RESUMO
PURPOSE: To evaluate the tissue response of the mucosa of the tympanic cavity of guinea pigs, when receiving biodegradable implant. METHODS: A total of 20 male guinea pigs were divided into 2 groups. After paracentesis in both ears, a biodegradable polymer of poly lactic-co-glycolic acid was implanted in only one middle ear. Histological analysis using neutrophil exudate and vascular neoformation (acute inflammation) and fibroblast proliferation and mononuclear inflammatory cells (chronic inflammation) as parameters was performed after 10 and 30 days of survival (groups 1 and 2, respectively). RESULTS: Four ears in group 1 and 7 in group 2 had an increase of neutrophil exudate. Vascular neoformation occurred in ears with or without the implant, in both groups. Fibroblast proliferation and mononuclear inflammatory cells (lymphocytes and macrophages) increased in ears with implant in group 2. CONCLUSION: The tissue response by histological analysis of the mucosa of the tympanic cavity of guinea pigs, when receiving biodegradable implant, showed no statistically significant difference between ears with or without the implant.
Assuntos
Implantes Absorvíveis , Orelha Média/efeitos dos fármacos , Lactatos/uso terapêutico , Polímeros/uso terapêutico , Ácido Tióctico/análogos & derivados , Animais , Biopolímeros/uso terapêutico , Orelha Média/patologia , Exsudatos e Transudatos , Fibroblastos/efeitos dos fármacos , Cobaias , Masculino , Mucosa/efeitos dos fármacos , Mucosa/patologia , Neovascularização Patológica , Neutrófilos/efeitos dos fármacos , Distribuição Aleatória , Reprodutibilidade dos Testes , Ácido Tióctico/uso terapêutico , Fatores de TempoRESUMO
Otitis media (OM) is one of the most common infections in children, Streptococcus pneumoniae and nontypable Haemophilus influenzae being the two most common pathogens isolated in the middle ear fluid (MEF) of children with OM. Cefditoren is a third-generation cephalosporin with broad-spectrum antibacterial activity, including activity against those pathogens commonly causing OM, with enhanced stability against common ß-lactamases. The main objective of this study was to evaluate the in vitro activity of cefditoren against pathogens collected from the MEF of Costa Rican children with OM between 2006 and 2011. A total of 715 samples were analyzed. Among the 89 S. pneumoniae strains that were penicillin-nonsusceptible, only 7% were cefditoren-resistant according to Spanish Regulatory Agency criteria; among the H. influenza and M. catarrhalis isolates obtained, 100 and 90% of the isolates, respectively, were cefditoren-susceptible. MIC50/90 against the 207 PCV-13 S. pneumoniae serotyped strains and the 79 serotypes not covered by PCV-13 for cefditoren were 0.03/1 and 0.03/0.12 mg/l, respectively. For both amoxicillin-susceptible and resistant H. influenzae strains, the MIC range against cefditoren was from ≤0.015 to 0.06 mg/l as well. In conclusion, the confirmation of the wide spectrum of activity of cefditoren and its intrinsic strength against resistant strains allows us to suggest that cefditoren might be included as one of the best choices among antibiotics that are widely used in empiric therapy for OM in pediatric patients.
Assuntos
Antibacterianos/uso terapêutico , Cefalosporinas/uso terapêutico , Orelha Média/microbiologia , Otite Média/tratamento farmacológico , Otite Média/epidemiologia , Antibacterianos/farmacologia , Cefalosporinas/farmacologia , Criança , Pré-Escolar , Costa Rica , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla/fisiologia , Orelha Média/efeitos dos fármacos , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana/métodos , Otite Média/diagnóstico , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação , Streptococcus pneumoniae/fisiologiaRESUMO
PURPOSE: To evaluate the tissue response of the mucosa of the tympanic cavity of guinea pigs, when receiving biodegradable implant. METHODS: A total of 20 male guinea pigs were divided into 2 groups. After paracentesis in both ears, a biodegradable polymer of poly lactic-co-glycolic acid was implanted in only one middle ear. Histological analysis using neutrophil exudate and vascular neoformation (acute inflammation) and fibroblast proliferation and mononuclear inflammatory cells (chronic inflammation) as parameters was performed after 10 and 30 days of survival (groups 1 and 2, respectively). RESULTS: Four ears in group 1 and 7 in group 2 had an increase of neutrophil exudate. Vascular neoformation occurred in ears with or without the implant, in both groups. Fibroblast proliferation and mononuclear inflammatory cells (lymphocytes and macrophages) increased in ears with implant in group 2. CONCLUSION: The tissue response by histological analysis of the mucosa of the tympanic cavity of guinea pigs, when receiving biodegradable implant, showed no statistically significant difference between ears with or without the implant. .
Assuntos
Animais , Cobaias , Masculino , Implantes Absorvíveis , Orelha Média/efeitos dos fármacos , Lactatos/uso terapêutico , Polímeros/uso terapêutico , Ácido Tióctico/análogos & derivados , Biopolímeros/uso terapêutico , Exsudatos e Transudatos , Orelha Média/patologia , Fibroblastos/efeitos dos fármacos , Mucosa/efeitos dos fármacos , Mucosa/patologia , Neovascularização Patológica , Neutrófilos/efeitos dos fármacos , Distribuição Aleatória , Reprodutibilidade dos Testes , Fatores de Tempo , Ácido Tióctico/uso terapêuticoRESUMO
BACKGROUND: Transtympanic administration of gentamicin may be suitable to achieve unilateral vestibular ablation, in order to control unilateral Ménière's disease. In low doses, gentamicin appears to affect selectively the vestibular system, with relative sparing of the cochlea. An experimental study on guinea pigs was conducted to determine what single dose of gentamicin would produce a unilateral vestibular organ lesion when applied to the middle ear. STUDY DESIGN: Experimental and prospective. METHODS: Four groups of guinea pigs received different gentamicin doses (1, 5, 10 and 25 mg) administered to the middle ear. The animals' vestibular organs were then assessed by scanning electron microscopy, in order to quantify the level of vestibular damage. RESULTS: Study of the utricular macula and the ampullar crista of the lateral semicircular canal revealed vestibular neuroepithelial lesions in all infused ears. CONCLUSIONS: The severity of the vestibular neuroepithelial lesions was dose-dependent. Lower gentamicin doses were observed to damage vestibular structures more than cochlear structures.
Assuntos
Antibacterianos/farmacologia , Orelha Média/efeitos dos fármacos , Gentamicinas/farmacologia , Animais , Antibacterianos/administração & dosagem , Relação Dose-Resposta a Droga , Orelha Média/ultraestrutura , Feminino , Gentamicinas/administração & dosagem , Cobaias , Masculino , Microscopia Eletrônica de Varredura , Sáculo e Utrículo/efeitos dos fármacos , Sáculo e Utrículo/ultraestrutura , Ductos Semicirculares/efeitos dos fármacos , Ductos Semicirculares/ultraestruturaRESUMO
Extramedullary involvement occurs infrequently in acute promyelocytic leukemia and is said to be more common after treatment with all-trans retinoic acid. We describe a 9-year-old girl who had an isolated external auditory canal and middle ear relapse after treatment with all-trans retinoic acid and chemotherapy. A patient with cytogenetically and molecularly confirmed acute promyelocytic leukemia developed isolated extramedullary relapse in the auditory canal and middle ear 4 years and 9 months after initial diagnosis, while in hematologic and molecular remission, successfully treated with arsenic trioxide alone.
Assuntos
Arsenicais/uso terapêutico , Meato Acústico Externo/patologia , Neoplasias da Orelha/diagnóstico , Orelha Média/patologia , Leucemia Promielocítica Aguda/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Óxidos/uso terapêutico , Trióxido de Arsênio , Criança , Meato Acústico Externo/efeitos dos fármacos , Neoplasias da Orelha/tratamento farmacológico , Orelha Média/efeitos dos fármacos , Feminino , Humanos , Leucemia Promielocítica Aguda/tratamento farmacológico , Resultado do TratamentoRESUMO
INTRODUCTION: Packing material is mandatory in middle ear (ME) surgery in order to avoid inflammation, adhesions and fibrotic healing. Collagen polivynil-pirrolidone (CPVP) is a healing modulator, which reduces inflammation and fibrosis. Hence we can hypothesize that packing of the ME with CPVP sponge will lead a good ME healing. OBJECTIVE: The aim of this study was to evaluate the otoscopic and microscopic changes induced on the healthy mucosa of the ME and Tympanic membrane (TM) after packing with CPVP sponge in guinea pigs. MATERIAL AND METHODS: Twelve guinea pigs were operated on of right myringotomy. The ME was packed with: Group I (n = 6): Absorbable gelatin sponge (AGS) in SS; Group II (n = 6): CPVP soaked in SS. TM and ME integrity was evaluated otoscopically, as well as residual packing material. Euthanasia was performed on the 4th post-operative week. ME mucosa histologic examination was done. RESULTS: Group I in all the cases showed residual packing material (p < 0.007 Student's test p < 0.001 ANOVA). Histologically both groups presented inflammation with polymorphonuclears, in addition group I showed severe lymphocytosis (p < 0.003 Student's, test p < 0.001, ANOVA). CONCLUSION: The CPVP sponge when it is used as material of packing in the OM of guinea pigs produces less chronic inflammatory changes, but more studies with the injured mucosa are required to validate their utility in the otologic surgery.
Assuntos
Colágeno/farmacologia , Orelha Média/efeitos dos fármacos , Orelha Média/patologia , Povidona/farmacologia , Animais , Cobaias , Mucosa/efeitos dos fármacos , Mucosa/patologia , Otoscopia , Tampões de Gaze CirúrgicosRESUMO
O óxido nitroso é um gás inalatório que pode aumentar a pressão intratimpânica durante o ato anestésico, bem como causar pressão negativa após sua suspensão, principalmente em pacientes com disfunção da tuba auditiva. Estas variações pressóricas podem trazer implicações clínicas, como ruptura de membrana timpânica, desarticulação da cadeia ossicular, hemotímpano, barotrauma, deslocamento de prótese de estapedotomia e lateralização do enxerto nas timpanoplastias, além da entrada de fluido seroso na orelha média durante a fase de pressão negativa. OBJETIVO: Avaliar a influência do óxido nitroso na pressão da orelha média em uma população sem disfunção tubária, realizando timpanometria no pré e pós-operatório. FORMA DE ESTUDO: Coorte transversal. MATERIAL E MÉTODO: Foi realizado um estudo prospectivo com pacientes internados no Hospital Universitário Clementino Fraga Filho - UFRJ, submetidos à anestesia geral com o uso do óxido nitroso a 50 por cento, durante o período de abril a julho de 2003. Avaliou-se ainda se a duração da cirurgia, anestésicos associados, presença de rinite alérgica e desvio de septo nasal poderiam influenciar no aparecimento das alterações da pressão intratimpânica. RESULTADOS: A amostra constituiu-se de 50 pacientes, encontrando-se em quase metade (48 por cento) alterações timpanométricas no pós-operatório (curva tipo C), quando comparado às de controle do pré-operatório (curva tipo A). Sexo e idade não interferiram no aparecimento das alterações timpanométricas no pós-operatório, bem como a duração da cirurgia. O tipo de anestésico volátil associado, desvio de septo nasal e rinite alérgica não exerceram influência na pressão da orelha média no pós-operatório. CONCLUSÃO: O óxido nitroso altera a pressão na orelha média tanto na fase de indução quanto na fase de resolução anestésica.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Testes de Impedância Acústica , Anestesia Geral , Orelha Média/efeitos dos fármacos , Óxido Nitroso/farmacologia , Membrana Timpânica/efeitos dos fármacos , Fatores Etários , Estudos Transversais , Orelha Média/fisiopatologia , Tuba Auditiva/efeitos dos fármacos , Tuba Auditiva/fisiopatologia , Septo Nasal/fisiopatologia , Pressão , Estudos Prospectivos , Rinite/fisiopatologia , Fatores Sexuais , Fatores de TempoRESUMO
UNLABELLED: The nitrous oxide is an inhaling gas that can increase intratympanic pressure during the anesthetic act and cause negative pressure after it is discontinued, mainly in patients with Eustachian tube dysfunction. These pressure variations may come up with clinical implications such as tympanic membrane rupture, ossicular system disarticulation, haemotympanum, barotraumas, prosthesis displacement stapaedotomy and tympanic graft lateralization after tympanoplasty, in addition to serous fluid entrance into the middle ear during the negative pressure phase. AIM: To evaluate the nitrous oxide influence on the middle ear pressure in a population without tube malfunction performing pre and postoperative tympanometry. STUDY DESIGN: Transversal cohort. MATERIAL AND METHOD: A prospective study was carried out with Universitário Clementino Fraga Filho Hospital- UFRJ intern patients, subject to general anesthesia with the use of 50% nitrous oxide from April to June 2003. It was also evaluated whether the duration of surgery, associated anesthetics, presence of allergic rhinitis and nasal septal deviation could contribute to the appearing of intratympanic pressure alteration. RESULTS: The sample is made up of 50 patients, in almost half of them (48%), postoperative tympanometry alterations (type C curve) were found, when comparing to the preoperative tympanometric control (type A curve). Neither sex nor age interfered in the appearing of tympanometry alterations during the post operative as well as the surgery timing. The anesthetic type volatile associate, nasal septal deviation and allergic rhinitis were not able to influence during the postoperative middle ear pressure. CONCLUSION: The nitrous oxide modifies intratympanic pressure during the anesthetic act as well as after it was discontinued.
Assuntos
Testes de Impedância Acústica , Anestesia Geral , Orelha Média/efeitos dos fármacos , Óxido Nitroso/farmacologia , Membrana Timpânica/efeitos dos fármacos , Adolescente , Adulto , Fatores Etários , Idoso , Estudos Transversais , Orelha Média/fisiopatologia , Tuba Auditiva/efeitos dos fármacos , Tuba Auditiva/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Septo Nasal/fisiopatologia , Pressão , Estudos Prospectivos , Rinite/fisiopatologia , Fatores Sexuais , Fatores de TempoRESUMO
A retrospective review was done, examining the charts of 41 patients admitted to The Eye and Ear Hospital of Pittsburgh with a diagnosis of sudden hearing loss (SHL). Treatment consisted of (1) systemic steroids; (2) daily intravenous histamine infusion; and (3) carbogen (95% oxygen and 5% CO2) inhalation. Parameters examined included age, sex, duration of symptoms prior to admission, days hospitalized, side of lesion, vestibular symptoms, tinnitus, blood work, radiography, vestibular function (ENG), and serial audiograms. Fifty-four percent showed improvement in hearing, defined as at least a 10-dB increase at any frequency following therapy. There was no correlation of preexisting signs, symptoms, or findings with hearing recovery. Since the natural history of this process demonstrates spontaneous improvement in approximately two thirds of patients without treatment, we conclude that for the group of patients that we treated, our therapeutic regimen was ineffectual.