ANCA were predominantly female compared with patients with PR3-ANCA. Patients with MPO-ANCA also had multisystem involvement. However, the prevalences of arthagia, skin rash, ophthalmic and ear involvement were significantly lower in patients with MPO-ANCA than those in patients with PR3-ANCA (46.3% vs. 70.6%, P < 0.05; 20.4% vs. 44.1%, P < 0.05; 27.8% vs. 58.8%, P < 0.01; 40.7% vs. 67.6%, P < 0.05, respectively). The prevalence of elevated initial serum creatinine was significantly higher in patients with MPO-ANCA than that in patients with PR3-ANCA (81.5% vs. 61.8%, chi(2) = 4.20, P < 0.05). CONCLUSION: Patients with MPO-ANCA positive WG were not rare in Chinese.

Cholesteatomas in Greenlandic Inuit. A retrospective study and follow-up of treated cases from 1976-91.

Chronic otitis media is frequent among the Inuit in Greenland, but reports of cholesteatomas are rare. To describe cholesteatoma in Greenland, we have performed a retrospective study and follow-up of Greenlandic Inuit treated at the ENT-department, Rigshospitalet, Denmark in the period 1976-91. We found 35 Greenlandic Inuit with cholesteatoma, the first in 1976. Median age was 19 years. The total incidence was calculated to 5 per 100.000 per year, or 2 new cases per year. The geographical distribution showed less cholesteatomas among the people with a traditional way of life in the Hunter region. The complication rate was 11%. The extension and pathology of the cholesteatomas indicated late and infrequent contact with an ENT specialist. The follow-up study revealed 53% dry ears with intact tympanic membrane, and 47% with intermittent ear discharge. Residual or recurrent cholesteatoma was found in 46% of the patients, less frequently when the primary operation included mastoidectomy with canal wall-down technique. We recommend this operation in most Greenlandic Inuit with cholesteatomas.

Prevalence: outer and middle ear disorders in black and Indian preschool children from Durban.

The aim of the study was to determine the prevalence of middle ear disorders in 4-5 year old Black and Indian children attending preschools in the Durban Central region. Thus, a sample of 728 subjects (mean age = 4, 6 years), 315 Black (135 male and 180 female) and 413 Indian (223 male and 190 female) subjects was screened using referral criteria based on a Middle Ear Screening Protocol (MESP). The results of this study indicated that there was a significant relationship (chi2 = 13,237, p < 0.0001) between race and the likelihood of subjects passing and failing the MESP. A prevalence of 13.0% failures on the middle ear screening tests (visual inspection of the eardrum and tympanometry) was found in the Black subjects and 14.3% failure in the Indian subjects. No statistically significant differences were found between sex (Black male, Black female and Indian male, Indian female) and the likelihood of subjects passing and failing on the middle ear screening tests. Due to excessive cerumen, a significant percentage of Black (38.4%) and Indian (49.9%) subjects failed on outer ear tests. These results are discussed with reference to the literature. The limitations, research and practical implications of the research are also discussed.

A practical intervention to address ear and lung disease in Aboriginal primary school children of central Australia.

Australian Aboriginal populations have an extremely high prevalence of lung disease and ear disease. In addition to an improvement in socio-economic conditions, implementation of strategies to address the problem, within the limitations of present conditions, is needed. A 5 month trial was conducted to investigate the effectiveness of a school-based intervention programme involving nose blowing, deep breathing and coughing combined with exercise performed daily. This was a community-based trial, designed to give priority to cultural and ethical considerations, to be non-intrusive and to utilize local skills and resources. Results of the trial showed that signs of upper and lower respiratory tract disease and pulmonary function measurements were statistically significantly improved. Hearing levels showed no statistically significant change. The programme met with a good response from children and teachers. This study does suggest that this strategy may help address the existing problems of lung and ear disease in Aboriginal primary school children, providing some immediate benefits within the limitations of the present socio-economic conditions.