Effect of pneumococcal conjugate vaccination on nasopharyngeal carriage in children with early onset of acute otitis media - a randomized controlled trial.

Abstract Conclusion: Although children vaccinated with heptavalent pneumococcal conjugate vaccine (PCV) had fewer episodes of acute otitis media (AOM), this trial was unable to prove a simultaneous decrease in nasopharyngeal carriage

Effective treatment of experimental acute otitis media by application of volatile fluids into the ear canal

To access publisher version of this article. Please click on the hyperlink in Additional Link fieldTo access full text version of this article. Please click on the hyperlink "View/Open" at the bottom of this pageEssential oils are volatile and can have good antimicrobial activity. We compared the effects of oil of basil (Ocimum basilicum) and essential oil components (thymol, carvacrol, and salicylaldehyde) to those of a placebo when placed in the ear canal of rats with experimental acute otitis media caused by pneumococci or Haemophilus influenzae. Progress was monitored by otomicroscopic examination and middle ear cultures. The treatment with oil of basil or essential oil components cured or healed 56%-81% of rats infected with H. influenzae and 6%-75% of rats infected with pneumococci, compared with 5.6%-6% of rats in the placebo group. Essential oils or their components placed in the ear canal can provide effective treatment of acute otitis media

”Hemma läser jag inte för då måste jag inte läsa” En kvalitativ studie om vad som motiverar elever i en åk 6 till att läsa skönlitteratur

Syfte och frågeställning: Internationella studier påvisar att läsförmågan hos svenska elever märkbart försämrats över tid. Mot bakgrund av dessa studier avsåg vi undersöka vilka faktorer en grupp elever i årskurs 6 upplevde som motiverande till att läsa skönlitterära böcker. Våra frågeställningar var följande: Vilka faktorer upplever eleverna själva som positiva med läsning av skönlitteratur? Vad motiverar dem till att läsa skönlitteratur? Vilka faktorer upplevs som hindrande i att få en positiv skönlitterär läsupplevelse? Metod och material: Underlaget för analysen har samlats in genom kvalitativ metodik med samtalsintervjuer som undersökningsinstrument. Våra respondenter var 17 elever från samma årskurs 6. Skolan ligger i ett upptagningsområde med elever från både stadsmiljö och landsbygd och varierande sociokulturella förutsättningar. För att öka reliabiliteten spelades intervjuerna in på band. Resultat: Resultatet av vår studie visar att elever motiveras till att läsa skönlitteratur av en mängd olika faktorer. Eleverna framhöll inre känslomässiga upplevelser, samt utvecklad läsförmåga, som motiverande. Tillika var boken och dess innehåll en motiverande faktor. Även den sociala kontexten kunde vara motiverande. Av resultatet framkom också hinder för en positiv läsupplevelse. Vi fann att bristande vägledning kunde medföra dålig anpassning av vald bok. Andra hinder var brister i läsförmåga samt att eleven inte kunde se någon mening i läsning som aktivitet och därför upplevde läsning som tråkigt eller ett tvång. En svag återkoppling från lärarna, med få gemensamma läsaktiviteter, bidrar till låg status för skönlitterär läsning och blir ett hinder för de elever som behöver stöd för sin läsförståelse. Betydelse för yrket: Som lärare är det avgörande att lyssna på eleven och utgå från dennes perspektiv. De faktorer som elever upplever som positiva kan användas och utvecklas i en lärandesituation. Viktigt är att skapa en god läsmiljö både med avseende på urvalet av böcker som den fysiska miljön. Genom god återkoppling och engagemang kan läraren lyfta värdet av elevens ansträngningar samt träna elever på att finna vägar in i den skönlitterära texten.

Healing of tympanic membrane after myringotomy during Streptococcus pneumoniae otitis media : An otomicroscopic and histologic study in the rat

The purpose of our study was to elucidate the course of healing of the tympanic membrane (TM) when myringotomy was performed during acute otitis media. The early and long-lasting structural changes of the TM were studied in an animal model. Rats were inoculated with Streptococcus pneumoniae (PnC) type 3 in the bulla. When the infection was manifest, myringotomy was performed. On days 4 and 12, and 3 and 6 months after myringotomy, the TM status was checked by otomicroscopy and TMs were prepared for light and electron microscopy. Comparison was made with PnC-infected TMs that were not perforated, as well as myringotomized noninfected TMs. The infection resolved more slowly in myringotomized ears compared to PnC-infected ears that were left untouched. After 6 months, the pars tensa of the myringotomized infected ears was thickened and showed a disorganized collagen structure, compared with myringotomized noninfected ears, in which TMs were normalized. The PnC- infected TMs without myringotomy were completely normalized after 2 months. We conclude that a combination of bacterial infection and myringotomy causes long-lasting changes in TM structure. This impaired structure of the connective tissue could be of importance in chronic middle ear disease as a presumptive site for retraction and perforation of the TM

Social support and ovarian cancer incidence : a Swedish prospective population-based study

Objective: Low social support is associated with worse prognosis for epithelial ovarian cancer (EOC) patients. However, few studies have explored the relation between low social support and incidence of EOC. The aim of this prospective nested case-control study was to examine whether self-perceived low social support was associated with the incidence of EOC. Methods: The Swedish Cancer Registry was used to identify participants in the Vasterbotten Intervention Programme (VIP) comprising 58,000 women, who later developed EOC. Each case was matched to four cancer free controls. The VIP uses the Social Support questionnaire, a modified version of the validated questionnaire "The Interview Schedule for Social Interaction" (ISSI) measuring quantitative (AVSI) and qualitative (AVAT) aspects of social support. Results: The risk of EOC in relation to AVSI and AVAT was similar between the 239 cases and the 941 controls after adjustment for educational level, smoking, BMI, Cambridge Physical Activity Index and age (aOR 0.85, 95% CI 0.72-1.01 and aOR 0.54, 95% CI 0.16-1.81). Lagtime was found to have no impact. A decreased risk of serous ovarian cancer was seen in women with fewer persons available for informal socializing (aOR 0.75, 95% CI 0.59-0.95). Adjusted analyses showed non-significant odds ratios below 1.0 in the vast majority of histotypes. Conclusions: A general trend towards a decreased risk of ovarian cancer associated with low AVSI and AVAT was identified. Solely the serous subtype was significantly associated with low scores of AVSI. Prospective pathophysiological and epidemiological studies regarding social support are needed

Nasopharyngeal cultures in children with AOM – A retrospective study on bacteriological findings and impact on management

Background: Despite a far from perfect correlation with middle ear growth, nasopharyngeal cultures are sometimes used in children with acute otitis media (AOM) in order to have some idea of the causative pathogen. How these cultures are used in clinical practice and to what extent they influence clinical management has not previously been studied. The objective with this study was to investigate in what circumstances nasopharyngeal cultures are performed in children with AOM, what the bacteriological results are and to what extent cultures influence clinical management. Methods: All nasopharyngeal cultures taken in clinical practice from children with AOM in the county of Skåne, Sweden, during 2017–2018 were retrieved together with details from the medical charts two months prior to and one month after the culture. Information about the reason for culturing, the bacteriological result, and whether this result changed the management of the child, was retrieved from the charts. Results: During the 2 years, 978 nasopharyngeal cultures were taken in children with AOM. The most common reasons for obtaining a culture was a recurrence of AOM (40%) or treatment failure (22%). Many of the children had ongoing or recent antibiotic treatment. M. catarrhalis was the most commonly identified pathogen (53%), followed by H. influenzae (30%) and S. pneumoniae (14%). Resistance rates were low, and the most commonly identified resistant pathogen was betalactamase-negative ampicillin-resistant H. influenzae. One in five cultures led to a change in management, such as a change of antibiotics or an additional check-up. This was most commonly seen in association with H. influenzae, reflecting clinical practice in Sweden, where AOM is primarily treated with penicillin V. Conclusion: Despite not having a perfect correlation with middle ear growth, nasopharyngeal cultures can provide clues about suitable alternative antibiotics in cases of treatment failure, and they can help monitoring nasopharyngeal carriage and resistance rates

Pneumococcal vaccination in children at risk of developing recurrent acute otitis media - a randomized study.

Aim: Acute otitis media (AOM) is a common childhood disease, which often becomes recurrent (rAOM). A small reduction of AOM episodes has been noted in unselected child cohorts after vaccination with heptavalent conjugate pneumococcal vaccine (PCV7). The purpose of this study was to investigate how vaccination affects young children at risk of developing rAOM. Methods: Ninety-six children with an AOM onset before six months of age, implying a high risk for rAOM, were closely monitored until the age of two years. Fortysix were vaccinated with PCV7 and 50 were not. All episodes of AOM, emergency visits and ventilation tube insertions were registered. Results: A total of 363 AOM episodes were diagnosed. The incidence was reduced by 26% (p=0.03), the number of emergency visits due to suspected AOM by 36% (p=0.01), and the proportion of children who received ventilation tubes was halved in the vaccine group(p=0.02). Conclusions: During the first two years of life, PCV7 significantly reduced AOM episodes, emergency visits and ventilation tube insertions in children with rAOM. Pneumococcal vaccine may be a future route to reduce antibiotic use and health care consumption in otitis-prone children

Prediction of upper respiratory tract bacteria in acute otitis media

Conclusions. Thorough otomicroscopical examination of the tympanic membrane in acute otitis media (AOM) might distinguish AOM episodes caused by different bacteria. It thus might be a way to select appropriate treatment for each patient without raising the number of dangerous complications. Objectives. The aim of this study was to see if it might be possible to predict the causative bacterium by judging the otomicroscopical appearance of the tympanic membrane in episodes of AOM. Patients and methods. The study was prospective. Patients suffering from non-perforated AOM were included. The tympanic membrane was photographed. A prediction of the causative bacterium was made and tympanocentesis was performed. Effusion from the middle ear and a nasopharyngeal swab were obtained for bacterial culturing. The causative bacteria were categorized into gram-positive (Streptococcus pneumoniae and S. pyogenes) or gram-negative (non-typable Haemophilus influenzae and Moraxella catarrhalis). Results. A total of 82 patients were included in the study. A correct prediction was made in 47/63, a false prediction in 16/63 ( kappa 0.48, p < 0.001)