Biomedical subjects

P Karma

Publications and source records attributed to P Karma.

117 records · Page 7Linked to original sources

PubMedDate not supplied

Incidence of acute otitis media up to the age of 1 1/2 years in urban infants.

The object of this prospective cohort investigation of 1,642 infants was to study the incidence of acute otitis media (AOM) in urban children during the first 18 months of life. The monthly incidence of AOM was greatest at the age of 10 months, and the largest proportion of children with AOM was also found in this 10-month age group. Before the age of 18 months, 56.7% of the infants had had at least one episode of AOM, while 26.9% had had one or two episodes and 29.8% three or more. The corresponding figures before the age of 12 months were: 45.3%; 26.8%; 18.5%, and before the age of 9 months: 30.5%; 22.1%; 8.4%. The AOM incidence, particularly as regards recurrent AOM, was rather higher in boys than in girls.

Acute Disease↗

PubMedDate not supplied

The Bayesian approach to the evaluation of risk factors in acute and recurrent acute otitis media.

A multivariant modelling method was used to analyse the risk, associated with 22 different factors, of contracting acute otitis media (AOM) in a prospective cohort of 1294 urban children followed up to the age of 17-32 (mean 25) months. By far the most important risk factor was the caring of the child at a day-care centre. The importance of this factor further increased with increasing recurrence of the attacks. Next in order came the existence of sibling(s) with AOM attacks during the follow-up. Prolongation of breastfeeding increased the protection against AOM during the first year of life. The frequency of AOM attacks was lowest around midsummer and highest in early winter.

Acute Disease↗

PubMedDate not supplied

Pneumococcal middle ear fluid antibodies after pneumococcal acute otitis media in infants.

Forty-one infants, who during their first (initial) acute otitis media (AOM) had culturable S. pneumoniae (Pn) in 57 middle ear fluids (MEFs) which prolonged or recurred during the follow-up, were observed for 7-15 months for the presence of Pn, Pn-antigens (Pn-ags) and initial-type/group Pn-antibodies (Pn-abs) in these MEFs. Initially, Pn-abs were found in only 3 MEFs. During the follow-up a total of 20 ears (35%) were, at various time-intervals, positive for Pn-abs; they belonged to all three major Ig-classes, but were often slight in quantity. Most regularly, and often with distinct positivity, Pn-abs were found to type 3, 9N and 14. Secretory abs were detected in 5 ears. Within one month after initial AOM, Pn-abs appeared in 9 of the 41 ears with MEF (22%); six of them cleared soon after that. MEFs with Pn-abs usually did not show initial-type Pn/Pn-ag, but new Pn/Pn-ag could later be simultaneously present in recurrent MEF. So, pneumococcal AOM may cause a local and/or systemically mediated immune response in the middle ear in infants. The response may protect the ear from homologous, but still be present in apparently non-homologous otitis media.

Acute Disease↗

PubMedDate not supplied

Sensorineural hearing loss and acute otitis media in children.

Sensorineural hearing of 359 otoscopically and tympanometrically normal 5-year-old children with known otitis-history was studied under ideal conditions. In the subgroups of children with a different number (0, 1-2, 3-7, greater than or equal to 8) of attacks of acute otitis media (AOM) in their history, the mean bone conduction thresholds unregularly varied from 0.1 dB to 7.4 dB, depending on the frequency and the subgroup studied. The proportion of the ears with a bone conduction threshold greater than 10 dB at 0.5, 1, 2 or kHz ranged, also unregularly, from 10.8% to 0.5%, the greatest percentages being found at 0.5 and 1 kHz in the children without a history of AOM. Thus, neither AOM nor its treatment, even if frequently occurring, seem to cause permanent sensorineural hearing loss in children.

Acute Disease↗

PubMedDate not supplied

Vertical hyoid bone displacement and fundamental frequency of phonation.

Vertical displacement of the hyoid bone as well as its effects on F0 were studied using five excised human larynges. Cranial force introduced to the hyoid bone caused a widening of the vestibule of the larynx, enlargement of the laryngeal ventricles, abduction of the ventricular folds, heightening of the epiglottis and slight abduction of the vocal folds. The displacement (X +/- SD) of the anterior part (corpus) of the bone was 8.0 +/- 5.2 mm and of the posterior part, 22.2 +/- 6.1 mm with a 10 N force. The difference was statistically significant and was found to depend mainly on the tight middle hyothyroid ligament. The cranial force displacing the hyoid bone invariably showed a positive relationship with F0. The F0 changes were statistically significant but relatively small (X +/- SD): 8 +/- 8.4 Hz (about 10%) with an intact hyothyroid ligament. When the subglottal pressure was low, a change in the vibratory pattern of the vocal folds was found in several specimens. The F0 changes found in the present study are too small to explain alone the differences in the so-called intrinsic F0 of vowels. However, they are believed to contribute to this phenomenon.

Cadaver↗

PubMedDate not supplied

Morbidity of very young infants with and without acute otitis media.

Perinatal and other morbidity of 96 consecutive infants with acute otitis media (AOM) before the age of 3 months is compared with that of 96 birthday- and sex-matched controls without AOM. Perinatal problems were found in 57 AOM infants and in 38 controls, prematurity and asphyxia being significantly (p less than 0.05) more common in the study group than in the controls. At the time of AOM, 51 infants had concurrent illnesses ('colds' excluded) or anomalies, while only 19 controls (p less than 0.001) showed any respective morbidity during their 3 months of life. While AOM infants frequently presented with other, especially respiratory, infections, the controls hardly ever did so. Symptomatology during otitis was varying, and frequently suggestive of respiratory problems other than AOM. Subsequent otitis morbidity of AOM infants was heavy, but other disease history was similar to that of the controls. The study stresses the importance of examining the ears in young infants presenting with any illness, and especially of a respiratory nature.

Acute Disease↗

PubMedDate not supplied

The pure-tone hearing thresholds of otologically healthy 14-year-old children.

The mean pure-tone air conduction (AC) and bone conduction (BC) hearing thresholds (HT) of 534 randomly selected, caucasian, white, urban children with normal otoscopy, otomicroscopy and impedance audiometry, i.e. normal middle ear function, are presented here. Children with pathological middle ear findings or abnormal impedance audiometry were excluded. The average age was 13.8 years, SD 0.5, at the date of examination. The mean air conduction thresholds varied between 0.6 dB at 1 kHz and 9.9 dB at 6 kHz, and the bone conduction thresholds varied between -1.1 dB at 0.5 kHz and 1.1 dB at 4 kHz. The pure-tone average (PTA) (the average of AC hearing thresholds of 0.5, 1 and 2 kHz) of all ears was 1.5 dB. Ninety to ninety-eight per cent of pure-tone AC hearing thresholds at frequencies of 0.5-4 kHz were between -5 dB and 10 dB. The distributions are presented and compared.

Adolescent↗

PubMedDate not supplied

C-reactive protein in acute otitis media.

Serum C-reactive protein (CRP) levels were studied in 79 children with acute otitis media (AOM), aged from 4 months to 5 years. The CRP was less than 10 mg/l in 27 children, greater than or equal to 20 mg/l in 34, and greater than or equal to 40 mg/l in 17 children, 25 of the 41 attacks caused by S. pneumoniae or H. influenzae showed a CRP of greater than or equal to 20 mg/l and 15 CRP greater than or equal to 40 mg/l, in 38 cases without major otitis pathogens, the respective figures were 9 (p less than 0.01) and 2 (p less than 0.001). Although statistically significant correlations between otitis-related clinical parameters and CRP levels were rare, there was a tendency toward higher CRP values among those with a more severe clinical picture. All five attacks with CRP greater than or equal to 100 mg/l were bilateral, caused by major pathogens, and preceded by a respiratory infection. They also tended to have high fever and a large amount of fluid in myringotomy. However, even in these the general course of AOM and other morbidity was not different from the others.

Acute Disease↗

PubMedDate not supplied

Pneumococcal vaccine and otitis media in infancy.

This is a review of present knowledge about the chances of preventing otitis media (OM) by vaccination. Studies of experimental pneumococcal OM in the chinchilla, and observations on serum antipneumococcal antibody levels in children in connection with OM morbidity suggested that protective immunity could be achieved by vaccination. On the other hand, many of the pneumococcal polysaccharides--including those four types that are most common in OM--are not highly immunogenic in infants younger than 2 years. The highest incidence of OM coincides with that very age of low responsiveness. Four large field studies in USA and Finland have shown that vaccination with 14-valent pneumococcal vaccine does prevent recurrent as well as first-time OM caused by species to which good immune response is obtained. Because the most common pneumococci do not belong to this category, the overall protective effect of such vaccination remains low (10 to 15% in the studies reported). Thus the present vaccine cannot be recommended for prevention of OM in infants younger than 2 years. The data strongly encourages efforts in vaccine development, in ways that improve immunogenicity in infants.

Antibodies, Bacterial↗