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Biomedical subjects

P Karma

Publications and source records attributed to P Karma.

At least 73 records · Page 4Linked to original sources
PubMed1981

The bacteriology of acute otitis media in children with special reference to Streptococcus pneumoniae as studied by bacteriological and antigen detection methods.

The middle ear fluid (MEF) was studied during an acute attack of otitis media in 519 children, aged 3 months to 6 years. Streptococcus pneumoniae (Pn) was cultured from 39% of the cases; serotypes 19, 6, 3 and 23 were the most common. Haemophilus influenzae (Hi) was cultured in 12%; only 2/64 strains were of type b. Pn were found equally often in all age groups, but Hi were significantly less often isolated in children older than 3 years. The number of negative cultures increased with the age of the child. Pneumococcal capsular polysaccharide was detected with counterimmunoelectrophoresis and/or latex agglutination in 83% of the MEFs from which Pn were cultured, but also in about one third of the MEFs from which no bacteria could be grown. Altogether, with these methods combined Pn were implicated in nearly 60% of the cases of acute otitis media. Gram staining showed polymorphonuclear leucocytes in 85% of pneumococcal otitis cases that were verified by culture but also in 72% of the cases from which no bacteria could be cultured, supporting the contention that also these latter are usually caused by bacteria.

Acute Disease↗
PubMed1980

Pneumococcal vaccine and otitis media.

After an acute attack of otitis media 827 children aged 3 months to 6 years were assigned randomly to receive either 14-valent pneumococcal polysaccharide vaccine or a control vaccine (Haemophilus influenzae type b capsular polysaccharide). In children older than 6 months serum antibody responses to most of the vaccine polysaccharides were satisfactory. The response to type 6A was poor. Correspondingly, no clinical protection was seen below 6 months of age or against otitis media caused by group 6 pneumococci. Among the children more than 6 months old, the first 6 months after vaccination saw significantly (p < 0.001) fewer attacks caused by the pneumococal types represented in the vaccine (group 6 excepted) in those who received the pneumococcal vaccine than in those who received the control vaccine. Protection against type 19F was statistically significant (p < 0.01). The overall protective efficacy was 58%--somewhat better in children older than 2 years than in those younger. Previous attacks of otitis caused by pneumococci did not influence the protective efficacy of the vaccine.

Age Factors↗
PubMed1980

The effect of polyvalent pneumococcal polysaccharide vaccine on nasopharyngeal and nasal carriage of Streptococcus pneumoniae.

To investigate the possible effect of a polyvalent pneumococcal vaccine on the nasopharyngeal and nasal carriage of Streptococcus pneumoniae, we studied 313 children under 8 years of age who had received either 14-valent pneumococcal capsular polysaccharide vaccine (Pn) or Haemophilus influenzae type b capsular polysaccharide vaccine (Hib) after having recovered from acute otitis media. Nasopharyngeal and nasal swabs were obtained during a symptomless phase, 6 to 12 months after the vaccination, and cultured by routine bacteriological methods. All S. pneumoniae strains were serotyped and among H. influenzae strains, type b was identified. In the group that had received the Pn vaccine, the carriage rate of S. pneumoniae types present in the vaccine (type 6 excluded) was 20%, somewhat but not significantly lower than the 30% carriage in the group having received the Hib vaccine. Conversely, the carriage rate of H. influenzae was slightly higher in the Pn (26%) than in the Hib (19%) vaccine group. 14% of the H. influenzae strains were of type b, and this proportion was the same in both vaccine groups. There were no differences between the two vaccination groups in the carriage rates of other S. pneumoniae types or of Staphylococcus aureus or of group A hemolytic streptococci. S. pneumoniae was more often cultured from nasopharyngeal than nasal swabs, especially in children over 6 years, whereas the total carriage rates of S. pneumoniae and H. influenzae were largely unaffected by age.

Bacterial Vaccines↗
PubMed1980

[Otitis media].

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Haemophilus Infections↗
PubMed1979

Bacteria in chronic maxillary sinusitis.

Sixty-one chronically inflamed maxillary sinuses produced 131 bacterial strains from mucosal pieces that were taken during a Caldwell-Luc operation and cultured aerobically and anaerobically. Sinus secretions showed only 62 and nasal secretions 106 bacterial strains. Fourteen mucosal strains, including 11 Haemophilus influenzae, grew heavily. None of 24 mucosal anaerobes showed heavy growth. Of 52 antral mucosae with culturable bacteria, 37 disclosed mixed and 15 pure growth. The bacteriological characteristics of the diseased sinus and the nose did not correlate. The duration or extent of the disease, the macroscopic appearance of the diseased sinus, or the presence or absence of allergy were unrelated to bacteriological findings, except that H influenzae was concentrated in purulent sinuses. Intraoperative culture of antral mucosa seems to give the most reliable picture of the bacteriological condition in chronic maxillary sinusitis.

Adult↗
PubMed1979

T cells as marked with acid alpha-naphthyl acetate esterase staining in secretory otitis media.

Non-specific acid alpha-naphthyl acetate esterase (ANAE) activity of the lymphocytes was investigated in smears made of middle ear secretions and peripheral blood from 61 children with secretory otitis media. On the average, 20.1% (right ear) and 2.1% (left ear) of the lymphocytes in the ear samples showed distinctive ANAE-positive spots in their cytoplasms, by the method used. The mean percentage of ANAE-positive cells in the blood was 47.8 and it was significantly (P less than 0.001) higher than the respective percentages of the ear samples. In normal childrne, 54.9% of the lymphocytes, on the average, were ANAE-positive. This difference in blood between patients and control group was significant (P less than 0.001). Consequently, the present study suggests that the relationship of T- and non-T-lymphocytes, as a marked with ANAE, are disturbed in children suffering from secretory otitis media. The importance of this finding and the validity of the method are discussed.

Child↗
PubMed1978

T lymphocytes in the effusions of secretory otitis media.

Smears were made from 39 middle ear effusions in 29 children with secretory otitis media (SOM) and stained with acid alpha-naphthyl acetate esterase (ANAE) to demonstrate T lymphocytes. The effusions showed on the average 21% of the lymphocytes to be ANAE positive, while simultaneously drawn peripheral blood revealed the proportion of ANAE positive cells to be 53% (P less than 0.001, the Student's t-test). Our finding suggests that T cell dependent defence mechanisms may be locally disturbed in SOM.

Child↗
PubMed1978

Access of metronidazole into the chronically inflamed middle ear with reference to anaerobic bacterial infections.

Strictly anaerobic bacteria were found in about one third of 138 consecutive cases of active chronic otitis media. These infections were always mixed involving aerobes as well. In 79 cases only aerobes were found and 16 cultures were sterile. To provide a basis for possible clinical trials, the penetration of metronidazole into the ear was studied after an oral dose of 2.4 g to patients with chronic otitis media. Significant amounts of biologically active metronidazole were found in 8 of 12 middle ear discharges at 2--4 h, the concentrations varying between 9.4 and 65.0 microgram/ml. Between 2 and 13 h after administration, significant drug concentrations all exceeding the highest reported bactericidal ones were found in the middle ear mucosa in 6 cases of the 8 in which the determinations were possible. Neither the mucosal nor the discharge concentrations correlated with the simultaneous serum levels of metronidazole, which were high in all 23 patients studied.

Administration, Oral↗
PubMed1977

Cholesteatoma in children.

The 65 cholesteatomas operated on in children showed a more expansive and rapid growth than those in adults. In one fifth of the cases cholesteatoma filled the whole air-cell area, which was wide in half of the children. Fifty-two ears of these children had an attic or a posterosuperior perforation. One case was complicated by a fistula in the horizontal semicircular canal, and the ossicular chain was unbroken in 23 cases (35%). Thus, the findings support the idea of the primary soft-tissue spread of cholesteatoma in children. Five ears (8%) discharged postoperatively, and three ears (5%) were reoperated on and showed residual tympanal cholesteatoma. Cavity obliteration with canal wall down technique proved safe, even in the cases of the most extensive and active cholesteatoma.

Adolescent↗