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Biomedical subjects

V M Howie

Publications and source records attributed to V M Howie.

At least 37 records · Page 2Linked to original sources
PubMed1985

In vivo sensitivity test in otitis media: efficacy of antibiotics.

During a 10-year period, antibiotics were assigned in random, double-blind fashion in six combinations to treat 948 episodes of otitis media in children. Exudate from the middle ear of all patients was cultured before treatment. Three follow-up visits were conducted; the first follow-up visit was three to five days after the start of therapy, and the second and third visits were 14 and 31 days after onset of treatment. Exudates were recultured for 75% of the patients on the first follow-up visit. Comparison of treatment results showed that triple sulfonamide combined with either phenoxymethyl penicillin, or benzathine and procaine penicillin G given intramuscularly (IM) was as effective as was ampicillin or amoxicillin. Phenoxymethyl penicillin and cyclacillin alone were usually effective against pneumococci but relatively ineffective against Haemophilus influenzae. Cefaclor and trimethoprim-sulfamethoxazole produced unsatisfactory results in about half the cases caused by pneumococci or H influenzae. Although production of beta-lactamase by some otitis-causing Haemophilus and Staphylococcus species may explain the ineffectiveness of some treatments, the percentage of organisms positive for beta-lactamase was too small to be responsible for the poor results with certain drugs.

Anti-Bacterial Agents↗
PubMed1984

Do children with recurrent Haemophilus influenzae otitis media become infected with a new organism or reacquire the original strain?

Using the techniques of outer membrane protein gel analysis and biotyping, we characterized nontypable Haemophilus influenzae isolates from middle ear aspirates of 30 children with recurrent nontypable H, influenzae (NTHI) otitis media. Nine of the 13 children with early recurrence of NTHI otitis (less than 30-day intervals) had respective first and second isolates that were identical. In contrast, 14 of 18 children with late recurrences of NTHI otitis (greater than 30-day intervals) had respective first and second isolates that were different, whereas four children had late recurrences with organisms that appeared to be identical with their respective initial infecting strains. These results suggest that early recurrent NTHI otitis usually is a result of relapse with the initial infecting NTHI strain. In contrast, late recurrent disease is usually the result of infection with a new organism. However, the observation that four children had late recurrences with the original strains suggests that strain-specific protective immunity may not uniformly develop after recovery from NTHI otitis.

Child, Preschool↗
PubMed1984

Use of pneumococcal polysaccharide vaccine in preventing otitis media in infants: different results between racial groups.

A total of 133 children between 6 and 11 months of age with at least one episode of otitis media were given one of two pneumococcal vaccines. One vaccine contained 25 microns of types 1, 3, 6, 7, 14, 18, 19, and 23 and the other vaccine (control) contained 25 microns of types 2, 4, 5, 8, 9, 12, and 25. Follow-up care of the 65 black infants revealed significantly more otitis media visits in those infants receiving the control vaccine. Among the 68 white infants there was no difference between control and vaccine groups after vaccination.

Alabama↗
PubMed1983

Acute otitis media. One year in general pediatric practice.

Diagnosis and treatment of otitis media (OM) occupied approximately one third of a pediatrician's time between October 1978 and October 1979. Of 4,602 office visits for sickness, 18% involved a diagnosis of acute OM, and an additional 14% were for follow-up of OM. Incidence was highest in March and lowest in July-August. The 830 episodes involved 677 children aged 1 week to 17 years: 40% were 24 months old or younger, and 12% were 60 months old or older. Pain and querulousness were absent in 24% of those brought in for mild upper respiratory tract infection, and fever (38.2 degrees C or higher) was absent in 75% of the study group. Of 650 children who returned ten days later for reevaluation, 50% had otoscopic or tympanometric signs of OM with effusion.

Acoustic Impedance Tests↗
PubMed1979

The effect of early onset of otitis media on educational achievement.

One hundred and forty-four patients from three different pediatric practices were compared using the Science Research Associates (SRA) tests for academic achievement. First, the patients were divided into those who had had three or more attacks of otitis media and those who had had no attacks of otitis media during the first 18 months of life as recorded by their pediatricians. Matched pairs by sex, birth date, occupation of father, school attended and year of testing were made for comparison purposes. Using the one-tailed t-test, a significant difference in the composite score was found favoring the group with no recorded otitis media in the first 18 months of life. All patients were treated with antibiotics.

Achievement↗
PubMed1978

Bacterial etiology of otitis media during the first six weeks of life.

Tympanocentesis was performed on 70 infants who had otitis media during the first six weeks of life. The bacteria isolated from their middle-ear effusions were Streptococcus pneumoniae (13 patients), Neisseria catarrhalis (11 patients), Hemophilus influenzae (ten patients), Enterobacteriaceae (four patients), Staphylococcus aureus (four patients), streptococci (groups A and B) (three patients), and Pseudomonas aeruginosa (two patients). Thirty patients (42.9%) had middle-ear effusions which did not contain pathogenic bacteria. Twenty-seven infants were followed for at least 12 months and 12 (44.4%) of these infants had six or more episodes of otitis media during the observation period. Further studies will be needed to establish the significance of middle-ear disease at this age and the role of therapy in improving its outcome.

Bacterial Infections↗
PubMed1978

Pneumococcal polysaccharide immunization in infants and children.

By using indirect hemagglutination, the antibody responses of normal infants and children to an octavalent pneumococcal vaccine that contained pneumococcal polysaccharide types 1, 3, 6, 7, 14, 18, 19, and 23 were evaluated. By 2 years of age, there was a significant rise in hemagglutination titers to all the polysaccharide types, except type 19. By 6 to 8 months of age, five of the eight types of pneumococcal polysaccharides tested resulted in up to 60% responders and, by 2 years, a significant number responded to all pneumococcal polysaccharide types in the vaccine. Pneumococcal polysaccharide type 3 resulted in a significant antibody response as early as 3 months of age, whereas type 19 never resulted in a significant antibody response. Except for type 3, it seemed that when the other pneumococcal polysaccharides tested produced an antibody response, the degree of resonse did not subsequently change significantly with increasing age. The relationship of antibody response to age for pneumococcal polysaccharides is similar to that found for other polysaccharide vaccines. Based on the results of our study, we would recommend immunization with pneumococcal vaccine at 6 months of age with repeat immunization at 2 years of age, especially in high-risk children.

Age Factors↗
PubMed1977

Antibody of polyribophate of Haemophilus influenzae type b in infants and children: effect of immunization with polyribophosphate.

Antibody to polyribophosphate, the capsular polysaccharide of Haemophilus influenzae type b, was measured in healthy ambulatory children by a radioactive antigen-binding assay. Titers fell from birth through nine months of age, then increased until six years, when they plateaued. Antibody activity was not correlated with the child's sex, ethnic status, or area of residence. Doses of 0.2-50 microgram of polyribophosphate given as single or booster doses had similar effects on antibody activity. Of 368 doses given to infants two to six months of age, 7% produced a significant antibody response; of 95 doses given to infants seven to 12 months old, 17% produced a response. The geometric mean titers of antibody resulting from immunization with polyribophosphate given at various times in relation to diphtheria-pertussistetanus vaccine did not differ significantly from one another or from titers observed in infants given only the latter vaccine. These data indicate that purified polyribophosphate will not provoke humoral immunity in young infants against H. influenzae type b and that it should no longer be considered as a candidate vaccine for this purpose.

Age Factors↗
PubMed1977

Immune response to acute otitis media in children III. Implications of viral antibody in middle ear fluid.

With the technique of radioimmunodiffusion and indirect FA staining, IgA antibody to measles, mumps, rubella, and polio-1 were determined in serum and middle ear fluid (MEF) of 103 patients with otitis media. The occurrence of IgA viral antibody in MEF and its absence in simultaneously drawn serum was used as an indicator of local antibody production. Of the 401 assays performed, 41 instances of IgA antibody exclusively in MEF were found. Only four of these occurred in specimens from unimmunized patients and were directed against rubella virus. Of the 37 remaining cases, 16 each were directed against measles and polio-1 and four and one, respectively, for mumps and rubella viruses. The mean specific IgA titers were from 8- to 17-fold higher in MEF from immunized individuals than in the unimmunized and persisted for at least 9 to 19 months after immunization. The data thus indicate 1) specific immunologic sensitization of the middle ear mucosa can be achieved by parenteral as well as oral routes of immunization, and 2) specific immunologic memory exists in the middle ear mucosa. These two factors are crucial to feasibility of immunization against acute otitis media.

Antibodies, Viral↗
PubMed1977

The bacteriology of pneumococcal otitis media.

The bacteriologic findings of 1205 episodes of pneumococcal otitis media are analyzed. Capsular types 6, 14, 19 and 23 have been found to account for more than half the initial and subsequent infections of the middle ear. Initial infection has been shown to be related to age, and recurrent infection with pneumococci of heterologous capsular types has been found to occur most often within six months of the initial attack. Nasopharyngeal carriage of the pneumococcal types most frequently causing otitis media may occur without causing infection, may antedate infection by as long as 13 months and may persist after infection for as long as 30 months. Recurrence of infection with a given capsular type has been identified following intervening infection with one or more heterologous capsular types. Simultaneous infection of the middle ear with two pneumococcal capsular types has been observed in 1% of the infections studied. The potential, but as yet unestablished, value of prophylactic vaccination against pneumococcal otitis media is considered.

Carrier State↗
PubMed1975

The "otitis-prone" condition.

We studied the incidence of exudative otitis media in 488 patients followed up from birth. Forty-nine percent (240) of the patients had their initial episode of otitis media in the first year of life and only 12% (56) in the second year of life. Thereafter, the incidence decreased steadily. Patients having six or more episodes of otitis media before age 6 were termed "otitis prone". Fifty-seven such patients were observed and this condition was found to be significantly related to the onset of otitis media in the first year of life and to the pneumococcal cause of the initial episode.

Acute Disease↗
PubMed1975

The immune response to acute otitis media in children. II. Serum and middle ear fluid antibody in otitis media due to Haemophilus influenza.

The antibody response in serum and middle ear fluid was studied in 40 children less than two years of age who had otitis media due to Haemophilus influenzae. Specific antibody in serum was determined by either a bacteriocidal test or an indirect fluorescent antibody test, and in the middle ear fluid by the latter test. For both assays the infecting bacterium of the patient was used. Half of the acute sera and three-fourths of the convalescent sera had antibody of at least one of the IgG, IgM, or IgA classes; IgG occurred most often. Fourteen patients had significant increases in specific antibody in the convalescent serum. Middle ear fluids from 22 to 29 patients had specific antibody. IgG and IgA antibodies occurred with equal frequency, but IgA antibody was found more often in middle ear fluids when IgA antibody was absent from serum. Thus it appears that infants with otitis media respond systemically and locally with specific antibody to H. influenzae.

Acute Disease↗
PubMed1974

Immune response to acute otitis media in children. I. Serotypes isolated and serum and middle ear fluid antibody in pneumococcal otitis media.

Seventy percent of pneumococci isolated from the middle-ear cavity of infants and children with acute otitis media were of one of the seven serotypes 1, 3, 6, 14, 18, 19, or 23. The immunological response in the serum and middle-ear fluid from otitis media caused by one of these serotypes was studied in 61 children by using either indirect hemagglutination or indirect fluorescent antibody tests, or both. Twenty-six of the patients had pneumococcal antibody present in the acute serum and 28 had it in the convalescent serum by at least one method. Thirteen of the 49 middle-ear fluids examined had antibody by the indirect fluorescent antibody technique. Serum pneumococcal antibody was found to reside predominantly in the immunoglobulin G or immunoglobulin M classes, whereas pneumococcal antibody with middle-ear fluid was found to be distributed equally among all three classes. Approximately 25% of the patients (16 of 61) had a positive immune response to their infection as evidenced by increased levels of pneumococcal antibody in the convalescent serum. The percentage of patients responding immunologically increased with age: 12% of infants less than 12 months showed a significant response, whereas 48% of children over 24 months responded.

Age Factors↗