·AIM: To compare the success and complication rates,duration of surgeries and clinical comfort after endoscopic dacryocystorhinostomy(END-DCR) or external dacryocysto-rhinostomy(EXT-DCR).·METHODS: Fifty pati...·AIM: To compare the success and complication rates,duration of surgeries and clinical comfort after endoscopic dacryocystorhinostomy(END-DCR) or external dacryocysto-rhinostomy(EXT-DCR).·METHODS: Fifty patients who underwent EXT- or END-DCR between January 2010-2012 were involved in the study. A questionnaire was applied to patients preoperatively, and postoperatively. Subjective success was defined by absence of epiphora, objective success by a normal nasolacrimal lavage and a positive functional endoscopic dye test(FEDT). Postoperative pain and cosmetic result of surgery were interpreted by the patients, who were also asked whether they would offer this surgery to a friend or would prefer this surgery once more if necessary.·RESULTS: Twenty-five patients underwent END-DCR and 25 underwent EXT-DCR. Mean duration of surgeries were 35 min both for EXT-DCR(30-50) and END-DCR(35-50)(P =0.778). Intraoperative bleeding were documented in 48% of EXT-DCR and 4% of END-DCR cases(P 【0.001). In total 96% of EXT-DCR and 100% of END-DCR patients had subjective success. Objective success was 100% in each group. There was no significant difference between the epiphora scorings and FDDT results in postoperative visits among the groups.END-DCR group reported less pain in first week and month(P 【0.05, P 【0.05). More patients in END-DCR group were happy with the cosmetic result in first week and month(P 【0.001, P 【0.001). More patients in END-DCR group offered this surgery to a friend(P 【0.001). All patients in END-DCR group preferred this surgery once more if necessary, only 48% in EXT-DCR preferred the same method(P 【0.001).·CONCLUSION: Although both END- and EXT-DCRs provide satisfactory outcomes with similar objective andsubjective success rates, we demonstrated that the endonasal approach caused significantly less pain in early postoperative period than the external approach.Clinical comfort defined by the patients was quite higher in END-DCR group, in which patients mainly were pleased to encounter a sutureless surgical area.展开更多
Introduction:Necrotising otitis externa(NOE)is a rare infection of the ear canal with frequent bone erosion.This study’s objective is to describe the different features of NOE as well as its management in an ear-nose...Introduction:Necrotising otitis externa(NOE)is a rare infection of the ear canal with frequent bone erosion.This study’s objective is to describe the different features of NOE as well as its management in an ear-nose-throat department.We also tried to identify the particularities of the fungal infection.Patients and methods:It is an observational cohort that included all the patients hospitalised for the management of NOE.The study was carried out in the ear-nose-throat Department of Mahdia University Hospital in Tunisia between January 2006 and december 2019.Results:A total of 40 patients were included.The mean age was 65±12.9 years and the sex ratio was 0.9.Ninety percent of the patients included were diabetics.The most common signs found were oedema of the external canal(97.5%)and auricular discharge(92.5%).The main pathogen isolated was Pseudomonas aeruginosa(61.7%).Fungi were isolated in 9 cases(26.47%).Computed tomography was performed for 32 patients(80%).Bone erosion was seen in 26 cases(81.3%).The main complications were cerebral venous thrombosis,retropharyngeal abscess and cerebral empyema.Thirty one patients received only antibiotics,2 received only antifungal treatment,and 7 received both antibiotics and antifungal treatment.All patients had a favorable outcome.Univariate analysis showed a higher median erythrocyte sedimentation rate was associated with fungal infections.No other differences were noted.Conclusion:Our management protocol seems to be efficient since all patients had initial favorable outcome.A higher median erythrocyte sedimentation rate was associated with fungal infections.展开更多
Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region(Italy) and the antibiotic susceptibility patterns of the isolated strains.Methods: A total of 122 dog...Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region(Italy) and the antibiotic susceptibility patterns of the isolated strains.Methods: A total of 122 dogs were examined by otoscopy, and auricular swab samples were collected from both ears in 74 dogs presenting clinical bilateral otitis and from single ears in 48 dogs displaying clinical unilateral otitis. Cytological examination,bacteriological analysis and antimicrobial susceptibility tests were performed.Results: Thirty-one out of 122 dogs were positive for yeast species(25.4%, 95% confidence interval(CI): 18.2%–34.2%) with a higher prevalence of Malassezia pachydermatis(21/31 isolates, 67.7%, CI: 48.5%–82.7%), and a total of 91 out of 122 dogs were positive for bacterial species(74.6%; CI: 65.8%–81.8%) with a higher prevalence of Staphylococcus pseudintermedius(45/143 isolates, 31.5%, CI: 24.1%–39.8%). These results are the first description of Streptococcus agalactiae-associated otitis. The yeasts isolated showed high levels of susceptibility to all antifungal agents tested; on the contrary all the isolated bacterial strains were highly resistant to at least four out of ten antimicrobial classes. Both Gram-positive and Gram-negative bacteria showed high resistance to amoxicillin/clavulanate and kanamycin hence they are not recommended as initial empirical therapy for the otitis treatment.Conclusions: This update illustrates an increase in antibiotic resistances providing an insight into the current knowledge of the therapeutic procedures followed on canine otitis externa in Italy. It also emphasizes the importance of considering the results of the microbiological and sensitivity tests to decide on an appropriate antibiotic therapy.展开更多
Ocular myiasis due to Oestrus ovis larvae infestation is an eye infection in humans.A case of ophthalmomyiasis externa in a young male from Karachi,Pakistan in winter(December 2012),without history of close proximity ...Ocular myiasis due to Oestrus ovis larvae infestation is an eye infection in humans.A case of ophthalmomyiasis externa in a young male from Karachi,Pakistan in winter(December 2012),without history of close proximity to domestic animals or visit to any rural area was reported.The condition is self-limiting and the disease is confined to the conjunctiva.The eye was locally anesthetized and washed with 5%povidine iodine solution.A total number of 27 first instar larvae of Oestrus ovis were removed with fine forceps.The patient received 0.5%moxifloxacin and diclofenac eye drops for one week.His eye was examined after one day,one week and one month and the recovery status was favorable.The present case raise the awareness among ophthalmologists regarding larval conjunctivitis as one of the causes of conjunctivitis and it can occur throughout the year in any season including winter.Moreover,it can occurr in any area either rural or urban with or without close proximity to domestic animals especially in subtropical regions with high parasitic burden.展开更多
Inflammation of a part or whole of the temporal bone and surrounding soft tissue is termed as malignant otitis externa,which typically spreads to skull base to involve cranial nerves VII.Rarely can it also effect one ...Inflammation of a part or whole of the temporal bone and surrounding soft tissue is termed as malignant otitis externa,which typically spreads to skull base to involve cranial nerves VII.Rarely can it also effect one or more of cranial nerves IX,X,XI,and XII.We present a case of malignant otitis externa which presented with symptomatic palsy of IX and XII nerves sparing the VII cranial nerve.The patient though later on had internal jugular vein thrombosis,which we presume is due to the involvement of the parapharyngeal space that prompted us to reconsider the diagnosis,and later on,to aggravate the therapy.With proper blood sugar control and appropriate long term antibiotics,not only that the patient is disease free at one year follow up,but the cranial nerve deficits also recovered.Apart from sharing the clinical and management details of this patient,we have reviewed the relevant literature in the discussion,which has shed some light onto some of the interesting facts about this condition and its prognosis.展开更多
Background: Acute otitis externa is a common multi-factorial disorder in the dog. Several topical preparations are available on the veterinary market, which are licensed for an either specified duration of treatment o...Background: Acute otitis externa is a common multi-factorial disorder in the dog. Several topical preparations are available on the veterinary market, which are licensed for an either specified duration of treatment or for a discretionary period that is determined by the clinician. Objectives: To compare the efficacy of two topical products, both licensed for the treatment of otitis externa in the dog, but with different treatment durations. Animal Population: One hundred and sixty dogs were enrolled in this multicentre field study from which 157 dogs were analysed in the Per Protocol sample (73 Aurizon?treated animals and 84 Easotic?treated animals). Method: Dogs were randomly assigned to Aurizon?or Easotic?treatment groups. Aurizon?(Vétoquinol SA: marbofloxacin, clotrimazole, dexamethasone) was administered daily in the affected ear(s) for 7 or 14 days, and was compared with a daily administration of Easotic?(Virbac SAS: gentamicin, miconazole, hydrocortisone aceponate) for 5 days. General and localised clinical signs were scored on days 0 (D0), 3 (D3), 7 (D7), 14 (D14) and 21 (D21). Results: Clinical cure rates at the end of treatment were 56.3% and 48.8% (p=0.35) in the Aurizon?and Easotic?groups respectively and 81.2% versus 74.7% one week after completing the course of treatment (p = 0.34). Twenty-one days after initially presenting for the study, cure rates were 84.3% in the Aurizon?group and 73.8% in the Easotic?(p=0.12). A relationship between severity of clinical signs and treatment duration was observed. Conclusion and Clinical Significance: At the end of the trial period, cure rates showed a tendency to be higher in the Aurizon?treated animals. The flexible dosage and the veterinary monitoring permitted treatment duration to be adjusted based upon the severity of otitis externa thus increasing the likelihood of clinical cure.展开更多
Chrysoperla externa is found in environment, their populations may experience several Brazilian agroecosystems and feeds on many agricultural pests. In each different environmental pressures that can favor the emergen...Chrysoperla externa is found in environment, their populations may experience several Brazilian agroecosystems and feeds on many agricultural pests. In each different environmental pressures that can favor the emergence of genetic mutations and interfere in insect＇s ecological plasticity. Such genetic phenomena can be observed through the use of molecular markers, in particular mitochondrial genes, which are easy to handle and extract. The aim of this work was to study haplotype diversity of Chrysoperla externa in the cities of Jaboticabal （SP）, Brotas （SP）, Rifaina （SP）, Sao Carlos （SP）, Sao Jose dos Campos （SP） and Sao Sebastiao do Paraiso （MG）, and evaluate the degree of genetic differentiation between these populations. Two mitochondrial genes were sequenced to compare these populations. It was found that there were eight haplotypes, six mutations for cytochrome c oxidase subunit 1 （COl） gene and a greater haplotype diversity was found in Brotas and Sao Sebastiao do Paraiso. There were four mutations and six haplotypes for 16S gene and the highest haplotype diversity was found in the city of San Sebastiao do Paraiso. No pattern of haplotype distribution for the populations analyzed was found. The genetic distance between populations of C. externa was not significant, showing that they are genetically compatible.展开更多
Ear cleaning is a therapeutic component in the management of otitis externa in dogs. The objectives of this study were to evaluate the in vivo efficacy and safety of a new ear cleanser, Sonotix? against EpiOtic? Advan...Ear cleaning is a therapeutic component in the management of otitis externa in dogs. The objectives of this study were to evaluate the in vivo efficacy and safety of a new ear cleanser, Sonotix? against EpiOtic? Advanced for the management of canine otitis externa. Eighteen clients owned dogs with a diagnosis of erythemato-ceruminous or purulent otitis externa were prospectively included and randomized to two treatment group: EpiOtic? Advanced and Sonotix?. Cytology and video-otoscopic examination (erythema, amount of cerumen and thickness and surface of ear canal covered by cerumen) of all affected ears were done at D0, both before (T0) and 30 minutes (T0 + 30 min) after ear cleaning. Then an ear medication was applied (Aurizon?, Vetoquinol). Owners were instructed to clean affected ears daily and apply the ear medication 30 minutes later for 5 days (D1-D5). Dogs were seen again at D6 for cytology and video-otoscopic examination. At T0, no significant differences were found between both ear cleansers groups regarding macroscopic and microscopic scorings. At T0 + 30 min and D6 cytological and video-otoscopic scores were significantly decreased (Wilcoxon test;p < 0.01) compared to baseline in both groups. However, the cleaning activity of Sonotix? was statistically superior to Epiotic? as evidenced by the median global scores of video-otoscopic examination at T0 + 30 min (Mann Whitney Test, p < 0.01). Effective ear cleaning is an essential part of any treatment scheme because it favours the contact between the ointment and the lining ear epidermis and speeds resolution by the removal of cerumen, microbial organisms and cellular debris. In our study, the important reductions in yeast, cocci, and rod-shaped organism counts were demonstrated in smears at T0 + 30 min and D6 in both groups. Video-otoscopic examination performed 30 minutes after ear cleaning suggests that Sonotix? seems to be more effective in removing cerumen than EpiOtic? Advanced.展开更多
With the continuous improvement of China's scientific and technological level, all kinds of new technologies are gradually developed and applied to the construction industry. Among them, the construction technolog...With the continuous improvement of China's scientific and technological level, all kinds of new technologies are gradually developed and applied to the construction industry. Among them, the construction technology of external wall board is applied more in the prefabricated building structure of the house construction project. Because the prefabricated building structure has good adaptability, whether the construction quality is qualified determines the safety and stability of the whole house construction project. Therefore, in the construction process, it is necessary to strictly control the construction technology of assembling building structure external wall panels to ensure their standardization. Based on this, this paper briefly analyzes the construction technology of external wall panels for assembled building structures, and discusses the key points of construction for reference.展开更多
Necrotizing otitis externa(NOE)is an aggressive and fast‐evolving infection of the external auditory canal.Late diagnoses and untreated cases can lead to severe,even fatal consequences and so early diagnosis and trea...Necrotizing otitis externa(NOE)is an aggressive and fast‐evolving infection of the external auditory canal.Late diagnoses and untreated cases can lead to severe,even fatal consequences and so early diagnosis and treatment are paramount.NOE is a notoriously challenging diagnosis to make.It is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive disease.This review aims to evaluate the different diagnostic options available in NOE and discuss their advantages and limitations,thus,providing an up‐to‐date picture of the multimodal approach required in the diagnosis of this disease.展开更多
Objective:To review the role of adjuvant hyperbaric oxygen therapy(HBOT)in the treatment of malignant otitis externa(MOE).Data sources:PubMed,Scopus,Web of Science,Science Direct,and Cochrane Library were searched for...Objective:To review the role of adjuvant hyperbaric oxygen therapy(HBOT)in the treatment of malignant otitis externa(MOE).Data sources:PubMed,Scopus,Web of Science,Science Direct,and Cochrane Library were searched for the following concepts:“hyperbaric oxygen”and“malignant or necrotizing otitis externa.”Methods:Studies were included if they contained(1)patients with reported evidence of MOE,(2)employment of adjuvant HBOT,(3)details on patients’medical condition,and(4)documented survival outcomes.Extracted information included patient demographics,underlying medical conditions,infectious etiology,signs and symptoms,medical and surgical treatments,duration of medical treatment,mean follow up time,HBOT setting,number of HBOT sessions,complications,survival rate,and all-cause mortality.Results:A total of 16 studies comprising 58 patients(mean age 68.0 years)were included.Diabetes was present in 94.7%of cases and Pseudomonas spp(64.3%)was the most common infectious agent.Cranial nerve VII was involved in 55.2%of cases.Overall,the disease cure rate with adjuvant HBOT was 91.4%and all-cause mortality was 8.6%.Among those who had cranial nerve VII involvement,72.0%had return of function and 93.8%of them survived.Conclusion:HBOT may be an effective treatment option for refractory or advanced MOE but its efficacy remains unproven due to lack of strong scientific evidence.However,its therapeutic value should not be underestimated given good results and few adverse events reported in this study.展开更多
The comprehensive knowledge that the delayed systemic and reproduction side effects can be even more deleterious than acute toxicity, has caused a shift in focus toward sublethal effects assessment on physiology and b...The comprehensive knowledge that the delayed systemic and reproduction side effects can be even more deleterious than acute toxicity, has caused a shift in focus toward sublethal effects assessment on physiology and behavior of beneficial insects. In this study, we assessed the risks posed by some insecticides with different mode of action through lethal and delayed systemic sublethal effects on the pupation, adult emergence, and repro- duction of the chrysopid Chrysoperla externa （Hagen, 1861; Neuroptera： Chrysopidae）, an important predator in pest biological control. The maximum field recommended dose （MFRD） and twice （2xMFRD） for chlorantraniliprole, tebufenozide, and pyriproxyfen were harmless to C. externa. In contrast, all the tested chitin synthesis inhibitors （CSIs） were highly detrimental to the predator, despite of their lack of acute lethal toxicity. There- fore, the safety assumed by using IGRs toward beneficial insects is not valid for chrysopids. Dose-response data showed that although all CSIs have a similar mechanism of action, the relative extent of toxicity may differ （novaluron 〉 lufenuron 〉 teflubenzuron）. For CSIs, the delayed systemic effects became obvious at adult emergence, where the predicted no observable effect dose （NOED） was 1/2 048 of the MFRD for novaluron （0.085 ng/insect）, and 1/256 of the MFRD for both lufenuron （0.25 ng/insect） and teflubenzuron （0.6 ng/insect）. Finally, this work emphasized the significance of performing toxicity risk assessments with an adequate posttreatment period to avoid underestimating the toxicities of insecticides, as the acute lethal toxicity assays may not provide accurate information regarding the long-range effects of hazardous compounds.展开更多
Objective:Otologic methicillin-resistant Staphylococcus aureus(MRSA)infection has historically been rare,but given the rise in community-acquired MRSA carriage and infection at other body sites,prevalence rates may be...Objective:Otologic methicillin-resistant Staphylococcus aureus(MRSA)infection has historically been rare,but given the rise in community-acquired MRSA carriage and infection at other body sites,prevalence rates may be changing.The goal of this study was to determine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa(AOE).Study design:Retrospective review of an institutional microbiologic database.Methods:A retrospective analysis was performedon serial culture isolates taken fromthe ear at a quaternary care hospital from January 2014 to April 2016.The causative pathogen and antibiotic sensitivity was determined by culture isolation and end point mean inhibitory concentration(MIC)testing.Medical records were reviewed to document patient characteristics,chronicity of infection,symptomatology,and previous treatments.Results:Over the study period,173 patients were diagnosed with AOE and underwent otologic cultures of the ear.Fifty-three(30.6%)of cultures grew S.aureus(SA).Of SA infections,15(28.3%)were identified as MRSA.MRSA patients were typically older than patients with methicillin-sensitive SA(MSSA)(mean age 46.717.9 vs 2919.4,PZ0.003)and had more medical comorbidities(4 vs 1.7,PZ0.001).Compared to patients with MSSA,patients with MRSAwere significantly more likely to have had prior ototopical antibiotic exposure(37%vs 73%,PZ0.019).Conclusion:Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared to historical reports in the literature.Clinicians should consider ear cultures to identify MRSA AOE.Level of Evidence:IV.展开更多
文摘·AIM: To compare the success and complication rates,duration of surgeries and clinical comfort after endoscopic dacryocystorhinostomy(END-DCR) or external dacryocysto-rhinostomy(EXT-DCR).·METHODS: Fifty patients who underwent EXT- or END-DCR between January 2010-2012 were involved in the study. A questionnaire was applied to patients preoperatively, and postoperatively. Subjective success was defined by absence of epiphora, objective success by a normal nasolacrimal lavage and a positive functional endoscopic dye test(FEDT). Postoperative pain and cosmetic result of surgery were interpreted by the patients, who were also asked whether they would offer this surgery to a friend or would prefer this surgery once more if necessary.·RESULTS: Twenty-five patients underwent END-DCR and 25 underwent EXT-DCR. Mean duration of surgeries were 35 min both for EXT-DCR(30-50) and END-DCR(35-50)(P =0.778). Intraoperative bleeding were documented in 48% of EXT-DCR and 4% of END-DCR cases(P 【0.001). In total 96% of EXT-DCR and 100% of END-DCR patients had subjective success. Objective success was 100% in each group. There was no significant difference between the epiphora scorings and FDDT results in postoperative visits among the groups.END-DCR group reported less pain in first week and month(P 【0.05, P 【0.05). More patients in END-DCR group were happy with the cosmetic result in first week and month(P 【0.001, P 【0.001). More patients in END-DCR group offered this surgery to a friend(P 【0.001). All patients in END-DCR group preferred this surgery once more if necessary, only 48% in EXT-DCR preferred the same method(P 【0.001).·CONCLUSION: Although both END- and EXT-DCRs provide satisfactory outcomes with similar objective andsubjective success rates, we demonstrated that the endonasal approach caused significantly less pain in early postoperative period than the external approach.Clinical comfort defined by the patients was quite higher in END-DCR group, in which patients mainly were pleased to encounter a sutureless surgical area.
文摘Introduction:Necrotising otitis externa(NOE)is a rare infection of the ear canal with frequent bone erosion.This study’s objective is to describe the different features of NOE as well as its management in an ear-nose-throat department.We also tried to identify the particularities of the fungal infection.Patients and methods:It is an observational cohort that included all the patients hospitalised for the management of NOE.The study was carried out in the ear-nose-throat Department of Mahdia University Hospital in Tunisia between January 2006 and december 2019.Results:A total of 40 patients were included.The mean age was 65±12.9 years and the sex ratio was 0.9.Ninety percent of the patients included were diabetics.The most common signs found were oedema of the external canal(97.5%)and auricular discharge(92.5%).The main pathogen isolated was Pseudomonas aeruginosa(61.7%).Fungi were isolated in 9 cases(26.47%).Computed tomography was performed for 32 patients(80%).Bone erosion was seen in 26 cases(81.3%).The main complications were cerebral venous thrombosis,retropharyngeal abscess and cerebral empyema.Thirty one patients received only antibiotics,2 received only antifungal treatment,and 7 received both antibiotics and antifungal treatment.All patients had a favorable outcome.Univariate analysis showed a higher median erythrocyte sedimentation rate was associated with fungal infections.No other differences were noted.Conclusion:Our management protocol seems to be efficient since all patients had initial favorable outcome.A higher median erythrocyte sedimentation rate was associated with fungal infections.
基金Supported in part by the Second University of Naples and University of Naples"Federico II",Fondi di Ateneo,by a fellowship from the University of Naples‘Federico II’(2012-4/STV-Project FORGIARE),and co-funded by"Compagnia San Paolo"of Turin,Italy
文摘Objective: To update the recent knowledge of the microbiological causes of canine otitis externa in Campania Region(Italy) and the antibiotic susceptibility patterns of the isolated strains.Methods: A total of 122 dogs were examined by otoscopy, and auricular swab samples were collected from both ears in 74 dogs presenting clinical bilateral otitis and from single ears in 48 dogs displaying clinical unilateral otitis. Cytological examination,bacteriological analysis and antimicrobial susceptibility tests were performed.Results: Thirty-one out of 122 dogs were positive for yeast species(25.4%, 95% confidence interval(CI): 18.2%–34.2%) with a higher prevalence of Malassezia pachydermatis(21/31 isolates, 67.7%, CI: 48.5%–82.7%), and a total of 91 out of 122 dogs were positive for bacterial species(74.6%; CI: 65.8%–81.8%) with a higher prevalence of Staphylococcus pseudintermedius(45/143 isolates, 31.5%, CI: 24.1%–39.8%). These results are the first description of Streptococcus agalactiae-associated otitis. The yeasts isolated showed high levels of susceptibility to all antifungal agents tested; on the contrary all the isolated bacterial strains were highly resistant to at least four out of ten antimicrobial classes. Both Gram-positive and Gram-negative bacteria showed high resistance to amoxicillin/clavulanate and kanamycin hence they are not recommended as initial empirical therapy for the otitis treatment.Conclusions: This update illustrates an increase in antibiotic resistances providing an insight into the current knowledge of the therapeutic procedures followed on canine otitis externa in Italy. It also emphasizes the importance of considering the results of the microbiological and sensitivity tests to decide on an appropriate antibiotic therapy.
文摘Ocular myiasis due to Oestrus ovis larvae infestation is an eye infection in humans.A case of ophthalmomyiasis externa in a young male from Karachi,Pakistan in winter(December 2012),without history of close proximity to domestic animals or visit to any rural area was reported.The condition is self-limiting and the disease is confined to the conjunctiva.The eye was locally anesthetized and washed with 5%povidine iodine solution.A total number of 27 first instar larvae of Oestrus ovis were removed with fine forceps.The patient received 0.5%moxifloxacin and diclofenac eye drops for one week.His eye was examined after one day,one week and one month and the recovery status was favorable.The present case raise the awareness among ophthalmologists regarding larval conjunctivitis as one of the causes of conjunctivitis and it can occur throughout the year in any season including winter.Moreover,it can occurr in any area either rural or urban with or without close proximity to domestic animals especially in subtropical regions with high parasitic burden.
文摘Inflammation of a part or whole of the temporal bone and surrounding soft tissue is termed as malignant otitis externa,which typically spreads to skull base to involve cranial nerves VII.Rarely can it also effect one or more of cranial nerves IX,X,XI,and XII.We present a case of malignant otitis externa which presented with symptomatic palsy of IX and XII nerves sparing the VII cranial nerve.The patient though later on had internal jugular vein thrombosis,which we presume is due to the involvement of the parapharyngeal space that prompted us to reconsider the diagnosis,and later on,to aggravate the therapy.With proper blood sugar control and appropriate long term antibiotics,not only that the patient is disease free at one year follow up,but the cranial nerve deficits also recovered.Apart from sharing the clinical and management details of this patient,we have reviewed the relevant literature in the discussion,which has shed some light onto some of the interesting facts about this condition and its prognosis.
文摘Background: Acute otitis externa is a common multi-factorial disorder in the dog. Several topical preparations are available on the veterinary market, which are licensed for an either specified duration of treatment or for a discretionary period that is determined by the clinician. Objectives: To compare the efficacy of two topical products, both licensed for the treatment of otitis externa in the dog, but with different treatment durations. Animal Population: One hundred and sixty dogs were enrolled in this multicentre field study from which 157 dogs were analysed in the Per Protocol sample (73 Aurizon?treated animals and 84 Easotic?treated animals). Method: Dogs were randomly assigned to Aurizon?or Easotic?treatment groups. Aurizon?(Vétoquinol SA: marbofloxacin, clotrimazole, dexamethasone) was administered daily in the affected ear(s) for 7 or 14 days, and was compared with a daily administration of Easotic?(Virbac SAS: gentamicin, miconazole, hydrocortisone aceponate) for 5 days. General and localised clinical signs were scored on days 0 (D0), 3 (D3), 7 (D7), 14 (D14) and 21 (D21). Results: Clinical cure rates at the end of treatment were 56.3% and 48.8% (p=0.35) in the Aurizon?and Easotic?groups respectively and 81.2% versus 74.7% one week after completing the course of treatment (p = 0.34). Twenty-one days after initially presenting for the study, cure rates were 84.3% in the Aurizon?group and 73.8% in the Easotic?(p=0.12). A relationship between severity of clinical signs and treatment duration was observed. Conclusion and Clinical Significance: At the end of the trial period, cure rates showed a tendency to be higher in the Aurizon?treated animals. The flexible dosage and the veterinary monitoring permitted treatment duration to be adjusted based upon the severity of otitis externa thus increasing the likelihood of clinical cure.
文摘Chrysoperla externa is found in environment, their populations may experience several Brazilian agroecosystems and feeds on many agricultural pests. In each different environmental pressures that can favor the emergence of genetic mutations and interfere in insect＇s ecological plasticity. Such genetic phenomena can be observed through the use of molecular markers, in particular mitochondrial genes, which are easy to handle and extract. The aim of this work was to study haplotype diversity of Chrysoperla externa in the cities of Jaboticabal （SP）, Brotas （SP）, Rifaina （SP）, Sao Carlos （SP）, Sao Jose dos Campos （SP） and Sao Sebastiao do Paraiso （MG）, and evaluate the degree of genetic differentiation between these populations. Two mitochondrial genes were sequenced to compare these populations. It was found that there were eight haplotypes, six mutations for cytochrome c oxidase subunit 1 （COl） gene and a greater haplotype diversity was found in Brotas and Sao Sebastiao do Paraiso. There were four mutations and six haplotypes for 16S gene and the highest haplotype diversity was found in the city of San Sebastiao do Paraiso. No pattern of haplotype distribution for the populations analyzed was found. The genetic distance between populations of C. externa was not significant, showing that they are genetically compatible.
文摘Ear cleaning is a therapeutic component in the management of otitis externa in dogs. The objectives of this study were to evaluate the in vivo efficacy and safety of a new ear cleanser, Sonotix? against EpiOtic? Advanced for the management of canine otitis externa. Eighteen clients owned dogs with a diagnosis of erythemato-ceruminous or purulent otitis externa were prospectively included and randomized to two treatment group: EpiOtic? Advanced and Sonotix?. Cytology and video-otoscopic examination (erythema, amount of cerumen and thickness and surface of ear canal covered by cerumen) of all affected ears were done at D0, both before (T0) and 30 minutes (T0 + 30 min) after ear cleaning. Then an ear medication was applied (Aurizon?, Vetoquinol). Owners were instructed to clean affected ears daily and apply the ear medication 30 minutes later for 5 days (D1-D5). Dogs were seen again at D6 for cytology and video-otoscopic examination. At T0, no significant differences were found between both ear cleansers groups regarding macroscopic and microscopic scorings. At T0 + 30 min and D6 cytological and video-otoscopic scores were significantly decreased (Wilcoxon test;p < 0.01) compared to baseline in both groups. However, the cleaning activity of Sonotix? was statistically superior to Epiotic? as evidenced by the median global scores of video-otoscopic examination at T0 + 30 min (Mann Whitney Test, p < 0.01). Effective ear cleaning is an essential part of any treatment scheme because it favours the contact between the ointment and the lining ear epidermis and speeds resolution by the removal of cerumen, microbial organisms and cellular debris. In our study, the important reductions in yeast, cocci, and rod-shaped organism counts were demonstrated in smears at T0 + 30 min and D6 in both groups. Video-otoscopic examination performed 30 minutes after ear cleaning suggests that Sonotix? seems to be more effective in removing cerumen than EpiOtic? Advanced.
文摘With the continuous improvement of China's scientific and technological level, all kinds of new technologies are gradually developed and applied to the construction industry. Among them, the construction technology of external wall board is applied more in the prefabricated building structure of the house construction project. Because the prefabricated building structure has good adaptability, whether the construction quality is qualified determines the safety and stability of the whole house construction project. Therefore, in the construction process, it is necessary to strictly control the construction technology of assembling building structure external wall panels to ensure their standardization. Based on this, this paper briefly analyzes the construction technology of external wall panels for assembled building structures, and discusses the key points of construction for reference.
文摘Necrotizing otitis externa(NOE)is an aggressive and fast‐evolving infection of the external auditory canal.Late diagnoses and untreated cases can lead to severe,even fatal consequences and so early diagnosis and treatment are paramount.NOE is a notoriously challenging diagnosis to make.It is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive disease.This review aims to evaluate the different diagnostic options available in NOE and discuss their advantages and limitations,thus,providing an up‐to‐date picture of the multimodal approach required in the diagnosis of this disease.
文摘Objective:To review the role of adjuvant hyperbaric oxygen therapy(HBOT)in the treatment of malignant otitis externa(MOE).Data sources:PubMed,Scopus,Web of Science,Science Direct,and Cochrane Library were searched for the following concepts:“hyperbaric oxygen”and“malignant or necrotizing otitis externa.”Methods:Studies were included if they contained(1)patients with reported evidence of MOE,(2)employment of adjuvant HBOT,(3)details on patients’medical condition,and(4)documented survival outcomes.Extracted information included patient demographics,underlying medical conditions,infectious etiology,signs and symptoms,medical and surgical treatments,duration of medical treatment,mean follow up time,HBOT setting,number of HBOT sessions,complications,survival rate,and all-cause mortality.Results:A total of 16 studies comprising 58 patients(mean age 68.0 years)were included.Diabetes was present in 94.7%of cases and Pseudomonas spp(64.3%)was the most common infectious agent.Cranial nerve VII was involved in 55.2%of cases.Overall,the disease cure rate with adjuvant HBOT was 91.4%and all-cause mortality was 8.6%.Among those who had cranial nerve VII involvement,72.0%had return of function and 93.8%of them survived.Conclusion:HBOT may be an effective treatment option for refractory or advanced MOE but its efficacy remains unproven due to lack of strong scientific evidence.However,its therapeutic value should not be underestimated given good results and few adverse events reported in this study.
文摘The comprehensive knowledge that the delayed systemic and reproduction side effects can be even more deleterious than acute toxicity, has caused a shift in focus toward sublethal effects assessment on physiology and behavior of beneficial insects. In this study, we assessed the risks posed by some insecticides with different mode of action through lethal and delayed systemic sublethal effects on the pupation, adult emergence, and repro- duction of the chrysopid Chrysoperla externa （Hagen, 1861; Neuroptera： Chrysopidae）, an important predator in pest biological control. The maximum field recommended dose （MFRD） and twice （2xMFRD） for chlorantraniliprole, tebufenozide, and pyriproxyfen were harmless to C. externa. In contrast, all the tested chitin synthesis inhibitors （CSIs） were highly detrimental to the predator, despite of their lack of acute lethal toxicity. There- fore, the safety assumed by using IGRs toward beneficial insects is not valid for chrysopids. Dose-response data showed that although all CSIs have a similar mechanism of action, the relative extent of toxicity may differ （novaluron 〉 lufenuron 〉 teflubenzuron）. For CSIs, the delayed systemic effects became obvious at adult emergence, where the predicted no observable effect dose （NOED） was 1/2 048 of the MFRD for novaluron （0.085 ng/insect）, and 1/256 of the MFRD for both lufenuron （0.25 ng/insect） and teflubenzuron （0.6 ng/insect）. Finally, this work emphasized the significance of performing toxicity risk assessments with an adequate posttreatment period to avoid underestimating the toxicities of insecticides, as the acute lethal toxicity assays may not provide accurate information regarding the long-range effects of hazardous compounds.
文摘Objective:Otologic methicillin-resistant Staphylococcus aureus(MRSA)infection has historically been rare,but given the rise in community-acquired MRSA carriage and infection at other body sites,prevalence rates may be changing.The goal of this study was to determine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa(AOE).Study design:Retrospective review of an institutional microbiologic database.Methods:A retrospective analysis was performedon serial culture isolates taken fromthe ear at a quaternary care hospital from January 2014 to April 2016.The causative pathogen and antibiotic sensitivity was determined by culture isolation and end point mean inhibitory concentration(MIC)testing.Medical records were reviewed to document patient characteristics,chronicity of infection,symptomatology,and previous treatments.Results:Over the study period,173 patients were diagnosed with AOE and underwent otologic cultures of the ear.Fifty-three(30.6%)of cultures grew S.aureus(SA).Of SA infections,15(28.3%)were identified as MRSA.MRSA patients were typically older than patients with methicillin-sensitive SA(MSSA)(mean age 46.717.9 vs 2919.4,PZ0.003)and had more medical comorbidities(4 vs 1.7,PZ0.001).Compared to patients with MSSA,patients with MRSAwere significantly more likely to have had prior ototopical antibiotic exposure(37%vs 73%,PZ0.019).Conclusion:Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared to historical reports in the literature.Clinicians should consider ear cultures to identify MRSA AOE.Level of Evidence:IV.
