RESUMEN
BACKGROUND: Otitis media with effusion is a clinical manifestation characterised by inflammation of middle-ear mucosa. This study investigated the therapeutic effect of erythromycin, clarithromycin, azithromycin and roxithromycin on a histamine-induced animal model of otitis media with effusion. METHODS: The animals were divided into five groups, receiving erythromycin, clarithromycin, azithromycin, roxithromycin or saline solution. The guinea pigs in the study groups received erythromycin (40 mg/kg/day), clarithromycin (15 mg/kg/day), azithromycin (10 mg/kg/day) or roxithromycin (10 mg/kg/day) for 3 days by gastric tube. Four hours after the end of the administration, histamine solution was injected into the right middle ear. RESULTS: The lowest neutrophil density value obtained using stereological techniques was in the azithromycin group (0.86 ± 0.25 × 10-5/µm3), while the highest value was observed in the control group (6.68 ± 3.12 × 10-5/µm3). The anti-inflammatory properties of clarithromycin, azithromycin and roxithromycin were similar to one another, but better than that of erythromycin. CONCLUSION: The use of macrolide antibiotics is recommended, as they show antibacterial and anti-inflammatory efficacy in otitis media with effusion.
Asunto(s)
Antibacterianos/farmacología , Antiinflamatorios/farmacología , Otitis Media con Derrame/tratamiento farmacológico , Animales , Azitromicina/farmacología , Claritromicina/farmacología , Modelos Animales de Enfermedad , Oído Medio/efectos de los fármacos , Eritromicina/farmacología , Cobayas , Histamina , Otitis Media con Derrame/inducido químicamente , Roxitromicina/farmacologíaRESUMEN
This study evaluated the efficacy of tropisetron compared with tropisetron and a subhypnotic propofol infusion in preventing postoperative vomiting following tonsillectomy. One hundred and forty healthy children, aged four to 12 years, undergoing tonsillectomy were recruited in a randomised, double-blind study. After induction with sevoflurane, anaesthesia was maintained with sevoflurane and nitrous oxide. All patients received tropisetron (0.2 mg/kg up to 5 mg; intravenously) and fentanyl (2 microg/kg; intravenously) and were intubated after atracurium which was reversed with neostigmine (and atropine). The tropisetron-plus-propofol group received a single dose of propofol (1 mg/kg) before intubation and a continuous infusion of propofol throughout surgery at 15 microg/kg/min. Data for postoperative vomiting were grouped into zero to four and four to 24 hour time intervals. A P value of < 0.05 was considered statistically significant. The percentage of patients exhibiting a complete response (no retching or vomiting for 24 hours) was 47.1% (33/70) in the tropisetron-alone group and 72.8% (51/70) in the tropisetron-plus-propofol group (P = 0.002). The 0.257 absolute risk reduction of vomiting with the addition of propofol represents a number needed to treat of 3.87, and a risk ratio of 0.51 (95% CI 0.32 to 0.79). Significantly fewer patients vomited in the tropisetron-plus-propofol group than in the tropisetron-alone group during the zero to four post-surgery interval (P = 0.016), but the difference was not statistically significant for the four to 24 hour postoperative period (P = 0.116). Intraoperative subhypnotic propofol infusion combined with tropisetron is more effective than tropisetron alone in reducing postoperative vomiting after tonsillectomy in children.
Asunto(s)
Anestésicos Intravenosos/administración & dosificación , Antieméticos/administración & dosificación , Indoles/administración & dosificación , Náusea y Vómito Posoperatorios/prevención & control , Propofol/administración & dosificación , Tonsilectomía , Niño , Preescolar , Método Doble Ciego , Quimioterapia Combinada , Femenino , Humanos , Masculino , Estudios Prospectivos , Resultado del Tratamiento , TropisetrónRESUMEN
Staphylococcal infections are the major causes of morbidity in haemodialysis patients. The source of the staphylococci is the anterior nares. Elimination of nasal carriage of staphylococci could result in a remarkable decrease in the infection rate. The aim of this study was to investigate if there was a difference in the bacterial flora between the nasal vestibule and cavity as well as their antibiotic susceptibility in haemodialysis. Swab samples obtained from 35 haemodialysis patients were subjected to conventional microbiological methods. The antimicrobial susceptibility test was performed for Staphylococcus spp. using cephazolin, cephaclor, trimetoprim + sulfamethoxazole, amoxicillin, oxacillin, clindamycin, erythromycin, tetracycline, ampicillin + sulbactam and amoxicillin + clavulanic acid. Staphylococcus spp. was found more often in the vestibule than in the cavity (88.5 vs. 77.1%). The effectiveness of clindamycin, erythromycin and tetracycline was particularly striking for the methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococci isolates. In conclusion, existence of difference in bacterial flora between the nasal cavity and vestibule and their responsiveness to antibacterial agents may require reconsideration of elimination of secondary infections in haemodialysis patients.
Asunto(s)
Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Infecciones Bacterianas/complicaciones , Infecciones Bacterianas/tratamiento farmacológico , Cavidad Nasal/efectos de los fármacos , Cavidad Nasal/microbiología , Diálisis Renal/estadística & datos numéricos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infecciones Estafilocócicas/complicaciones , Infecciones Estafilocócicas/tratamiento farmacológico , Adulto JovenRESUMEN
The aims of our study were to assess whether the increased oxidative stress in experimental otitis media with effusion (OME) induced by histamine was reflected erythrocytes and middle ear effusion fluid by lipid peroxidation; to survey the alterations in antioxidant enzyme activities in experimental OME; and to determine the effect of dantrolene on this oxidative stress. Erythrocyte and middle ear effusion malondialdehyde (MDA) level, erythrocyte glutathione (GSH) and glutathione peroxidase (GSH-Px), glutathione reductase (GRD) and glutathione-S-transferase (GST) activities were measured in three groups of seven guinea pigs, 3 hours after injection of 0.1 mL of histamine (or saline) into the middle ear in guinea pigs with OME (experimental group), in a dantrolene sodium group and in a control group. Erythrocyte and effusion MDA levels in the dantrolene group were significantly lower than those of the experimental group. Erythrocyte GSH-Px, GST, GRD activities, and GSH levels were significantly higher in the dantrolene group than in the experimental group. Dantrolene sodium decreased the erythrocyte and effusion MDA levels, on the other hand, it increased the GSH and GSH-dependent enzymes. These findings suggest that reactive oxygen species (ROS) play a role in histamine-induced OME. Pre-treatment with dantrolene sodium increases antioxidant enzymes activities and decreases formation of MDA, the indicator of lipid peroxidation, in histamine-induced OME.
Asunto(s)
Dantroleno/farmacología , Eritrocitos/efectos de los fármacos , Peroxidación de Lípido/efectos de los fármacos , Relajantes Musculares Centrales/farmacología , Otitis Media con Derrame/prevención & control , Animales , Modelos Animales de Enfermedad , Eritrocitos/enzimología , Glutatión/metabolismo , Glutatión Peroxidasa/metabolismo , Glutatión Reductasa/metabolismo , Glutatión Transferasa/metabolismo , Cobayas , Histamina , Masculino , Malondialdehído/metabolismo , Otitis Media con Derrame/inducido químicamente , Otitis Media con Derrame/metabolismo , Estrés Oxidativo/efectos de los fármacosRESUMEN
Platelet activating factor (PAF), a potent inflammatory mediator, is a biologically active phospholipid. Recent studies have shown that PAF may play an important role in the pathogenesis of otitis media (OM). WEB 2170 BS has been shown to be a PAF antagonist both in vitro and in vivo. In this study, the anti-inflammatory effects of WEB 2170 BS were investigated in a guinea pig model of OM induced by middle ear (ME) inoculation of killed Staphylococcus aureus. The outcome of treatment was determined by measurement of myeloperoxidase activity in the samples of ME mucosa, evaluation of temporal bone histopathology, and the presence of ME fluid. The myeloperoxidase activity in the WEB 2170 BS-treated group was found to be significantly lower than that in the control group. Histopathology of the temporal bones indicated decreased inflammation in the treated group as compared to the controls. In addition, ME fluid was absent in 16 of the 20 ears of the 10 treated animals. These results demonstrate that WEB 2170 BS can produce significant anti-inflammatory effects in this model of OM.
Asunto(s)
Azepinas/farmacología , Otitis Media/patología , Inhibidores de Agregación Plaquetaria/farmacología , Glicoproteínas de Membrana Plaquetaria/antagonistas & inhibidores , Receptores de Superficie Celular , Receptores Acoplados a Proteínas G , Infecciones Estafilocócicas/patología , Triazoles/farmacología , Animales , Modelos Animales de Enfermedad , Oído Medio/efectos de los fármacos , Oído Medio/patología , Cobayas , Peroxidasa/metabolismo , Hueso Temporal/patologíaRESUMEN
Leiomyosarcoma is a malignant tumour of smooth muscle origin. These tumours are rarely encountered in the head and neck region. A case of leiomyosarcoma of the auricle is presented. There are two cases of external auditory canal leiomyosarcoma in the literature. To our knowledge the present case is the first example of leiomyosarcoma of the auricle.
Asunto(s)
Neoplasias del Oído/patología , Oído Externo , Leiomiosarcoma/patología , Anciano , Neoplasias del Oído/cirugía , Humanos , Leiomiosarcoma/cirugía , MasculinoRESUMEN
A case of a large dentigerous cyst containing a canine tooth in the maxillary antrum is presented. This case is of interest due because of its extensiveness and the presence of a canine tooth in the roof of the maxillary sinus. In addition, this caused a right-sided epiphora. Enucleation of the cyst containing the ectopic tooth was made.