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PubMed1987

A comparative study of benzydamine hydrochloride ("Difflam" pump spray) and placebo as analgesics following tonsillectomy.

The use of benzydamine hydrochloride pump spray as a post-operative analgesic in children undergoing tonsillectomy was assessed in a double-blind trial in 56 subjects of ages ranging from 4-11 years. The raw tonsil bed was sprayed before the childrens' mealtimes and the appraisal of post-operative pain was made on the soreness of the throat as assessed by child, parent and surgeon; also assessed were the degree of referred earache, the ability of the child to swallow without discomfort, and the macroscopic appearance of the healing tonsillar bed. Results showed that the benzydamine spray was more effective than placebo in the control of post-operative pain.

Administration, Topical↗
PubMed1987

The reevaluation visit for acute otitis media.

Seventy children with acute otitis media diagnosed at a suburban, private primary care practice were examined after a ten-day course of antibiotic therapy and were then monitored closely for an additional 20 days. Parents were advised to seek prompt attention if symptoms of earache, fussiness, or fever recurred at any time during the 30-day study period. Of 14 symptomatic recurrences of acute otitis media, eight (57 percent) occurred within one week of discontinuing antibiotic therapy. Four (10 percent) of 41 children with persistent otitis media with effusion on days 10 to 14 developed symptomatic acute otitis media over the next 18 days, as did four (17 percent) of 23 children who had a normal middle ear examination on days 10 to 14. Early follow-up visits immediately following antibiotic therapy commonly detect persistent otitis media with effusion but appear to have limited value in detecting asymptomatic, posttreatment acute otitis media. the optimal timing of reevaluation visits for children with acute otitis media deserves further study.

Acute Disease↗
PubMed1981

Perceived first contact care for disabled children.

In a mail-back questionnaire survey, 169 mothers of myelodysplastic children were asked whom they would contact first for each of 24 health-related problems. These problems ranged from earaches to shunt obstruction to sexual counseling. All children were being followed in a comprehensive care clinic at a regional center; however, nearly half of these families lived in rural areas distant from the clinic. Eighty percent of children were said to have local physicians. Mothers tended to perceive clinic staff and specialists for first contact care according to severity of the child's motor paralysis, the greater the child's hospitalization experience, and the shorter the travel time from home to clinic. However, when travel time was controlled, there was no difference in overall perceptions for those mothers living more than 90 miles away from the clinic. In a second survey to 91 physicians designated as the "child's local doctor" and a third survey to the 27 clinic staff members, respondents were asked whom should mother contact first for each of the 24 health-related problems. The clinic staff tended to prefer itself, despite the general policy of the clinic to encourage families to utilize community resources, including their physicians. Local physicians tended to prefer themselves over clinic staff, a position consistent with the philosophy of primary care to the chronically disabled child.

Adult↗
PubMed1984

Otitis media.

Earache, a common symptom in children, causes many parents to seek medical attention. Aside from trauma and the discomfort that often accompanies viral infections of the upper respiratory tract, acute otitis media with effusion is the commonest cause of otalgia in infants and children. Proper management requires a team effort between the physician and the child's parents or caretaker. The physician must transmit to the parents a concise but thorough overview of the problem and a plan for management. This should include information on the pathophysiology of ear disease, its incidence, therapy and the potential adverse effects, and any measures that the parents may take to prevent recurrence. The primary responsibility for transmittal of this information lies with the physician. Ancillary medical personnel and communication aids (videotapes, computers, printed materials) should be utilized, if available, to reinforce the physician's "message."

Acute Disease↗
PubMed1984

Physicians treating their own spouses: relationship of physicians to their own family's health care.

Fifty-one family physicians and a comparable group of 65 lawyers were surveyed to determine how each group treated the medical problems of their spouses. There was no significant difference between physician and lawyer controls in the treatment of headaches, sore throats, vomiting, depression, pregnancy, and warts. In fact, the controls treated back pain and stomachaches more often. The physicians treated earaches and deep lacerations more often. The physicians more frequently took a symptom history and examined their spouse. Both groups treated their spouses' headaches, sore throats, and stomachaches at a high rate. This study supports the impression from a literature review and case studies that unique multiple interacting factors determine whether a physician will treat his or her spouse. These factors are feeling of responsibility to answer a request for treatment, cost, convenience, confidentiality, lack of confidence, emotional involvement or detachment, ego needs, and legal considerations. It is concluded that (1) physicians do not generally treat their spouses more often, but they do evaluate their spouses' symptoms more often than do nonphysicians, and (2) the decision to treat by the physician may compromise good care for his or her spouse. It is recommended that physicians and their spouses have an alternative, nonrelated physician to care for their health.

Adult↗
PubMed1982

Embryonal rhabdomyosarcoma of the middle ear presenting as sarcoma botryoides. Favorable outcome in a 12-year-old boy.

A 12-year-old boy presented with a history of earache, fever and granuloma of the auditory canal. Biopsy revealed embryonal rhabdomyosarcoma. The patient was treated with chemotherapy and radiation therapy, which led to complete disappearance of the tumor without recurrence after three years. Diagnosis, staging and timing of the treatment plan is discussed for this rare but highly malignant tumor.

Child↗
PubMed1994

Saturation diving with heliox to 350 meters. Observation on hearing threshold, brainstem evoked response and acoustic impedance.

Four divers were compressed to 350 m to observe changes in hearing threshold, brainstem evoked response and acoustic impedance. The divers experienced no tinnitus, impairment of hearing, earache during compression. Examination showed that the threshold of lower frequency range of hearing was elevated because of the masking effect of the noise in the hyperbaric chamber. Changes in waveform and latency of brainstem evoked response were due to changes in sound wave transmission affected by the chamber pressure and a poor ratio of signal to noise in the hyperbaric environment with heliox. All these changes were transient. After leaving the chamber, the hearing threshold and brainstem evoked response returned to normal. Besides, there were no changes in tympanogram, acoustic compliance and stapedius reflex before and after diving. This indicated the designed speed of compression and decompression in the experiment caused no damage to the divers' acoustic system, and the functions of their Eustachain tubes, middle and inner ears were normal during the diving test.

Acoustic Impedance Tests↗
PubMed1994

Management of craniomandibular disorders. Part II: Clinical assessment of patients with craniocervical dysfunction.

Comprehensive evaluation of mandibular function requires a broader assessment of the head, neck, and jaws than is normally performed. Examining only the teeth and periodontium will fail to assess problems in muscles and joints, which should be considered in the management plan. Recognition of function-related symptoms is important in the prediction of treatment outcomes. Stress-induced muscle tension and traumatic oral habits may be linked with reported symptoms of headache, earache, and temporomandibular joint problems, and the significance of these symptoms should be assessed through detailed clinical examination.

Craniomandibular Disorders↗
PubMed1994

[Anomalies of the first branchial cleft].

Account of the case of a little girl of four and a half years brought to the consulting otologist because of her earache, otorrhoea, retroauricular inflammatory swelling and oedema of the external ear canal on left side. Frequency, evolution, diagnostic means and management measures for first branchial cleft are reviewed.

Branchial Region↗
PubMed1993

Clinical study of Mycoplasma pneumoniae pneumonia.

From 1982 to 1991, we experienced 76 patients with Mycoplasma pneumoniae pneumonia which were confirmed by serologic tests. There were 32 (42%) male and 44 (58%) female patients. One patient had underlying disease of diabetes mellitus while the other patients were in good health. The age ranged from 9 months old to 72 years old. All the patients complained of fever and coughing; 63% had dry cough and 37% had sputum production. Upper respiratory tract complaints such as rhinorrhea, sore throat, or earache were noted in 57% of the patients. Fifty-five percent of the patients had GI symptoms of anorexia, nausea, vomiting, or diarrhea. Other complaints included myalgia/arthralgia (29%), headache (30%), and general malaise (32%). Dyspnea (17%) and chest pain (20%) were occasional complaints. Seventy-one percent of the patients had WBC counts < 10000/cu mm and 29% > 10000/cu mm. The mean value of C-reactive protein (CRP) was 53.1 micrograms/ml, while 16% of the patients had a CRP value above 100 micrograms/ml. Thirty-one percent of the patients were noted to have a transient elevation of serum transaminase. Four different patterns of infiltration were seen in chest radiographic manifestation: 1) peribronchial and perivascular interstitial infiltrates (18.4%), 2) nonhomogeneous patchy consolidations (22.4%), 3) homogeneous acinar consolidations (27.6%), and 4) mixed interstitial and alveolar infiltrates (27.6%). Interstitial infiltration was more commonly seen in pediatric than adult patients (46% vs 20%). Other features of the radiologic manifestation were as follows: unilateral lesions in 80% of patients, single lobe lesions in 77%, lower lobe predominant in 69%, pleural effusion in 7%, and radiographic deterioration in 10%. Mycoplasmal pneumonia should be considered in the differential diagnosis of community-acquired pneumonias.

Adolescent↗
PubMedDate not supplied

Chief complaints in a free walk-in clinic: a study of 3,009 consecutive patient visits.

Men under 20 and over 50 years of age used a free walk-in clinic of the Navy more than women of the same age. Women 20-50 years old used it more than men in this age group. This appears to be a result of the distribution of Navy health care facilities in the study area. Teenagers used the clinic as much as patients over 50. Sore throat, skin rash, abdominal pain, earache, and backache were the five most common complaints (302 per 1,000 patients.) These complaints and 19 other problems were responsible for 822 patient visits per 1,000 in a study of 2,272 consecutive new patient visits. Eighteen percent of all visits were return visits for a specific complaint. An analysis of complaints by body system showed that 21.9 percent were otolaryngological, 18.8 percent musculoskeletal, 12.5 per cent gastrointestinal, 9.7 percent dermatological, 8.7 percent cardiopulmonary, 7.8 percent genitourinary, 9.0 percent general (fatigue, nervousness, malaise, or weakness), and 11.6 percent other system (neurological, hematological, and miscellaneous). These data indicate that a physician's time might be used more efficiently in a walk-in setting and that training for such a clinic must be different from traditional training for such fields as internal medicine.

Adult↗
PubMed1993

[The value of the computer tomography (CT) and magnetic resonance (MR) in tumors of the ear].

The first case report is an undifferentiated squamous cell carcinoma of the ear. This patient complained with pain and discharging ear, which led us to practice a TC followed by an attico-antrotomy. The pathologist could detect in the removed tissue the neoplasm in its early evolutive stages. In the other case the earache and the suppuration suggested at first a carcinoma. In spite of the TAC and MR exams the surgery that followed was not confirmative of the tumor presence.

Adult↗
PubMed1993

The effect of self-care brochures on use of medical services.

A random sample of 14,917 new enrollees in a state-wide health maintenance organization was selected as part of a study of the effectiveness of medical self-care brochures. Medical ICD-9 codes related to each of the conditions described in the brochures were examined for the intervention group (N = 7439) and controls (N = 7478). Significantly less utilization was found for visits due to colds in the month following brochure distribution (P < .01). While not statistically significant, trends in the expected direction of less utilization for earaches and less total medical charges for the intervention group were also found. No significant differences were found related to headache and backache symptoms, although a greater proportion of the intervention group reported backache symptoms. Utilization related to sore throats and fever was significantly (P < .001) higher in the intervention group. These findings suggest that a minimal intervention such as brochure distribution can have a favorable, albeit minimal, impact on medical services utilization. Self-care education may also play a role in increasing utilization for certain types of health conditions.

Adult↗
PubMed1996

Health effects of passive smoking in adolescent children.

OBJECTIVE AND DESIGN: To study the effects of passive smoking on health in adolescent schoolchildren by questionnaire, spirometry and laboratory investigations. SETTING: Two schools in the Vanderbijlpark area. PARTICIPANTS: Seven hundred and twenty-six high-school children of average age 16 years. OUTCOME MEASURES: Lung function, serological abnormality or historical (i.e. questionnaire) evidence of ill health. RESULTS: The prevalence of respiratory illness before and after 2 years, respiratory symptoms, earache over the past year, low birth weight and learning difficulties were found to be significantly increased in the children exposed to parenteral smoke in the home, especially those exposed to maternal smoking. Spirometric and laboratory parameters, however, were not affected by passive smoking.

Adolescent↗
PubMed1996

Acute otitis media: making an accurate diagnosis.

The diagnosis of acute suppurative otitis media is not as easy and straightforward as it may seem. Many of the signs and symptoms in children with acute otitis media are also observed in children without it. Furthermore, several of the "classic" findings of acute otitis media, such as fever and earache, are often absent, even in cases confirmed by myringotomy. An otoscope with a fresh bulb and a good power source, as well as a view of the tympanic membrane that is not obstructed by cerumen, are essential to making the diagnosis of acute otitis media. A bulging, cloudy, immobile tympanic membrane is highly associated with otitis media. Erythema of the eardrum alone, however, is often the result of viral infection, crying or attempts to remove cerumen and should not be the sole basis for the diagnosis of acute otitis media. To avoid the common problem of overdiagnosing acute otitis media, the clinician should consider the predictive values of the various symptoms and physical examination findings associated with ear infections.

Acoustic Impedance Tests↗
PubMed1996

[Carotid dissection during childbirth].

A 33-year-old woman presented transient ischemic attach (hemiparesis of the left arm and right amaurosis), 14 days after childbirth, due to dissection of the right carotid that occurred probably during delivery as suggested by right earache at that time. Carotid dissection during pregnancy or after childbirth is rare an exceptional during delivery. Neurological symptoms and arterial lesions were followed by duplex ultrasound.

Adult↗
PubMedDate not supplied

[Clinical aspects of craniomandibular disorders. I. Analysis of a sample group of patients and diagnostic classification].

Data collected on 406 patients of both sexes, aged between 9 and 78 (mean age 30.47) and suffering from algias and craniomandibular disorders, have been examined, in order to show the more frequent clinical variables and to improve the knowledge of the stomatognatic dysfunction, by characterizing diagnostic subgroups. The observed prevalence of the female sex and young adults is in agreement with the literature. Older subjects seem to accept more easily dysfunctional problems; the developmental age needs an active prevention. The data were similar to those of the previous researches, demonstrating that the trend of this disease is constant, during the last 15 years. The most frequent sign and symptoms were: joint noise, muscles tenderness, mandibular hypomobility, cephalalgia, earache. The classified, variously imbricated, pathologies were the muscular disorders (40.1%), the internal derangement (disk dislocations), (35.8%) and the inflammatory and degenerative (morpho-structural) changes (19.6%). The multifactorial aetiology was confirmed by investigating the main pathogenetic factors, which resulted: bruxism (35.9%), loss of vertical dimension (34.7%), postural problems (33%), mandibular entrapment (26.6%), facial asimmetry (26.1%).

Adolescent↗
PubMedDate not supplied

[Clinical aspects of cranio-mandibular disorders. II. Symptom profiles of subgroups].

The more frequent clinical variables of cranio-mandibular disorders in a sample of 406 patients of both sexes, aged between 9 and 78 (mean age 30.47), were used to classify the different pathologies of the stomatognatic dysfunction. Radiological imaging completed and improved the diagnostic assessment. The breakdown of the total patient population into diagnostic subgroups was: functional disorders, with a mainly myogenous component (19.7%); disk displacement with reduction (24.1%); disk displacement without reduction (11.7%); osteoarthrosis (10.8%); synovitis of various origin (8.8%); growth disorders (0.9%). A mixed group consisted of many patients displaying signs of internal derangement and contemporary pronounced muscular disorders (20.4%); finally some subjects did not show true disturbances of the masticatory system (3.6%). Considerable differences were found among the subgroups and the findings formed the basis of specific symptom profiles, that mainly considered the chief complaints as masticatory algia, earache, cephalalgia, migraine and neck and shoulders postural disturbances. The prevalence of specific pathogenetic factors confirmed the multifactorial aetiology and the need of a more directed choice of treatment.

Adolescent↗