Panel 7: otitis media:treatment and complications

Objective: We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources: PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods: All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified. A total of 1122 potential related articles were reviewed by the panel members; 118 relevant articles were ultimately included in this summary. Conclusions: Recent literature and guidelines emphasize accurate diagnosis of acute otitis media and optimal management of ear pain. Watchful waiting is optional in mild to moderate acute otitis media; antibiotics do shorten symptoms and duration of middle ear effusion. The additive benefit of adenoidectomy to tympanostomy tubes in recurrent acute otitis media and otitis media with effusion is controversial and age dependent. Topical antibiotic is the treatment of choice in acute tube otorrhea. Symptomatic hearing loss due to persistent otitis media with effusion is best treated with tympanostomy tubes. Novel molecular and biomaterial treatments as adjuvants to surgical closure of eardrum perforations seem promising. There is insufficient evidence to support the use of complementary and alternative treatments. Implications for Practice: Emphasis on accurate diagnosis of otitis media, in its various forms, is important to reduce overdiagnosis, overtreatment, and antibiotic resistance. Children at risk for otitis media and its complications deserve special attention

The effect of changing the gas composition on soot oxidation over DPF and SCR-coated filters

In this study, we have investigated the effect of changing the gas feed composition on soot oxidation over diesel particulate filter (DPF) and SCR-coated filter during temperature ramp experiments from 200 to 750 degrees C. For DPF, the increasing NO2/NOx ratio promoted soot oxidation across a fairly low temperature range (200-500 degrees C) and, in addition, soot oxidation was enhanced by water. Interestingly, the presence of NH3 in the gas feed inhibited the soot oxidation under various feed compositions for the DPF. Moreover, ammonia oxidation was also observed over the filter and based on these experiments together with experiments without soot, we conclude that ammonia oxidation is actually occurring on soot particles and that the interaction of the ammonia with the soot is inhibiting soot oxidation. Further, fast and NO2 SCR reactions were found to occur on soot particles, while no reactions with NO under standard SCR conditions was observed. Thus, the NH3 and NO2 molecules are interacting with the soot. When comparing the DPF and SCR-filter we found that the SCR material enhanced the soot oxidation under standard and fast SCR conditions, because of the fact that soot oxidation was inhibited by NH3 and would be rapidly consumed under SCR reactions with the Cu-zeolite in the SCR-filter. Furthermore, during fast SCR conditions, because NO2 is consumed during fast SCR reaction for the SCR-filter, the opposite results were found where soot oxidation occurred at lower temperature for the DPF. (c) 2017 Elsevier B.V. All rights reserved

A 4-Cylinder High Performance Diesel Engine Concept for D/E-class Vehicles Featuring Low Fuel Consumption and EU7 Emission Levels

Within the EU / Horizon 2020 funded project “REWARD”, Volvo Cars and AVL developed a High Performance Engine concept based on Volvo´s 2.0 l 4-cylinder engine architecture. The power output is increased to over 100 kW / liter by simultaneously reducing fuel consumption by 5% compared to Best In Class D/E class vehicles 2014 and achieving EU7 emission levels."br" A completely new “Zero-Swirl” combustion concept was developed with a rather straight intake port geometry and a stepped piston bowl concept. Increased injection pressure of up to 3000 bar and fast, accurate injection control allows optimal spray conditions. The charging concept is based on a permanent operating 2-stage turbo system with water cooled air intercooler to achieve the peak power level. It is supported by an electrical compressor for low end torque and response improvement. Furthermore, the Exhaust Aftertreatment System was optimized to achieve the challenging NOx targets and reducing exhaust back pressure to enable the high performance target. All results will be demonstrated in a Volvo XC60 to verify the fuel consumption and emission targets in both WLTC and in real driving conditions

Oscillatory behaviour in Galvanostatic Formaldehyde Oxidation on Nanostructured Pt/Glassy Carbon Model Electrodes

The electrocatalytic oxidation of formaldehyde, which results in CO, and HCOOH formation, was investigated under galvanostatic conditions on nanostructured Pt/glassy carbon (GC) electrodes fabricated by employing colloidal lithography (CL). The measurements were performed on structurally well-defined model electrodes of different Pt surface coverages under different applied currents (current densities) and at constant electrolyte transport in a thin-layer flow cell connected to a differential electrochemical mass spectrometry (DEMS) setup to monitor the dynamic response of the reaction selectivity under these conditions. Periodic oscillations of the electrode potential and the CO, formation rate appear not only for a continuous Pt film, but also for the nanostructured Pt/GC electrodes when a critical current density is exceeded. The critical current density for achieving regular osillation patterns increased with decreasing Pt nanodisk density. Lower oscillation frequencies of the electrode potential and lower CO2 formation rate for nanostructured Pt/GC electrodes compared to continuous Pt film at similar applied current densities suggest that transport processes play an essential role. Moreover, from the simple periodic response of the nanostructured electrodes it follows that all individual Pt disks in the array oscillate in synchrony. This result is discussed in terms of the different modes of spatial coupling present in the system: global coupling, migration coupling and mass transport of the essential chemical species, and the coverage of corresponding adsorbates

Effect of vaccination on cattle subclinically infected with foot-and-mouth disease virus in Cameroon

© 2018 Foot-and-mouth disease (FMD) is one of the most contagious and economically important livestock diseases worldwide. Four serotypes of FMD virus (FMDV; O, A, SAT1, SAT2) circulate in Cameroon, and a trivalent inactivated vaccine against the three most common serotypes (O, A, SAT2) was recently introduced in 2014. The objective of this study was to characterize vaccine performance in cattle under natural hyperendemic conditions in the Adamawa region of Cameroon. Vaccinated cattle (n = 50) and non-vaccinated controls (n = 100) were monitored by serum and oropharyngeal fluid (OPF) sample collection through a 12-month period. Anti-FMDV non-structural protein (anti-NSP) seroprevalence increased from 59.3% (89/150) at the beginning of the study to 85.8% (103/120) at the end of the study, and FMDV RNA was found in 28% (42/150) of animals overall, despite detection of clinical signs of FMD in only 6 non-vaccinated animals. Viral sequence analysis indicated that subclinical infections of FMDV serotypes O and A were present within the study herds during the study period, which was reflected by an overall increase of anti-NSP seroprevalence during the study. There was no association between vaccination status and seroconversion or prevalence of FMDV RNA in OPF. Younger cattle had higher odds of detection of FMDV RNA in OPF, but older animals were more likely to be seropositive. This study suggests vaccination of herds previously exposed to FMDV may help to limit clinical signs and reduce economic losses caused by FMDV. These findings also suggest that subclinical circulation of FMDV occurs in hyperendemic regions regardless of vaccination

Serum amyloid A mediates human neutrophil production of reactive oxygen species through a receptor independent of formyl peptide receptor like-1.

International audienceSerum amyloid A (SAA) is one of the acute-phase reactants, a group of plasma proteins that increases immensely in concentration during microbial infections and inflammatory conditions, and a close relationship between SAA levels and disease activity in rheumatoid arthritis (RA) has been observed. RA is an inflammatory disease, where neutrophils play important roles, and SAA is thought to participate in the inflammatory reaction by being a neutrophil chemoattractant and inducer of proinflammatory cytokines. The biological effects of SAA are reportedly mediated mainly through formyl peptide receptor like-1 (FPRL1), a G protein-coupled receptor (GPCR) belonging to the formyl peptide receptor family. Here, we confirmed the affinity of SAA for FPRL1 by showing that stably transfected HL-60 cells expressing FPRL1 were activated by SAA and that the response was inhibited by the use of the FPRL1-specific antagonist WRWWWW (WRW4). We also show that SAA activates the neutrophil NADPH-oxidase and that a reserve pool of receptors is present in storage organelles mobilized by priming agents such as TNF-alpha and LPS from Gram-negative bacteria. The induced activity was inhibited by pertussis toxin, indicating the involvement of a GPCR. However, based on FPRL1-specific desensitization and use of FPRL1 antagonist WRW4, we found the SAA-mediated effects in neutrophils to be independent of FPRL1. Based on these findings, we conclude that SAA signaling in neutrophils is mediated through a GPCR, distinct from FPRL1. Future identification and characterization of the SAA receptor could lead to development of novel, therapeutic targets for treatment of RA