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The purpose of this study is to describe challenges in diagnosis and treatment of otologic fungal infections.; 2) Methods: Case series and literature review 3) Results: Three patients treated at Louisiana State University Health Sciences Center – Shreveport between November 2020 – November 2023 were identified with complicated fungal otitis externa requiring detailed radiologic and histopathologic workup to aid in diagnosis and management. 4) Conclusion: Diagnosis of otologic fungal infection is often complex due to similar presentation of more common pathogens, overlapping features among common fungal specimens, and limitations of available diagnostic methods. Patient factors, including diabetes with poor glycemic control, may further complicate this challenging disease. High index of clinical suspicion, collaboration between multidisciplinary teams is essential to differentiate between common and uncommon fungal ear infections. A combination of mechanical debridement, topical and/or systemic therapy, and longitudinal follow-up with otolaryngology and infectious disease teams is required for successful treatment. [ABSTRACT FROM AUTHOR]

A significant change in the seasonal patterns of ear infections has been observed due to the modification of aquatic leisure habits, also altering the etiology of the most frequently causing otitis in its various forms of presentation. This work aims to become the largest series documenting ear infections by this bacterium, carrying out a characterization and considering the possibility that the mechanism of action occurs both through contact with contaminated waters and colonization of the middle ear. [ABSTRACT FROM AUTHOR]

Background: Otitis media is an inflammation of the middle ear that affects both adults and children, leading to hearing loss and impacting intellectual performance, especially in developing countries. Key factors contributing to its development include lack of vaccination, inadequate breastfeeding, overcrowding, and malnutrition. Major bacterial pathogens involved are Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumoniae, Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.This systematic review and meta-analysis revealed the pooled prevalence of bacterial ear infections and multidrug resistance in Ethiopia. Methods: Thorough searches were conducted across electronic databases and grey literature using precise entry terms or phrases. Eligible studies were compiled into MS Excel and imported into STATA version 14 software for statistical analysis. The collective prevalence of bacterial ear infections and multidrug resistance patterns were calculated using a random-effect model, with heterogeneity assessed via the I2 value. Publication bias was examined using a funnel plot and Egger's test. Sensitivity analysis was performed to gauge the impact of individual studies on the overall effect size. Result: Seventy studies met the criteria for qualitative analysis, with 14 selected for the meta-analysis. These studies reported a total of 3,667 bacterial isolates. The prevalence of bacterial ear infections varied significantly, ranging from 28.2% to 98.2% across individual studies. In this systematic review and meta-analysis, the pooled prevalence of bacterial ear infections in Ethiopia was found to be 73.39% (95% CI: 65.15–81.63), demonstrating substantial heterogeneity (I2 = 98.5%, p < 0.001). Additionally, the pooled prevalence of multidrug resistance among bacterial ear infections was 72.45% (95% CI: 66.86–78.04). The most frequently identified isolate was Staphylococcus aureus, with a pooled prevalence of 68.87% (95% CI: 13.94–123.79), followed closely by Proteus spp. at 68.55% (95% CI: 3.15–140.26), Pseudomonas aeruginosa at 48.15% (95% CI: 1.84–94.45), and Escherichia coli at 37.15% (95% CI: 14.03–88.34). Conclusion: The pooled prevalence of bacterial ear infections in Ethiopia is alarmingly high, accompanied by significant levels of multidrug resistance. These findings highlight the urgent need to reevaluate empirical treatment strategies due to the rising antimicrobial resistance. [ABSTRACT FROM AUTHOR]

This study explored the influence of tobacco consumption on the respiratory health of two historical Dutch populations (1300–1829 CE). We conducted a macroscopic examination of 235 skeletons for which tobacco consumption status was known, focusing on the presence of sinusitis, ear infection, and pulmonary inflammation. Our goal was to investigate the correlation between respiratory diseases and tobacco consumption. Despite all conditions being prevalent in the total sample (sinusitis: 50.2%, ear infection: 23.2%, pulmonary inflammation: 14.1%), almost no significant correlation was found between disease and tobacco consumption. Our findings suggest that additional factors, such as exposure to second-hand smoke and unsanitary living/working environments, may have also impacted respiratory health. However, our interpretations are difficult to confirm due to the limitations of macroscopic analysis in determining tobacco consumption status. Future research should consider employing biomolecular techniques and expand beyond respiratory diseases to enhance our understanding of historical health implications of tobacco use. [ABSTRACT FROM AUTHOR]

Aim: To test the efficaciousness of the 10 warning signs of Jeffrey Modell Foundation (JMF) and routine laboratory tests in predicting Primary Immunodeficiencies (PIDs). Methods: Hospitalized children <12 years age satisfying at least two of 10 warning signs were subjected to routine and confirmatory tests. Results: Of 35 204 admitted patients, 66 satisfied the JMF criteria and 34 had PID. Also, 59% were infants, with a female preponderance. The most common immunodeficiency disorder group were antibody deficiencies and phagocyte defects (35.3%). Chronic granulomatous disease (CGD) was the commonest overall (29.4%). The need for intravenous antibiotics was the most sensitive (91%) criterion for predicting PID. When combined with positive family history of PID, sensitivity (94%) increased further. The two most specific indicators were recurrent ear infections (88%), and family history of PID (88%). The best positive predictor was family history of PID (69%), and the best negative predictor was recurrent sinus infections (58%). Significant association was found between persistent oral thrush and PID (p.043), and insufficient weight gain and antibody deficiencies (p.037). Absolute neutrophil count, CRP, and elevated ESR were also significantly associated with PIDs (p‐values being.036,.011, and.014 respectively). Conclusion: Out of all 10 JMF criteria, the three most important ones to predict PID were need for IV antibiotics, family history of PID, and recurrent ear infections. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) was strongly associated with health status, with fewer related studies in adolescents (12–19 years). Most current studies using questionnaires to assess PA levels were not objective enough. So, this study used a wearable device to assess PA levels quantitatively and focused on the association between PA levels and self-reported 4 health status among adolescents. Methods: Data were obtained from adolescents (2241) with both PA and health status assessments from two cycles of NHANES, 2011–2014, using a wearable accelerometer-based device to assess PA levels quantitatively, MIMS-units as the metric, averaging over all valid days of wear (MIMS-units average). There were 4 health statuses, including (1) whether or not flu, pneumonia, or ear infection, (2) whether or not stomach or intestinal illness, (3) whether or not head cold or chest cold, and (4) general health condition, from the past 30 days self-reported. Weighted multiple logistic regression was used to analyze the association between the 4 health statuses and the MIMS-units average and MIMS-units average quartiles respectively. Subgroup analyses were also conducted on age, sex, BMI, and race. Results: After controlling confounding factors, there was no significant correlation between the MIMS-units average and the four physical health conditions in Table 3 model 3. While MIMS-units average quartiles results showed that compared to lower PA levels (Q1), higher PA levels (Q4) were linked to a lower incidence of "flu"(OR = 0.94, 95% CI [0.91, 0.99], P < 0.001). Furthermore, Q3 was linked to a decrease in the incidence of "head cold" (OR = 0.91, 95% CI [0.85, 0.96], P < 0.001), while Q2 showed a decrease in "stomach illness" (OR = 0.95, 95% CI [0.92, 0.99], P = 0.003) in Table 3 model 3. Subgroup analyses showed that higher PA levels significantly reduced "flu" risk among 12–15 year-olds, girls, obese, and Non-Hispanic White; decreased "head cold" risk among 16–19 year-olds, boys, obese, and Non-Hispanic White; significantly lower risk of "stomach illness" in girls. Conclusions: Enhancing PA levels can help prevent flu, head cold, and stomach or intestinal illness in US adolescents. Further studies are needed to determine whether adolescents in other regions have similar results, and high-quality cohort studies are needed to further validate the causal association. [ABSTRACT FROM AUTHOR]

This work aims at improving the proven protocol for doubled haploid production in wheat. This procedure has some deficits, for example, microbial infection of ears as well as of the nutrient culture medium. In the present study, the potential effect of sterilization by detached tiller culture fungicides of ears as well as of nutrient medium to control microbial infection, and its effect on the formation of caryopses and embryos (CFF, EFF) was studied. In a further experiment, the UV‐light was used as physical sterilant for the nutrient medium. All of the fungicides and their concentrations studied were found to be effective to control infection on ears except the concentration 0.05% tilt. 0.1% tilt gave the highest CFF (79.5%) followed by 0.1% Bayleton (78.0%). The lowest CFF was recorded in control treatment (48.8%). Among Bavistin treatments, the 0.2% Bavistin gave maximum CFF (68.5%) as well as EFF (29.1%) followed by 0.1% Bavistin (64.9%, 23.7%). The higher concentration of tilt (0.2%) showed detrimental effects on EFF (17.5%). Bavistin in tiller culture nutrient medium reduced infection in medium and was shown to improve CFF and EFF (67.4%, 29.8%). [ABSTRACT FROM AUTHOR]

Staphylococcus aureus is a major cause of neonatal infections in various anatomical sites, resulting in high morbidity and mortality in The Gambia. These clinical infections are often preceded by nasal carriage of S. aureus, a known risk factor. To determine whether potential sources of newborn S. aureus infections were from carriage, and to characterize S. aureus present in different anatomical sites (blood, ear, eye, umbilical cord, skin, pus, oropharynx, breast milk and vagina), we performed whole-genome sequencing of 172 isolates from clinical sites as well as from healthy and unhealthy carriage. A random selection of mothers (n = 90) and newborns (n = 42) participating in a clinical trial and testing positive for S. aureus were considered for this study. Sequence data were analyzed to determine S. aureus multilocus sequence types and selected antimicrobial and virulence gene profiles. Our findings revealed that in The Gambia, ST15 is the dominant sequence type associated with both carriage and clinical infection. In addition, S. aureus isolates causing clinical infection among neonates were genetically similar to those colonizing their oropharynx, and the different anatomical sites were not found to be uniquely colonized by S. aureus of a single genomic profile. Furthermore, while S. aureus associated with clinical infection had similar antimicrobial resistance gene profiles to carriage isolates, only hemolysin and adhesive factor virulence genes were significantly higher among clinical isolates. In conclusion, this study confirmed S. aureus oropharyngeal colonization among neonates as a potential source of clinical infection in The Gambia. Hence, interventions aiming to reduce neonatal clinical infections in The Gambia should consider decreasing oropharyngeal S. aureus carriage. Trial registration The trial was registered at ClinicalTrials.gov NCT03199547. [ABSTRACT FROM AUTHOR]

Background: Otitis media (OM) is the most frequent and complex middle ear condition with multifactorial etiology including genetic predisposition. OM depicts a variable clinical spectrum, leading to speech, developmental delay, and hearing loss. Here, we report the clinical and genetic findings of chronic suppurative otitis media (CSOM) segregating in a six‐generation consanguineous Pakistani family PKOM08. Methods: Clinical evaluations, including audio and tympanometry, were conducted to assess OM manifestation and their impact on hearing function. Exome sequencing was performed to identify potential genetic variants underlying CSOM in the study participants. Results: Clinical evaluation of participating individuals revealed varying degrees of disease severity, with mild to moderate hearing loss. All the affected individuals had CSOM with no other apparent comorbidity. Whole exome followed by Sanger sequencing revealed two rare heterozygous variants [c.1867C>T, p.(Pro623Ser) and c.11015G>A, p.(Arg3672Gln)] of BSN gene in most of the affected individuals of family PKOM08. BSN encodes a scaffold bassoon protein involved in synaptic vesicle trafficking. The identified variants replaced evolutionary conserved amino acid residues in the encoded protein and are predicted to impact the ionic interactions in the secondary structure. Conclusion: A deep intronic variant of BSN has been previously implicated in the etiology of childhood ear infections. Our study further supports a link between BSN‐impaired function and ear infection and CSOM in children. [ABSTRACT FROM AUTHOR]

Trichoderma afroharzianum, a ubiquitous soil-borne fungus found on plant roots and decaying residues, displays competitive traits and mycoparasitic behavior against diverse microorganisms. Selected strains of this fungus are known in agriculture for their beneficial effects on plant growth and as bio-fungicides. However, recent findings have pinpointed Trichoderma afroharzianum as the causal agent behind maize ear rot disease in Europe since 2018, notably impacting maize cobs in Germany, France, and Italy. This study aims to evaluate the severity of Trichoderma ear rot disease on maize fresh matter content and specific quality parameters under semi-field conditions. Two distinct maize varieties were artificially inoculated with a pathogenic Trichoderma isolate at the flowering stage using needle pin or silk channel methods. Disease severity was assessed visually at the time of harvest based on the percentage of infected kernels according to EPPO Guidelines (PP 1/285). Fresh matter content and quality parameters such as alpha-amylase activity, C/N ratio, water, and sugar content were analyzed. Results showed that needle pin inoculation led to higher disease severity (60%) compared to silk channel inoculation (39%). Cob weight decreased significantly at the highest disease severity level by up to 50% compared to control plants. In both varieties, alpha-amylase activity increased significantly with higher Trichoderma disease severity, resulting in starch degradation and increased glucose release. The germination rate was severely affected by the infection, with only 22% of grains germinating, and the seedlings showed shortened and deformed growth. This is the first report on Trichoderma ear rot infection and its effect on fresh matter content and quality parameters in maize after artificial inoculation under field conditions. The results address an important knowledge gap and provide valuable insights into the infection pathway and impact on maize quality. [ABSTRACT FROM AUTHOR]

The overprescription of antibiotics due to diagnostic uncertainty and inappropriate patient expectations influence antimicrobial resistance. This research assesses (i) whether communicating diagnostic uncertainty reduces expectations of receiving antibiotics and (ii) which communication strategies minimise unintended consequences of such communication. In two experimental online studies conducted in January and April 2023, participants read a vignette describing a doctor consultation for an ear infection and expressed their expectations of receiving antibiotics, trust in their doctor, rated the doctor's reputation and provided their intention to get a second doctor's opinion. Study 1 (N = 2213) investigated whether communicating diagnostic uncertainty and social externalities of antibiotic use (the negative social impacts of developing antibiotic resistance) decreases expectations for antibiotics and explores potential unintended consequences on the doctor–patient relationship. In Study 2 (N = 527), we aimed to replicate and extend the findings by adding specific treatment recommendations. Disclosing diagnostic uncertainty (vs. certainty) and communicating (vs. not communicating) the social externalities of antibiotic overuse reduced patients' expectations of receiving antibiotics. Yet, communicating uncertainty impaired trust in the doctor and the doctor's reputation. Combining the communication of uncertainty with specific treatment recommendations—particularly delayed antibiotic prescriptions—showed important to prevent these unintended consequences. [ABSTRACT FROM AUTHOR]

We describe detection of the previously rarely reported gram-positive bacterium Auritidibacter ignavus in 3 cases of chronic ear infections in Germany. In all 3 cases, the patients had refractory otorrhea. Although their additional symptoms varied, all patients had an ear canal stenosis and A. ignavus detected in microbiologic swab specimens. A correct identification of A. ignavus in the clinical microbiology laboratory is hampered by the inability to identify it by using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Also, the bacterium might easily be overlooked because of its morphologic similarity to bacterial species of the resident skin flora. We conclude that a high index of suspicion is warranted to identify A. ignavus and that it should be particularly considered in patients with chronic external otitis who do not respond clinically to quinolone ear drop therapy. [ABSTRACT FROM AUTHOR]

Introduction: Pseudomonas aeruginosa is a leading cause of canine otitis externa. Enrofloxacin is often applied topically to treat this condition, although recalcitrant and recurring infections are common. There is evidence that exposure to blue light (400-470 nm) has a bactericidal effect on P. aeruginosa and other microorganisms. Methods: In the present study, we tested the biocidal effect of blue light (375-450 nm), alone or in combination with enrofloxacin, against six isolates of P. aeruginosa from dogs with otitis externa (5 of which were resistant to enrofloxacin). Results: Treatment of planktonic cell cultures with blue light resulted in significant (p < 0.5) reductions in Colony Forming Units (CFU) for all seven strains tested, in some cases below the limit of detection. The greatest bactericidal effect was observed following exposure to light at 405 nm wavelength (p < 0.05). Exposure to blue light for 20 min usually resulted in a greater reduction in Pseudomonas aeruginosa than enrofloxacin treatment, and combination treatment typically resulted in the largest reductions in CFU. Analysis of the genome sequences of these strains established that enrofloxacin resistance was likely the result of a S466F substitution in GyrB. However, there was no clear association between genotype and susceptibility to blue light treatment. Discussion: These results suggest that blue light treatment, particularly at 405 nm wavelength, and especially in combination with enrofloxacin therapy, could be an effective treatment for otherwise recalcitrant canine otitis externa caused by Pseudomonas aeruginosa. It may also provide a way of extending the usefulness of enrofloxacin therapy which would otherwise be ineffective as a sole therapeutic agent. [ABSTRACT FROM AUTHOR]

Background: Mastoiditis frequently occurs in children as they are more susceptible to middle ear infections, but infrequently occurs in adults. A rare complication that results from mastoiditis and an obstructing cholesteatoma is a Bezold's abscess, of which there are less than 100 reported cases in literature to date. Case presentation: Here, we present a case of a 72-year-old Caucasian man who has had no history of prior ear infections and was found to have a cholesteatoma and advanced acute coalescent mastoiditis complicated by a Bezold's abscess. Conclusions: Bezold's abscess is a rare entity infrequently encountered in the modern era, likely owing to more prompt treatment of otitis media. Cholesteatoma poses a great risk for both the development of otitis media and further progression to mastoiditis and its associated complications, such as Bezold's abscess. Knowledge of said abscess is crucial; without prompt recognition, further spread of infection can occur with vascular or mediastinal involvement. [ABSTRACT FROM AUTHOR]

Acute otitis media (AOM) is a common diagnosis in children who present with symptoms of otalgia, fever, or irritability and is confirmed by a bulging tympanic membrane or otorrhea on physical examination. It often is preceded by a viral infection, but the bacterial pathogens isolated most commonly are Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis. Watchful waiting may be appropriate in children 6 months or older with uncomplicated unilateral AOM. When antibiotics are indicated, amoxicillin is the first-line treatment in those without recent treatment with or allergy to this drug. Otitis media with effusion (OME) is fluid in the middle ear without symptoms of AOM and typically resolves within 3 months. Tympanostomy tube placement is the most common ambulatory surgery for children in the United States. It is used to ventilate the middle ear space and may be performed to treat recurrent AOM, persistent AOM, or chronic OME. Acute otitis externa is inflammation of the external ear canal, often due to infection. On examination, the ear canal is red and inflamed, with patients typically experiencing discomfort with manipulation of the affected ear. It is treated with a topical antibiotic with or without topical corticosteroid. [ABSTRACT FROM AUTHOR]

Ear infections are a common health problem, the most common microorganism which cause of infection is Pseudomonas aeruginosa. The study aimed to detection for bacterium ability of virulence factors production, molecular detection on that Exoenzyme effectors. The results of P. aeruginosa is the most type at18.62%. This bacterium was had a high level of resistance to the Ticarcillin antibiotic at 73.69%, were 10% of isolates (MDR), 42% (XDR) and 5% (PDR), production was each of the biofilm at 89.47%, protease enzyme at 79.94%, and Metallo betalactamase at 47.36%. Presence of exoenzyme genes (exoS:57.89%, exoT: 84.21%, exoU: 73.68% and exoY: 89.47%). [ABSTRACT FROM AUTHOR]

High deoxynivalenol (DON) levels in corn (Zea mays L.) is a grain quality issue for many growers in the US Great Lakes region. High DON levels can be attributed to the interaction of environment, pathogen (Fusarium spp. causing ear rot), and hybrid susceptibility. However, ear‐feeding insects can provide easy access for fungal infection and increase DON accumulation, hence the evaluation of insect protection strategies such as hybrid insecticidal proteins is crucial. Field trials were conducted at four locations in Michigan to study the impact of hybrids insect protection trait on ear injury, ear rot infection, and DON levels. Fungicide application (prothioconazole at silking stage) was conducted at two locations and included non‐treated control. Insect feeding incidence (IFI) and ear rot incidence (ERI) were correlated at three locations but were stronger at locations with environments not conducive to fungal growth soon after silking. Correlation between IFI and DON was observed only at locations with highest insect pressure. Hybrid with Vip3A protein reduced IFI by >70% at all locations but lowered DON concentration at one out of three tested locations compared to non‐Vip3A hybrids. Fungicide application reduced ear rot severity at one of two locations but did not impact ERI or DON levels. Overall, results showed that ear‐feeding by insects can lead to an increase in ear rot and DON levels, and use of hybrids with Vip3A protein can reduce DON levels especially under high insect pressure. Core Ideas: Ear‐feeding by insects can lead to ear rot infection and deoxynivalenol (DON) accumulation in corn grain.Use of effective insect protection trait in hybrid selection reduced ear injury by >70% and can lower DON levels.Fungicide application reduced ear rot at one location but did not impact DON levels at both study locations.Optimal DON management strategies might vary based on field‐specific environmental conditions. [ABSTRACT FROM AUTHOR]

Objective: The aim was to analyze the global impact of the COVID‐19 pandemic and national lockdowns on the incidence of otitis media (OM), a common otolaryngologic disease. Data Sources: PubMed, Scopus, and CINAHL. Review Methods: A systematic review and meta‐analysis were performed using PRISMA reporting guidelines. OM incidence (measured as newly diagnosed OM cases over total patients seen over a time period), OM antibiotic prescriptions (OM cases for which antibiotics were prescribed over total OM cases), and tympanostomy tube surgeries (all tympanostomy tube surgeries over total surgical cases) were extracted. Meta‐analysis of proportions and comparison of proportions were performed. Results: Of 1004 studies screened, 26 studies in 11 countries met inclusion criteria. The percentages of OM cases pre‐ and during‐lockdown were 6.67%, 95% CI [4.68%, 8.99%], and 2.63% [2.02%, 3.31%], respectively, with an OR of 0.31 favoring during‐lockdown [0.25, 0.39] (p < 0.00001). Antibiotic prescriptions per all OM episodes pre‐ and during‐lockdown were 1.61% [0.17%, 8.46%] and 0.62% [0.07%, 3.32%], with an OR of 0.37 favoring during‐lockdown ([0.35, 0.40], p < 0.00001). Tympanostomy tube surgery proportions pre‐ and during‐lockdown were 31.64% [6.85%, 64.26%] and 29.99% [4.14%, 66.55%], with an OR of 0.94 favoring neither during‐ nor pre‐lockdown [0.45, 2.00] (p = 0.88). Conclusion: The incidence of OM decreased significantly following international lockdowns due to the COVID‐19 pandemic, with antibiotic prescriptions for OM episodes showing a corresponding decrease. Despite these reductions, numbers of tympanostomy tube procedures did not change significantly. These reductions are likely due to social distancing, decreased exposure through high transmission facilities such as day cares, decreased health care utilization, and even possibly decreased air pollution. Laryngoscope, 134:2028–2037, 2024 [ABSTRACT FROM AUTHOR]

Otitic Hydrocephalus (OH) is one of the most significant life-threatening complications of otological infections. Given their low prevalence and non-specific ear symptoms, this complication requires a high index of suspicion for diagnosis. In this case report, we aim to provide an analysis of OH and describe common clinical signs and symptoms, treatment options, morbidity and mortality. [ABSTRACT FROM AUTHOR]

Cleft palate leads to difficulty in suckling, speech abnormalities, dental problems, hearing loss and middle ear infections. Feeding plate acts as a barrier between the oral and nasal cavities allowing the normal development of jaws and enhanced nutritional supply to the patient. Fabrication of the feeding plate using digital means provide better adaptability due to the engagement of all the possible favourable anatomic undercuts, thereby, providing better retention. This case report discusses the hybrid technique including both the digital and conventional means for fabrication of a feeding plate to obturate the defect between the oral and nasal cavity. [ABSTRACT FROM AUTHOR]

Otitis externa, commonly known as a swimmer’s ear, is an inflammation of the external auditory canal, often caused by bacterial infection, primarily affecting individuals engaged in water activities. Acute otitis externa is the most prevalent form among swimmers, characterized by symptoms such as ear pain, itching, and discharge. This article explores the epidemiology, anatomy, pathogenesis, diagnosis, and treatment of otitis externa, highlighting the condition's prevalence in warm, humid climates and its exacerbation by water exposure. Differential diagnosis is crucial to distinguish a swimmer's ear from other ear conditions, such as acute otitis media. Preventive measures, particularly for athletes, include the use of earplugs, drying ears after water exposure, and avoiding ear trauma. Treatment typically involves topical antibiotics, with the addition of corticosteroids to reduce inflammation and pain. Severe cases may require oral antibiotics or surgical intervention. Complications of untreated otitis externa might lead to hearing loss and could be life-threatening. Early diagnosis and appropriate treatment are vital to avoid severe outcomes and ensure optimal recovery for athletes and other affected individuals. Aim The aim of this study is to gather and analyse the current state of knowledge about the pathogenesis, symptoms, diagnosis and the treatment of swimmer’s ear. Methods The study contains data available in freely accessible databases like PubMed, the National Library of Medicine, Google Scholar. While searching the keywords such as swimmer’s ear, otitis externa, swimming hygiene, ear infections were used. Articles were selected based on their title, abstract and were written in English.

The escalating global concern of antimicrobial resistance in human and veterinary medicine is exacerbated by the inappropriate prescription of antibiotics for bacterial infections in companion animals. This study aimed to determine the distribution of coagulase-positive staphylococci causing clinical skin and ear infections in dogs and to determine methicillin-resistant isolates. A total of 78 staphylococcal strains were isolated from clinical samples taken from patients at the Dermatology Clinic at the Faculty of Veterinary Medicine in Belgrade, Serbia. Multiplex PCR was used for species-specific identification, and mecA and mecC genes were used to determine methicillin resistance, in addition to phenotypic determination, MIC values and detection of PBP2a. Out of the 78 samples analyzed, 65.8% were identified as Staphylococcus pseudintermedius, 22.4% as S. aureus, 7.9% as S. coagulans, and 3.9% as S. intermedius. Four S. aureus isolates exhibited methicillin resistance confirmed by cefoxitin disk diffusion, while five were confirmed with MIC testing and latex agglutination. MecA gene was detected in 29.4% of S. aureus and 30% of S. pseudintermedius isolates. These isolates were classified as methicillin-resistant S. aureus (MRSA) and methicillin-resistant S. pseudintermedius (MRSP), respectively. No isolates carried the mecC gene. This study provides insights into the prevalence of CoPS species and methicillin resistance in isolates from dogs. Continued surveillance is essential to monitor and understand the emergence and dissemination of antimicrobial resistance in veterinary medicine and the results of this study accent the need for establishment of a continuous antimicrobial resistance surveillance program in the Republic of Serbia.

• Therapeutic administration of a pneumococcal whole cell vaccine was evaluated. • Whole cell vaccine reduces pneumococcal nasopharyngeal density. • The reduction in density requires antibodies. • Whole cell vaccine also reduced pneumococcal shedding and middle ear infection. Pneumococcal Conjugate Vaccines (PCVs) have substantially reduced the burden of disease caused by Streptococcus pneumoniae (the pneumococcus). However, protection is limited to vaccine serotypes, and when administered to children who are colonized with pneumococci at the time of vaccination, immune responses to the vaccine are blunted. Here, we investigate the potential of a killed whole cell pneumococcal vaccine (WCV) to reduce existing pneumococcal carriage and mucosal disease when given therapeutically to infant mice colonized with pneumococci. We show that a single dose of WCV reduced pneumococcal carriage density in an antibody-dependent manner. Therapeutic vaccination induced robust immune responses to pneumococcal surface antigens CbpA, PspA (family 1) and PiaA. In a co-infection model of otitis media, a single dose of WCV reduced pneumococcal middle ear infection. Lastly, in a two-dose model, therapeutic administration of WCV reduced nasal shedding of pneumococci. Taken together, our data demonstrate that WCV administered in colonized mice reduced pneumococcal density in the nasopharynx and the middle ear, and decreased shedding. WCVs would be beneficial in low and middle-income settings where pneumococcal carriage in children is high. [ABSTRACT FROM AUTHOR]

Chlamydia bacteria were isolated and identified from One hundred ear swab are collected from patients had otitis externa and otitis media. Ear swabs are taken from patients attending the ENT consulting clinics at Basra General Hospital and Abi Al-Khasib Hospital, of both sexes and of different ages, from November 2022 to May 2023. Polymerase chain reaction (PCR) is used to diagnose 19 cases of chlamydia, including 11 cases of chlamydia trachomatis and 8 cases of chlamydia pneumonia, There are 14 co-infections with other bacteria and 5 single cases of chlamydia. The results of the current study shows the registration of 19 cases of C.trachomatis, C.pnemoniae and more injuries within the age group (1monthes-10) years, by 7 cases of infection and by 36.8%, while 5 cases of infection are recorde in the age group (11-20) years and by 26.3%, 4(21.05%) cases of infection in the age group (21-30) years,Two cases of infection in the age group (31-40) rate of (10.5%) and One case (5.2%) in the age group (>60) .These pathogens are find inside cells that are difficult to identify, and they are the cause of pneumonia, ear effusion, inflammation of the auditory canal, and perforation of the eardrum, which affects the hearing mechanism. [ABSTRACT FROM AUTHOR]

The Early Childhood Longitudinal Study–Kindergarten Class of 2010–2011 (ECLS-K:2011) ascertained timing of ear infections within age specified intervals and parent's/caregiver's report of medically diagnosed hearing loss. In this nationally representative, school-based sample of children followed from kindergarten entry through fifth grade, academic performance in reading, mathematics, and science was assessed longitudinally. Prior investigations of this ECLS-K:2011 cohort showed that age has a non-linear, monotonically increasing functional relationship with academic performance. Because of this knowledge, a semiparametric partial linear model is proposed, in which the effect of age is modeled by an unknown monotonically increasing function along with other regression parameters. The parameters are estimated by a semiparametric maximum likelihood estimator. A test of a constant effect of age is also proposed. Simulation studies are conducted to evaluate the performance of the proposed method, as compared with the commonly used linear model; the former outperforms the latter based on several criteria. We then analyzed ECLS-K:2011 data to compare results of the partial linear parametric model estimation with that of classical linear regression models. [ABSTRACT FROM AUTHOR]

Background: Otitis media (OM) encompasses a spectrum of inflammatory conditions affecting the middle ear, contributing significantly to health-care visits and prescriptions. Complications arising from OM frequently result in avoidable hearing loss, particularly in developing nations. Aims and Objectives: This study aims to ascertain the bacterial profile and antimicrobial susceptibility pattern of ear infections characterized by ear discharge complaints. Materials and Methods: The present study was conducted in the microbiology department of a tertiary care hospital over a 2-year period. The study involved 581 samples diagnosed with OM. Trained nurses collected pertinent patient information, while both nurses and an ENT doctor collected samples during specimen collection, utilizing an otoscope and headlight. Thorough documentation of relevant history and physical examinations accompanied the meticulous collection of ear discharge. Results: Culture-positive samples accounted for 96.39% (560 samples), with no growth observed in 3.61% (21 samples). Gram staining revealed 570 positive samples. Of the 581 OM samples, aerobes were isolated from 73.67% and anaerobes from 51.64%. The total isolates numbered 845, with 61.54% being aerobic and 38.46% anaerobic. Among the bacterial isolates, gram-negative bacteria slightly exceeded gram-positive bacteria, constituting 60.57% and 39.42%, respectively. Conclusion: In conclusion, the isolated aerobes and anaerobes shed light on the prevalent organisms in our region causing OM. The antibiotic sensitivity analysis conducted in this study emphasizes the identification of drugs suitable for the earliest treatment of OM. [ABSTRACT FROM AUTHOR]

Introduction: Otitis media eith effusion (OME) is an inflammatory condition of the middle ear that involves accumulation of sterile fluid or effusion in the tympanic cavity with the tympanic membrane intact. The pathophysiology of OME is undoubtedly multifactorial. Aim: To assess the co-occurrence of OME, allergic rhinitis, and asthma. Material and methods: The study involved a group of 18,617 subjects aged 6-7 years, 13-14 years, or 20-44 years. ECRHS and ISAAC questionnaires, validated and adopted for Polish conditions, were used in the study. Results: OME increases the risk of developing allergic rhinitis by nearly two-fold (OR = 2.07, 95% CI: 1.738-2.479 in 6-7-year-olds; OR = 1.61, 95% CI: 1.299-1.995 in 13-14-year-olds, and OR = 1.55, 95% CI: 1.262-1.83 in 20-44-year- olds). Protective factors against otitis media with effusion include the number of siblings (the more children in the family, the higher the risk of chronic OM; OR = 2.00, 95% CI: 1.15-1.346) and consumption of dairy products rich in lactic acid bacteria. Conclusions: OME significantly more often co-exists with other conditions, particularly allergic rhinitis. [ABSTRACT FROM AUTHOR]

Zenker's diverticulum is a false diverticulum arising in the oesophago-pharyngeal junction. It may cause symptoms like dysphagia and regurgitation. In Central Norway, treatment is centralized to St. Olavs hospital, either as an endoscopic stapled oesophago-diverticulostomy procedure at the Department of Gastrointestinal Surgery or as laser diverticulostomy at the Department of Ear, Nose and Throat Surgery, depending on diverticulum size. Retrospective, population-based, study from 2001–2020 on patients treated for Zenker's diverticulum, at the time with a rigid endoscopic approach. Patients were identified through the in-hospital register for operations. The two treatment groups were compared on relevant pre-, intra-, and postoperative variables by review of the individual patient records. 78 consecutive patients, 36 at Dept. of Ear, Nose and Throat Surgery and 42 at Dept. of Gastrointestinal Surgery, were treated with a total of 104 interventions. Crude incidence for a surgery-demanding Zenker's diverticulum was 0.57 per 100 000 per year. The Dept. of Ear, Nose and Throat Surgery administered significantly less often prophylactic antibiotics than the Dept. of Gastrointestinal Surgery (p < 0.001), administered more frequently intraoperative dexamethasone (p < 0.001), and had significantly more postoperative infections (19.6% vs 3.4%, p = 0.01). No procedure-related mortality was registered. Although no standardized follow-up took place, at a median of 119 months elapsed, observed clinical recurrence was 35% for the endostapler treatment and 51% for the laser treatment procedure. Both rigid endoscopic stapled oesophago-diverticulostomy and laser diverticulostomy are safe treatments for Zenker's diverticulum, however with a substantial risk of recurrence. [ABSTRACT FROM AUTHOR]

Ear disease in children are a major public health problem in developing countries and if left untreated, it may result in various social and psychological problems for affected children. Among all ear diseases, ear infections are a common but treatable cause of morbidity in children. Long term consequences of persistent severe ear infection can result in speech development disorders, poor academic and educational development and overall lower quality of life. Most of ear diseases leading to hearing loss are preventable if diagnosed and treated early. A cross sectional study was conducted in Government Rural Primary School students, 2160 students in Patiala district of Punjab state in India with aim to study the prevalence of ear disease and associated hearing loss in students and their relationship with socioeconomic status. The data was collected, compiled and analysed statistically. [ABSTRACT FROM AUTHOR]

Background: Watchful waiting management for acute otitis media (AOM), where an antibiotic is used only if the child's symptoms worsen or do not improve over the subsequent 2–3 days, is an effective approach to reduce antibiotic exposure for children with AOM. However, studies to compare the effectiveness of interventions to promote watchful waiting are lacking. The objective of this study is to compare the effectiveness and implementation outcomes of two pragmatic, patient-centered interventions designed to facilitate use of watchful waiting in clinical practice. Methods: This will be a cluster-randomized trial utilizing a hybrid implementation-effectiveness design. Thirty-three primary care or urgent care clinics will be randomized to one of two interventions: a health systems-level intervention alone or a health systems-level intervention combined with use of a shared decision-making aid. The health systems-level intervention will include engagement of a clinician champion at each clinic, changes to electronic health record antibiotic orders to facilitate delayed antibiotic prescriptions as part of a watchful waiting strategy, quarterly feedback reports detailing clinicians' use of watchful waiting individually and compared with peers, and virtual learning sessions for clinicians. The hybrid intervention will include the health systems-level intervention plus a shared decision-making aid designed to inform decision-making between parents and clinicians with best available evidence. The primary outcomes will be whether an antibiotic was ultimately taken by the child and parent satisfaction with their child's care. We will explore the differences in implementation effectiveness by patient population served, clinic type, clinical setting, and organization. The fidelity, acceptability, and perceived appropriateness of the interventions among different clinician types, patient populations, and clinical settings will be compared. We will also conduct formative qualitative interviews and surveys with clinicians and administrators, focus groups and surveys of parents of patients with AOM, and engagement of two stakeholder advisory councils to further inform the interventions. Discussion: This study will compare the effectiveness of two pragmatic interventions to promote use of watchful waiting for children with AOM to reduce antibiotic exposure and increase parent satisfaction, thus informing national antibiotic stewardship policy development. Clinical trial registration: NCT06034080. [ABSTRACT FROM AUTHOR]

Issue addressed: Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent‐reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years. Methods: The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent‐reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0‐5 years; 2008) predictors of being free of parent‐reported ear symptoms in both Waves 2 and 3. Results: A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19‐3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59‐5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income–government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors. Conclusion: These findings suggest relationships between different sociodemographic and health factors and parent‐reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent‐reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories. [ABSTRACT FROM AUTHOR]

Objective: Myiasis is a parasitic infestation by fly larvae. It is usually associated with poor hygienic conditions. Most of the literature consists of individual case reports or short case series. In this study, we report eight cases of myiasis who present with aural or nasal symptoms. Material and Methods: It’s a retrospective study included 8 patients with ear, nose and throat myiasis diagnosed over a 9-year period, from 2013 to 2022. Results: The study included 6 male and 2 female patients, aged from 9 to 84 years. Two patients were bedridden. There were 6 cases of aural myiasis and 2 of nasal myiasis. All of the patients with aural myiasis had a history of chronic otitis media. A patient with nasal myiasis had a nasogastric tube as a predisposing factor. In the other case of nasal myiasis, there was no comorbid disease, there was a history of ocular myiasis. For the treatment of myiasis infection, all maggots were cleaned one by one with a microscope or endoscope. No reinfection was observed in patients followed up for 1 month. Conclusion: Otorhinolaryngologic myiasis is very rare and mostly seen as an ear infection. Especially for aural myiasis, suppurative otitis can be a predisposing factor. Diagnosis is often easy. Myiasis should be kept as one of the possible diagnoses in patients with otitis media and in patients with long-term nasal tubes. Treatment of this parasitic infection is resection of maggots. [ABSTRACT FROM AUTHOR]

Objective: In the tropical and subtropical areas otomycosis is a very common fungal infection of the ear worldwide. Aim of our study is to identify the role of occupation in causing otomycosis and to see the status of opposite ear of the patients. Materials and Methods: Here the patients who met the inclusion criteria for this crosssectional study are included and examined after taking written informed consent. After obtaining a thorough medical history, ear swabs from affected ear and opposite ear collected for culture, sensitivity, and potassium hydroxide were provided. Patients with positive culture results were studied between September 2019 and March 2021. Results: • Among 103 cases observed for 18 months in the Department of ENT, Rajarajeswari Medical College, and Hospital, Bengaluru, India, we found that males (56.31%) were more affected than females (43.68%). • The most common predisposing factor was the usage of earbuds (26.21%) followed by water in the ear (23.3%) and oil in the ear (16.50%). • Unilateral infection was most common (96%), and the left ear was most affected (64.07%). • 36 (34.95%) were farmers, 31 (30.097%) were homemakers, 16 (15.53%) were labourers, 12 (11.65%) were students, 8 (7.76%). • 93 patients (90.29%)) had normal opposite ear followed by 9(8.73%) safe type CSOM opposite ear and one unsafe ear. Conclusion: • The most common predisposing factor of otomycosis is the usage of earbuds in the ear followed by water entry in the ear. • Farmers are the first to get otomycosis followed by homemakers • Status of the opposite ear is normal in most of the cases. [ABSTRACT FROM AUTHOR]

Background: Pseudomonas otitidis belongs to the genus Pseudomonas and causes various infections, including ear, skin, and soft tissue infections. P. otitidis has a unique susceptibility profile, being susceptible to penicillins and cephalosporins but resistant to carbapenems, due to the production of the metallo-β-lactamase called POM-1. This revealed genetic similarities with Pseudomonas aeruginosa, which can sometimes lead to misidentification. Case presentation: We report the case of a 70-year-old Japanese male who developed cellulitis and bacteremia during chemotherapy for multiple myeloma. He was initially treated with meropenem, but blood culture later revealed gram-negative bacilli identified as P. otitidis using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Carbapenem resistance was predicted from previous reports; therefore, we switched to dual therapy with levofloxacin and cefepime, and favorable treatment results were obtained. Conclusion: This is the first reported case of P. otitidis cellulitis and bacteremia in an immunocompromised patient. Carbapenems are typically used in immunocompromised patients and P. otitidis is often resistant to it. However, its biochemical properties are similar to those of Pseudomonas aeruginosa; therefore, its accurate identification is critical. In the present study, we rapidly identified P. otitidis using MALDI-TOF MS and switched from carbapenems to an appropriate antimicrobial therapy, resulting in a successful outcome. [ABSTRACT FROM AUTHOR]

Background: Chronic suppurative Otitis Media is a common ear infection in India. Canaloplasty done with tympanoplasty helps to remove bony overhangs and provide complete visibility of fibrous annulus of tympanic membrane. Aim: 1. To determine the hearing outcome in chronic otitis media (mucosal type) patients undergoing type 1 tympanoplasty with canaloplasty. 2. To determine the hearing outcome in chronic otitis media (mucosal type) patients undergoing type 1 tympanoplasty without canaloplasty. 3. To compare the hearing outcome in the above mentioned 2 groups of patients. Materials and Methods: 56 patients of 15–60 years of age with mucosal type of Chronic otitis media, with central dry perforation and intact ossicles were included in our study. They were divided into group 1 (type 1 tympanoplasty + canaloplasty) and group 2 (type 1 tympanoplasty without canaloplasty), on alternate basis. AC, BC, Air bone gap avg was assessed via pure tone audiometry at 4 frequencies preoperatively and postoperatively at 3rd and 6th month, % closure of ABG average was calculated. Results: Type 1 tympanoplasty along with canaloplasty has better hearing improvement in pure tone audiometry compared to type 1 tympanoplasty alone, as % closure of ABG at postoperative 3rd and 6th month holds significant. Conclusion: The canaloplasty provides better surgical exposure via removing bony overhangs, aids in excellent functional outcome in the form of % closure of ABG. Hence canaloplasty is added as an adjunct to routinely performed aural surgeries to enhance hearing outcome. [ABSTRACT FROM AUTHOR]

The term chronic suppurative otitis media (CSOM) refers to middle ear infections lasting more than three months that lead to perforated tympanic membrane. Low socioeconomic strata of the society are more likely to have the disease in developing countries. There have been many studies focusing on the bacterial flora of CSOM, but little is known about the mycological aspects, which have become increasingly important over the last few decades. The present study was aimed to speculate the presence of fungal flora responsible for the cases of CSOM among patients who attended the Ear, Nose, and Throat Department of our hospital a tertiary care center. This retrospective study was conducted in a tertiary care centre after taking the approval of the protocol review committee and institutional ethics committee. Total 100 Patients of chronic otitis media were included with no history using ear drops for last one week and using two sterile swab without touching the external auditory canal, discharge was taken from middle ear and placed in sterile container and sent for potassium hydroxide (KOH) mount and observed. The age ranged from 18 months to 87 years and the mean age was 37.27+/- 12.59 years. The study population of male is 42 (41.6%) and female is 59 (58.4%). Distribution of KOH positivity observed for 33 (32.7%) and KOH negative for the study population of 68 (67.3%). When antibacterial treatment does not seem to relieve persistent otorrhea, otologists should suspect mycotic otitis media probable cause. [ABSTRACT FROM AUTHOR]

Chronic otitis with cholesteatoma is a potentially dangerous disease that can lead to the development of intracranial abscesses. Although cerebellar abscess is half as common as cerebral abscess, it is known for its particularly difficult diagnosis, which requires the visualization of the pathological process continuity from the mastoid to the posterior fossa. In this article, we present an extremely rare case from the literature of cholesteatomatous otomastoiditis complicated with meningitis and cerebellar abscess, along with the description of technical surgical details for the plugging of the bony defect between the mastoid and posterior fossa with muscle and surgical glue. The particularity of this case lies in the late presentation to the doctor of an immunocompetent patient, through a dramatic symptomatology of life-threatening complications. We emphasize the importance of responsibly treating any episode of middle ear infection and considering the existence of underlying pathologies. In such cases, we recommend additional neuroimaging explorations, which can prevent potentially lethal complications. The treatment of such intracranial complications must be carried out promptly and requires collaboration between a neurosurgeon and an ENT surgeon. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the anatomical relationships between the structures adjacent to the cartilaginous portion of the ear canal in children with Work type I congenital branchial cleft anomalies (CFBCAs) and to develop new classifications and surgical strategies. Methods: Retrospective analysis was performed on 50 children with Work type I CFBCAs admitted between December 2018 and December 2022. Results: Among the 50 children, total parotidectomy was performed on 49 sides. In 44 cases (88%), the main body of the lesion was closely associated with the cartilage of the inferior ear canal wall. Among these cases, the lesions in 40 cases occurred within the space enclosed by the dorsal inferior wall cartilage, mastoid process, and parotid gland, while in the remaining four cases, the lesions were located between the anterior inferior wall cartilage and parotid gland. Based on the preoperative imaging observations, clinical manifestations, and intraoperative findings, the cases were classified into 6 subtypes (a to f) including 21 cases (42%) of Type Ia (inferior wall of EAC), 7 cases (14%) of Type Ib (bottom wall of EAC), 12 cases (24%) of Type Ic (posterior–inferior wall of EAC), 4 cases (8%) of Type Id (anterior–inferior wall of EAC), 4 cases (8%) of Type Ie (anterior ear wall of EAC), and 2 cases (4%) of Type If (isolated from parotid). Conclusion: Surgical intervention is the only treatment for first branchial cleft anomalies and a comprehensive understanding of the classifications will help with the precise localisation and excision of the lesions. [ABSTRACT FROM AUTHOR]

Cholesteatoma and the ensuing chronic inflammation may promote temporal bone tumorigenesis. Our patient is an 80-year-old female who had undergone left ear surgery 72 years prior. She presented with a 3-month history of left facial asymmetry associated with otalgia. Patient had been having intermittent discharge from the left ear since her first ear surgery but worsened in the recent 3 months. The patient underwent mastoid exploration. Histopathological study showed no evidence of dysplasia or malignancy. At one-year post surgery, the patient was noted to have soft tissue swelling in the mastoid region which was reported as squamous cell carcinoma. Scans showed extensive disease with possible extradural involvement. Therefore, she was given radical radiotherapy. Chronic ear infection, especially cholesteatoma, may progress to temporal bone malignancy. If the tumour is advanced or the patient's condition is unfavourable for the surgery, radiotherapy can be a useful modality of treatment. [ABSTRACT FROM AUTHOR]

Chronic suppurative otitis media (CSOM) is one of the common problems encountered by individuals in India. It can cause permanent hearing loss at a very early age if not treated at earliest. CSOM is a common disease encountered in ENT practice, and proper evaluation and treatment can prevent the morbidity due to its complications. This study was conducted to know the clinical profile of patients with CSOM. It was a cross sectional study of 50 patients with CSOM of all age groups and both sexes, attending the Out Patient Department and those admitted in Otorhinolaryngology wards. 30 % of patients were in age group og 31-40 years. Infection was most common cause of CSOM. 80 % patients had Ear discharge. 44 % had hearing loss. 64 % had pain in ear. 48 % patients had Mucopurulent ear discharge and 22 patients % had Purulent ear discharge. Recurrent ear infection will cause hearing impairment over the years as a result of mucosal changes in the windows and ossicles. CSOM is a common condition in developing countries and requires support and cooperation of both medical professionals and patients for the proper and timely management of the problem. [ABSTRACT FROM AUTHOR]

Background: Among cutaneous squamous cell carcinomas, the ear (ecSCC) is one of the most common sites. Loco regional lymph node metastasis is found in six to eleven percent of cases, corresponding to increased metastasis compared to other sites. The aim of this study was to test the markers PD-L1, PD-1, CD4, CD8, and FoxP3 for suitability as prognostic predictive markers. Methods: Sixty-four patients with ecSCC were included in this study. The expression of immunohistochemical markers (PD-L1, PD-1, CD4, CD8, FOXP3) was correlated with retrospective clinic pathological parameters (lymph node metastasis, distant metastasis, lymph node metastasis during follow-up, disease progression, disease-specific death). Results: There was a correlation between increased disease specific death and a weak Foxp3 (p = 0.003) or reduced CD8 (p = 0.04). A PD-L1 expression > 1% was found in 39.1% of patients. Conclusion: The investigated markers (CD4, CD8, FoxP3, PD-1, PD-L1) seem overall rather inappropriate for prognostic evaluation in ecSCC. Only the correlation of disease specific death with CD8 or FoxP3 seems to be worth testing in larger collectives. [ABSTRACT FROM AUTHOR]

Background: Eustachian tube dysfunction (ETD) is a common disorder causing ear pressure, pain, and hearing loss. Balloon Eustachian tuboplasty (BET) is an emerging technique for dilating the Eustachian tube and treating ETD. Whether adding myringotomy improves BET efficacy is controversial. Methods: This retrospective study included 95 ETD patients undergoing BET alone (n = 44) or BET with myringotomy (BET + M; n = 51) between June 2020 and August 2021 at a single medical center. The primary outcome was the change in ETDQ-7 symptom scores from baseline to 6 months after treatment. Secondary outcomes included audiometry, endoscopy, Valsalva maneuver, and complications. Results: The ETDQ-7 scores improved significantly after treatment in both groups (p < 0.001), without significant between-group differences (p = 0.417). No significant differences occurred in the audiometry, endoscopy, and Valsalva results or in most complications between groups. One BET + M patient had a persistent tympanic membrane perforation. Conclusions: Both BET alone and BET + M effectively and safely improved the subjective and objective ETD outcomes. However, adding myringotomy did not further improve the outcomes over BET alone, while it incurred risks such as persistent perforation. BET alone may sufficiently treat ETD without requiring myringotomy in this cohort. Further randomized controlled trials should identify optimal candidates for BET alone versus combined approaches. [ABSTRACT FROM AUTHOR]

Common bunt caused by Tilletia tritici and T. laevis has re-emerged as a major threat to wheat yield and quality, especially in organic farming. Resistance against its causal agents is present in the wheat gene pool and provides the most economically efficient and sustainable way to combat the disease since seed treatments approved for organic farming are rare and do not always provide full protection. We tested a winter wheat diversity panel with 128 lines for common bunt resistance in Austria and Czechia, and evaluated the applicability of markerassisted selection (MAS) via Kompetitive Allele-Specific PCR markers in genotypes with high variation in their genetic background. Field trials were conducted across two years and artificially inoculated with local bunt populations. The virulence patterns of these inocula differed between locations and only 15% of the tested genotypes showed stable resistance across test sites. Number and weight of bunt sori relative to the total number and weight of wheat grains in sampled ears revealed that partial infections of ears were frequently appearing. Forty-two breeding lines harboring combinations of four different resistance QTL were developed through MAS. Out of these, a quarter were resistant with a maximum of 5% common bunt incidence. On the other hand, only six out of 46 tested commercial cultivars and breeding lines showed no infection with common bunt, underlining the present scarcity of bunt-resistant cultivars for organic wheat production. By this study we showed that MAS is a useful tool to speed up the selection of resistant lines even in populations with highly diverse genetic backgrounds, and that it is efficient in pyramiding resistance loci and thereby improving the level of resistance. [ABSTRACT FROM AUTHOR]

The three additive manufacturing techniques fused deposition modeling, gel plotting and melt electrowriting were combined to develop a mimicry of the tympanic membrane (TM) to tackle large TM perforations caused by chronic otitis media. The mimicry of the collagen fiber orientation of the TM was accompanied by a study of multiple funnel-shaped mimics of the TM morphology, resulting in mechanical and acoustic properties similar to those of the eardrum. For the different 3D printing techniques used, the process parameters were optimized to allow reasonable microfiber arrangements within the melt electrowriting setup. Interestingly, the fiber pattern was less important for the acousto-mechanical properties than the overall morphology. Furthermore, the behavior of keratinocytes and fibroblasts is crucial for the repair of the TM, and an in vitro study showed a high biocompatibility of both primary cell types while mimicking the respective cell layers of the TM. A simulation of the in vivo ingrowth of both cell types resulted in a cell growth orientation similar to the original collagen fiber orientation of the TM. Overall, the combined approach showed all the necessary parameters to support the growth of a neo-epithelial layer with a similar structure and morphology to the original membrane. It therefore offers a suitable alternative to autologous materials for the treatment of chronic otitis media. Millions of people worldwide suffer from chronic middle ear infections. Although the tympanic membrane (TM) can be reconstructed with autologous materials, the grafts used for this purpose require extensive manual preparation during surgery. This affects not only the hearing ability but also the stability of the reconstructed TM, especially in the case of full TM reconstruction. The synthetic alternative presented here mimicked not only the fibrous structure of the TM but also its morphology, resulting in similar acousto-mechanical properties. Furthermore, its high biocompatibility supported the migration of keratinocytes and fibroblasts to form a neo-epithelial layer. Overall, this completely new TM replacement was achieved by combining three different additive manufacturing processes. [Display omitted] [ABSTRACT FROM AUTHOR]

Staphylococcus schleiferi represents an uncommon pathogen in human infections. As a veterinary pathogen, S. schleiferi causes canine ear and skin infections. Chronic osteomyelitis is a progressive process characterized by bone destruction and the formation of sequestrum. It may be a sequela of untreated or undertreated acute osteomyelitis or septic arthritis. Descriptions detailing the pathogenicity and virulence of S. schleiferi osteomyelitis were limited to a few case reports. Among the three reported cases of S. schleiferi osteomyelitis, immunosuppression, malignancy, and recent surgical procedures were comorbidities. Compared to those who are immunosuppressed, immunocompetent individuals are generally not susceptible to uncommon microorganisms. Early detection of osteomyelitis, aggressive appropriate prolonged antimicrobial treatment and a multidisciplinary approach contribute to optimal recovery. We report the first case of S. schleiferi chronic osteomyelitis in an immunocompetent adolescent. [ABSTRACT FROM AUTHOR]

Objective: Telomere length (TL) attrition is related to chronic disease risk. However, less is known on whether TL predicts infectious outcomes, especially in childhood. We examined whether leukocyte TL (LTL) was associated with subsequent infectious morbidity in schoolchildren. Methods: We assessed LTL in 717 Colombian children 5–12 years‐old at the beginning of a school year and followed them through the year for daily occurrence of common infection symptoms and doctor visits. We estimated adjusted incidence rate ratios (IRR) with 95% confidence intervals (CI) of gastrointestinal and respiratory syndromes for quartiles of standardized LTL Z score and per unit LTL Z score. Results: A longer LTL was associated with increased incidence of all infectious morbidity syndromes considered. Adjusted IRR (95% CI) per unit LTL Z score were 1.55 (1.20, 2.00) for diarrhea with vomiting, 1.34 (1.13, 1.60) for cough with fever, 1.70 (1.28, 2.28) for ear infection, and 1.66 (1.36, 2.02) for doctor visits with symptoms. Conclusions: Longer LTL is related to increased incidence of common infectious morbidities in middle childhood. [ABSTRACT FROM AUTHOR]

Maize (Zea mays L.) is a major staple crop in most of the sub-Sahara Africa (SSA) region, constrained by a multitude of plant diseases, with the ear and kernel rots being the most widespread and difficult to manage on maize. The objective of this study was to access the agronomic performance of F1 maize hybrids exposed to Aspergillus flavus, under different agro-ecological conditions, in Cameroon. A total of 120 genotypes of maize, including four commercial hybrids, were evaluated under A. flavus infection at two sites; namely Bangangte in the Western Highlands and Mbalmayo, in the Bimodal Humid Forest Zone of Cameroon. The study was conducted during 2020 - 2021 cropping seasons. Results revealed that at Bangangte site, six (89343X88094, 88099X88094, 90204XExp 124, 89246X87036, TZI-5-1171XExp 124 and 90219X1368) out of the top 20 high yielding hybrids, had significantly high (p<0.001 tolerance (0% severity) to Aspergillus ear rot infection. At Mbalmayo site, eight (8923X88094, TZI-5-1171XExp124, 89343X88094, 90219X87036, 89243X87036, 87014X88094, TZSTR1150X87036 and 89248X88094) out of the top 20 high yielding hybrids also showed significant high (P<0.001) tolerance (0% severity) to Aspergillus ear rot infection. The interaction between hybrids and location was significant (P<0.05) for all measured traits, except ear height, grain texture, ear insect damage and husk cover (P>0.05). The pooled broad sense heritability of hybrids in the two locations varied from 5% for grain texture to 92% for days to 50% physiological maturity. Grain yield was negatively correlated with Aspergillus ear rot disease incidence and severity. Hence, promising high yielding maize hybrids with appreciable tolerance to Aspergillus ear rot disease could be selected among the tested genotypes. [ABSTRACT FROM AUTHOR]

Summary: This consensus statement provides new recommendations for primary care assessment of ear health and hearing status of young Aboriginal and Torres Strait Islander children who are not known to have, or are not being actively managed for, ear health and hearing problems. Any child identified with otitis media should be actively managed. This national consensus statement extends existing treatment and management guidelines. Main recommendations: Undertake checks at least 6‐monthly, commencing at 6 months until 4 years of age, then at 5 years. Undertake checks more frequently in high risk settings for children under 2 years, when acceptable to families, or in response to parent/carer concerns.Ask parents/carers about concerns, signs, and symptoms; check children's listening and communication skills; and assess middle ear appearance and mobility.Otoacoustic emissions testing is suggested when equipment is available, primary health practitioners have capability and confidence to use the equipment, and there is local preference for its use.Video otoscopy is suggested for health promotion purposes, and/or for sharing images with other health practitioners.Audiometry should be done as per existing guidelines: when there are parent/carer concerns, signs of persistent/recurrent otitis media, or when listening and communication development is not yet on track. Changes in management as a result of this statement: Key practice changes include routine use of tympanometry, and listening and communication skills checklists. Implementation will require access to equipment and training; clear information on immediate, practical actions for families; timely pathways to referral services; and a change management process that shifts perception and tolerance of otitis media and its impacts and raises expectations that Aboriginal and Torres Strait Islander children can have healthy ears and hearing. [ABSTRACT FROM AUTHOR]

Background: Ear, Nose and Throat diseases are common in school going children who often miss school due to these illnesses. ENT diseases have not been given due importance by majority of the school authorities. The importance of ENT diseases screening is to identify the children at-risk, which may hamper their scholastic performance, and to refer them for detailed investigation and intervention. Objectives: 1. To find out the pattern of common Ear, Nose and Throat Disorders among School children. 2. To find out the association if any regarding ENT morbidities and socio-demographic variables of the parents. Materials and Methods: The study was a descriptive observational type of cross-sectional design. The school was chosen by random sampling method. Data were collected by interviewing the school children with a pre-designed and pretested schedule. Clinical examinations were done with the help of a check list containing the standard answer and definition of ENT morbidities. Collected data were analysed and proportions and Chi-square test were done. Results: Among study population 52.6% were female and most of the children (63.5%) were < 14 years of age group. 61.6% having some form of ENT morbidities. Literacy status of parents and economic condition of the family were significantly associated with ENT morbidities. Conclusion: Urgent need for health education and regular Ear, Nose and Throat check-up among the school children to increase their level of awareness and knowledge regarding ENT diseases and also decrease morbidities. [ABSTRACT FROM AUTHOR]

Objectives: Acute otitis media (AOM) and otitis externa (OE) are common ear infections which may warrant antibiotic therapy. For many infections, there is a rise in antimicrobial resistance, which is associated with treatment failure, morbidity, prolonged hospitalisation and mortality. This study aimed to identify longitudinal changes in microbiology and antimicrobial resistance in aural swabs taken from patients with AOM or OE. Design: Retrospective observational analysis. Setting: Aural samples processed at Manchester Medical Microbiology Partnership Laboratories between January 2008 and December 2018 were analysed to record organism isolated and antimicrobial sensitivity. Participants: Individual aural swabs from 7200 patients. Main Outcome Measures: Changes in the incidence of organisms and antimicrobial resistance between two time periods (2008–2012 and 2013–2018) were compared using the chi‐squared test (alpha = 0.05). Results: From 7200 swabs, 2879 (40%) were from children. The most frequently isolated organisms were Staphylococcus aureus (25%), Pseudomonas aeruginosa (24.4%), yeast (9.1%), mixed anaerobes (7.9%) and Haemophilus influenzae (6.1%). In children aged 0–4 years, H. influenzae had particularly high incidence (25%). Overall, the incidence of P. aeruginosa decreased significantly with time (p = 0.05). Isolates displaying resistance to one or more antimicrobial agents increased significantly in number in the second time period for P. aeruginosa (p = 0.04) and H. influenzae (p = 0.03). There was increased resistance to amoxicillin for P. aeruginosa (p = 0.01) and to erythromycin for H. influenzae (p < 0.01). Conclusion: Variations in type and frequency of organisms with increasing age likely result from differences in the preponderance of AOM compared to OE in children versus adults. We found increasing antimicrobial resistance for two organisms commonly isolated from AOM and OE infections, suggesting that aspects of current UK treatment practices and national recommendations may need to be revised. [ABSTRACT FROM AUTHOR]